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Our Parents in CrisisOLD AGE IS NOT A DIAGNOSIS
So Get Your Ass Off The Cot

In his tell-all memoir, “Becoming a Doctor: A Journey of Initiation in Medical School,” Melvin Konner recalls a lecture by a gerontologist who “had been brilliant, outrageous, and funny.” The star lecturer spoke during Konner’s preclinical years, when medical-school students are fire-hosed by information, but not yet burned out on patients and the demands of their upper-class clinical rotations.

This exceptional gerontologist, Konner relates, “used to shout at us, ‘You think life expectancy is threescore and ten! You think old people are supposed to die! You’re lying there at three A.M. in the on-call room and your beeper rings. There’s a patient in the E.W. with chest pain. It’s an eighty-two-year-old man! You do a lightning calculation. This guy’s life expectancy is minus twelve years! You turn over and go back to sleep.

“‘Well let me tell you something! This guy’s life expectancy is not much different from that of a sixty-five-year-old. This guy’s life expectancy may not be much different from yours! This guy is a survivor! He’s here at eighty-two because he’s tough! And he’ll be here at ninety-two for exactly the same reason! So get your ass off the cot and down to the E.W. and save his goddamn life!’

“. . . This brilliant man,” Konner reflects, “had indelibly impressed on us that old people are not sick because they are old. They are sick because they are sick. Our job is to find out what is wrong with them. Age has no bearing on how much someone deserves a diagnosis, and old age is not a diagnosis. Even the slightest shift in expectations, based solely on age, could bias us and become a dangerous, unprofessional, self-fulfilling prophecy.”i

I have spent more than 12 years as a healthcare advocate, companion, sounding board, and watchdog for my parents. Thanks to these two remarkable people, I intimately understand that old age is not a diagnosis. I also know how hard it can be to get a doctor’s ass “off of the cot” because of ingrained ageist thinking.

In my advocacy, I have encountered the expectations, biases, and dangerous and unprofessional prophecies that are rooted in medical ageism. I’ve also encountered the pitfalls of today’s highly specialized and fragmented U.S. healthcare system: the disconnections between physicians; the lack of continuity in treatment; the costly errors and misdiagnoses, and so many more failings than even I, a skeptical lawyer, journalist, and daughter of two physicians, ever imagined.

If a doctor ever asks you, one of your parents, or another older loved one, “What do you expect at your age?,” ask him or her, “What do you expect?,” and then find another doctor. Life is hard enough without having to put up with ageist nonsense from people who should know better.

Old age is a fact in a story that differs among storytellers. Here is mine.

_______________________________

i. Melvin Konner, Becoming a Doctor: A Journey of Initiation in Medical School (Penguin Books, paperback, 1987), pp. 303-04. Konner was a 35-year-old Harvard professor of anthropology when he decided to pursue a medical degree and enrolled at (thinly disguised) Harvard Medical School. He never practiced medicine.

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