What two inventions of recent years have enhanced the lives of older people more than any others?  My answer would be the cell phone and email.

In a short time, wireless telephones have proven themselves socially beneficial. They have improved our safety and security to a remarkable extent. When we are in serious distress, they enable us to summon help immediately. If we have trouble finding the way to our destination when driving, we can call and ask for directions, as friends have done on their way to my house. And they reassure us of people’s wellbeing: While she was her way through the streets of Paris, my daughter would converse animatedly with her mother and me.

Email puts us in touch with grandchildren, if we have them, other family members and friends even when they are scattered throughout the world. It enables us to reach out to people to whom we are unlikely ever to write letters. With precious little effort we can reach to the ends of the earth.

Mind you, I still have some quarrels with these wonders of modern technology. I regard cell phones as often, ironically, anti-social.  You see people walking the streets entirely abstracted from those who are heading toward them. And when you are listening to a concert or even to a sermon in church, someone’s phone rings, jarring you out of your absorption.

And email has led, I fear, to the near demise of personal letter-writing. How many collections of emails have you seen in a bookstore or on anyone’s shelf? Emails may also have damaged the prose style of some writers.

I am also aware of omitting some other good candidates for an MVT Award, for Most Valuable Technology. In the medical field, for example, pacemakers and stents for coronary arteries must be judged marvels of human ingenuity. Uncounted numbers of people are still alive because of them.

I recently proposed my nominations for best recent technology to Joseph Coughlin, the innovative director of MIT’s AgeLab. He readily agreed that email and the cell phone deserve recognition for the value they have added to the lives of many elders.

Though not all older Americans yet have access to these two devices, they have passed Professor Coughlin’s requirements for new products. For him, they must meet the threefold test of acceptability, availability, and affordability. Most people are pleased with email and cell phones and can readily learn how to use them; they are plentiful and can be easily procured; the majority of Americans have enough money to purchase these services.

By contrast, think of the palm pilot, an electronic device that, appearing some ten years ago, promised to help people put their lives in order. In practice, however, it has turned out to be of less value than a notebook in which you can write with a no. 3 lead pencil.

And long-term care health insurance, a different kind of invention, is a product that few of us buy, either because we cannot afford it or because we are not convinced it will provide us enough coverage when we need people to take care of us.

Exercise machines are products that people buy but find they quickly stop using. Many a cellar features such a machine gathering dust in the corner because people find it’s easier to go out for a walk than to get on the contraption. However, precious few of us actually do either.

Technological innovation will surely leave its mark on the lives of older Americans over the next decades as our numbers increase dramatically. Among the possibilities, Dr. Coughlin foresees us gaining access to personalized advice for what he calls “wellness care.” If some 110 million of us out of a total population of 290 million have at least one chronic disease, then the need for easy recourse to medical advice becomes clear.

I find Dr. Coughlin’s concept of technology enticing. He considers technology “an extension of oneself.”  It represents human ingenuity’s success in figuring out ways to increase a person’s reach. Devices we cannot yet imagine will someday enable us to do what now seems impossible or, at least, impractical.

Such inventions will help give shape to Coughlin’s vision of the future. “We need to get rid of retirement as an idea,” he says. Instead, we must develop a more compelling outlook and we need to renegotiate the social contract that rigidly separates schooling, work and retirement. Instead, we should think bigger and let improved technology help us revolutionize our aging society.

That is what the two inventions cited show signs of doing. Email and cell phones enable us to extend the scope of our power of communication far more widely than we could have imagined. I feel glad to have been blessed with enough longevity to see them come into being and to be enabled to make good use of them.                                                                                                                                                                                                                                                                                                                                                                                                                                                             

Richard Griffin

Americans old enough to remember World War II sometimes imagine that all adult Germans of that era supported Hitler and accepted his terrible crimes against humanity. We can thus remain ignorant of the struggles of more than a few heroic citizens of Germany who opposed the Nazi regime at the risk of their lives.

One person who did so is Freya von Moltke, a 94-year-old woman who has lived for many years in Vermont. She ranks as one of my spiritual heroes for the part she played in the resistance against the rulers of her country during the 1930s and the first half of the following decade.

This courageous woman is the widow of Helmuth James von Moltke who was a leader of the Kreisau Circle that planned the overthrow of Hitler and the building of a new postwar Germany. He was arrested in January, 1944, imprisoned for almost a year and, for his part in the Kreisau group, finally executed in January 1945.

I recently talked with Freya von Moltke about her memoir of those days, a volume of some 90 pages that recently appeared in English. Translated from the German original by Julie Winter and published by the University of Nebraska Press, the book is entitled “Memories of Kreisau and the German Resistance”

Unfortunately, the book is priced at $49.95, a prohibitive cost for most readers. However, a paperback edition may be in the planning stages and meanwhile the hardcover can perhaps be found in libraries. The author told me: “I’m very happy the book exists in English.”

