Louisville Medicine Volume 67, Issue 10 | Page 8

FEATURE THE GOLDEN AGE AUTHOR David Seligson, MD I looked down at my forearm – it was bleed- ing. One advances in a medical career by being compliant; compliant means not making waves. So, I dutifully reported for the annual mandatory tuberculosis (TB) screening and after filing out the paper- work, took a seat in the waiting room. Finally, an employee not known to me applied the required subcutaneous dose to my forearm – no Band-Aid. A drop of blood wandered toward my hand, enough perhaps to create a problem if I tried to scrub in. It was a bright, blue-sky day but this medical testing made me feel old and used. Today TB, tomorrow whatever. It was not productive to muse how many times this annual Mantoux test ritual produced a positive result in Native American physicians with no exposure to TB. Some assistants who had Bacillus Calmette–Guérin as children and took a diluted test with the false promise of no reaction, wound up with ugly sores that lasted for weeks. TB testing is an exercise in the executive power of institutions mobilizing their army to send notices, threatening emails and even 6 LOUISVILLE MEDICINE certified letters to get a job done that does not need doing—another reminder that it is no treat to grow old. Where are the results of this activity? What is the cost-benefit analysis? It is not entirely unexpected that a certain amount of indignity comes naturally with older age. I spent three hours between flights in the Sky Lounge in the Atlanta airport trying to register for a security clearance program that required fingerprints. No amount of rolling, oiling, powdering or pressing would get the computer to accept my identity – the ridges and swirls on my fingers had simply worn off from 40 years of scrubbing, brushing, wiping and gloving: the small price of surviving into the computer age. My malpractice insurance carrier sent a formal letter last year to inform me that all their doctors 72 years of age and older would be required to have a physical exam with their own primary care physician to include an EKG. Does this constitute age discrimination since doctors not yet 72 can be insured without an EKG, or since all 72-year-olds are to be treated equally, does this demand meet the requirement of the law mandating equality for all without age discrimination? There are really no damages, so it would be hard to