It's a rainy day on the Hudson River, about 35 miles north of New York City. About every 30 minutes our little floating house will be rocked by a wake from the many giant barges that travel the river. Hold on to the coffee maker.
The recent discussions regarding the brain function of certain prominent persons has me musing about my own experiences. When I finally finished my surgical training, all of 16 years after high school, I began my adult (getting paid) career in Billings, Montana in cardiovascular surgery. I was a pretty young looking 34 (still had hair) and one patient expressed concern, during a preoperative visit, that I was, well, "less seasoned" than I might be. I said I understood, then asked a patient, aged 83, upon whom I had done an aortic valve on three days earlier, to help me out. I gave him a white coat, brought him down to the first patient's room, and said "how about this guy?" The patient laughed and signed the consent.
It is extremely unlikely I'd let an 81-year-old surgeon do my heart operation. I don't recall, in all the places I've worked, anyone over 75. Airlines cut their pilots off in the mid-60s. Apparently, things like flying planes and doing heart surgery are a big deal, and being president of the U.S. is less so.
If you think getting the car keys out of grandpa's hands is challenging, try getting an aged surgeon to quit when he doesn't want to.
As chief of staff at a large hospital, I denied a surgeon who requested privileges to do an operation that he was much too addled and shaky to do. I got sued, and was surprised by the lack of support I received from other surgeons and the hospital administration. Apparently, I was being mean to a nice guy. What about the poor patient?
In the sporting world, the instant you lose a step, or can't hit the curve, or can't cover, you are history. Running backs are done at 30. In other less visible roles, however, we collude and conceal. We do it in our own families at times, hoping that the memory lapse or the fender bender isn't a symptom of a bigger problem. It is so much easier to cover up than confront.
When discussing cognitive decline with a loved one, avoid an accusatory tone ("you're losing it, you old goat") and substitute an offer of help ("I would love to drive you to Bible study") instead. Having an outside party (usually primary care provider) gently confirm the cognitive difficulties helps obviate claims of personal bias.
For ourselves, assuming you have decided not to run for another term, staving off senility involves a few things we can change, some we can't, like genetics. Nicotine is really bad. Booze, as little as you can live with. Blood pressure, control it. Cholesterol, keep those brain arteries open. These are obvious because they either affect cerebral circulation or are poisonous.
What is most intriguing is the social aspect of dementia. Isolated people, those with fewer interactions and connections, are more likely to have earlier dementia. So your kids live a million miles away, your friends are moving or croaking, yes, it is tough sometimes. But fighting loneliness and dementia have the same toolbox - be intentional. Look at the board at the post office or the grocery store and go to everything. Get a part time job.
In the last 15 years there has been a dramatic increase in reported loneliness and depression, and at the same time, a dramatic decrease in church attendance. Save your brain, go to church. I'm going to trademark that.
Most of all, be honest with yourself. Quit driving before you must. When someone expresses concern to you, don't immediately dismiss them. Yes, losing your marbles is a bummer, but not shameful.
The photo you see is a helpful marker that I leave on the helm of our boat. The channels on many of the waterways are marked with large buoys, the red ones on the right, green ones on the left, except when they are the other way around. Sometimes I can't recall if a route is upstream or downstream, because it is often, in my mind, arbitrary and capricious. So I have my little stick.
I expect there will be more little sticks in my future.
Reader Comments(0)