A dear, sweet friend wrote to me last week on learning of my recent ulcerative colitis diagnosis and considerable weight loss. Among the many kind and empathetic words she wrote were, “I hope that your quality of life is not too impaired.”
This got me thinking. “Quality of life”? What’s that? I literally had to research its meaning. In that moment, the concept felt foreign to me.
According to Crispin Jenkinson, writing in Britannica, “quality of life” is defined as “the degree to which an individual is healthy, comfortable, and able to participate in or enjoy life events.” The term is inherently ambiguous, he says, and highly subjective.
“Whereas one person may define quality of life according to wealth or satisfaction with life,” Jenkinson writes, “another person may define it in terms of capabilities (the ability to live a good life in terms of emotional and physical well-being). A disabled person may report a high quality of life, whereas a healthy person who recently lost a job may report a low quality of life.” (For the whole article, go to: https://www.britannica.com/topic/quality-of-life.)
What would I report? I wondered. Lately, because I’ve been feeling so punk due to this life-altering (but non-life-threatening), incurable chronic disease, I confess my report would read “low.” It’s a whole new life challenge, I’m finding, and at the moment I’m failing to see any “quality” in it.
Sometimes, when I get stuck on a thought, my mind runs in endless circles. I ruminate (too much?), like the bovine (Taurus) animal I am. Can a high quality of life be created? Constructed, like a high school science project? Baked, like a cake, into one’s life? If a cake, what are the exact ingredients? Everybody knows cakes require exact ingredients to rise.
What sort of quality of life does the woman [not me] trapped in a dried-up, loveless marriage have? Or a man serving a life sentence for a crime he never committed? Or someone who’s suffered a tragic loss and can’t stop grieving? Or migrants who’ve fled a hostile country only to find themselves in an inhumane, overcrowded camp on the border of an inhospitable country? Or a person, like my mother was, dying of brain cancer but being kept alive by “heroic” (read: avaricious) doctors years after her quality of life was gone?
Is it inevitable that one’s quality of life gradually declines with advanced age and ebbing health? Is this just one of the many challenges to be faced and dealt with (with wisdom and grace, one hopes) in our latter years? Having never been here before, I don’t know. I’m only just now learning.
Clearly, quality of life isn’t fixed. It changes, like the seasons; it varies, depending on one’s current circumstances. Yesterday on my walk I was stopped by an image that seemed emblematic of the fragility and ephemerality of “quality of life” for me, so I tried to capture it in this photo:
To escape the swirling thoughts in my head, I reached out to some friends here in San Miguel de Allende to learn their personal views on the subject of quality of life. I sent an e-mail to a small group of women my age (I’ll be 76 next month), who, like me, are single, independent, self-supporting, retired professionals. Three of them responded:
Suzanne: “Quality of life is a subject near and dear to my heart ever since I read Atul Gawande’s book Being Mortal: Medicine and What Matters in the End. What comes to mind was my decisions to travel to Boston for the summer and return to SMA in the fall. Both decisions were based on the quality of my life during those time periods. I knew it was risky to travel, but I could not give up the summer in New England. Nor could I fathom living anywhere but SMA for the winter.
“The winter here was long, but to wake up each morning to birdsong, the occasional whoosh of hot air balloons, barking dogs, church bells and thankfully distant roosters reminded me that life is indeed continuing, despite the fear and uncertainty that the pandemic has caused.
“The color, culture, and courtly behavior of the Mexicans add to life’s quality here, too. When I first moved to San Miguel, it was about the weather. Over the years, the weather has dropped to maybe number ten on my reasons for living here.”
Helaine: “I equate the term ‘quality of life’ with ‘peace.’ If I am at peace, I consider my quality of life excellent. ‘Peace’ includes mental, emotional, and spiritual levels. It means good friendships, the company of people who are reasonably content with their lives, and living in a place [now San Miguel] that nurtures me.”
Toni: “My quality of life is excellent! My two-room apartment is affordable on my Social Security income. I have Internet that works, a landline phone that is under $20 a month and includes free calls to the U.S., and a Mexican cell phone that provides everything for $140 a year. I can afford to have a maid who does all the cleaning chores I always hated. Doctors and dentists are affordable, and for anything big I have Medicare. The sun shines every day. And best of all, I am living in a community where there are a gillion women in my age group who share the same joys and concerns that can only be understood and appreciated by kindred souls.”
