“Don’t make up some BS phrase that also weirdly blames the victim.” It turned out plenty of doctors have had the same thought. “Just say you have no f-ing clue what happened,” Fischer said. It tends to be written into the medical charts of older adults, sometimes without the patient or family being told. patients seen in 2021, some 126,000 of them had “adult failure to thrive.” Look only at hospitalizations, and the fraction gets larger: 1.5% had been assigned this code. But in a dataset from health-records giant Epic, among 65 million U.S. Some physicians say they haven’t heard the phrase in years.
No laughing detective agency code#
The term is official enough to have a code in the American version of the International Classification of Diseases - R62.7 - and common enough for medical coders to know that code by heart. What did it even mean? Fischer looked it up, only to find that it could mean a whole bunch of different things - a slippery phrase in a realm where things were supposed to be definite, measurable. To say he’d failed to thrive sounded judgmental. It sounded mechanical, biological - a body giving out, as everyone’s eventually would. To say he’d died of probable aspiration was one thing. It reduced him to an old man in a memory care home, no longer able to do anything of value. “Adult failure to thrive” brushed those sorts of stories aside.
He’d jotted down similar observations about his own son, a black binder that would end up packed away with Seth’s childhood artwork. As a graduate student, he’d raised a rhesus monkey in his cramped apartment, naming her Frodi, taking careful notes. He’d encouraged kids to act as little scientists, collecting evidence about the world. His dad had been a developmental psychologist. As if old age were a test his father had failed. Those words made it sound like the illness had been his dad’s fault. You’ve got to be kidding me, Fischer thought. There, among the contributing causes of death, was “adult failure to thrive.” It was May 2020, a month after his father’s burial. He was sitting in his Los Angeles apartment, trying to put his loss into words when the document arrived from his stepmom. The death certificate conveyed the same sentiment, a kind of official shrug. I don’t want to be offensive, someone from the health department had said, but he’s already dead, what good’s it going to do? He’d requested a post-mortem coronavirus test, and had been told there weren’t enough. He would go for runs, only to find himself passing the white bulk of mobile morgues, refrigeration whirring - and his mind would end up back on his dad, in respiratory distress, dying of Covid or Alzheimer’s, he’d never know which. Seth Fischer was already angry: a physical feeling, an overwhelming internal buzz. The death certificate made everything worse. Exclusive analysis of biotech, pharma, and the life sciences Learn More
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