7 ms·

Doctor T, don’t you get tired of only seeing older patients?

278 points by happy-go-lucky 7y ago

briandear 7y ago
Wow. Just what I needed to read. Thanks to whomever posted this to HN.
todd3834 7y ago
There are a lot of older people in the complex where I live. They are some of the friendliest and most interesting people I’ve ever met. It’s kind of funny because while I’m much more interested in their stories they always seem to want to hear about mine. I feel like the stereotype of the grumpy old man is falling apart, at least for me. Sure they exist but most of the older people I’ve been getting to know are very kind interesting people who don’t fit that stereotype at all.
- zdragnar 7y ago
  There are a few living stereotypes just up the road from me (rural countryside) but so many more who are friendly and so full of life that every chance to talk to them is a joy. I've seen the world change a lot in my years, and I can only imagine what it's like for someone who has lived two or even three times as long. Keep in mind they were born at a time when nearly half of the houses in America didn't have indoor plumbing.
- firstplacelast 7y ago
  I've always felt like people after 60 calm way the fuck down. They're done, over it, just trying to take it slow and enjoy life. I had a job selling newspaper subscriptions door-to-door when I was young (like 15ish), the thing I noticed was that grumpy people are normally in the mid-30s to mid-50s range. I worked that job for 9 months (it was awful) and I would talk to upwards of 30 people a night, 4-5 nights a week. What I noticed (and this is all anecdotal), 30's-mid 40's women were always very polite and would make time if they had it, men in that range were extremely rude and had little patience for a solicitor. Mid-40's to 60 the roles reversed, women would be a lot ruder, but the men would be nicer and almost had an appreciation that I was hustling and would make some time for me. Over 60, most women and men were pretty laid back and accommodating if they had the time.
  - icebraining 7y ago
    Could be a generational thing, though.
  - sizzle 7y ago
    30's typically are settling down years and might have a young kid or crying newborn keeping them steadily sleep deprived and agitated if I had to guess what was behind you observation for that age group.
    - asveikau 7y ago
      My experience with raising kids is that you develop more compassion, empathy, forgiveness, giving people room to make mistakes and correct them -- extended towards people outside your family too. It's all very humbling. But I am sometimes surprised when people tell me that's not a universal feeling. At some point I came across some study claiming to show that it made people less trusting of people outside of family.
  - maire 7y ago
    Your observation is definitely correct. I took care of my mother until she passed away at 90. When she was young she never relaxed about anything. I think this was because of growing up during the great depression. When she came to live with us she became very sweet and child like in her outlook. I think it was because she trusted us and felt she could relax. I feel sorry for my sisters because they only knew her middle years and never saw the person I saw.
- asveikau 7y ago
  Sounds a bit like... Pardon the term... Survival bias. Perhaps the grumpy ones stress themselves out and don't make it as long. Or less morbidly, perhaps the grumpy ones are just not those you are likely to get to know.
  - sosuke 7y ago
    Oh if only that were universally true. There are some terrible people that survive and some folks would say they live to suffer for their life of ill.
dmix 7y ago
And that child’s name? Albert Einstein.
riantogo 7y ago
Do you see little kids losing it over little things like not getting their art work just right? Or a bit older kid getting very upset over something their friend said? Or maybe a young graduate taking their first job extremely seriously? We even play along and parents share a chuckle at their “important” problems, appreciating their young and limited perspective, and knowing everything will be just fine. Now consider how grandma thinks of that critical deadline of your “world changing“ project or that important deal that are losing sleep over. I always try to think about their perspective during stressful times :)
- rubber_duck 7y ago
  But is that stress what got the kid to be better at art ? Obsessing over what others said led you to understand other people and yourself ? Taking your first job seriously built habits and earned you credit among your peers ? I don't think acting like a 70 year old in 20s/30s/40s is wise - you're not retired with most of your accomplishments behind you.
  - Errancer 7y ago
    Taking something seriously and being stressed/obsessed are two different things
  - saiya-jin 7y ago
    Improving mainly by negative pressures sucks, life should be enjoyed and not sucked through because you're in some rat race with your imaginary/real competitors. Of course nobody is going to stop you if you prefer it that way, but I'll make my best to discourage similar approach in my kids/friends
    - ThrowawayP 7y ago
      > "...life should be enjoyed and not sucked through because you're in some rat race with your imaginary/real competitors" Reminds me of words from Mary Schmich's famous "Sunscreen" column (https://www.chicagotribune.com/columns/chi-schmich-sunscreen-column-column.html https://www.chicagotribune.com/columns/chi-schmich-sunscreen...): "... Sometimes you're ahead, sometimes you're behind. The race is long and, in the end, it's only with yourself." Not sure whether I agree with you and her or not. Yes, the race is damned long and I recognize that it is ultimately only with myself. On the other hand, much like trying to beat your own high score, it can be kind of fun and, perhaps more realistically, like many I have nothing better to do.
XaspR8d 7y ago
