Year: 2006
Type: article
Abstract: During my first year of medical school, I interviewed 34 men as part of a small pilot study within the Physicians' Health Study, a cohort recruited from male members of the American Medical Association. To assess healthy aging in the very old, I spoke to 31 nonagenarians and three centenarians. Their average age was 96.7 at the time of the interview. For anyone in the profession of medicine or entering it, the lives of these old doctors foreshadow our own futures. Like them, we will face great changes and challenges as the practice of medicine evolves. And like them—if we are lucky—we will also face the personal challenges that come with old age. For us then, these men are apt case studies and potential repositories of wisdom from which we can draw. One centenarian doctor still sees half a dozen patients a day. Medicine has always been his life. During the most active portion of his career, he saw patients from six o'clock in the morning until eight o'clock at night every day, making house calls when needed. When there was an emergency, patients telephoned him at home. Now, at 100.5 years old, he continues to practice. He no longer writes prescriptions, but he still makes house calls, often hand delivering his patients' medicines. He reads four medical journals, because he doesn't want to be an “old doctor,” out of touch with contemporary techniques. But the way he practices is appreciated as much as his knowledge. Younger local doctors praise him for doing the things that they would do if only they had more time. He wins community awards and remains a part of his patients' families. A career of more than 75 years is exceptionally long even by the standards of these doctors. But this man is not unique. I have also spoken to a 96-year-old psychiatrist who works 4 days a week and a 98-year-old internist who gives unofficial medical advice in the retirement community where he once worked as a primary care physician. Another doctor, 95 years old, formally retired from the practice of medicine in 1977 yet says that he continues to treat patients nightly; he sees them in his dreams. Medicine has changed, and the lives of these men have changed with it. They have been forced to face new realities of personal health, as well as a new kind of medicine. By defying their own illnesses, they now prove that they possess the same courage they have sought to engender in patients. One nonagenarian lives alone on a 350-acre cattle ranch. Help is available, but he prefers to do much of the ranching by himself, digging fence posts and lifting 5-pound bags of cattle feed. How does he maintain such energy? In part, through an almost impossible optimism. Despite strokes, cancer, and heart disease, these men consistently describe their health as excellent. These healthy survivors have learned to bring to their own lives the indomitable hopefulness they once shared with patients. For a curious medical student or a younger practitioner, these men have lessons to teach beyond the power of positive thinking. They are eager to share tales of a medicine different from the kind that I am now learning in school. How to take a medical history, to counsel someone on a difficult decision, or to break bad news—these are things their generation has done well. Through their stories, I have seen medicine as it existed before angioplasty, before computed tomography and magnetic resonance imaging scans, before antibiotics. I have learned that, even without these life-saving interventions, there was much that a doctor could do for the patient. Someday, we may be able to identify specific factors that promote robust longevity. In the meantime, these doctors' extended lives and careers are themselves instructive. What lessons can we learn from them? If nothing else, the lives of these long-lived physicians prove wrong the common misperception that old age is necessarily marked mainly by decrepitude and depression. These men were once full-time professors of medicine or advocates of good health to their patients. Today they teach us by example. Financial Disclosure: I have no conflicts of interest of any kind. Author Contributions: I am the sole author of this manuscript. Sponsor's Role: I have received partial support from Harvard Medical School's Patient-Associated Science: Training, Education, Understanding, and Research student fellowship without editorial oversight.
Author: Daniel E. Freedberg
Institution: Harvard University
Language: English
Field: Psychology
Domain: Social Sciences
Open Access status: bronze
OpenAlex ID: W2079357001