They say that people look like their dogs. That’s obviously an over statement, but I have to admit I’ve occasionally noticed some resemblance in folks who walk their dogs in the neighborhood. For a long time I’ve observed that a doctor’s medical practice is a reflection of his attitude and care. I once had a partner who changed his practice emphasis to addictionology. It wasn’t long before our waiting room swarmed with people wanting their hydrocodone prescriptions refilled. Some doctors never seem to be available and their patients just get sicker and land in the hospital. “A long time ago in a galaxy far away,” a colleague in our week-end call group left forty patients in the hospital for me to care for! His instructions for me were to “feed and water” over the weekend. I no longer associate with either of these doctors who have such a different vision of care.
Have you seen the commercial of a tree falling in the forest and calling out for someone to notice and help it get up? It’s a clever ad and has allusions to the philosopher George Berkley who once said that if there is no human to hear a tree falling in the forest it doesn’t make a “sound.” The professor argued that a sound is actually an interpretive perception in the human brain of sound energy transmitted from a vibrating ear drum. Don’t worry, I’m not going philosophical on you this week. The problem is a lot of my older trees are falling down.
Last week three of my older patients fell down resulting in two hip fractures and a broken pelvis. There was no storm that uprooted my folks or toppled them. They tripped and their balance and muscle strength was insufficient to save them from disaster. I’ve seen trees in the forest that, for no apparent reason, die and then fall over. The TV commercial tree was alive and talking as it crashed to the forest floor; and my folks survived their falls and are still with us.
My wife and I have more aches and pains now that we’re north of sixty. We’ve had our share of misery from injuries, but those aches arose from identifiable causes rather than from the mysterious “stiffness” that settles in us each evening. Apparently, my patients are a reflection of their older doctor. I haven’t fallen yet and I’ve not lost any limbs to rot, unless you count the bald spot on the back of my head.
I preach to my patients they must “use it or lose it.” This is especially true of flexibility and strength in the legs. You see it is the thigh muscles that get you up, keep you going and then set you down safely without toppling over.
I love the song “Summer time and the living is easy…” from Porgy and Bess. In the summer time of our lives everything works, but when we move into the fall it’s harder. I often give pep talks to patients who are struggling with movement they once took for granted. I use the metaphor of treading water in the lake. I say, if you quit treading you’ll sink and drown.
I have a new iPhone that I’m struggling to adjust to. I was happy with my old smart phone, but the technology is changing and I must do so as well or sink. I had to make the change because my old “smart” phone was no longer able to update my apps and I need these to keep my medical edge. So I had to change and I find it’s like buying a new pair of shoes and trying to break them in without blisters. I like old comfortable shoes, but sometimes these wear out and have to be replaced.
I’m not a techy person so the twenty-first century is harder for this twentieth century guy. Nonetheless, I’m thankful for Cat Scanners which hadn’t been invented when I began medicine. I’m thankful for the word processor which allows a “hunt and pecker” to write creatively. You see, I came up as a science guy and I never learned my key board. I’m still waiting for word recognition technology that’s good enough to understand a mid-southern dialect with the nasal twang of our Tennessee Mountains.
Lastly, you may think it strange, but I’m thankful for text messaging. This technology allows me to interact with my family across the country and share pictures, witticism, and news. It’s better than email and isn’t stiff like Skype. Of course, there is the danger that everyone will just retreat into their smart phones instead of talking to their dinner guest or spouse. There have always been rude people, and some I’d just as soon stay in their virtual world.
I believe you’ll quickly find yourself over the hill if you stop trying to be better. There is a fundamental principle of our universe called entropy. This principle of physics holds that all energy systems wind down. A spinning top eventually slows and falls over unless you keep pumping energy into the system. I encourage my patients to listen and apply the SNL advice of Hans and Franz and “Pump it up.”
My folks with the broken bones have gone to rehab to pump them up and help them get back up. I only wish I could do the same for my country. You see, America has fallen and I hope someday it can get back up.