These are nice scenes, and I think we all could take care to remember the unique and compelling stories behind everyone else's lives, particularly the old. However I don't necessarily think the response is fair to the student, who could also be asking challenging questions beyond "old people suck, amirite?". Particularly: - Don't you get tired of [emotionally coping with interacting with people who tend to have more health issues and issues with worse outcomes]? (Is it fair to want to see healthier individuals for your own personal reasons? How does one defend their psyche from seeing trauma so often?) - Don't you get tired of [having to work primarily with a population that has a limited set of recurring problems that may not be as interesting or rewarding to work on]? (How ethical is it to want specific kinds of engagement from your job? Is it okay to be annoyed with individuals with preventable diseases and injuries?) I have a number of close friends who are new doctors, and they grapple with these kinds of issues all the time.
- ggggtez 7y ago
  Or additionally, maybe the student is asking legitimately because they want to go into pediatrics, or gynecology, or a number of other fields where they are more likely to deal with younger patients. We can't know what the conversation was like, or either the doctor or student's story, but I agree it's not necessarily helpful to the student to just wax poetic.
- icebraining 7y ago
  > people who tend to have more health issues and issues with worse outcomes I wonder if that's true, from the perspective of the doctor. The stereotype, at least where I live, is that old people will go regularly to the doctor almost just to chat, whereas a young person will only go when there's something wrong with them.
  - XaspR8d 7y ago
    True, though it depends a lot on the field: most of my social group works in emergency medicine, where people don't drop in just to chat quite as often!
- sosuke 7y ago
ConradMcK 7y ago
Seniors are some of the greatest treasures a country has. They're a living passport into another age, and incredibly fascinating to listen to. When you stretch out the timescale, the importance of things changes. 90 years is a long time. My grandfather is 96. The Nazi's kicked him out of Vienna in 1938. A lifetime of lessons, of loss, of disappointment, of excitement, of calm, of contribution. One of the more exciting recent trends in healthcare (in my opinion) is the emerging focus on holistic quality of life for seniors as they age and move through their healthcare transitions. A person is more than just their physical health; we have emotional, spiritual, intellectual, creative, vocational, and environmental health needs as well. Considering and incorporating those ideas into how we, as a country, take care of our seniors is incredibly important and impactful. I echo briandear, thank you to the person who linked these tweets. Note: USA perspective
- sosuke 7y ago
  Wow 96, what an amazing grandfather to have! I hope to survive as long but it seems the my grandparents generation can't make it past 80. So much so that my nephew thought when you hit 77 you died and that was how life worked.
scarejunba 7y ago
The lady doth protest too much, methinks.
oneepic 7y ago
>My student doesn't seem to understand. Someday, she will. ...Or you could just tell her right now, instead of going off and tweeting your smug thought. Still, this was a nice set of stories.
- keiferski 7y ago
  > ...Or you could just tell her right now, instead of going off and tweeting your smug thought. Modernity in a nutshell right there.
  - AstralStorm 7y ago
    The difference is that things you learn stay with you for long, and things you're told rarely do. Not sure how or why you would teach young people about general meaninglessness of most things. It's risky and could kill talents and inventions. Finally people do not get interesting without making mistakes.
  - Aeolun 7y ago
    - Times I’ve learned my lesson by experience: 100 - Times I’ve learned a lesson by advice: 0 - Times a lesson taught by advice turned out to be false: 400 I don’t know. There’s so many things people take for granted that it is a dangerous thing to just take someone’s word for it.
    - mar77i 7y ago
      Put this way, it seems rather important to trust one's own judgement. That is a useful basis - one need to start somewhwere. If you give up both your judgement and other people's advice, you won't get anywhere at all before making that decision. I sometimes wonder if bad advice is running more rampant today or if it was always this bad.
    - throwaway66920 7y ago
      So did you get hit by a car before learning to look both ways when crossing the street? Or did someone tell you?
deleted 7y ago
[deleted]
userword 7y ago
hello
matt_morgan 7y ago
For 27 years I saw the same doctor. He was a GP by the time I met him, but as an infectious diseases specialist had been on the front lines of AIDS in the 80s. I can still find old quotes from him now and again, calming people scared about touching doorknobs. I trusted him thoroughly, with everything. He was about 10 years older than me and I worried what it meant when he retired and I no longer had access to this person who so deeply understood me--exactly when I started needing him most. This post is encouraging, to say the least.
thesausageking 7y ago
I'm amazed he has time to listen to patients talk about their gardens or hear their stories of meeting Elvis. Every doctor I know barely has enough time to diagnose a patient and enter everything into the EHR. Do doctors for older patients have more slack in their schedules or is there some trick in how his practice works?
- oneepic 7y ago
  I've personally worked with doctors that had a lot more time because fewer patients see them in a day. They weren't older patients, necessarily, but this doctor (General Surgery department I think?) would only see around a dozen patients per day. Visits were scheduled for 15 mins, but could go longer if they needed it. This doctor had quite a lot of free time. It was a moderately-sized hospital in the Midwest.

