Three Plagues of nursing home existence: boredom, loneliness, and helplessness. - Atul Gawande

During the Second World War, for example, Lieutenant Colonel Henry K. Beecher conducted a classic study of men with serious battlefield injuries. In the Cartesian view, the degree of injury ought to determine the degree of pain, rather like a dial controlling volume. Yet 58 percent of the men — men with compound fractures, gunshot wounds, torn limbs — reported only slight pain or no pain at all. Just 27 percent of the men felt enough pain to request pain medication, although such wounds routinely require narcotics in civilians. Clearly, something that was going on in their minds — Beecher thought they were overjoyed to have escaped alive from the battlefield — counteracted the signals sent by their injuries. Pain was becoming recognized as far more complex than a one-way transmission from injury to “ouch.

Whereas today people often understate their age to census takers, studies of past censuses have revealed that they used to overstate it.

elderly are left with a controlled and supervised institutional existence, a medically designed answer to unfixable problems, a life designed to be safe but empty of anything they care about.