Doctor: Thad Cochran's health raises a tough question for us all

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Story highlights

  • Ford Vox: Sen. Thad Cochran's recent health issues raise question for all of us: When should the aging hand over the keys?
  • Vox: It's unavoidable human fact that our capacity to do our jobs will slip, but that doesn't mean our lives can't remain full and rewarding.

Ford Vox is a physician specializing in rehabilitation medicine and a journalist. He is a medical analyst for NPR station WABE-FM 90.1 in Atlanta. He writes frequently for CNN Opinion. Follow him on Twitter @FordVox. The opinions expressed in this commentary are his.

(CNN)At 79, Thad Cochran isn't the oldest United States senator, but his age-related health condition is putting him in an unwelcome spotlight.

An unspecified urological procedure kept him away from Washington for weeks. His office then announced that he suffered a series of urinary tract infections after treatment.
The day he finally returned to work, Politico reported that he seemed too confused to navigate security at the Capitol, was unable to locate the Senate chamber where he has served for 44 years, then cast a mistaken vote, which he then had to take back. On Thursday, reporters asked Cochran whether he was healthy enough to continue in office. The Associated Press quoted the senator replying, "It's up for the people to decide."
    Of course, that answer is incorrect. The term of a senator is six years, a vast expanse of time for those who reach the 70s, 80s or beyond. Sen. Cochran could choose to remain in office until his current term is up in 2020. There's no recall process by which the people decide, so a senator can only be removed by an expulsion vote by two-thirds of his colleagues, a highly unlikely event. Only 15 senators have ever been expelled, the last batch as part of the Civil War.
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    So senators themselves must choose to hand over their keys. We depend on them to correctly perceive when their duty to step down -- because of diminished ability to serve -- transcends their desire to stay on the job. Trends in society influence such decisions, and in the United States the choice of an elder elected official to remain in office increasingly mirrors the choices of the people they represent.
    Senators aren't part of the growing class of Americans who feel they have no choice but to work well into their golden years. Their decisions to continue working surely do involve altruistic considerations about the good they can do their constituencies and their nation, given their seniority, but our aging Congress is also symbolic of a dark side of the American work ethic. We wrap up our very identities and self-worth too tightly with our job roles.
    For many people in seats of political power, I fear their tenacious grasp on high office may reflect not simply their desire to serve, but their desire to live. With success in any career path, the job can become all-engrossing, taking over every sphere of your life. Without the office, a question may linger in the subconscious: is there a life to live?
    We've been here before in politics. Age and health are omnipresent concerns as our nationally elected leadership inches up in age. They're inevitable topics on the presidential campaign trail every four years, including this past cycle as a now 71-year-old Donald Trump battled a now 69-year-old Hillary Clinton.
    It's a difficult challenge for which I certainly do not have an easy solution, engrossed as I am in my own job as a physician, adding more related elements to this core identity year after year, to the extent that if I left my lifestyle on autopilot I, too, wonder what life would viably exist outside of my career in a decade or two. It's a valid worry any dedicated professional should think about, even senators.
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    When I was a kid, my grandfather used to advise me that I should live a "four square life" consisting of attention to family, religion, work and health/self. Having grown up into an agnostic adult, the best I can do under that rubric is a triangle life, I suppose. But whether you're a triangle or an octagon, the point is that there must be life beyond any single element, including your profession, and maintaining that balance should be your top job.
    I do think plenty of folks who work up until their dying day will do so having lived fulfilled lives. But the type of job does matter. You don't want a doddering physician, that much is plain, so most hospital medical staffs and state medical boards require some extra scrutiny as doctors get up in years.
    But what about senators? Weighing in as they do over every aspect of our lives, from our personal rights, our health care, to our social services, there's no reason the concerns we apply toward people in my profession as we age shouldn't apply to them as well.
    About 30% of American workers don't plan to retire until age 70, and 1 in 5 don't think they'll retire at all. It's not just us, either: the average age of retirement is inching up around the world, as people remain healthier longer, and as a matter of economic security.
    Alas, there are only 100 jobs in the US Senate to go around.
    This is not to say that our current Congress, which is one of the oldest ever, is representative of the demographics of the nation they serve. As Kevin King, head of communications at the public affairs software company Quorum, reported, "[t]here are 44 congressional districts in which the age of the Representative is more than double the median age of their constituents."
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    Among them is the eldest member of Congress, Rep. John Conyers (D-Michigan), who at age 88 is representing a district with an average age of 35.
    Not everyone serving on Capitol Hill will be a super-ager. Last week, Mike Kim, a pharmacist who serves Capitol Hill, was quoted in Stat News stating that Alzheimer's medications are among the prescriptions he is filling for people who are "running the country." He added:
    "It makes you kind of sit back and say, 'Wow, they're making the highest laws of the land and they might not even remember what happened yesterday.'"
    After his comments started generating viral online speculation about who he could be referencing, as well as comments questioning the pharmacist's ethics, Stat News published an update informing readers that Dr. Kim wanted to add "I am not aware of any member that actually has Alzheimer's and would certainly not disclose any such information if I did know, patient privacy is a very serious matter that I am committed to upholding." [italics added]
    Yet Stat News kept the remarks in the original report and journalist Erin Mershon has provided no additional insight into the tone of voice or context of the remarks that would put their truthfulness in question.
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    Cognitive science informs us that even in normal aging, brain connections pare back (to the extent that the aging brain actually shrinks in size), reducing our ability to learn new information and make important new connections.
    Well short of dementia, the average normally aging, healthy person in his 80s is not as mentally in touch with the world as someone of middle age.
    No doubt many people who have attained high office managed to do so precisely because of their superior intellect. That "cognitive reserve" serves them well as they age. But it is an unavoidable fact of the human condition that we do not adapt as well to the changing world around us as we age.
    Members of Congress in the upper decades of life will experience increasing difficulty fully representing society as it stands today, through no fault of their own but a common biology we all share. Some may well be representing a society that no longer exists.
    The more complicated the geometry of the lives we maintain as we age, the more roads we'll continue traveling down in comfort as our capacities inevitably change. Depending on your job, exercising your carefully preserved lifestyle options can benefit many more people than just yourself.