Rethinking Aging. Nortin Hadler.

Hadler N. Rethinking Aging. U of N Carolina Press 2011. N;04/12.

I’m of two minds about this interesting book. Mind one: he gets it. Understands that we have a deadly medical system that arrogates everything unto itself, and in doing so changes all and everybody into an illness and a patient. And of course I envy his terrific success with previous books. He’s not just a pretty good writer, but is also one of those iconic American medical giants. Important man, important message. He characterizes frailty correctly, and bravely adds the characteristic nobody wants to talk about: it is a stage of life to which there is no successor. What a nice way of putting the “life’s a bitch, then you die” message.

Then there’s mind two. I find the book disorganized and stuffed in parts with irritating filler. It starts out with that great American medical mystique, trademark of US medical authors, by way of introduction ere we get into the content itself. It’s the medical family, tough times and how difficult the training is, and the same self-congratulation we get from Abraham Verghese: doctors are Olympian mystical beings who once having got their MD can never again exist in quite the same world as everybody else. Why can’t somebody this sophisticated and visionary about the system’s falsehoods and weaknesses see what he’s doing ?

Not letting myself get too annoyed with that, the introductory chapter completely hooked me. It slides gently into skepticism about fixed beliefs: prevention, stents, drugs drugs drugs, exercise, and (yes) diet. Brave and true. But then he veers off into a bit too much science, discussed as though the reader is accustomed to processing academic information. To me there isn’t enough explanation for the layperson of its machinery, and that ellipsis (again how could he miss it?) smacks again of elitism: what, you can’t critically read academic papers? Two choices: believe me ’cause I know what I’m talking about, or drop everything and apply for medical school.

And after that I’m afraid things start to fall apart and the book slowly comes to resemble a lumber pile: bits and pieces of textbook rheumatology (Dr Hadler’s specialty although from a radical and skeptical perspective), and some not-directly-related amateur political philosophy. Is this in some way what readers want? Or is what they want a book by Hadler they can say they read? I get the feeling a successful author was sold a hot topic idea by a publisher, got given a deadline, and hurried to produce something not adequately thought through or for that matter edited. There could be all sorts of other things going on here but that’s the way it feels to me. And maybe it doesn’t matter, because most readers will just think they’re too dumb to follow the “thinking”, be glad of the medical content, a bargain at 30 bucks, and put the book away for future reference. Pretty much the same experience I had: getting bored and skimming or skipping a lot of the clinical textbook filler.

Careful, John, says my self-interested self. Nobody will read this review of course but if Dr. Hadler ever did, I suppose I could lose some potential endorsement of something I might write, and annoy someone who agrees with my views. Such people are few and far between. Still, it’s like a very expensive wine with an old impressive label that’s unexpectedly a bad bottle. I haven’t yet read any of his other books, and they may be wonderful. An d anyway isn’t somebody like Nortin Hadler entitled to a corked howler maybe one in ten? But somebody like me is entitled to call it as I see it, and I’m afraid although it has its moments overall I’m put off by the smell. 5.5.

About John Sloan

John Sloan is a senior academic physician in the Department of Family Practice at the University of British Columbia, and has spent most of his 40 years' practice caring for the frail elderly in Vancouver. He is the author of "A Bitter Pill: How the Medical System is Failing the Elderly", published in 2009 by Greystone Books. His innovative primary care practice for the frail elderly has been adopted by Vancouver Coastal Health and is expanding. Dr. Sloan lectures throughout North America on care of the elderly.
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