Kreisau, the town that has given its name to the group that opposed the Nazis, is in Silesia, a region that used to be part of eastern Germany. The estate there, along with outlying farms, had been bought by Field Marshall Helmuth Von Moltke, the hero of the Franco-Prussian War of 1870. This military leader was buried on the grounds of the estate and the place became a place of pilgrimage visited by tourists.

Freya first visited Kreisau in 1930 where she met her future husband for the second time and fell in love with him and his home. The following year they married and thus began her long association with the Von Molke family along with the farm and the village with which they all became identified.

 After the war, Silesia reverted to Poland and the village became known as Krzyżowa.  Now the estate serves as a center for promoting European understanding, supported by the governments of both Germany and Poland.

In her memoir the author recounts her husband’s death in only a few words, without apparent emotion. Though she provides some important information about the workings of the Kreisau Circle, her focus throughout much of this book rests upon efforts that she made to take care of her children and to keep the farm at Kreisau running.  Eventually, however, with the advance of Russian armies and the end of the war, she would be forced to leave her home.

Despite the sobriety of the narrative, the author’s heroism does emerge in the way she supported her husband to the tragic end. From the beginning she had given him practical and emotional support as he embarked on a course that he knew might end in his death. She could easily have been arrested herself and have been charged with treason as Helmuth was.

During his imprisonment she corresponded daily with Helmuth and continued spending much of the time in Berlin with people close to Kreisau Circle members. She remained one with her husband in his time of suffering, a union manifest in the letters they exchanged.

The book does not seem at all grim but instead is filled with sweet memories of the family farm and the beautiful countryside of which it formed a part. Freya looks back on a time full of danger but she maintained confidence that one day a new Germany would emerge from the ruins of a devastated society.

Next July, Freya von Moltke will deliver a speech at a church in Berlin marking the 60th anniversary of the abortive coup against Hitler. This commemoration will serve to remind younger Germans and all who love freedom of the sacrifices made by her husband, herself, and many others to deliver their country from the tyranny that held them so tightly bound.

Richard Griffin

So many Americans are now living to be old. And we require so much health care. Do these two facts mean we need to ration this care on the basis of age?

Since the 1980s, Daniel Callahan has been suggesting as much. And at a recent conference on end-of-life issues he raised again the questions that have made him a target for elder advocates.

This conference, sponsored by Boston College, drew to Newton some 65 presenters and attenders from around the country, researchers and practitioners in medicine, law, social work, and other fields.

As keynote speaker, Daniel Callahan asked the question “Does Age Matter?” making it the title of his talk.

Co-founder of the Hastings Center in Garrison, New York in 1969, Callahan has been talking and writing about medical ethics for many years. He has authored or edited 35 books and many articles. Mild-mannered though he is in his own person, he has managed to turn some of his critics into angry hornets.

1. Aging and death are on a collision course, this keynoter points out, since most people – – in this country, at least – – do not die until well into their 70s or beyond. This increased longevity makes for three tensions:
2. In the United States, old age is no longer seen as a time of certain decline and disability;
3. Physicians do not accept the inevitability of death and most Americans believe unlimited benefits should be available to everyone;
4. Older people should be treated on an individual basis, no matter what the pressures on Medicare and other funding sources.

Palliative care, as distinguished from medical services focused on cures, has become an ideal for at least some physicians. However, to make palliative care the norm, when cure is not realistic, requires an acceptance of death that goes beyond where many doctors are. A leading researcher among them, William Haseltine, has called death “nothing but a series of preventable diseases.”

Professionals with this mentality accept death only when technology cannot do anything more. Callahan believes that palliative care –  –  that is, the effort to keep patients as comfortable and as pain-free as possible –  –   should be much more honored than it is.

“Care must be seen of equal value with cure,” he says. For him the time has come for restoring a balance between the two. He would also like to see this kind of care made available to those patients who are not terminally ill.

Death should not be seen as the enemy. Callahan does not approve of what he terms the “medical arms race with death.” He takes as a fine model the practice of people in the Czech Republic, a place where he has spent considerable time. There people grow old and are allowed to die rather than being kept alive by technology.

Callahan feels some hope for a different future in our attitudes toward end-of-life treatment. “We are beginning to come to our senses,” he says. “It has been a wonderful ride, but we are reaching the point where enough is enough.”

“We have no moral obligation to keep people alive,” says this moral philosopher. Old people do not fear death in itself, he believes, only dying poorly, without any room for decisions being left to themselves and their families.