Wow. Just what I needed to read. Thanks to whomever posted this to HN.

There are a lot of older people in the complex where I live. They are some of the friendliest and most interesting people I’ve ever met. It’s kind of funny because while I’m much more interested in their stories they always seem to want to hear about mine. I feel like the stereotype of the grumpy old man is falling apart, at least for me. Sure they exist but most of the older people I’ve been getting to know are very kind interesting people who don’t fit that stereotype at all.

zdragnar 7y ago
There are a few living stereotypes just up the road from me (rural countryside) but so many more who are friendly and so full of life that every chance to talk to them is a joy. I've seen the world change a lot in my years, and I can only imagine what it's like for someone who has lived two or even three times as long. Keep in mind they were born at a time when nearly half of the houses in America didn't have indoor plumbing.
firstplacelast 7y ago
I've always felt like people after 60 calm way the fuck down. They're done, over it, just trying to take it slow and enjoy life. I had a job selling newspaper subscriptions door-to-door when I was young (like 15ish), the thing I noticed was that grumpy people are normally in the mid-30s to mid-50s range. I worked that job for 9 months (it was awful) and I would talk to upwards of 30 people a night, 4-5 nights a week. What I noticed (and this is all anecdotal), 30's-mid 40's women were always very polite and would make time if they had it, men in that range were extremely rude and had little patience for a solicitor. Mid-40's to 60 the roles reversed, women would be a lot ruder, but the men would be nicer and almost had an appreciation that I was hustling and would make some time for me. Over 60, most women and men were pretty laid back and accommodating if they had the time.
- icebraining 7y ago
  Could be a generational thing, though.
- sizzle 7y ago
  30's typically are settling down years and might have a young kid or crying newborn keeping them steadily sleep deprived and agitated if I had to guess what was behind you observation for that age group.
  - asveikau 7y ago
    My experience with raising kids is that you develop more compassion, empathy, forgiveness, giving people room to make mistakes and correct them -- extended towards people outside your family too. It's all very humbling. But I am sometimes surprised when people tell me that's not a universal feeling. At some point I came across some study claiming to show that it made people less trusting of people outside of family.
- maire 7y ago
  Your observation is definitely correct. I took care of my mother until she passed away at 90. When she was young she never relaxed about anything. I think this was because of growing up during the great depression. When she came to live with us she became very sweet and child like in her outlook. I think it was because she trusted us and felt she could relax. I feel sorry for my sisters because they only knew her middle years and never saw the person I saw.
asveikau 7y ago
Sounds a bit like... Pardon the term... Survival bias. Perhaps the grumpy ones stress themselves out and don't make it as long. Or less morbidly, perhaps the grumpy ones are just not those you are likely to get to know.
- sosuke 7y ago
  Oh if only that were universally true. There are some terrible people that survive and some folks would say they live to suffer for their life of ill.

