BOSTON -- I hope he will forgive another intrusion. There's been quite enough speculation on Joe DiMaggio's health already.
The baseball great, who awoke from a coma last month to discover his doctors supplying updates for a media death watch, was appalled. This is not the sort of fame that the Hall of Famer wanted.
If rumors of his death were premature, so were recent reports of it. When a news bulletin accidentally crawled across the bottom of a "Dateline NBC" report announcing his demise, Mr. DiMaggio was sitting in a chair watching his life flash before his eyes.
Let's not replay that.
Nevertheless, those of us who have read the agate type on this 84-year-old's illness -- a 99-day saga of lung surgery, pneumonia, coma, last rites, awakening -- cannot help but find powerful resonance in the scripts that describe the two separate realities of his "recovery."
In the first scenario described by his old friend Morris Engelberg, Mr. DiMaggio's release from the hospital is a modern medical miracle. The slugger fought back and won. The doctors saved his life. The duly designated greatest living baseball player is readying himself to throw the first pitch at the Yankees' Opening Day.
In the second scenario, offered by the New York Daily News and other reports, Mr. DiMaggio was brought home on a stretcher. He's bedridden, using a ventilator. He will, said one reporter, "need round-the-clock nursing care for the foreseeable future."
These alternative universes do more than beg the question, "Where have you gone Joe DiMaggio?" They remind us of the starkly different destinations modern medicine leads to.
Ask anyone who has faced a medical crossroad -- especially for an elder. These are the opposite futures we imagine as we try to decide if we are saving a life or preserving it for another cruel round of dying.
An age bias
The week Mr. DiMaggio left the hospital, there was a study in the Annals of Internal Medicine describing an age-bias in health care. Doctors, it reported, were much less likely to give life-sustaining treatment -- a ventilator, surgery, dialysis -- to critically ill patients who are 80 and older than to those who are 50 or younger.
This is just the kind of research that makes us wary in these cost-saving times. What? Not give elders the same treatment? Are we discriminating against octogenarians?
But the nut of the research came when the authors confessed their uncertainty. This is what they didn't know: Whether doctors were giving the elders too little care or giving the younger patients too much care. More to the point, they wrote, "We could not determine whether these treatments were potentially beneficial to patients."
They didn't know when the care was futile and when it was helpful and where the line was. They didn't know because doctors can't always say whether we are heading for the ventilator or the first pitch at Opening Day. Or somewhere in between.
The last year
One-third of all our medical spending goes for the last year of life, but we only know in retrospect that it was the last year. The big picture of medical care is writ in dollar signs. But we care for our elders in the small picture, each a carefully etched portrait of one person we love.
These days, many of my fifty-something friends find themselves around the hospital beds of their parents. We face multiple-choice questionnaires for which there are no right answers.
A daughter asks, are we right to urge chemotherapy on mother? A son asks, are we wrong to order only morphine for father? If pneumonia is the old person's friend, are those antibiotics the enemy, asks another? Or is death the only enemy?
The lucky ones have parents who make these decisions for themselves. But it's often the family trying to figure out what kind of time they are buying with what kind of treatment. These choices fill our waking hours.
"No one wants to live to be 100" my grandfather used to say, "until you ask the man who's 99." But that, of course, depends on which man you ask.
The other day Sadie Delany died peacefully in her sleep in her own home at age 109. She and her late sister Bessie became best selling authors with their oral history: "Having Our Say: The Delany Sisters' First 100 Years." They had the time of their lives at 100.
As for Mr. DiMaggio? Of those scenarios hanging in the air, allow me to choose my favorite: See you on Opening Day.
Ellen Goodman is a syndicated columnist.
Pub Date: 1/31/99