On December 12, 1799, George Washington rode out on his horse to check everything on his farm was in order. As the snow began to fall, he headed home, and headed straight to dinner, without immediately changing out of his wet clothes. The next morning he awoke with a sore throat. And soon after 10 p.m. on December 14th, the first US president died of acute epiglottitis.
When Thomas Jefferson was 83, he began suffering from a variety of medical problems, including rheumatism, severe stomach problems, and a series of various infections. The third president was unwell for a few months, and by June 26 he was bedridden. Less than two weeks later, he died at 12:50 p.m. on July 4th, 1826, the 50th anniversary of the Declaration of Independence.
On that same day, Jefferson’s predecessor, John Adams lay on his deathbed. He was 90 years old and afflicted with a many ailments. He was almost blind, he had lost his teeth, and had chronic rheumatism but less than a month before his death he was still actively concerned with the governance of the country. His actual cause of death is unknown. According to a descendant, it was, “merely the cessation of the functions of a body worn out by age.” According to myth, unaware that his fellow revolutionary had passed away a few hours earlier, Adam’s last words were, “Thomas Jefferson still survives.” In fact, his last words were mumbled and unclear.
Exactly five years later, in 1831, the fifth US president, James Monroe, became the third president to pass away on Independence Day. However, unlike the earlier presidents, who remained active until the last few weeks of their lives, Monroe had been ailing for over a decade. During the 1820s he was gradually forced to give up more responsibilities as his infirmity increased.
He gave up writing a book about the US government and was unable to complete his autobiography. In 1830, his beloved wife Elizabeth passed away. Unable to care for himself, the 72-year-old president moved to New York to live with his daughter and son-in-law, Maria Hester Monroe and Samuel L. Gouverneur. Over the next year, his health gradually declined. His final words, “I regret that I should leave this world without again beholding him,” referred to his best friend, the fourth president of the USA, James Madison.
The Talmud (Bava Metzia 87a) states that the patriarch Abraham brought aging to the world.
Until Abraham, there was no aging. Someone who wanted to speak with Abraham would [unintentionally] speak with Isaac, [and someone who wanted to speak] with Isaac would [unintentionally] speak with Abraham. Abraham came and prayed, and there was aging, as the verse states, “And Abraham was old, advanced in days,” (Genesis 24:1).
However, it was Jacob who prayed for the infirmity and illness that often accompanies old age.
Until Jacob there was no illness. Jacob came and prayed, and there was illness, as the verse states,“He said to Joseph, behold your father is ill,” (Genesis 48:1).
However, until recently, a long dotage accompanied by debilitating illness did not really exist. With no antibiotics, if the body did not have the ability to fight infection death would usually come swiftly. Without advanced diagnostics, there was no chance of staving off an illness until the symptoms were severe. And without modern knowledge and equipment, very few illnesses could be cured. Except for those suffering from tuberculosis, which could be a long, drawn-out sickness, most old people who became ill would either recover on their own or pass away within a few days or weeks.
But advances in medicine meant that for the past century or more, more people have been living longer. And this created a different type of problem.
In many societies, those too old or infirm to care for themselves would, like Monroe, be cared for by family. Those without family or resources to pay for care, would have very few options. Atul Gawande wrote in “Being Mortal” (page 62) that:
If you were elderly and in need of help but did not have a child or independent wealth to fall back on, a poorhouse was your only source of shelter. Poorhouses were grim, odious places to be incarcerated – and that was the telling term used at the time. They housed poor of all types – elderly paupers, out-of-luck immigrants, young drunks, the mentally ill – and their function was to put the “inmates” to work for their presumed intemperance and moral turpitude.
As recently as 1912, the Illinois State Charities Commission described one such poorhouse as “unfit to decently house animals… rats and mice overrun the place… Flies swarm [the] food… There are no bathtubs.”
However, Medicare and Medicaid passed into law in 1965, giving the infirm elderly more options. With money available, old age homes sprung up to care for those unable to look after themselves. But in many ways, the residents were still considered “inmates.” Even though conditions were vastly better than those of the poorhouse, the focus was on safety and security of residents, with little thought for their quality of life.
In 1969, Keren Brown Wilson’s mother suffered a stroke at the age of 56. For the next decade she lived in a nursing home. She was told when to eat, when to sleep. Apart from a few clothes, she was permitted virtually no possessions of her own in the room she was forced to share with another woman.
One day, she asked her daughter, who was studying gerontology, “”Why don’t you do something to help people like me? I want to live a normal life.”
It took Wilson until 1983, when she had jumped through all the legal hurdles and was able to open her first assisted living home. It was a 117-unit where residents had their own front door. They were free to make their own decisions, to have their own furniture, to take their own risks.
Eventually, Wilson’s assisted living concept became a billion-dollar industry. People can now live longer and happier lives with greater independence.
Now the challenge becomes to find meaning and purpose. As the sands of the hourglass run through, the possibilities become fewer but the urgency greater.
Another president, Ulysses S. Grant, spent his final year in a race against time.
On May 6, 1884, Grant lost all his money due to his ill-advised investment in a pyramid scheme. A few weeks later, he was diagnosed with throat and tongue cancer. Bankrupt and dying, the former president and Civil War hero seemed to have few options. Mark Twain stepped in, paying Grant $1,000 to write his autobiography which would be the first title for Twain’s new publishing house.
Grant had been an exceptional general, but not a great president. When it came to writing his memoirs in a race against time, he showed his strengths, approaching the task as he would a battle.
He wrote as much as 10,000 words a day, until his hand became too weak. So, he employed a stenographer. Eventually, even speaking became almost impossible. He continued, in a whisper, struggling with every breath, and ultimately producing one of the finest presidential autobiographies ever written.
On July 16, 1885, less than a year after he began the task, Grant’s book was finished. Twain informed him that he had already sold 100,000 advance copies. Grant died a week after completing his autobiography, happy in the knowledge that book sales would support his wife and family for the foreseeable future.
This week’s Torah portion, Chayei Sarah, begins with the death of the matriarch Sarah. Abraham eulogized his wife, his life partner, who had accompanied him physically, emotionally, and spiritually along every step of his transformative journey.
Despite the hugeness of his loss, and his own advancing years, Abraham knew he still had an important task to perform. If he did not marry off his son, Isaac, he would be left without a legacy. Unable to travel himself, he gave specific instructions to his servant, Eliezer, to find a suitable wife for his son.
The Torah alludes to the value of having a goal in the phrase used to describe Abraham’s advanced age (Genesis 24:1): “Abraham was old, he came with his days.” The strange wording of “days” shows that each day was its own struggle, but also had meaning and purpose.
And after achieving his goal, and seeing Isaac married, Abraham craved company. He also needed to find continued purpose and meaning. Despite being in at least his 14th decade of life, he remarried. “Abraham added, and he took a wife, named Ketura,” Genesis 25:1). He went on to father half a dozen more sons.
The Torah describes his death (Genesis 25:8).
And Abraham expired and he died in good old age, elderly and satisfied, and he was gathered to his people.
“Elderly and satisfied.” Abraham lived a life filled with meaning. Every day had a purpose. Every minute had a goal. When he achieved one task, he set himself the next one. Even at the very end of his life, he continued to focus on ensuring his legacy. His final act was to write his will, giving gifts to his children with Ketura, and leaving everything else he had to Isaac.
Like Grant, Abraham died knowing he had provided for his family and ensured his legacy would continue.
This is a powerful reminder to all of us to live every day and every moment of our lives focusing on what is important. Creating our legacy leads to our immortality.
In memory of Chief Rabbi Lord Jonathan Sacks.
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