Quarterly Essay 57 Dear Life

In this moving and controversial Quarterly Essay, doctor and writer Karen Hitchcock investigates the treatment of the elderly and dying through some unforgettable cases. With honesty and deep experience, she looks at end-of-life decisions, frailty and dementia, over-treatment and escalating costs.

Ours is a society in which ageism, often disguised, threatens to turn the elderly into a “burden” — difficult, hopeless, expensive and homogenous. While we rightly seek to curb treatment when it is futile, harmful or against a patient’s wishes, this can sometimes lead to limits on care that suit the system rather than the person. Doctors may declare a situation hopeless when it may not be so.

We must plan for a future when more of us will be old, Hitchcock argues, with the aim of making that time better, not shorter. And we must change our institutions and society to meet the needs of an ageing population. Dear Life is a landmark essay by one of Australia’s most powerful writers.

‘The elderly, the frail are our society. They are our parents and grandparents, our carers and neighbours, and they are every one of us in the not-too-distant future … They are not a growing cost to be managed or a burden to be shifted or a horror to be hidden away, but people whose needs require us to change …’ —Karen Hitchcock, Dear Life

‘In Dear Life, Hitchcock has laid out her most important work to date in the type of clear, rational, respectful prose that the topic demands. As much as our natural instinct may be to avert our gaze from death, to push it from our minds at every opportunity, this essay is inspirational and aspirational in its scope. It is highly recommended to all those who hold life dear, and especially to those whose professional lives are devoted to helping us through illness and death with dignity.’ —Weekend Australian

‘Hitchcock’s essay is not comfortable reading, but it is compelling’ —Saturday Paper

‘One of the most compelling and powerful ever published in the Quarterly Essay series’ —Sydney Morning Herald

‘A sensitive, rigorous, and moving account that exposes the prevailing ageism in our medical services and in Australian society as a whole.’ —Australian Book Review

Karen Hitchcock is the author of Quarterly Essay 57 Dear Life: On caring for the elderly, the award-winning story collection Little White Slips and a regular contributor to the Monthly. She is also a staff physician in acute and general medicine at the Alfred Hospital, Melbourne.