Med students learning respect, empathy for older patients
Elizabeth Shepherd, center, speaks with medical student Zachary Myslinski during a geriatric interview at Weill Cornell Medical School in New York. Students at more than 20 medical schools in the United States are getting an earful “about life, about perspective” from healthy seniors.
Whatever the cluster of second-year students at Weill Cornell Medicine in New York expected to hear from an 82-year-old woman — this probably wasn’t it.
At first, Elizabeth Shepherd, one of several seniors invited to meet with future doctors in an anti-ageism program called “Introduction to the Geriatric Patient,” largely followed the script.
As student Zachary Myslinski, 24, read off questions from a standard assessment tool, she responded in matter-of-fact tones.
Health conditions? Macular degeneration, replied Shepherd, a working actor who also teaches Shakespeare at the Stella Adler Studio of Acting. But she was getting treatment. Recent falls?
Just one, when she missed a bottom step. “In the subway! In public! That was no fun.”
Weight loss? “Unfortunately not.” Shepherd, elegant in an animal-print tunic and dangling earrings, easily tucked her hands behind her head, displaying good range of motion. She remembered three words — “pineapple, blue, honesty” — when asked to recall them several minutes later in a cognitive test.
But after telling her rapt audience that she’d raised a son born “out of wedlock” in 1964 and had divorced twice, she added, “I immigrated to Lesbianland for a little while in my 50s.”
Eventually returning to heterosexual relationships, she continued, she met a 90-year-old online and had “the most wonderful summer with this man.” She’s now involved with a 65-year-old, she added. But “he’s in Afghanistan at the moment, so my sex life is not as active as I’d like.”
Dr. Ronnie LoFaso, the faculty geriatrician guiding the session, said, “This is taking an interesting turn.” But that was the point. “It’s important that they don’t think life stops as you get older,” Shepherd said afterward. “So I decided I would be frank with them.”
Dr. Ronald Adelman, cochief of geriatrics at Weill Cornell, developed this annual program — which includes a theater piece and is required for all second-year students — after he realized that medical students were getting a distorted view of older adults.
“Unfortunately, most education takes place within the hospital,” he said. “If you’re only seeing the hospitalized elderly, you’re seeing the debilitated, the physically deteriorating, the demented. It’s easy to pick up ageist stereotypes.”
These misperceptions can influence people’s care. In another classroom down the hall, 88-year-old Marcia Levine, a retired family therapist, was telling students about a gastroenterologist who once dismissed her complaints of fatigue by saying, “At your age, you can’t expect to have much energy.”
She switched doctors and learned she had a low-grade infection.
At least 20 medical schools in the United States have undertaken similar efforts to introduce students to healthy, active elders, said Dr. Amit Shah, a geriatrician who helps direct the Senior Sages program at the Mayo Clinic School of Medicine.
Though the teaching efforts can be voluntary or mandatory, can emphasize clinical skills or encourage new perspectives, they reflect broad agreement on the problems that ageism brings.
In health care, “you hear a lot of infantilizing language: ‘sweetie,’ ‘cutie,’ ‘honey,’” said Tracey