OPINION
DOCTORS' Lounge
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DON’T CALL ME Shirley
Mary G. Barry, MD
Louisville Medicine Editor
[email protected]
C
all me Elder.
As of Groundhog Day, I offi-
cially hit Medicare age. God only
knows what Medicare will be like
by the time I use it; this is just one
of the worries you have when you turn 65.
As an internist, I discuss problems of ag-
ing on a daily basis with many different peo-
ple. I have found it useful for us to estimate
the varying ages of our parts. My knees, for
instance, are quite a bit older than my head,
but not quite as old as my wrists, which re-
mind me regularly of 40 years spent writing
and typing. My patients’ estimate of their
various components’ ages is a good way to
focus on the issues important to the visit.
My friend, Dr. Diane Schneider (UofL
class of ’84), is a fellow internist and also a
geriatrician and geriatrics researcher. She
uses the term “Senior.” She taught me about
the “young elderly” and the regular “elderly”
and then the “very elderly,” but those terms
are cumbersome for daily use and better for
research purposes. Most people agree that
if you are 90, you are definitely entitled to
be called Old, but whether you want to be
called that is another matter.
Maggie Kuhn, who in 1970 founded the
Gray Panthers, preferred to describe herself
as an “old woman.” Nowadays we would say
“owning it.” She believed that using other
words was euphemistic and false. She be-
lieved that we become less and less visible
to others as we age, a statement I agree with.
My skin crawls when someone addresses a
patient as “young lady” when she is clearly
bent, wrinkled and deaf. The person who
does this thinks it is a compliment. I view
it as dismissive, a verbal way to pat some-
one on the head; it diminishes rather than
recognizes.
Maggie Kuhn said that calling us Old is
a way to draw attention to our real selves.
Calling us Old claims our place in society
and focuses attention on what we need as we
age. When she founded the Gray Panthers,
she made it multigenerational on purpose,
to address social issues of concern to all
of us, with the slogan “Age and Youth in
Action.” After all, one hopes that the young
will become the old, eventually, and still be
fighting for what is needed. Over the years,
the Gray Panthers have fought successful-
ly to preserve Medicare, to reduce credit
discrimination against the old, to ban the
mandatory retirement age, and to improve
care and oversight in nursing homes. Cur-
rently they have a global focus to protect the
rights of the aging, working in concert with
the United Nations. Naturally, one may join
them on Facebook, Instagram and Twitter.
Ms. Kuhn, who lived to be 89, fought
ageism as a tool of discrimination. We have
to challenge our assumptions, she said.
In medicine, that is particularly vital.
Thinking of a person that you take care of
as ancient and broken down and frail might
simply be truthful. But assuming that every
part of that person is in equally bad shape is
usually a mistake. If you are a young physi-
cian, you may have misjudged a merely sick
old person as a decrepit wreck, and allowed
yourself to think that she no longer needs
intense diagnostic efforts or treatment.
It is far better to think of a person who
is old the same way as you think of a person
who is young. Who are they? What do they
do? What can’t they do because of this ill-
ness or injury? What support do they have?
What are they afraid of? Where do they
hurt? Most importantly, what is their goal
of treatment? Knowing what we are trying
to accomplish here, and defining it well, puts
doctor and patient both on the same page.
(continued on page 28)
FEBRUARY 2018
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