Infirmity

My 18-year old cat (around 80-100 in human years) is teaching me about infirmity and providing a sneak preview of my own future. He can no longer run but he can sort of hurry-walk. He can no longer jump, but he can just about manage to clamber up on the couch with a sort of still-elegant half-bound. But he prefers a ramp or stairs even for that.

And his mobility has a precarious quality to it. He can walk in a straight line, and make slow turns, but a slight unexpected sideways bump will topple him. And from some positions, such as being on his side on a slight slope, he has trouble getting up again. The days when he could stumble from a height and twist and turn in the air to land on his feet are long gone.

This quality of precarious nominality extends to all his life processes. Any change to his routine upsets him, and he has trouble coping and recovering. But he seems to have developed a curious kind of patience — sometimes grumpy, sometimes placid — for the coping and recovering too. There is a gentle, self-aware insistence on choosing life every day, despite the growing costs.

While he seems to enjoy his life, and earns his keep by continuing to enrich ours, everything has to be just so, within a tightening range, for that to be the case. His youthful days of open-ended exploration and eagerly looking for variety and surprise at every turn are long gone. He still has a certain tepid curiosity about novel things if they’re close enough to examine without getting up, and he will play lazily with a toy, but basically, he’s had a full and interesting life, and is now content to live out the rest of it by repeating the same day over and over. He doesn’t need novelty anymore. He’s retired to a sort of personally satisfying, perfected Groundhog Day that he doesn’t feel the need to exit. It’s quite impressive actually, and I’m glad we can give him that in his sunset years.

This is infirmity — a self-aware, falling tolerance for normal variations around a nominal life process, accompanied by increasing costs of coping and recovery from those variations when they do occur. It is not an unpleasant condition so long as things stay nominal. It can even be pleasurable and satisfying indefinitely. It does not need constant stimulation and novelty to be worthwhile, either to you, or to those working to maintain the nominality you need.

Unlike fragility in the Talebian sense, infirmity isn’t about rare, black-swan events, or vulnerabilities created by flimsy thinking and building. Infirmity is about everyday variations in ordinary events that you used to be able to handle easily, without any special regimen of maintenance or preparedness.

Of course, maintenance and antifragile preparedness would help. If there were a way to get aging cats to do deadlifts, this specific problem of infirmity in feline mobility could probably be mitigated somewhat. But aging isn’t about increasing infirmity in one or two processes; it is about increasing infirmity in all processes, all at once. It is about whether the cost of battling infirmity on all fronts is worth it.

My cat has half a dozen managed ailments in a delicate balance: weak kidneys, weak gut (he can only eat a couple of raw foods without vomiting), chronic nausea, arthritis, and so on.

From my limited experience witnessing death by aging, the main cause seems to be that as all life processes become increasingly incapable of handling routine variation, the balancing act becomes increasingly delicate. So routines require steady tightening up. It’s like you’re entering a personal outer-space, requiring complex life support.

Normally, in systems with slack and surplus, when one process fails, other processes can restore a temporarily viable balance through a pattern of compensatory variation. If you have food poisoning you can skip a meal or two or drink fluids only while the gut recovers. But if other conditions demand that you not skip meals, you can’t do that.

When all life processes are infirm, there is shrinking room to make tradeoffs, so any given failure is increasingly likelier to trigger cascades of other failures. Aging seems to be a convergence to all-systems-nominal as the only sustainable life-process. There is eventually no room for error, no slack available for recovery. Life gets to the point where it is hanging on by a thread, and then that thread snaps. That, I suspect, is the phenomenology of “death by aging,” as opposed to death by some specific condition like cancer that’s snowballing towards anomalous fatality, or a catastrophic thing like a gunshot. Death by aging is a sort of negative network effect.

There is some sort of relationship between death by aging and the one-horse shay in Oliver Wendell Holmes’ poem — a system where there is no slack anywhere, so it fails all at once. Personally, I think it’s a nice way to make your exit.

I think you can work on the main infirmities, and do so in a strategic way. Perhaps there are “eigen-infirmities” so to speak. Maybe if you lift weights, cut out seed oils and carbs, and listen to podcasts at 2x for 90 minutes a day like the paleo-theologians recommend, you’ll age with the fewest, least inter-connected infirmities.

But I sincerely doubt you can keep all life processes bounded away from infirmity forever, no matter how good your assistive technologies and how admirable your lifestyle. The compounding costs will get to be too much, as process after process transitions from low-cost, unconscious self-maintenance to expensive, conscious, externalized maintenance. There is no “one weird trick” to cheat death and live forever. Just a growing cost to staying alive.

Nor, I think, would I want to cheat death, personally.

Personally, I think there is something elegant about this process of aging in an engineering sense. It is a good way to design a complex system, and it is worth trying to come to terms with it if you are such a system. Aging is about a coherent complex system hitting some sort of natural thermodynamic limit of adaptive potential, beyond which there is only creative destruction and renewal. Or to put a more positive spin on it, it’s about convergence to a perfect — and perfectly fragile — optimal end-state.

Which is not to say we shouldn’t try to work on longevity, and especially healthy longevity. That one thread of life you converge to might be incredibility fulfilling to live out indefinitely, and perhaps even incredibly valuable to others because of the unique things it can do — so long as it is protected from sideways nudges it can’t handle. Or more precisely, so long as it is worth protecting from those nudges. And as that cost steadily rises, eventually it will not be worth it.

