Robert N. Butler, MD

Robert N. Butler, MD: Visionary of Healthy Aging

W. ANDREW ACHENBAUM
Copyright Date: 2013
DOI: 10.7312/ache16442
Pages: 288
https://www.jstor.org/stable/10.7312/ache16442
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  • Book Info
    Robert N. Butler, MD
    Book Description:

    Robert Neil Butler (1927--2010) was a scholar, psychiatrist, and Pulitzer Prize--winning author who revolutionized the way the world thinks about aging and the elderly. One of the first psychiatrists to engage with older men and women outside of institutional settings, Butler coined the term "ageism" to draw attention to discrimination against older adults and spent a lifetime working to improve their status, medical treatment, and care.

    Early in his career, Butler seized on the positive features of late-life development -- aspects he documented in his pathbreaking research on "healthy aging" at the National Institutes of Health and in private practice. He set the nation's age-based health care agenda and research priorities as founding director of the National Institute on Aging and by creating the first interprofessional, interdisciplinary department of geriatrics at New York City's Mount Sinai Hospital. In the final two decades of his career, Butler created a global alliance of scientists, educators, practitioners, politicians, journalists, and advocates through the International Longevity Center.

    A scholar who knew Butler personally and professionally, W. Andrew Achenbaum follows this pioneer's significant contributions to the concept of healthy aging and the notion that aging is not synonymous with physical and mental decline. Emphasizing the progressive aspects of Butler's approach and insight, Achenbaum affirms the ongoing relevance of his work to gerontology, geriatrics, medicine, social work, and related fields.

    eISBN: 978-0-231-53532-8
    Subjects: Sociology, History, Psychology, Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. PREFACE
    (pp. ix-xvi)
    Robert Neil Butler
  4. ACKNOWLEDGMENTS
    (pp. xvii-xx)
  5. one LIFE REVIEW
    (pp. 1-24)

    “Life review” has become a standard method of working with older people in clinical settings and adult learning centers. Life review gives older people an opportunity to arrange the threads of their biographies. They can review afresh both the primary and dystonic motifs that become manifest in the process. Ideally, life review—rarely a one-time exercise—prepares subjects to face finitude with equanimity, possibly to tie up loose ends in representations of self and relationships with others.

    I start with life review because Butler, at age thirty-six, stressed its value for treating the aged—even those abandoned in nursing homes....

  6. two THE FORMATIVE YEARS
    (pp. 25-46)

    Although in life reviews Butler downplayed the childhood trauma he experienced, he endured significant hardships growing up in the Great Depression. He suffered extended bouts of poverty, separation from parents, a grandfather’s sudden passing, and his own brush with death. Yet there was enough love, happiness, and social support—provided by elders, teachers, a doctor, friends, and kindly strangers—to sustain the child’s self-confidence in his ability to thrive, not merely survive. He went on to excel in high school. A stint in the Merchant Marines demonstrated his grit and leadership potential.

    Hard knocks prepared Butler for the Ivy League....

  7. three A PROFESSIONAL APPRENTICE
    (pp. 47-68)

    Butler’s decision to become a gero-psychiatrist was an unusual career path in the 1950s. Most psychiatrists treated children, adolescents, and young adults; mental illnesses afflicting the aged attracted little interest. Concurrently, psychiatry was undergoing a paradigm shift in America after World War II. Medical schools were revamping core curriculums and modifying residency requirements to take account of the explosion of knowledge in post-Freudian theories, specialists’ appreciation of the neurobiology of psychiatric illness, and the advent of alternative methods of treatment (Haak & Kaye, 2009). The federal government’s increasing interest and investment in research and training in the mental-health arena opened career...

  8. four FORGING WASHINGTON CONNECTIONS
    (pp. 69-90)

    Between 1963 and 1975, from his departure from the National Institute of Mental Health to his start at the National Institute on Aging (NIA), Butler benefited greatly from living and working in Washington, D.C. During this period he coined the term “ageism” and wrote Why Survive? Being Old in America, for which he won a Pulitzer Prize. He earned respect as a smart, compassionate, and versatile physician with a knack for advocacy. His sudden metamorphosis from professional apprentice to gerontological insider caught even Butler by surprise. After all, he was primarily a practicing psychiatrist who supplemented his income by teaching...

  9. five BUTLER AT THE NATIONAL INSTITUTE ON AGING
    (pp. 91-114)

    Interviewing Butler in 1976, shortly after he assumed responsibilities at the National Institute on Aging (NIA), an official from the American Hospital Association characterized the founding director as “militant and mild, aggressive and compassionate; he is the ideal physician-scientist to take on the heavy responsibilities that confront elderly Americans” (Lesparre, 1976:50). To his new post Butler brought vision, energy, passion, tact, and survival instincts. Over the next six years he would deploy skills and stratagems that he had refined as a scientist, psychiatrist, and advocate. He knew how to communicate to powerbrokers in Washington, D.C., as well as to lay...

  10. six EXPANDING THE SCOPE OF GERIATRICS
    (pp. 115-138)

    Prior to 1978, wrote William R. Hazzard, geriatric education in postwar America “had no recognition as a specialty by the American Board of Internal Medicine and no designated training programs for faculty development or clinical geriatrics training” (John A. Harford Foundation, 2005). Hazzard created training programs at the University of Washington, Johns Hopkins, and Wake Forest schools of medicine, but he might have added that prior to 1978 there were no geriatrics departments in any U.S. medical school or model-care program. Nor was there a prescribed course of study for licensing nurses or credentialing social workers, dentists, and public health...

  11. seven RECASTING THE NEW GERONTOLOGY THROUGH THE INTERNATIONAL LONGEVITY CENTER
    (pp. 139-164)

    Chairing discussions about productive aging at the Salzburg Seminar in the early 1980s heightened Butler’s sense that he and fellow idea brokers in gerontology should be addressing major aging-related issues on an international scale: “My own long-standing interest in the relationships among aging, productivity, and health was reinforced in no small measure by experiences gained during travels to different countries, Japan and the Soviet Union among them” (Butler & Gleason, 1985:xi–xii). Butler saw merit in inviting experts in the United States and abroad to meet to exchange strategies for tackling global issues such as income security, health promotion, and ageism....

  12. eight AMERICA’S AGING VISIONARY
    (pp. 165-188)

    At age seventy-nine, Butler reported in 2006 that he had started to take better care of his physical health after his wife Myrna died:

    Since her death, I’ve been very protective of myself, quite purposively. I go to bed earlier. I’ve been more thoughtful about my diet and activity levels. I pace myself. On weekends, I have this walking club. A whole group of us walk six miles through the city. I feel like I have to take care of myself. I still have work to do. And it’s important work!

    (Dreifus, 2006)

    Robert Butler always enjoyed very good health,...

  13. EPILOGUE
    (pp. 189-198)

    “Now we have both past work as a foundation and new scientific tools offering hope that we may soon have a more prolonged, vigorous, and productive life and added longevity,” Butler predicted in The Longevity Revolution (2008:187) . “During the twenty-first century, the century of the life sciences, longevity science should truly come of age.” Determining the best approaches to harvest the fruits of Butler’s productivity becomes ongoing legacy work for current and future students of human aging.

    Our task is to build on Butler’s capacious and optimistic vision of aging, in which young and old would grow into healthful,...

  14. appendix: PROLOGUE OR INTRODUCTION TO LIFE REVIEW
    (pp. 199-218)
    ROBERT N. BUTLER
  15. REFERENCES
    (pp. 219-252)
  16. INDEX
    (pp. 253-268)