The Living End: The New Sciences of Death, Ageing and Immortality: The Future of Death, Aging and Immortality (MacSci) [Hardcover]

The Living End: the future of death, aging and immortality is a facinating read about life and death; aimed it appears to me at the non-specialist reader. Dr. Guy Brown tells us that he wants to describe how the: "new sciences have changed our understanding of death and how death is likely to change in the future". He also sets out to: "understand how the revolutionary changes in death and the life sciences will impact on our concepts of life and death".

On the face of things, Dr Brown's book might seem dark and pessimistic but on the contrary it is simply a realistic and to some extent optimistic book. As Dr Brown himself says: "in this book I intend to 'rage, rage against the dying of the light' as well as exploring options for changing our fate". Furthermore, as Dr Brown realises that his subject matter might be "heavy and depressing", he tells us he will lighten our journey with various distracting interludes". Each of the main chapters, therefore, are accompainied by an interlude. I am not sure that Dr Brown's interludes provides relief because they are just as realistic and hard hitting as the main chapters. However, they provide a wonderful historical and literary digression. For example, there are medical history, myths and poetry. There are quotations from Dante, Homer, Shakespeare and a twentieth century poet, Dylan Thomas.

I read the book in an optimistic frame of mind but was constantly faced with a bleak reality. As I read I spotted this conundrum: "life expectancy in the UK rose by 2.2 years between 1991 and 2001, but healthy life expectancy rose by only 0.6 years; while ill health rose by 1.6 years". I tried to solve the conundrum by reafirming that I will retire from work no later than 65 and not press on any further as recently suggested as a way to solve the pension crisis. However, Dr Brown soon presented another set of statistics that showed: "old age people are supposed to undergo a process of 'disengagement' from family, friends and society". Bear in mind that Dr Brown regards old age as starting at 65. I felt hopelessly loss; I felt like going into work and immediately announce my retirement.

It is not that I was afraid of Dr Brown's main message. On the contrary that message: "people dying today are old or very old, and die from chronic, degenrative dieases that kill them over years or decades" is to be welcomed. The problem I had with the message was that one was left with the impression that Dr Brown has an axe to grind as like a leitmotif it kept recurring throughout the book in various guises. Here is the same message rapt in a slightly different package: "people are dying older and older, so exposing them to illnesses that increase with age".

In contrast to the above issue about the way many of us will die, Dr Brown flips the coin on the other side and examines two contrasting theories of how life is lived doday. His explanation of these two theories are very clear. There is the digital theory of life as opose to the analogue theory of life. The former theory depicts an all or nothing scenario of life while the latter depicts a life of degrees and shade.

Another major theme of the book, or perhaps a variation on a theme, that I found quite intriguing was the issue about how we have moved from acute diseases and death to chronic diseases and death. This recurring theme raised a number of important questions such as, are we prepared to pay more taxes to provide medical treatment for the chronically sick? Are we prepared to re-organized our lives to provide more care for our elderly relatives? And should we have to tolerate a slow lingering death?

But as Dr Brown outlined how debilitating diseases such as Alzheimers attack the brain and reduce once highly active people to mere dependants, he managed to convey,very well, an aspect of the human condition, decline and death, that is not normally well covered in other literature. His account of pope John Paul's II decline was quite simply moving.

Dr Brown also shows us the impact of politics and econmics on medicine. There is little point in pharmaceutical companies striving to develop cures - this would not make economic sense. But if that is the case one has to ask what are governments doing about it? After all in many developed countries it is the government who subsidises medical treatment by of course taxation.

Ultimately, Dr Brown's thesis is a subtle argument for euthanaisia, one that I don't necessarily opose. However, I believe that The Living End will quite simply be the most thought provoking and influential book that I will read this year.