get anyone except a bored close relative to take the case. To comply,
I arranged an EKG with the hospital cardiology service using my
health insurance to pay for the test. In the EKG lab the technician,
who was nice enough, put the EKG leads on my chest and did the
tracing. She handed me the printout. The printout said, “Abnormal
“What did that mean,” I asked, as my heart, except for a few
premature ventricular contractions, was running at 62 and regular.
“You will have to ask your doctor,” was the reply. She gave me no
clue. I had images of cardiac catheterization, sore and ecchymotic
veins in my groin and then an unsightly pacemaker pouch above
my breast, like many other elderly members at the health club.
When I got to the gym with the ‘abnormal’ EKG in my coat
pocket, Dr. S, a really good cardiologist, was in the locker room. “Can
I show you something?” I asked, “Sure!” he said. He looked at the
tracing. “It’s OK, the jitters are from your chest hairs. The machine
always opines that that’s an abnormal tracing.” The tech must have
known – that’s what she does all day. The hours of anxiety were just
another part of the conspiracy against the elderly.
My next surprise was a letter from the hospital saying that since I
was of a certain age, I must make an appointment for and submit to
psychological testing. The presumption that the elderly have reduced
cognitive function which could lead to significant misadventures in
patient care is part of a cultural prejudice against seniors. In some
societies, the opinions of older persons are considered as wisdom; in
our society these opinions, particularly contrary opinions, are signs
of senility, dementia, or worse, Alzheimer’s disease. Alzheimer’s is
worse than mere dottiness because it implies a physical change in the
brain - tangles, inclusions and other inalterable anatomical features.
So, I was led by a nice lady of a certain age past bland painted
corridors into depths of the Hospital Personnel Department, asked
to sit at a table, required to sign a disclaimer and then was tested
(actually, there is no one to share data with if they should find
anything, my mother is dead and I have tenure in the university).
They proceeded to give me what turned out to be a standard federal
government battery of cognition tests. This meant I had to identify
the sketch of an elephant as an elephant, a bear as a bear, subtract
seven from 100 endlessly, do a timed drawing of a multi-sided box
and remember a string of words, the first of which was “violet” or
“velvet.” By this time, I was bored and failed miserably. Worried that
I might have, at best, age appropriate onset of memory failure or,
at worse, Korsakoff ’s psychosis, I later asked a nurse practitioner
sitting next to me at medical council meeting what to make of my
inability to remember seven-digit phone numbers. She reassured
me that she has to write them down too.
As the year came around again, I got another letter from my
malpractice insurer. This time, it was to be an audiogram followed
by an interview. I evaded the requirement for a referral by asking my
colleague in ENT to arrange the test – did I have exposure to “loud
noises?” Or, “Do you mean like helicopter operations off a naval
ship at sea or target practice in the submarine service, perhaps? Or
perhaps a recent firing range experience where my practice partner
let loose with a handgun next to my head?” The audiogram showed
loss – lots of it!
If these are the continuing indignities of old age, I’ll draw the
line when they ask next year for a colonoscopy.
Dr. Seligson is professor in the Department of Orthopedics at UofL School of Medicine
and practices with University of Louisville Physicians. He specializes in orthopedic
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