29 June 2015

'Fear of death keeps many doctors from engaging with ageing'


Gender equality took 100 years. The next step is equality between young and old, according to ageing researcher, Professor Rudi Westendorp.

As a young man, Rudi Westendorp enjoyed working on motorbikes; he loved speed, would often be covered in oil, and was about as diligent at school as any other boy his age. However, when his elder sister Ans nearly died, he found his path.

“Today, you can hardly call it a disease, at least not a fatal one, but she was admitted to hospital with asthma, and she nearly choked to death. Watching the doctors at work was an eye opener. I thought that becoming a doctor and helping others was a good thing to do,” 56-year-old ageing researcher, Professor Rudi Westendorp remembers. 

He is originally from Holland and currently, he conducts his research at the Department of Public Health and the Centre for Healthy Ageing.

“It was probably also one of the reasons why I spent four years as a consultant in an intensive care unit. I wanted to help save human lives. But as time went by, I wanted something more than that. Don’t get me wrong, it is incredibly important work, but I felt a desire to explore other territories as well.”

Why research into ageing?

“These days, not much happens in the first 40 years of our lives in terms of diseases. A hundred years ago, half of the children died from all sorts of causes. Much energy and effort was put into research into children’s health – it was all about getting them safely through the early years. We have practically solved all those problems now. I felt a need to look at the other half of our life cycle. Halfway though our lives, we are on top, physically, and then we start becoming more susceptible to manifold diseases, we become more fragile and finally, we die. And honestly, we don’t have a clue yet why it is like that.

If you enter a hospital today, more than 65% of the patients are above 65 years old. So all you have to do is open your eyes, and you’ll see how important research into ageing is.

And when I put it like that, its importance may appear quite obvious. But, and there is a “but”, it’s as if many doctors have an inner barrier to working with the ageing factor. If I ask an auditorium full of young medical students, who want to become a paediatrician, a third of them will raise their hand. To them I say, ‘Fine, go to Africa, you are needed there’. If I ask who wants to work with old people, three will put their hand up and I ask them to stay’. To the rest I say, ‘Go home and think about a career change’,” Rudi Westendorp explains with a smile, while also shaking his head a little.

Why do you think that is the case?

“Ageing is almost always linked to something negative, and it’s definitely not as highly estimated as other research areas. It’s something evolutionary. We are programmed to have sex and make babies. This makes us feel happy. Practically everybody loves children, but far from everybody love older people, there was no need for. It is the fear of facing death that keeps researchers and doctors away from engaging with ageing.

I like old people. They know stuff we don’t. Some are boring but others are visionary – as are a lot of young people. But older people can combine looking forward with looking back! They have experience. They remind me of wine and I mean that in the best possible way. Some wines are more complex; undrinkable in their youth but the better they become as they mature. Almost everybody knows someone old who is both energetic and interesting. It’s fascinating to think of how they were in fact the driving force in shaping the world, as we know it today.”

Why is your research important for society?

“We have witnessed an explosion of life. Never before have so many people lived for so long in that good health. It’s grandioso – a medical and societal success. Almost all of us live to a ripe old age, but this also poses us with huge challenges. That is the great theme in my research: what are we going to do with all that extra life. There are so many things to conquer in this unknown territory. And we’re not just talking about better DNA repair and need of stem cells, but also how you psychologically cope with physical loss and death.  It is “ageism”, discrimination on the basis of age that holds us back".

“Gender equality took us more than 100 years. Now we face the same challenge between young and old. Do we regard older people as equal? I’d venture no, and that is the real challenge we have to do something about.”

Personally, he intends to set an example for his own research by continuing his work for many years to come.

“I’d just written a book on the second half of life. When finished I knew that I had to renew myself. I’ll probably live to be 95, as two of my grandparents were nearly hitting a hundred. How should I spend the next 30-40 years? It made me pondering and making plans and finally I ended up here, he says with a smile.

"Denmark is a highly sophisticated society. Trust and transparency are key. If you want to explore new areas these are basic tools. The Dutch have a lesson to learn from the Danes’ societal success.”

What is the best thing about your work?

“The academic discipline of always asking the big question ‘Why’. Behave like a little kid, be wondered. In academia, I have found what I love the most. It couldn’t’ be any better.”

What do you do when you are not researching?

“Outdoor activities to stop my brain buzzing. I hate sports. You’ll never find me at a fitness centre. But you will find me cycling to the beach. Or hiking with a rucksack. I don’t go for peak performances, but endurance. Long, very long walks – that end up in a pub with a beer and french fries. Is there any more?”