Aronson, Louise. “Elderhood: Redefining Aging, Transforming Medicine, Reimaging Life”, Bloomsbury, 2019.
Many of us do not want to think about getting older much less talk and/or read about it yet it is a fact of life. We do not see ourselves as older and we certainly not anxious to talk about aging. Not so long ago, I went to an alumni reunion— the 50th anniversary of being awarded a higher degree. My sister who is 20 months younger than I picked me at the airport. I had not seen her for about five years and I thought to myself that she is getting old and then I went to the reunion and had the same thoughts about most of the alumni there who had been my classmates. Of course I realized that if they looked old, so did I.
For more than 5,000 years, “old” has been defined as between the ages of 60 and 70. If that is true, most people alive today will spend more years in elderhood than in childhood, and many will be elders for 40 years or more. However, now that humans are living longer than ever before, old age has become something of a disease, “a condition to be dreaded, denigrated, neglected, and denied. “
Author Louise Aronson uses stories from her years (25) of caring for patients, and takes from history, science, literature, popular culture, and her own life to give us a vision of old age that’s “neither nightmare nor utopian fantasy”. Her vision is full of joy, wonder, frustration, outrage, and hope (about aging, medicine, and humanity itself).
I don’t like to admit it but I am old. I see it and I feel it but I try not to let it stop me from doing what I love. Aronson’s empathy, knowledge, and reporting skills give us a look at how today’s elders are treated. Her examination of aging and the human condition is full of poignant stories as well as the viewpoints of medical experts, writers, historians, and scientists. Her knowledge is first hand, gleaned from her professional work as a geriatrician, her personal experience as a daughter, her common sense, and her analysis of our social supports and cultural messaging.
This is an honest and humane analysis of what it means to grow old in America. The book is part memoir, part history, and part social critique. Aronson is sharply critical of the “anti-aging industry” that has tried to turn being elderly into some sort of disease. She tells us that “life offers just two possibilities: die young or grow old.” Here is a book for those who want to grow old and stay human while doing so. “Elderhood” looks at why aging must be understood and redefined and why the medical establishment’s usual goals of saving lives and curing disease is misplaced and ill-advised for many older patients. Successful aging is possible for those who do not perceive meaning in aging itself, but instead, find meaning in being themselves in old age. Of course, adaptability and self-acceptance are required.
Dr. Aronson tells us that most doctors view medicine from the viewpoint of youth. All but a few medical studies use subjects who have not yet reached 65 years of age. Very few doctors choose geriatrics as their specialty, opting instead to work in more lucrative fields where the prognosis is generally for improved health and vitality. Doctors dealing with the problems of the elderly are more likely to observe patients who are declining in health and who are becoming more fragile.
As we age, our blood pressure, glucose and cholesterol levels often become elevated. Thinking that these conditions are going to decrease life expectancy, doctors are prone to prescribe medications to counteract the effects of aging but that can also produce serious side effects that reduce the quality of life for the older patient. Many surgical procedures, should be last resorts to be used only when they are necessary to save the life of the patient.
As we grow older, we lose our independence, become isolated from family, and lose friends to death. As a result, our lives seem to have less meaning and our days become dreary and long. Surgery and medications do nothing to counter these negative aspects of getting old. What we need is greater understanding of the aging process and an easing of the downsides of aging.
Aronson’s book is also an autobiography centered on her life experience and medical career and a critique of geriatrics, American medicine and of how our society deals with aging. She shows us a medical system that is “almost caste-ridden” in its hierarchy of specialties, in which geriatrics is low-rated, as well as American medicine’s fragmented approach to patients, funding, medical training and hospital vs. home care. She shares the shortcomings and the horrors of senior acute care and senior facilities. She explains the gap between doctors’ objectivity and simply “not caring” and a lack of imagination. And she shares some surprises as well but you will have to read the book to find them.