‘I hated adult hospitals, and adult medicine and adult patients’: Chris Adrian’s ‘A Better Angel’ and American medicine’s anxious relationship to ageing

American author-physician Chris Adrian’s short story ‘A Better Angel’ (2006) explores US healthcare’s problematic relationship to ageing and death and how this is shaped by its ‘cultural infatuation with youth’. The story follows the immature and feckless Dr Carl as he becomes a reluctant companion to his dying father. Paediatrician Carl is a junkie who has cheated his way through medical school, despite the constant presence of a hypercritical guardian angel. Though he is a doctor, Carl abhors the adult world and its association with ageing, frailty, and vulnerability, declaring he hates ‘adult hospitals, and adult medicine and adult patients’. Terrified of the ‘emotional contagion’ that interdependent relationships demand, medicine ironically becomes the perfect haven for a man who despises responsibility and obligation. I argue that the depiction of childhood, parent–child relationships and the elderly in Adrian’s story makes visible how youth and ageing are one of the binaries upon which the discourse of American medicine depends. An ‘Impaired Physician’, Carl deploys the compartmentalised culture of modern medicine to maintain a barrier between himself and what he considers to be the ugly side of human existence that entails dependence, decline and the inevitability of death, reflecting Alan Bleakley’s claim that ‘modern medicine is like a spoiled child who becomes unable to develop adult caring and warm relationships or emotionally satisfying collaboration’.