dmix 7y ago

And that child’s name? Albert Einstein.

riantogo 7y ago

Do you see little kids losing it over little things like not getting their art work just right? Or a bit older kid getting very upset over something their friend said? Or maybe a young graduate taking their first job extremely seriously? We even play along and parents share a chuckle at their “important” problems, appreciating their young and limited perspective, and knowing everything will be just fine. Now consider how grandma thinks of that critical deadline of your “world changing“ project or that important deal that are losing sleep over. I always try to think about their perspective during stressful times :)

rubber_duck 7y ago
But is that stress what got the kid to be better at art ? Obsessing over what others said led you to understand other people and yourself ? Taking your first job seriously built habits and earned you credit among your peers ? I don't think acting like a 70 year old in 20s/30s/40s is wise - you're not retired with most of your accomplishments behind you.
- Errancer 7y ago
  Taking something seriously and being stressed/obsessed are two different things
- saiya-jin 7y ago
  Improving mainly by negative pressures sucks, life should be enjoyed and not sucked through because you're in some rat race with your imaginary/real competitors. Of course nobody is going to stop you if you prefer it that way, but I'll make my best to discourage similar approach in my kids/friends
  - ThrowawayP 7y ago
    > "...life should be enjoyed and not sucked through because you're in some rat race with your imaginary/real competitors" Reminds me of words from Mary Schmich's famous "Sunscreen" column (https://www.chicagotribune.com/columns/chi-schmich-sunscreen-column-column.html https://www.chicagotribune.com/columns/chi-schmich-sunscreen...): "... Sometimes you're ahead, sometimes you're behind. The race is long and, in the end, it's only with yourself." Not sure whether I agree with you and her or not. Yes, the race is damned long and I recognize that it is ultimately only with myself. On the other hand, much like trying to beat your own high score, it can be kind of fun and, perhaps more realistically, like many I have nothing better to do.

XaspR8d 7y ago

These are nice scenes, and I think we all could take care to remember the unique and compelling stories behind everyone else's lives, particularly the old. However I don't necessarily think the response is fair to the student, who could also be asking challenging questions beyond "old people suck, amirite?". Particularly: - Don't you get tired of [emotionally coping with interacting with people who tend to have more health issues and issues with worse outcomes]? (Is it fair to want to see healthier individuals for your own personal reasons? How does one defend their psyche from seeing trauma so often?) - Don't you get tired of [having to work primarily with a population that has a limited set of recurring problems that may not be as interesting or rewarding to work on]? (How ethical is it to want specific kinds of engagement from your job? Is it okay to be annoyed with individuals with preventable diseases and injuries?) I have a number of close friends who are new doctors, and they grapple with these kinds of issues all the time.

