Louise Aronson subtitles Elderhood with the following: Redefining Aging, Transforming Medicine, Reimagining Life. I submit that she focuses primarily on the second of these topics, rather than the other two. And that makes sense because she has many years of experience as a geriatric physician, much of it in a house calls practice.
I’m a former caregiver to my now deceased parents and a person over 50. When I started reading, I hoped for much more about “living my best life” while also being 50+ than about how poorly the U.S. medical system treats the elderly. Aronson writes a stem to stern indictment of both primary care and specialist physicians, medical training practices, hospitals, their staff, and administrators, as well as everything about nursing homes and home care.
Still, it’s best to go into my own elderhood with my eyes wide open, right? And Aronson definitely provides that. Elderhood taught me a tremendous amount about widely ranging topics. And I do mean widely ranging. I made a list of the topics that have stuck with me since finishing the book.
- The realities of being old or caring for someone who is
- Death and dying—the process and honoring people’s wishes
- The “exceptional” elderly, like Oliver Sacks or the author’s mother
- Ageism and institutional bias in medicine
- Doctoring in geriatrics or gerontology—pathologies and philosophies
- Inequities in physician specialties—in pay and prestige, for example
- Physician burnout, and the part EMR (electronic medical record) plays in it
- Proposals for improvement in medical facilities to better accommodate elders
- Proposals for changing how we care for elders (not necessarily better procedures)
- The author’s internal debates about embracing her graying hair
Aronson organizes her topics by the stages of life, starting with Conception, Birth, and Childhood, and continuing through various Adulthood and Elderhood stages, then ending with Death. At the same time she discusses her progression from medical student to doctor, to burnout and reinvigorated physician and writer.
Like a densely-layered cake, she adds patient stories to her own life experiences. And then philosophy, history, science, and many other topics. At times the layer cake threatens to topple with the weight of these varied and intense topics. But I progressed, bite by bite, through her book. I recommend taking your time with this one, in order to really absorb her topics.
Had the chapters been arranged by topic, a reader could review those areas whose content appealed or applied to them. Of course, they would then filter the information through their own lens of experience. But ignoring one part means not seeing the entire picture, as Aronson sees it. Her structural decisions force the reader to see elderhood through her lens, with its specificity and diversity.
This isn’t an easy book. And I mean that in terms of both content and style. Reading about age, declining function, bad medical experiences, and good death was ultimately pretty depressing. But everyone ages. There’s no avoiding it, despite rampant anti-aging culture. Aronson provides a valuable perspective, one I’ll recommend to many people.
Aronson’s writing style doesn’t read easily. She’s spent a career reading medical journals and sometimes it shows in the duller sections. Conversely, her ability to tell the highly nuanced patient stories is terrific. And there are definitely moments when it feels like she’s trying to hard to make philosophical connections.
Nevertheless, if you are her intended audience, I think you’ll like Aronson’s book. Elderhood itself is just as complex as this book, so be aware going in. I’m giving it 3.5 stars, for its depth of content if not always its organization and style.
Thanks to NetGalley, Bloomsbury USA, and the author for a digital advanced readers’ copy of this book in exchange for this honest review.