Death was almost just a part of life when I was a child. Helped in some ways by the fact that I had a large number of much older relatives (all my grandparents had multiple siblings), & of course the memory of those who had died during the War.
There were usually one or two half-orphans in my class, & a couple of total orphans at school – the ones we knew about, who were being looked after by a relative who was their legal guardian; we did not usually know the background of the children who were adopted.
To be widowed in your forties was not uncommon – womens magazines ran regular features on how to cope. These days the phrase widows & orphans has almost no place in the pension scheme.
Death – among family, friends, or acquaintances seems almost more rare now than it used to be, despite our advancing age.
Death in anyone under 70 is rare, & then almost always, if not accidental, due to cancer or one of the nasty neurological diseases, with one or two clearly the result of couldn’t-careless-ness or unwisdom in the choice of lifestyle.
The last person I knew who died of a heart attack before he reached 50 was over 20 years ago; yesterday it occurred to me that it is at least as long as that since I heard of anyone having a stroke – is that because they do not have them, or because treatment has advanced so much that it is no longer the kind of thing that makes people say – Did you hear about …?, to the shaking of heads because, at the very least, that meant that they would never work again.
The astonishing reduction in mortality remains something of a mystery, not entirely explained by advances in treatment or changes in lifestyle.
I have been wondering if we may have underestimated the effect of improvements in medical treatment. For example, the elimination of many of the common diseases of childhood does not just prevent death directly; it also avoids the debilitating effects which may make the body more vulnerable to future shocks & insults. Much the same can be said about the use of antibiotics to treat severe infections at any age – the concomitant scarring & damage to tissue is much reduced. And of course the huge improvements in antenatal, maternal & paediatric care has meant healthier children right from the start, in smaller families with more intense parental care & attention for all.
Advances in anaesthesia have made it possible to operate on those who would have been considered too frail not all that long ago. It is less than 20 years since I had to do my best to support a friend whose mother was dying, distressingly, with cancer which was ‘of course’ inoperable ‘at her age’; such callousness would usually seem unthinkable now.
Then there are the huge effects of advances in A&E – not just in preventing immediate death, but, through the care & repair of wounds making the patient stronger & less vulnerable to insults to health even years down the line.
Last but not least there are all the improvements in emergency services, stabilising patients, removing them from dangerous situations & getting them to hospital ASAP. As Belton Cobb found, much of the reduction in the ‘murder’ of policemen on duty in the second half-century of the existence of modern police forces was due to the simple availability of improved care for the injured.
Which means that we should not of course forget the telephone – without which such prompt provision of care would not be possible.
And which also means, paradoxically perhaps, that the internal combustion engine has made its contribution too; yes, it has been responsible for more than its fair share of needless death & destruction, but when speeded along with blues & twos it plays an essential role in the reduction of mortality.
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