So now it’s your turn. What does “quality of life” mean to you? Please share your thoughts on this subject in the Comments section.
find me on facebook
Bonnie, I have a 3rd cousin, who she and her siblings usually call me an Aunt. She has had Ulcerative Colitis since a young girls with several hospitalizations and operations. She could not have children and one of her best friends she grew up with decided to have a baby (or two) for her. They were born early, around or less than a pound. In the hospital for months, came home with lots of equipment and on feeding tubes. She and my granddaughter are friends also, and the kids now five are friends with my great grandchildren. The babies are twins girl Cadence, has food aversion and diagnosed with clinical anxiety, Jackson has been diagnosed with Autism. Jordan is challenged so much with her condition but following her story with the twins since birth and her joy in watching and sharing the twins accomplishments has put so much into perspective for me, she is an amazing mother. I would encourage you to look up their story on “Journey to Mini-Moore” As difficult as life has been for you, you continue to write articles which make us think, inspire and encourage.
Also, there is a project I would like to talk to you about. I will be emailing you later in May regarding a writing project.
Keep on doing what you are called to do. WRITE
Susie
Thank you so much, dear Susie, for sharing this and for your encouragement. It sounds like your cousin has found, despite health challenges, a high quality of life. — Abrazos, BB
I feel the quality of my life is better than the average 70 yr old. I say this in spight of the fact that my back hurts every day. I say this because although it hurts to walk far, i still ride an electric bike, clean my house, cook and care for my animals. What makes me feel the best is that my friends and I give human aid to people who walk across the border. I am grateful for all the abundance in my life. That, I think,is quality.
So true, dear Jamie! Thank you so much for sharing your perspective and experience. — xx
“Quality of Life” means, in part, having long-time friends like you, dear BB.
Same for me, with you, dear John. Thank you.
Bonnie, I’m so sorry to hear of your recent ulcerative colitis diagnosis. As a former caterer and person for whom the joy of cooking is important, this must be devastating, but also good to have a definitive diagnosis so you can tackle special dietary needs and medication wirh knowledge and taste. But man what a big bad bummer. As we age and grow wiser I imagine our idea of quality of life is ever evolving.
Thank you, dear Lyn, as ever, for your thoughtful and sensitive response to my new post. Yes, it’s definitely a plus to have a culinary background: I can make really, really tasty (and healthy, and soothing) chicken soup! 🙂 I’m reading Atul Gawande’s book BEING MORTAL now, and I’m finding it just the tonic for my overactive mind. Best wishes to you and Lee, BB
Dear Bon,
I can only speak for myself, but quality of life seems to depend upon what a person is willing to accept in his or her own situation. I can’t expect to do some things as well as I used to, so I have to decide how much I am willing to let that interfere with my enjoyment of life. I have to admit, sometimes it interferes a considerable amount. Luckily, there are some things that improve with age and that provides balance. One of these is the ability to accept the vagaries with at least the appearance of grace. I also doubt that any I answer I come up with today will remain constant over time.
Much love,
Paul
Thank you, dear Paul, for your input. I’m loving all the responses I’ve been receiving to this post (both here in the Comments section and in private e-mails). This subject seems to hit a nerve! And, yes, I so agree with you: the definition of “quality of life” changes over time. I am (very slowly) learning how to accept this new illness and to find ways to live with it. Another mountain to climb! — LU, BB xx
Considering “quality of life” in my mind is a comparative enterprise. The only way to discern whether my current situation is preferable to another time is to do the apples to apples test. I often ask myself “where would I rather be?” My silent answer to that query is always ” I like it here.” For all of the usual reasons, i.e. “the weather”, “the beauty of the place”, “the courteous, friendly people”, ” the availability of culture and access to a chosen sport”, I find that my expectations are met most enjoyably in this “heart of Mexico.”
Patrick
Thanks, Patrick, for your perspective, which (I know) is shared by most of us gringos here in San Miguel. We’re so fortunate to be here in this beautiful, embracing place.
Quality of life: clean water to drink and bathe, nutricious food to eat, lots of time spent outdoors, friends and family to laugh with, and lots of paper to draw and write on.
Joanna dear — SO good to hear from you and to learn your Q of L list! If only everyone in the world could have these things, especially the children. — xx
Bonnie querida, I am sure you will be cooking tasty and nutritious dinners for yourself.
For me quality of life means, first and foremost, being able to write. Spending time with my viejo. Laughing. Being in a beautiful place is important too, that’s why I still miss Taos, but ni modo 🙂 Muchos hugs
Dearest Te — Thank you for this! You MUST come and visit me in SMA because it’s such a beautiful place. And thank you for teaching me a new expression — ni modo! I’ll be using it a lot… Muchos hugs back to you.