ggggtez 7y ago
Or additionally, maybe the student is asking legitimately because they want to go into pediatrics, or gynecology, or a number of other fields where they are more likely to deal with younger patients. We can't know what the conversation was like, or either the doctor or student's story, but I agree it's not necessarily helpful to the student to just wax poetic.
icebraining 7y ago
> people who tend to have more health issues and issues with worse outcomes I wonder if that's true, from the perspective of the doctor. The stereotype, at least where I live, is that old people will go regularly to the doctor almost just to chat, whereas a young person will only go when there's something wrong with them.
- XaspR8d 7y ago
  True, though it depends a lot on the field: most of my social group works in emergency medicine, where people don't drop in just to chat quite as often!
sosuke 7y ago

ConradMcK 7y ago

Seniors are some of the greatest treasures a country has. They're a living passport into another age, and incredibly fascinating to listen to. When you stretch out the timescale, the importance of things changes. 90 years is a long time. My grandfather is 96. The Nazi's kicked him out of Vienna in 1938. A lifetime of lessons, of loss, of disappointment, of excitement, of calm, of contribution. One of the more exciting recent trends in healthcare (in my opinion) is the emerging focus on holistic quality of life for seniors as they age and move through their healthcare transitions. A person is more than just their physical health; we have emotional, spiritual, intellectual, creative, vocational, and environmental health needs as well. Considering and incorporating those ideas into how we, as a country, take care of our seniors is incredibly important and impactful. I echo briandear, thank you to the person who linked these tweets. Note: USA perspective

sosuke 7y ago
Wow 96, what an amazing grandfather to have! I hope to survive as long but it seems the my grandparents generation can't make it past 80. So much so that my nephew thought when you hit 77 you died and that was how life worked.

scarejunba 7y ago

The lady doth protest too much, methinks.

oneepic 7y ago

>My student doesn't seem to understand. Someday, she will. ...Or you could just tell her right now, instead of going off and tweeting your smug thought. Still, this was a nice set of stories.

keiferski 7y ago
> ...Or you could just tell her right now, instead of going off and tweeting your smug thought. Modernity in a nutshell right there.
- AstralStorm 7y ago
  The difference is that things you learn stay with you for long, and things you're told rarely do. Not sure how or why you would teach young people about general meaninglessness of most things. It's risky and could kill talents and inventions. Finally people do not get interesting without making mistakes.
- Aeolun 7y ago
  - Times I’ve learned my lesson by experience: 100 - Times I’ve learned a lesson by advice: 0 - Times a lesson taught by advice turned out to be false: 400 I don’t know. There’s so many things people take for granted that it is a dangerous thing to just take someone’s word for it.
  - mar77i 7y ago
    Put this way, it seems rather important to trust one's own judgement. That is a useful basis - one need to start somewhwere. If you give up both your judgement and other people's advice, you won't get anywhere at all before making that decision. I sometimes wonder if bad advice is running more rampant today or if it was always this bad.
  - throwaway66920 7y ago
    So did you get hit by a car before learning to look both ways when crossing the street? Or did someone tell you?

deleted 7y ago

[deleted]

userword 7y ago

hello

matt_morgan 7y ago

For 27 years I saw the same doctor. He was a GP by the time I met him, but as an infectious diseases specialist had been on the front lines of AIDS in the 80s. I can still find old quotes from him now and again, calming people scared about touching doorknobs. I trusted him thoroughly, with everything. He was about 10 years older than me and I worried what it meant when he retired and I no longer had access to this person who so deeply understood me--exactly when I started needing him most. This post is encouraging, to say the least.

thesausageking 7y ago

I'm amazed he has time to listen to patients talk about their gardens or hear their stories of meeting Elvis. Every doctor I know barely has enough time to diagnose a patient and enter everything into the EHR. Do doctors for older patients have more slack in their schedules or is there some trick in how his practice works?

oneepic 7y ago
I've personally worked with doctors that had a lot more time because fewer patients see them in a day. They weren't older patients, necessarily, but this doctor (General Surgery department I think?) would only see around a dozen patients per day. Visits were scheduled for 15 mins, but could go longer if they needed it. This doctor had quite a lot of free time. It was a moderately-sized hospital in the Midwest.