A BITTER PILL by John Sloan, M.D.
Greystone Books, Toronto, 2009. Reviewed by William Sheridan.
The North American population, along with the rest of humanity, is aging at a predictable rate. Longevity is increasing, and the median age is on the rise. The United Nations predicts that the challenge of aging will be one of the most important social issues of the 21st century. Most countries are NOT adequately preparing for this challenge.
Amongst the elderly, some are healthy and robust, but many are not. Dr. Sloan visits and attends to those seniors who are both frail and ill. Their numbers will only grow as longevity continues to increase and medical intervention continues to innovate. Regrettably however, conventional medical practices do NOT serve the needs of the frail.
As Dr. Sloan sees it, there is a radical disconnect between the methods of conventional medicine and the needs of the frail elderly. In most cases these people are suffering from multiple pathologies, their systems can no longer benefit from standardized medication, and their primary concerns are to maintain simple functions and gain some degree of comfort. More tests, more procedures, more drugs – none of these will any longer help.
What WILL help is to listen effectively to their articulated needs, and administer the kind of assistance that will restore functioning (walking, eating, etc.) and produce comfort (easing pain and constant worrying). None of this is really very hard to do – BUT it will only likely happen in the context of an understanding of both the benefits AND the limits of conventional medicine.
This is the case that Dr. Sloan makes. The available evidence clearly indicates that his is correct. The demographic trends now underway suggest that the current situation will only worsen. Both medical care givers AND the elderly themselves need to read this book, and then pass it onto someone in a policy-making role. Only through the coordinated actions of the elderly, medical practitioners, and health policymakers can the true needs of the frail elderly be administered to, and the costly misapplication of resources be corrected.