Published 1 February 2011.
I very much enjoyed reading How We Age: A Doctor's Journey into the Heart of Growing Old. (2011).I found Agronin to possess a great blend of intellect, spirit and emotion as he moves from describing very specific incidents with patients and very general observations about the process of aging.
Dr. Marc E. Agronin graduated from Harvard and then Yale Medical school before becoming a psychiatrist at the Miami Jewish Helath Systems.
He combines viewpoints from the sciences, social sciences and the humanities to describe what he sees while working with people in their 70s, 80s, 90s and 100s.
Agronin does focus a great deal on what he labels "The Four Horesmen of Old Age": depression, dementia, delirium, and destitution.
But his book is not all gloom and doom. He also describes older adults experiencing laughter, healing, restoration, intimacy, legacy, and insight in their final chapter of life.
As a psychiatrist, he is trained to heal both the mind and the body. He does use talk therapy and shows a great understanding of the interplay among overlapping constructs of the brain, the mind, emotions, identity, and memory.
Agronin also describes the delicate nature of treating older adults with prescription medications. Because their bodies are frailer and they often have many chronic diseases if not terminal diseases, a change in prescriptions or even a small change in dosing can disturb the precarious homeostasis of an aging body.
Agronin also describes other realms of living such as physical health, social support systems, living arrangements, finances, spirituality, personal history, and identity.
His book contains 25 chapters in the body of the book with some front matter and back matter.
The book is too rich for me to summarize thoroughly, so let me just highlight a few chapters:
In "Old Pickled Brain," we meet a very wealthy man who achieved great success in his vocation by being narcissistic and aggressive. He also had problems with mental illness, infidelity and substance abuse. He was completely out of control when Agronin met him as a patient. Things only got worse. I won't spoil the ending by telling you how everything unfolds--except this cranky old business man insisted that Agronin write up his story as a case study for the benefit of others. I was riveted with every detail about his treatment.
In "The Elders," Agronin describes the phenomenon of achieving wisdom in advanced age. There are a lot of details and concepts in this chapter. In order to give shape to his ideas, Agronin organizes his observations around the life, career and aging process of George S. McGovern. The ideas transcend this one man's experience, but it's an interesting anchor.
In "The Seamstress," we meet Emma, a woman who had a very difficult life and a very difficult death. Despite his training as a physician and his far-ranging reading in the humanities and social sciences, Agronin really struggles to connect with Emma. As he yearns towards her and aches for her, we see tenderness and poignancy in realizing that we can't always connect with others or make others' lives fit into an ideal we have prefabricated.
I have read more than a hundred books about aging in the last few years, and How We Age is a clear member of my "Top 10 Best Reads on Aging" for its mix of story and science, detail and concept, hardship and hope.
Related:
Books on Aging
Books about the Brain
Theft of Memory: Book Review
Is It Dementia or Delirium?
