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The tyranny of safety

Young, old. No one escapes the tyranny of safety. Credit: Image: Greg Hollobaugh

In the era of school shootings and terrorism it is understandable that safety has become a priority. But has it also become an obsession?

Are we so focused on “safety” that we overlook the downsides, or at least the other side, of this priority?

In her provocative book, A Field Guide to Getting Lost, Rebecca Solnit notes, “A recent article about the return of wildlife to suburbia described the snow-covered yards in which the footprints of animals are abundant and those of children entirely absent.

“As far as the animals are concerned,” Solnit continues, “the suburbs are an abandoned landscape, and so they roam with confidence. Children seldom roam, even in the safest places. Because of their parents’ fear of the monstrous things that might happen (and do happen, but rarely), the wonderful things that happen as a matter of course are stripped away from them . . . I wonder what will come of placing this generation under house arrest.”

Others have also commented on the constrictions of so-called helicopter parenting and the over-scheduled child. A concern for safety is at least part of what has eroded the opportunities for children to roam the neighborhood and have the unstructured time to do so.

But it is not only the young that lose out when safety becomes an unquestioned norm. It is also the old.

In the new book of physician-author Atul Gawande, Being Mortal, Gawande describes what has happened as safety becomes the be-all and end-all as people age and encounter the trials of sickness and mortality. Safety, concludes Gawande, is not the same thing as meaning.

Gawande’s is a profound book and a timely one. It is part of a larger re-thinking of how we conceive and talk about aging and mortality. We are coming, Gawande argues, to the end of a half-century experiment in social engineering in which “we have treated the trials of sickness, aging and mortality as medical concerns.” The name of the game has been keeping people alive and safe.

This is an experiment that has failed. “If safety and protection were all we sought in life, perhaps we could conclude differently. But because we seek a life of worth and purpose . . . there is no other way to see what modern society has done.”

In seeking to keep the ill and aged “safe” above all, we have failed to ask the more important questions: What gives meaning to a person’s life? What trade-offs are they willing to make that might add meaning, even if safety is somewhat lessened?

Gawande relates a series of inspiring stories where care of the aged and infirm is being done differently.

One such story is that of The Chase Memorial Nursing Home in New Berlin, New York and its director, Bill Thomas. On his arrival at Chase Memorial, Thomas — who also operated a small farm — was struck by the bubbling abundance of life on the farm and the dry absence of life in the nursing home.

So Thomas innovated, adding two dogs, four cats and a hundred birds as residents of Chase Memorial. It doesn’t take much imagination to foresee the objections — particularly from staff and residents’ relatives — in the name of “safety.” Dog poop? Bird droppings?

Here’s Gawande’s quick summary: “That fall, they moved in a greyhound named Target, a lap-dog named Ginger, the four cats, and the one hundred birds. They threw out all their artificial plants and put live plants in every room. Staff members brought their kids to hang out after school; friends and family put in a garden at the back of the home and a playground for kids. It was shock therapy.”

With kids, dogs and cats, and birds the residents were arguably less safe, but they were also more alive. People who the staff thought unable to speak began talking. Some who had been withdrawn and who did not walk began coming to the nursing station and saying, “I’ll take the dog for a walk.”

There were quantifiable upsides as well. The use of psychotic drugs to control agitation decreased significantly, with drug costs dropping by 38 percent. Deaths fell by 15 percent.

Chase Memorial is but one of the delightful stories of a new direction in nursing homes and elder care that Gawande relates. Still, his is not a romantic book. He looks with clear eyes at the challenges of illness and mortality. He concludes, “Making lives meaningful in old age is new. It therefore requires more imagination and invention than making them merely safe does.”

Not long ago, one of our adult sons bought us a child car seat for when we drive a grandchild. We had of course had our own children's car seat when he was young. I couldn’t help notice the changes in car seats from then to now. The new generation car seats are big and heavy. It’s no small job to pick the thing up, much less get it anchored in place. The system of belts and buckles almost requires a degree in engineering to sort out. I’ve been known to mutter under my breath when installing this car seat. Still, I’m grateful for such devices.

But I’m also grateful that our backyard has an ancient cherry tree where our three-year old grandson enjoys climbing in the spreading branches. There are rock walls he likes to ascend and nooks and crannies where a three-year-old can hide out or even get lost. He’s not utterly and completely safe out there.

But safety, both for the young and the old, is not the only thing to be considered.

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