You can feel pretty vulnerable sitting on the crisp white paper atop a doctor’s examining table. Exposed even, both literally and figuratively. Especially when you start by saying, “There’s something wrong with me,” (or more specifically, with my foot, or my hand, or my head, or my gut).
The power dynamics are stark: you’re weak; the doctor is strong. It bothers you that he/she only knows your sickness, your ailment, what’s broken, and probably doesn’t realize what a competent human being you actually are outside the medical cubicle. You must fight the urge to tell him/her because you know you’ve got 10, 12, 15 minutes of time at the most, and you understand your priority is your need for this doctor to fix your Something Wrong.
If you’ve experienced a chronic illness or any number of serious health crises, you’re probably much better at managing these relationships. But if, like me, you’ve been inexplicably lucky and avoided all but the most routine exams for many decades, there are, as with all things aging, adjustments to be made. And not, it turns out, only by the patient.
I learned this at a recent doctor’s visit to address an ulcer on my foot which, rather than healing under my benign neglect, was showing signs of infection and having an impact on the way I walk. I know it takes things longer to heal when you’re older (and I don’t really care why), and I understand that most people “my age” don’t care quite so much about being as active as I’ve been determined to be since my crooked back damaged a nerve and gave me drop foot. But I really don’t want Age to be the determinant for my health care, even given that number’s prominence at the top of any medical chart.
Imagine my delight, then, when the Physician’s Assistant, a woman in her fifties, entered my exam room, looked briefly at the sore, looked down at my chart, looked up at me, and said, “70?!!” Gesturing up the length of the table, she continued, “This is 70? You look fabulous! That’s how I want my 70 to be!” OK, yes, there’s a whole lot of vanity at work there. But I also felt tremendous relief, as her generous comments came across as reassurance that she would be working with me to heal my foot and restore my active lifestyle. She was not assuming I was on my way to a wheelchair anyway and therefore no aggressive treatment was required. She saw me, a whole person, and not just a number or a test result. Healing could begin.
I’m not ignoring reality. I am 70, and I concede I’m no longer as strong and energetic as I once was, 20, 30, 40 or 50 years ago. But I’m not dead yet, either. Because I have experienced several dispiriting encounters with doctors and other health care providers that suggested they were willing to more or less give up on the 70- or 80-year-old patient just because they were 70 or 80, I may be particularly sensitive to the role — and/or the perception — of Age in medical care today. But it’s not just age. I am convinced care providers need to “see” the whole person, whatever the vulnerability a patient presents, to optimize any fix or cure, any treatment or healing. And perhaps we who are most vulnerable by virtue of age, have the opportunity to teach our health care professionals that skill by insisting, at every instance, that we are more — much more — than the numbers on our chart.
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