An interesting thought experiment is to think about what one might call heirloom lives (the notion of living national treasures is an approximation). Systems — biological or artificial — that converge to a kind of priceless perfection that is worth keeping alive whatever the cost of maintaining the tight nominal conditions required to do so. Traditionalists and preservationists of all sorts are perhaps a little too willing to attribute that kind of priceless perfection to both living and non-living systems, but the idea itself is intriguing. Heirloom eternals would make for a fun science-fictional god archetype. Imagine a million-year-old god who requires a highly specialized advanced life-support chamber to keep alive, which consumes the surplus resources of an entire galactic empire. But the god can do one thing that’s worth all the trouble — see the future.

But in practice I do think living things beyond a certain threshold of complexity are necessarily mortal in some sense, which means aging and death are part of the design. Beyond a point, even heirloom lives are not worth the costs of eternal end-of-life sustenance, either to themselves, or to others.

So conscious dying should perhaps be a part of the idea of living well. Understanding and settling into growing infirmity, with a graceful awareness and resistance, knowing you’ll have to steadily cede ground, while striving to keep the value of life above the cost of keeping it going, is perhaps the first step.

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About Venkatesh Rao

Venkat is the founder and editor-in-chief of ribbonfarm. Follow him on Twitter

Comments

  1. I didn’t want to relate to this, but at the backside of fifty, with parents in their eighties, this is precisely what I needed. Thanks!

  2. Thank you.

  3. Beautiful piece! Thank you!

  4. So well written and insightful. Thank you!

  5. Milind Kopikare says

    So well written and insightful, Gurra!🙏🏾

  6. Our cat had kidney failure and showed a lot of those issues in his last few weeks. It was very important to me to allow him to die the right way including when we buried him. This touched on a lot of what I felt the but couldn’t really describe. Thank you.

  7. You write, “So conscious dying should perhaps be a part of the idea of living well.” I also think this includes a conscious decision about when to die, with gentle assistance pharmacologically if desired. In my medical career I knew many well-lived interesting people who were ready to go, but “assisted suicide” was legally off the table, and they suffered greatly, and for no particular reason, as a result.

  8. You write quite eloquently, and there are platitudes and peace in what I often read. However, I cannot agree with a sentiment that promotes premature death as a trait, and so long as infirmity remains a forced biological imperative, regardless of what can be well debated as a cosmic success; the production of complex, intelligent, and self-ware life from otherwise inorganic matter, it could be equally argued that there should be no “well adjusted” acceptance of those conditions. They are not inevitable, merely entropically expensive to engineer a permanent solution to. I’m sure many have, do, and will likely share the sentiment that if the only objective purpose for life is to continue to exist until it can no longer, then the estimated “life” of the known cosmos would suggest that there is energy and stable matter aplenty to sustain the end-result of human cognition for many trillions of years to come. Shouldn’t the question be: “Shouldn’t infirmity be a voluntary choice, when one has experienced their fill of existence, and not the result of natural selection?”

  9. Ravi Daithankar says

    Beautifully written, Venkat!

    The one caveat to the idea of an inevitable, graceful slide into infirmity is some kind of straight up magical scientific breakthrough. I am talking stuff like synthesized proteins and tissues in 3-d printed organs. That is equal measure utopian and dystopian, yes. But if you think of what the general outlook on life was just 50 years ago with say a broken hip, knees that had turned to mush, or a cataract in your eye, it would adhere almost fully to the perspective on infirmity you’ve shared here. Yet, being consigned to infirmity from any of those things today is an anomaly. So while there’s a lot to be said about looking at infirmity as the kind of graceful petering out you’ve described it to be, there’s a good chance we’ll see these horizons expand dramatically within our lifetimes itself.

  10. Anand Jacob says

    Beautiful and thoughtful. I am a fan of cats, and have lost two, and during the pandemic took charge of another, who was at the time an abandoned kitten, knowing what it meant in terms of commitment. But beyond the cats – your post touched me because I’m dealing with my own suddenly intransigent joints (I’ll be 50 in a couple of months), and with the slow but steady decline of my father, who will be 86 in a few weeks.

  11. Last year I lost a cat that was 21 years old. She died gracefully and quietly when I wasn’t looking. I can only hope, at the age of 72, that I die as well as she did. I can offer a bit of hope for you however; get another cat, a rescue cat like I did. It will help soften the loss and the antics of a young cat will cheer your day.

  12. Gal Tal-Hochberg says

    So fun side note – there is actually a pretty popular sci-fi story around that premise- the Emperor of Mankind from Warhammer 40k, whom to keep alive thousands of people need to be sacrificed daily but whom can kinda tell the future and, more importantly, enables mankind faster-than-light travel. https://warhammer40k.fandom.com/wiki/Emperor_of_Mankind

    • I suspect human sacrifice had to be added to the character because otherwise people might have actually liked a SciFi theocracy.

  13. Mac Mahmood says

    Never really understood why people keep pets. Antics of pets may be pleasant to observe and their lives may even be thought provoking as in the case of the author, but those by themselves cannot be sufficient justiication for keeping pets.
    Aging is, of course, for most of us a process of closing up of options, at times one by one, at times severally together, mostly imperceptively and sometimes abruptly, and the process goes on until there is only the one option left. You take that with good grace, or kicking and screaming, or as a happy release. Tamam shud.

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