Surgery at the century mark? No way!
Miracle stories are like miracle drugs. When you look closer at the miracle, there's usually a reasonable explanation.
So it goes with stories in the media about remarkably fit centenarians who are able to undergo major surgery and continue living. Well, those are the folks who survive to have miraculous newspaper stories written about them—but there are dozens of others who are not surviving surgeries or whose doctors have taken the more normal course and elected not to be aggressive in scheduling surgery for a 98-year-old.
It's a question of the law of averages.
The overall trend is good. Medical improvements mean that Americans are living longer. The number of centenarians is growing at a remarkable rate. But the optimism about this trend is leading to risky — and often foolish — surgeries.
More patients in their nineties are being approved for surgeries that were never done in simpler technological times — joint replacements, pacemaker installations, heart bypass operations, and treatments for slow-growing cancers.
I'm worried that too many surgeons are going for the home run — the surgery on a 90-something-year-old patient whose miraculous recovery might make a winning magazine article — while many, many other patients have a poor chance of surviving surgeries with the attendant shock to their aged bodies, compounding health challenges with surgical complications.
The Census Bureau reported that as of June, there were 90,422 centenarians in America, with the number increasing all the time. The big debate in geriatric care is how far to go in providing major medical services to extend these very long lives.
Many times the aggressive treatment of late-stage chronic diseases results in a poor quality for the remaining weeks or months these patients have left, and these commonplace stories are not the stuff of "miracle centenarian" reports in the media.
The other demographic feature at play here is, of course, that the increase in people surviving into their nineties and hundreds opens up a new market for drug marketers, the little voices in the ears of many docs contemplating aggressive surgeries.
