Butthedismalfinancesofgeriatricsareonlyasymptom
ofadeeperreality:peoplehavenotinsistedonachange
inpriorities.Wealllikenewmedicalgizmosanddemand
that policy makersensure they arepaid for.We want
doctorswhopromisetofixthings.Butgeriatricians?Who
clamorsforgeriatricians?Whatgeriatriciansdo—bolster
ourresiliencein oldage,ourcapacityto weatherwhat
comes—is both difficult and unappealingly limited. It
requires attention to the body and its alterations. It
requiresvigilanceovernutrition,medications,andliving
situations.Anditrequireseachofustocontemplatethe
unfixablesin our life,thedeclinewe willunavoidably
face, in order to makethe smallchangesnecessary to
reshapeit.Whentheprevailingfantasyisthatwecanbe
ageless,thegeriatrician’suncomfortabledemandisthat
we accept we are not.
FOR FELIX SILVERSTONE, managing aging and its
distressingrealitieswastheworkofalifetime.Hewasa
nationalleaderingeriatricsforfivedecades.ButwhenI
methimhewashimselfeighty-sevenyearsold.Hecould
feelhisownmindandbodywearingdown,andmuchof
what he spent his career studying was no longerat a
remove from him.
Felixhadbeenfortunate.Hedidn’thavetostopworking,
evenafterhesufferedaheartattackinhissixtiesthatcost
himhalfhisheartfunction;norwashestoppedbyanear
cardiac arrest at the age of seventy-nine.
“Oneevening,sittingathome,Isuddenlybecameaware
ofpalpitations,”he toldme.“Iwasjustreading,and a
fewminuteslater Ibecameshortof breath.Alittlebit