When I tell people I'm a geriatrician, the most common response is some version of: "I'm so glad someone is willing to do that."
It is meant to be kind. It also reveals something. The assumption underneath it, usually unspoken, is that aging is all loss, that the work of caring for older people is the work of accompanying decline and grief. Someone willing to do that work seems either unusually brave or slightly sad.
Those things- decline, loss, grief- are real. They are not the whole story. The people geriatricians care for are living life. They are still deciding what matters to them, navigating relationships and goals and changes and new chapters, caring for family members, teaching, and solving problems. Later life contains much more than loss. The life part is honestly what drew me to the field. In training, many of my patients were living more meaningful and richer lives than I was; they inspired me.
Most specialties in medicine are organized around a body part, a disease, or a technology. Cardiologists treat the heart. Oncologists treat cancer. Radiologists interpret images. Geriatricians are organized differently. Like pediatricians, we are defined by a stage of human life. Our frame is not a disease or a body part. It is the life context in which health or disease occurs.
Geriatricians are experts in what normal aging looks like, and how to tell it from disease, but expertise in that biology is only part of it. Beyond that is an understanding the interaction between what is happening in someone's body and what is happening in their life. This is important in all medicine, but in many other fields falls through the cracks and people still get good (or at least adequate) care. In Geriatrics, we can't afford for the life part to fall through the cracks. When disease impacts day-to-day function or time may be short, that lens is no longer optional.
My goal in writing here is not to provide answers (the world has enough of those), but to find and share more interesting questions. One interesting question that has come out of my work and training in geriatrics, but is relevant more broadly, is: How do we best show up for people while acknowledging the context of their human lives, as individuals and in the systems we build?
Hit reply and tell me what you think.
Rachel