Memories, half a century old, set off a stream of consciousness triggered by the sad news of Javed Masood passing away. He was visiting his daughter in Washington and according to a mutual friend was not doing too good. A phone call from us in New Jersey would cheer him. We waited for him to lighten up before dialing him. Now, it’s too late. He is no more. His mortal remains travelled back for burial in Islamabad.

JM, as we used to call him was serving as assistant commissioner in Jhelum way back in the the ’60s. Jhelum was our home, too. Driving down to Mangla was our weekly treat. It was little America, complete with a bowling alley, a pizzeria, a fancy restaurant and a theatre that screened the latest American movies. An Italian-US conglomerate constructing the Mangla dam had built the complex for its staff. Life was on a roll. We were young, carefree and very happy.

Aging is a reality. It descends stealthily. Soon, it’s time to leave. So, what’s a good age to kick the bucket? This is not a sick joke, as many of you may think. Nor is it black comedy that rakes up unpleasant, frightening images of death and decay. It’s a simple fact of life that most of us like to avoid bringing up. But all humans are mortals.

Here’s one man who thinks the ideal time to quit the world is at age 75. Why would Dr Zeke Emanuel, director of the clinical bioethics department at the US National Institutes of Health, exalt death? Because, old age, according to his prognosis, renders “many of us, if not disabled, then faltering and declining, a state that may not be worse than death but is nonetheless deprived.” Most of us would think the doctor to be talking through his head, but here’s what he says about old age: “It robs us of our creativity and ability to contribute to work, society, the world. It transforms how people experience us, relate to us, and most important, remember us. We are no longer remembered as vibrant and engaged but as feeble, ineffectual, even pathetic.”

Are good doctors bad for your health?

‘Dr Death’, as I call Zeke Emanuel, is in a minority in America. Americans want to live, not die! Daily we read of breakthroughs in wellness and beauty. Not only do the wealthy here want to lead an active lifestyle forever but want to look young, fresh and ready to go! Notice the current pack of presidential candidates vying with each other to win the White House next November. Hillary Clinton will be in her 70th year if she wins and will be 78 when she leaves the Oval Office. Her Democrat rival Bernie Sanders is already 74, so you do the math by the time he is done being the president of the most powerful country. Moving on to billionaire Donald Trump, the guy with a weird hairstyle but a darling of the Republican voters is already in his 70th year. He is like a generator who continues to throw up megawatts of energy that keeps his fans entertained and him buzzing wherever he goes.

Listen to the latest bit of unsolicited advice from Doc Zeke which he himself calls “truly shocking and counterintuitive.” According to his research “Not having the country’s famous senior heart doctors caring for you might increase your chance of surviving a cardiac arrest.” In other words, if you’re having a heart attack, don’t run to the most famous cardiologist in town because chances are that you may not survive!

This sure is shocking and counterintuitive to repeat Zeke. His provocative theory has its origins in JAMA Internal Medicine journal published by the American Medical Association. The study finds that “patients with acute, life-threatening cardiac conditions did better when the senior cardiologists were out of town.” The data says that one possible explanation may be that while “senior cardiologists are great researchers, the junior physicians — recently out of training — may actually be more adept clinically.” Also, senior cardiologists try more interventions like stents, to open up their coronary blood vessels if the patient is in acute cardiac arrest, which could kill the patent.

I am sure a top heart specialist in Pakistan would rubbish JAMA’s claims. But the 10 years of data involving tens of thousands of patients show that their chances of survival were better at a teaching hospital where they received better care than in a regular hospital, no matter how fancy. A teaching hospital as we know is a hospital that is affiliated with a medical school, in which medical students receive practical training. America’s teaching hospitals are responsible for training new generations of physicians and are the frontrunners in medical research and technology. Pakistan too has many teaching hospitals, some of them outstanding.

Now if you’re going in for an X-ray or an exploratory procedure, be sure to ask your doctor four simple questions advises Doc Zeke: What difference will it make? Will the test results change the approach to treatment? Second, how much improvement in terms of prolongation of life is the treatment actually going to make? Third, how likely and severe are the side effects? Fourth, is the hospital a teaching hospital? “It is surprising how uncomfortable some physicians get when you ask these questions. No one likes to be second-guessed or have to justify their decisions,” he says.

In sum, ask questions; freely and unreservedly of life itself, not just of your doctors. Listen to your life, say the sages. See it for the fathomless mystery that it is, in the boredom and pain of it, no less than in the excitement and gladness: touch, taste, smell your way to the holy and hidden heart of it, because in the last analysis, all moments are key moments, and life itself is grace.

Steve Jobs, the man who revolutionalised our lives with the invention of Apple repeated two words thrice before life left him: “Oh wow. Oh wow. Oh wow.”

Published in Dawn, Sunday Magazine, December 6th, 2015