"The Art of Aging"

There was an article by Atul Gawande in the April 30 New Yorker ("The Way We Age Now") that I found pretty depressing, but two letters in the May 28 issue perked me up. (I just read them today.) I'll type them here for your edification (I can't find them online I don't have a scanner and OCR at home) (emphasis mine):

The mainstream of geriatric research over the past twenty years has shown that the way we age is largely a consequence of life-style choices, and that a much higher quality of life is available to almost anyone who is willing to work at it. . . . The message of our book, "Younger Next Year," is that most American aging is optional. The science is compelling: exercise, decent nutrition, and emotional and social connections are biological interventions that exceed anything medicine has to offer, reversing most functional aging and giving us strong odds of living well until the end. Be we are ignoring that message. As of 2001, only a third of Americans were getting even the minimum recommended exercise, and fewer than three per cent were following federal dietary recommendations fully. In this context, training more geriatric specialists, urgently as they are needed, is not the solution, any more than training more surgeons to staple stomachs is the solution to our obesity epidemic. It is up to us, as individuals and as a society, to take charge of aging. Most of us can expect to live out our lives with quality and dignity--if we choose to.

Henry S. Lodge, M.D.
Assistant Professor of Clinical Medicine
Columbia University College of Physicians and Surgeons

Chris Crowley
New York City

Gawande concludes that there will not be enough geriatricians to care for the large increase in the number of older Americans in coming years. As a geriatrician, I have spent more than thirty years caring for older people, developing clinical and academic programs, and studying the issue of aging; I agree that the way to best prepare our nation for the coming elder boom is to contribute geriatrics training to the education of all medical students, residents, and practicing physicians. It is also important to point out that some of the decrepitude Gawande [who is not a geriatrician, by the way] attributes to aging is actually a function of disease, not aging per se. Upon closer inspection, though, many of the negative phenomena attributed to aging are a result of subtle disease, environmental effects, diet, and behavior, all of which are modifiable.

Richard W. Besdine, M.D.
Chief of the Division of Geriatrics
Rhode Island Hospital
Director of the Center for Gerontology and Health Care Research, The Warren Alpert Medical School
Brown University
Providence, R.I.