*New England Journal of Medicine* (Volume 356, Number 25,
June 21) includes a review of the book *The Art of Aging: A Doctor’s
Prescription for Well-Being* by Sherwin B. Nuland (302 pp., Random
House, 2007. $24.95. ISBN 978-1-4000-6477-9).

The review is by A. Mark Clarfield, M.D., Ben-Gurion University of the
Negev, Beersheva, Israel.

Here’s the review:

As a geriatrician, I am familiar with most of the biological and medical
topics discussed in this book. But as Sherwin Nuland is above all an
excellent and thoughtful writer, I simply enjoyed reading it. The book
does not, it seems to me, speak primarily to physicians or their aged
patients but speaks to anyone interested in human aging. As Nuland
points out, the purpose of the book is “to tell of human aging and its
rewards — and also of its discontents . . . to tell of how best to
prepare for the changes that inevitably demand accommodation, demand a
shift in focus, and demand a realistic assessment of goals and directions.”

Nuland, a retired surgeon who had a long career in general surgery at
Yale-New Haven Hospital and is currently a clinical professor of surgery
at Yale University, has written a number of popular and well-received
books on subjects both medical (How We Die: Reflections on Life’s Final
Chapter. New York: Vintage, 1995) and nonmedical (Maimonides. New York:
Schocken, 2005). Perhaps it was inevitable that as he began to age,
Nuland would turn his formidable analytic and literary skills toward the
universal biological process of aging.

This is not a long book, and it does not try to exhaust the subject of
gerontology. It does, however, touch on many aspects, from the basics of
the biology of aging to the sociology of senescence. Nuland reports on
his interactions with superstars of aging — including Michael DeBakey,
pushing 100 and going strong — as well as with more ordinary people to
show how they have tried (more or less successfully) to deal with their
own aging. This literary device is useful, but the book does not offer
enough examples of the many unfortunate people who feel defeated by
their old age or who just hang on by the skin of their increasingly
loose teeth. Given that Nuland has written an award-winning book on
dying, I was surprised that so little of this book deals with the
subject — one of the many concerns of older people, their caregivers,
and (though perhaps not often enough) their physicians.

Nuland builds a strong case for the “use it or lose it” school of
thought, and he gently but effectively debunks the notion that the human
lifespan may be increased to hundreds, if not thousands, of years.
Nuland, along with most gerontologists, thinks that such a lifespan
would render our world unlivable. His critique, primarily ethical and
sociological, is convincing.

The Art of Aging offers a lot of good advice and thoughtful ideas for
the interested lay reader, and it wouldn’t hurt for doctors to read the
book — especially those who hope to reach a healthy old age themselves.
They could do worse than to recommend this fine work to their patients,
especially to baby boomers, who are not likely to go so gently into that
good night. Those who take Nuland’s advice will be spared a lot of grief
as they age.

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