In his lifetime, Robert N. Butler wore a lot of hats: physician, gerontologist, Pulitzer Prize-winning author, founding director of the federal government's National Institute on Aging. But perhaps Butler's biggest impact on the lives of older Americans was his coining of the term "ageism." He used it to describe prejudice, discrimination and abuses committed against the elderly in a 1969 article that he wrote for The Gerontologist, a medical journal.
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Butler was one of the first to perceive the denigration, mistreatment and systematic exclusion of older people on a massive level, and to equate it with discrimination and stereotyping because of race, ethnicity or gender.
Moreover, he saw the widespread dismissal of older people as "geezers" or "codgers" who were incapable of working, caring for themselves or experiencing sexual intimacy as a "psychosocial disease" that harms not just them, but society as a whole.
"Prejudice against age is a prejudice against everyone," he once wrote. "We all chance to become its ultimate victims as longevity increases."
Butler saw a better way. He championed the notion that older people had valuable insights and experience to contribute to society, and that if afforded the opportunity, they could continue to lead productive, fulfilling lives.
Butler's interest in older people — and his affection for them — began early in life. The native New Yorker's parents separated when he was just 11 months old, and he was raised by his grandparents in New Jersey. After serving as a Merchant Marine during World War II, he earned undergraduate and medical degrees at Columbia University and did a residency at the University of California-San Francisco hospital.
During his medical training Butler was shocked to hear professors refer to older patients as "crocks" — boring patients with big, thick medical charts. Worse yet, he once recalled, "every effort was made to introduce us to middle-aged and younger patients, but older patients were considered to be beyond help — in other words, not teaching material."
That attitude didn't make any sense to Butler because as a hospital intern, he had a large portion of elderly patients. Butler realized that people were living longer, a fact that demographers would confirm. (In 1900, the average American could expect to live just 49.2 years; by 1961 the number had reached nearly 70. He had his first inklings that both health care and society as a whole needed to adjust to that new reality.
Another profound influence on Butler's thinking was a landmark 1963 study of older patients. It found that many of the symptoms previously attributed to aging were actually the result of diseases, some of them treatable. To Butler, that made obsolete the conventional view of aging as a disease.
Instead, he saw, it was a normal stage of life. And while older people were at more risk for diseases such as Alzheimer's, diabetes and osteoporosis, age wasn't the primary cause of these maladies, and it was possible for an older person to remain healthy.
Those ideas stuck with Butler, and he nurtured and developed them further throughout his career. He took his first job in 1955 as a research psychiatrist at the National Institute of Mental Health, where he studied the effect of aging on the central nervous system. He continued working with the elderly for the U.S. Public Health Service and as a researcher at the Washington School of Psychiatry in the 1960s, where he helped pioneer the new medical field of gerontology, which focused upon aging. After Congress established the National Institute on Aging in 1974 Butler was a natural choice as founding director.
Around that time he also published his book-length manifesto, Why Survive? Being Old in America, for which he was awarded a 1976 Pulitzer Prize. In 1982, he moved to Mount Sinai School of Medicine, where he established the first-ever medical school geriatrics department, and in 1990, founded the International Longevity Center, which is now part of Columbia's Mailman School of Public Health.
Butler himself provided proof of his view that older people could lead productive, healthy lives. Into his 80s, he continued to publish books, still worked 60-plus hours a week and continued to see patients, and exercised daily. "I can't imagine being retired," he once explained. "There's too much to do."