Tuesday, December 3, 2013

Joys of Geriatrics

Geriatrics is a crucial rotation to have in residency training.  I’m glad that residents can start taking it earlier than their third year now.  The rotation and the attending physicians involved really make you step back and look at the whole picture.  So often I think that we, as residents, get caught up in the minute details and linguistic web of describing someone’s coronary anatomy, or quantifying how much air they can blow out in one second (which is still important); that we lose sight of looking at the patient and their progression through a lifetime.  Geriatricians are emphatic about looking at the whole patient, which I think is a quality any physician should aspire to possess.

                Not only is this broad view incorporated; but also paying attention to the subtlety of a patient’s presentation.  The tempo of their speech.  The way that they walk before sitting down.  Small changes in behavior patterns such as beginning to eat less.  Presentation of common diseases is often subtle, and not textbook when dealing with elderly patients.  A good example of this is depression; which is why it is so important to screen in this population.  Physicians have to be thorough in this population, otherwise treatable disorders can get missed.

                Overall, I enjoyed my time spent on the Geriatrics rotation.  Not only for the reasons and lessons above, but I believe that it made me a more thorough and caring resident.  There was an element of continuity in the nursing homes that I enjoyed.  Regrettably, I will not be able to see how those patient’s do over the next coming months.  For a rotation that I thought I was not going to enjoy, I was certainly both impressed and humbled; not only by the physicians that I worked with, but also by the patients that allowed me to participate in their care.

-- Mitch Tener

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