Medical Student

Medical Student(max leonard) “Good evening,” says Al in his bass voice, exaggerating each syllable like he’s answering the front door of the Munster Mansion. He grins and calmly raises his arm as if to shake my hand but only extends an index finger.

“You better not ask me to pull your finger,” I exclaim. We both recoil in our seats with laughter.

Always a jokester, this is how Al McCull, my eighty-five-year-old church choir buddy, greets me each week at rehearsal. Because he has dementia and arthritis that limits his mobility, I help Al put on his singing robe, assist him up and down the choir loft on Sundays, and turn his sheet music when he has trouble following along. I also watch Al’s physical demeanor carefully. A wobbly stance while singing, clammy palms, or flushed face are sure signs he needs a break and should sing the next hymn sitting down. Despite requiring extra help and attention, Al is an integral and valued member of our choir. He’s quick-witted, pleasant, and sings like a bird--if a bird could reach a low E-flat.

Over the years, I have been inspired by the courage, wisdom, and kindness of Al and several other elderly friends at church. In turn, they have shaped my understanding of compassionate care and have strengthened my desire to serve older patients.

By the year 2030, one in five Americans will be 65 or older. However, it’s estimated there will be only one geriatrician per 3,800 Americans over 75 years old. Advanced age correlates to increased risks for dementia, Alzheimer’s disease, heart disease, infection, and type II diabetes. Couple these physiological concerns with a geriatric patient’s unique social and psychological needs due to thoughts of death and afterlife, lack of mobility, isolation, financial constraints, and it’s easy to see why proper care for older adults is so lopsided. As a physician, I’m eager to work creatively at tackling the issues related to geriatric medicine, including lack of accessibility and a need for more comprehensive patient care.

In a society where we reward specialists who order the most procedures, perform the most surgeries, and prescribe the most drugs, medicine must instead emphasize care for patients as a whole. While volunteering for the music therapy program at Wesley Woods Geriatric Hospital, I worked extensively with patients with severe dementia and Alzheimer’s disease. Upon arriving each week, many patients were wheelchair bound, mumbling to themselves with eyes glazed over. They appeared oblivious to their surroundings and incapable of speaking above a whisper. Therefore it was amazing to watch how animated and cognizant these older adults became when therapy started. With a little encouragement, they began singing “I’ve Been Working on the Railroad” and “This Land is Your Land;” they clapped in rhythm, tapped their feet, and even offered suggestions for the next song to be sung. The goals of therapy were not only to mentally stimulate the patient, but to nurture their body with physical activity and social interaction.

I want to be a physician who advocates the importance of staying active, who recognizes that appropriate levels of mental and physical stimulation can be just as beneficial for the health and wellbeing of geriatric patients as a daily prescription drug or vitamin supplement. I will also approach patients with the same level care and empathy I consistently witnessed while shadowing my mentor, Dr. Kelan Lass, at his practice in LA, California.

On one occasion, a young woman came into the examination room for a routine prescription refill. She was upset at recent divorce proceedings that had her child taken by the court system. With a waiting room full of other appointments, a good doctor would offer his condolences, write the prescription, and send the woman on her way; but a great doctor, like Dr. Lass, intentionally unloaded the woman’s burdens onto himself over the next hour and gave her the psychological tools necessary to take charge of the situation. By the end of the appointment my feet felt like stubs from standing still so long and my back was on fire, but I finally understood how a physician must always put his patient’s interests, values, and dignity first.

Becoming a physician stems from my desire to serve a community I deeply care about. The heart of geriatrics revolves around listening to the stories patients tell and building meaningful and deep relationships. On top of that are the awe of discovering the human body, the honor of being trusted to give advice, and the gratitude for helping someone through a difficult illness. I want to become a physician to make contributions to the field of geriatrics, and to make positive impacts in the lives of the elderly.