#35

From the tree of the knowledge of good and evil you shall not eat, for in the day that you eat from it you will surely die.     Genesis 2:17

The Kid is an antique movie (2000) in which an unlikable consultant named Rus (played by Bruce Willis) is suddenly confronted by his eight-year old self, a boy named Rusty (played by some kid). Upon realizing who Rusty is, and learning that he is wealthy, powerful, and successful, young Rus despondently declares, “So, I’m forty, I’m not married, I don’t fly jets, and I don’t have a dog? I grow up to be a loser.”

I wish that teenage Me could glimpse the life that still very young Me lives today. He would be shocked, and probably deeply disappointed: “So I’m 51, I’m not an executive, we have only one car (a 4-door!), and I drink coffee? I grow up to be an uber-dork!

He would be right.

If you could know your future, would you want to? For most of history this has been a comfortable question to toss around in the evenings by the fire or down at the pub, but it was never anything more than that, since it was an impossibility. And then, suddenly, it wasn’t. Today, you can find out more about your future than you may want to know.

The average woman in the US has about a 12% chance of developing breast cancer during her lifetime. But if her DNA contains mutations in genes called BRCA1 or BRCA2, her risk soars to more than 80%, and the cancer is more likely to occur in both breasts, and at a much younger age.  An 80% chance is not a certainty, but it is close enough that many women (including Angelina Jolie) are choosing to undergo preventive mastectomies.Guys: if you carry these mutations your risk of breast cancer (you hadn’t considered that, had you?) climbs to 8%, still very low, but 80 times the normal rate. My middle-aged male friend who had a mammogram tells me he felt profoundly out of place in the doctor’s waiting room.

We lost my father to early-onset dementia three years ago. Being in your fifties and realizing that your father began losing his faculties in his sixties can change your perspective. In my case it led to some serious discussions with Laura about how we can live life to the fullest now, rather than putting a lot of things off. It also led to me standing in my bathroom trying to muster up enough saliva to fill a sample tube for my own genetic test. Do not underestimate the difficulty of producing enough spit to fill what is described as a “small tube” but that starts to seem like Lake Superior. You laugh? Try it yourself, spit-boy.

The leading predictor of dementia is simply getting old, and as more of us reach post-post-middle age, more of us will get it. By age 80, around 16% of people have it, regardless of their genes. In my case the test results told me it’s much higher than that, as in ‘flip a coin and if it’s heads, Mark loses his head,’ so to speak. NOTE: this does not give anyone (Ed) permission to start closely observing me and nodding knowingly when I……..so…..um…..huh…..where was I?

This “knowledge of evil” took some getting used to for me; for some people it is so troubling that they choose to have this part of their test results removed before they see the rest. Fair warning: everything I have read says you should not choose to get this information the way I did (more on why in a moment).

Here’s the reality. Every human life comes with a death sentence; we just don’t know the execution date. For some of us, knowing more can help us make productive changes, but for others, it’s going to be severely anti-happy, so here’s my advice:

First, if you are a Serial Internet Self-Medical-Diagnoser, you need to stop that stuff right now. Doctor visits are up an astounding 71% since the arrival of the Internet, as people self-diagnose every skin bump as a “death-enoma,” or leprosy, or the first stage of them mutating into a giant fly. How do I know that people do this? Because I made that statistic up, and some of you have already re-posted it. Also because I sometimes do this myself. Remember that no information is infinitely better than bad information.

Second, what does all this have to do with happiness? Is ignorance really bliss? The REVEAL study looked at how people respond to this kind of genetic gut punch, and here’s the result:

  • People who learn they have a higher chance of the disease tend to improve their health-related behaviors, like eating and exercising, and more of them buy long-term care insurance.
  • These same people show no significant long-term psychological impact, depression, or anxiety, when compared to people who got better results, meaning most of them found out, adjusted, and got on with life.

After our son unexpectedly died I spent a lot of time pondering whether it would have been better to know what was coming or to live in ignorance. I’m still not entirely sure. I’ve always liked the story of the self-consumed king Hezekiah of Judah, who got some bad news: after his death, everything he owned would be plundered and carried off, and his sons would be castrated and become palace servants for another king. Hezekiah’s response to this news was either humorous or tragic:

“This message you have given me from the LORD is good.”  For the king was thinking, “At least there will be peace and security during my lifetime.”

Now that is perspective. I hope he didn’t share the “good message” with his sons.

Personally, I’m glad to know my odds. I figure I have at least a decade to live really well and for researchers to work really hard on what is becoming a national health crisis, and frankly 2027 is further out than I can focus right now anyway. I also plan to live as if I won’t be here forever, which is just as true for you as it is for me. I’m putting a note in my calendar for today’s date in 2022 and I’ll update you then. So far it looks like I’m free that day.

So draw up a will, even if it makes you uncomfortable. Get a colonoscopy if you are fifty or older, (it will definitely make you uncomfortable). Make plans for what happens to you (both your body and your soul) after your death sentence is carried out, and then get on with living life like there may be no tomorrow.

Because there may be no tomorrow.

Postscript: Between the first and final drafts of this post, I located a more recent study that suggests my odds of getting dementia are actually much lower than it first appeared, though still a bit above average. Because this research is in constant flux, don’t go looking for this kind of information unless you are prepared for what you might find, and don’t make any rash decisions until you talk to a real doctor.

Learn more about genetics and dementia here.

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