Editor’s note: I went to both summer camp and college with Abbie, but didn’t know her well. Now I read her work with great interest–it often hits a nerve. This is from the New York Times. It is funny yet pointed. Re-blogged below.
A Shortage of Juggling Doctors
by Abigail Zuger, M.D. Dec. 15, 2014
A controversial statistic suggests that in the near future our country will be in desperate need of more doctors. The Association of American Medical Colleges has estimated that by 2025 we will be about 130,000 short, thanks primarily to an exploding older population. Ten thousand Americans now turn 65 every day, entering their golden years of disproportionate consumption of medical care.
Not all the experts agree with these calculations. A panel at the Institute of Medicine, for example, has countered that geographic variability always undermines these dire predictions, with a reliable glut of physicians persisting in some places and reliable shortages in others. The real problem, they say, is a profession top-heavy with specialists, leaving too few to provide primary care.
I have no particular professional expertise to inform an opinion on these matters. I do, however, have a pertinent personal perspective, having lived in a miniature version of our soon-to-be-geriatric nation for most of my adult life. Thanks to extremely long-lived parents who married late in life with a sizable age difference between them, it is now closing in on three decades that our nuclear family has contained an extremely old person to worry about.
So here’s the bottom line: We have had no doctor shortage. In fact, even with just the one permanently on-call house doctor (me), I would say we have actually had enough doctors. Maybe even a surplus.
My mother, ever the comic, used to drag out an annoying little routine at dinner parties to the effect that she and my father sent me to medical school specifically to supervise their old ages. After many years chewing that one over, I am forced to conclude that the joke is on her. Not the best choice, Mom.
It would have been better by far to send me to nursing school. Talk about shortages — how our little world could have used an in-house individual formally trained in patience and small acts of kindness, one whose knowledge of health care reflected the more practical, symptom-focused schematic that distinguishes nursing from medical education. Certainly, doctors are now making tentative forays into this territory: We have, for instance, added the concept of “comfort care” to our knowledge base, and we use the term freely. But most of us are not too clear on the actual techniques.
It would have been better to send me to physical therapy school. No surprise there: A doctor’s familiarity with obscure diagnoses — and the ingrained habit of reviewing them compulsively when something goes wrong — is considerably less helpful for the old than an understanding of some normal activities, like sitting, standing and tottering around. Unless you are a rare physician indeed, you know nothing about the process of rising from a chair except to politely conceal your impatience while it is accomplished.
It would have been better to send me to design school, given the fact that every single item marketed to help old people stay in their homes is uglier than ugly, making their reliable decision to have nothing to do with it (cane, walker, bathing aids, you name it) particularly difficult to countermand. Furthermore, nowhere in the universe does there exist a portable, slim, elegantly designed, mechanically sound, reasonably priced chair that a person with no strength or balance can spend a lot of time in and then actually get out of.
It would have been better, much better, to send me to clown school, to pick up some validated tools for amusing and distracting people. It turns out that when a lifelong worker no longer works, a reader no longer reads, a person who never took a vacation is on a long one, miserably elastic time stretches long and wide and heavy in every direction. The days may be running out, but there are still too many of them and they are all much too long. An on-call juggler would be just the ticket.
Best of all, I think, would have been the decision to send me to graduate school in philosophy, to observe wiser minds making sense of it all, possibly to absorb some rudimentary techniques for soaring high above the small, sad details to a serene understanding of the bigger picture. Or perhaps a few years in aviation school would have provided the same perspective.
You could certainly say that our family has experienced serious decadeslong shortages of various professionals. But doctors — those valiant but limited warriors schooled to think only about their own tiny little battles in an irreversibly lost war — were not among them. We probably had one too many of those.
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