The numbers are right there in the book's introduction: By 2030 there will be 72 million people in the United States over age 65, and 10 million of them will be over 85 years old. But "Memory Lessons" isn't quite a policy paper, although it does offer some sobering data on how poorly equipped our infrastructure is for aging baby boomers' needs. Nor is it a manual for adult custodians of the previous generation, although author Jerald Winakur, a gerontologist with 30 years' experience, provides an inspiring model of a man caring for his elderly parents. Rather, "Memory Lessons" is a frank memoir about one man's struggle to manage his father's debilitating Alzheimer's while navigating the ethical and practical perils of a career in medicine.
Beginning with clear, unsentimental family history, Winakur recalls his father's doomed pawnshop in Baltimore and his family's financial struggles. Thrust prematurely into the role of provider for his unemployed parents, Winakur attended medical school during a transformative time in medical science. He tells his story with the sort of elegant prose that puts him in the ranks of Jerome Groopman or Atul Gawande -- that rare physician who can frame the byzantine machinations of his practice in terms the rest of us can understand.
The story of Winakur and his father is heartbreaking, and yet they are among the relatively fortunate -- an experienced gerontologist ideally positioned to get his father the best care possible. Their plight is cast against a grimmer big picture: a nation of seniors whose physical, cognitive and emotional faculties are failing them, and a nightmarishly underfunded and shorthanded infrastructure to act as safety net.
Winakur's narrative voice is measured and thorough, taking the reader through the many mistakes and lessons of a career in medicine, mourning the patients he was unable to save and cursing the system that occasionally failed them. He unflinchingly describes the dark realities his profession would rather forget: the high suicide rate among physicians; the guilt that can haunt a doctor for years after a patient's death; Big Pharma's terrifying grip on the health care system.
Every memoirist must find a framework upon which to place his or her life's story. For Jerald Winakur, his father's decline is that framework, bearing up the book's larger themes: father-son relationships, career ambitions, a nation's late-20th-century loss of innocence. Yes, "Memory Lessons" is a book about Alzheimer's, but in a broader sense Winakur is tackling the same fundamental problems that all great literature addresses: How do we give our lives meaning, minimize suffering and love one another? "We have a slim window of opportunity to transform America before our golden years crush us," he writes. "What a difference we can make before we go."
Jake Mohan of Minneapolis has written for Utne Reader and City Pages.