Not surprisingly, designated responders at the conference disagreed with Callahan’s main points. Sara Fry, a Boston College researcher with a background in nursing, stated that “age should never be a criterion for end-of-life care.” Instead, she sees the patient’s prospects or prognosis as the standard by which to judge. How well the patient can bear certain treatments is more relevant than age.

Later Fry would repeat her basic view: “No matter my age, I want a doctor to bring me a cure. I don’t want options eliminated because of age.”

Another respondent, David Solomon from Notre Dame’s Center for Ethics and Culture, judged Callahan not radical enough. He ought to have questioned the distinction between curing and caring, Solomon said, if only because patients see curing as caring.

“If you put curing and caring in tension,” Solomon claimed, “curing will win every time.” This respondent also said that it would be difficult to reduce medical benefits unless elders could be convinced it was for their own good.

John Paris, a Jesuit priest who is an ethicist on the Boston College faculty, recalled his grandmother who worked as a matron at Boston City Hospital. “It’s sinful what they’re doing to those patients,” she would have said. Father Paris sees acceptance of the human condition as the key to it all.

Readers will find discussed here only one session of a conference that lasted a day and a half and featured many other presentations rich in content. The part reported here, however, does raise some central questions that are bound to stir debate for the foreseeable future.

Richard Griffin

Finally, I have succumbed to the craze. After several years of resistance on my part, the battering ram of popular practice has broken down my defenses. I have joined the ranks of cell phone users.

Now, fortunately, I have gained access to all sorts of new social privileges.

At airports, I can talk more loudly than ever before. Other passengers, while waiting in the lounge for their next flight, will share the privilege of listening in on my conversations. They can follow blow-by-blow accounts of my latest fall-out with a friend or a giant business deal about to come together. And it will all come at a high pitch of volume ensuring that whatever attention they had been giving to reading a best seller or holding a face-to-face conversation with a companion will have to give way to my talk.

I can also demonstrate my personal importance by receiving calls during professional meetings or at lunch with friends. Associates will surely be impressed as a dark-blue device smaller than my hand relays a message from a friend in San Francisco or Paris. Up to now they may have considered me as an old guy of not much account in the larger world, but they will now realize that I rate. Friends will come to know even better how widely I am known from coast to coast and abroad.

People can now reach me even during the Sunday liturgy in my parish church. The priest may be approaching the most solemn part, commemorating the Last Supper of Jesus, but I will rattle on about the next party on my social schedule. And the same priest’s efforts to present a coherent sermon will be enhanced by the pseudo-musical ring of my phone.

Another benefit comes in my no longer needing to walk around town unaccompanied. Now abject solitude will find relief any time I want. In my town, however, so many people are already talking to themselves without need of a cell phone that they should not easily presume I am using one. Perhaps this fact will motivate me to talk even more loudly into my new hand-held device so that everyone will recognize me as in touch and not isolated.

If I leave the cell phone connected, then I can also hope for someone to contact me during a movie. Others in the theater, absorbed as they are in their popcorn and ongoing conversation with the person next to them, will surely not mind if I interrupt Renée Zellweger or Sean Penn in whatever they are trying to say.

Also I will feel free to drive my car while talking with friends in the Berkshires or snowbirds in Florida. It will serve as a pleasant relief from devoting tiresome attention to the roadway. Maybe cats and dogs will run some risk of encountering me but I suspect that most humans will escape my onrushing Toyota.  

Perhaps the phone will prove valuable during Sunday softball games as well. When stranded at second base (a fairly rare event, given my batting prowess), I can talk with someone at home (in either sense), relieving the tedium created by a pitcher who cannot get the ball over the plate.

Also routine physical exams can be rather boring, especially when your doctor does not have much to say. I heard recently of a patient who carried on a cell phone conversation during the process, a practice that strikes me as a fine remedy for the ho-humness of so much medical practice.

Readers can gather from the irony in all of the above what were the factors that kept me from purchasing a cell phone up to now. So much about the use of these devices puts me off. I consider them to have unleashed a torrent of anti-social habits like those parodied here.

Paradoxically enough, a gadget invented to put people in touch with one another too often alienates us. Rather than enhancing the pleasure of being in the actual presence of others, it abstracts people from the present situation in favor of a distant relationship. I begrudge having the person I am talking with spurn me for someone else far removed.

Despite these gripes, however, I also hail the cell phone as one of the finest inventions of our time. Especially for those of us in later life, it comes as a great boon. Used selectively, it enhances both our social life and our security. If we should need assistance at almost any time, help can be more easily summoned than ever before.

Joseph Coughlin of MIT's AgeLab shares this view of mine. He considers it a model of the way technology can serve the needs of later life. Like so many other inventions, it looks easy and obvious, but that’s only after it been invented.

Again, despite my reservations about its misuse, we are lucky to have it.

Richard Griffin