It was the year of saying goodbye.
In 2015, The Times began following six people age 85 and up, documenting their journeys through a stage of life that is often invisible.
Four were still alive at the start of 2019. Jonas Mekas, 96, began the year at home from the hospital, tired, hoping to finish a film he was making for a performance of Verdi's Requiem. "Another year," he said last New Year's Day. "Hope it will be busy and productive."
On Jan. 23, he asked his son, Sebastian, to sit him upright in a chair — a preparation, Sebastian said, for his spirit to go forward to the next adventure. He died at the small wooden table where he'd sat with so many friends.
Jonas was the last of the three men in the Times series. Of the three women, two also died in 2019. Both were 95.
In late December, Ruth Willig, 96, learned that she was the only one left. "Ohhhh," she said, taking it in. "What happened? Am I the only one? I'm going to cry."
Death had been a regular part of our conversations over the past five years, as it had been with the others. Ruth had been consistent: she did not worry much about death, but she did think about how she would go. Would it be painful or drawn out? Would she become a burden to her children?
"You saw I was almost crying before when you told me about that," she said. "It really hit me. I can't believe…." She stopped.
Finally, she said, "I'm ready, I am. But I worry about my children. They're so devoted to me. It scares me."
More ...
https://www.nytimes.com/2020/01/03/nyregion/ruth-willig-oldest-death.html?
Saturday, January 4, 2020
Older People Need Geriatricians. Where Will They Come From? - The New York Times
Linda Poskanzer was having a tough time in her late 60s.
"I was not doing well emotionally," she recalled. "Physically, I didn't have any stamina. I was sleeping a lot. I wasn't getting to work."
A therapist in Hackensack, N.J., Ms. Poskanzer was severely overweight and grew short of breath after walking even short distances. Her house had become disorganized, buried in unsorted paperwork. The antidepressant she was taking didn't seem to help.
Her son, visiting from Florida, called his sisters and said, "Mommy needs an intervention."
One of her daughters made an appointment with a geriatrician — a physician who specializes in the care of older adults. Dr. Manisha Parulekar, now chief of geriatrics at Hackensack University Medical Center, suggested her new patient take action on several fronts. She arranged for a sleep study, which found that Ms. Poskanzer suffered from apnea. She prescribed a different antidepressant, and physical therapy in a pool to help rebuild her stamina.
And weight loss. Eventually, the geriatrician agreed that bariatric surgery made sense. Over nine months, Ms. Poskanzer lost 75 pounds; she has shed another 15 since.
Now about to turn 80, Ms. Poskanzer is still providing therapy, 30 hours each week, feels "full of spirit" and continues to see her geriatrician every four months. "She sits and talks, which a lot of doctors don't do anymore," Ms. Poskanzer said. "And she knows me. I feel very well taken care of."
Testimonials like this spotlight the rising need for geriatricians. These doctors not only monitor and coordinate treatment for the many ailments, disabilities and medications their patients contend with, but also help them determine what's most important for their well-being and quality of life.
More ...
https://www.nytimes.com/2020/01/03/health/geriatricians-shortage.html?
"I was not doing well emotionally," she recalled. "Physically, I didn't have any stamina. I was sleeping a lot. I wasn't getting to work."
A therapist in Hackensack, N.J., Ms. Poskanzer was severely overweight and grew short of breath after walking even short distances. Her house had become disorganized, buried in unsorted paperwork. The antidepressant she was taking didn't seem to help.
Her son, visiting from Florida, called his sisters and said, "Mommy needs an intervention."
One of her daughters made an appointment with a geriatrician — a physician who specializes in the care of older adults. Dr. Manisha Parulekar, now chief of geriatrics at Hackensack University Medical Center, suggested her new patient take action on several fronts. She arranged for a sleep study, which found that Ms. Poskanzer suffered from apnea. She prescribed a different antidepressant, and physical therapy in a pool to help rebuild her stamina.
And weight loss. Eventually, the geriatrician agreed that bariatric surgery made sense. Over nine months, Ms. Poskanzer lost 75 pounds; she has shed another 15 since.
Now about to turn 80, Ms. Poskanzer is still providing therapy, 30 hours each week, feels "full of spirit" and continues to see her geriatrician every four months. "She sits and talks, which a lot of doctors don't do anymore," Ms. Poskanzer said. "And she knows me. I feel very well taken care of."
Testimonials like this spotlight the rising need for geriatricians. These doctors not only monitor and coordinate treatment for the many ailments, disabilities and medications their patients contend with, but also help them determine what's most important for their well-being and quality of life.
More ...
https://www.nytimes.com/2020/01/03/health/geriatricians-shortage.html?
Friday, January 3, 2020
Opinion | Why Are You Publicly Sharing Your Child’s DNA Information? - The New York Times
A few years ago, Angela Evans decided she wanted to test the DNA of her 10-year-old daughter and 7-year-old son. She was interested in knowing whether they had a mutation of the MTHFR gene, as she does. The mutation is linked to a number of disorders — women with the mutation may have a higher risk of having babies with defects like spina bifida — and Ms. Evans wanted to make life changes for her children based on the results.
When doctors told her they didn't think there was a medical need to test her children, she decided to use 23andMe, the direct-to-customer genetic testing company.
To use 23andMe's services, the user simply sends in a saliva sample. Within five weeks the company returns the results, without the mediation of a doctor or genetic counselor.
Along with finding out that both her children had a mutation of the MTHFR gene, she also received 23andMe's analysis of her children's genetic susceptibility to a number of adult-onset diseases, including Parkinson's. Ms. Evans shared the results with her children, family members and friends.
Then she uploaded their DNA data to MyHeritage and GEDmatch hoping to learn more about the family's genealogy. Sites like GEDmatch and others are "open-source databases" on which people freely share their DNA online, usually in the hopes of finding long-lost relatives.
More …
https://www.nytimes.com/2020/01/02/opinion/dna-test-privacy-children.html?
When doctors told her they didn't think there was a medical need to test her children, she decided to use 23andMe, the direct-to-customer genetic testing company.
To use 23andMe's services, the user simply sends in a saliva sample. Within five weeks the company returns the results, without the mediation of a doctor or genetic counselor.
Along with finding out that both her children had a mutation of the MTHFR gene, she also received 23andMe's analysis of her children's genetic susceptibility to a number of adult-onset diseases, including Parkinson's. Ms. Evans shared the results with her children, family members and friends.
Then she uploaded their DNA data to MyHeritage and GEDmatch hoping to learn more about the family's genealogy. Sites like GEDmatch and others are "open-source databases" on which people freely share their DNA online, usually in the hopes of finding long-lost relatives.
More …
https://www.nytimes.com/2020/01/02/opinion/dna-test-privacy-children.html?
Wednesday, January 1, 2020
NYTimes: Doctors, Nurses and the Paperwork Crisis That Could Unite Them
Broken, wasteful, inhuman, expensive, deadly. The problems with the American health care system, or non-system, are neither subtle nor unrecognized — especially by those of us doctors and nurses who actually provide the care. And yet we all too often feel the most helpless, seeing how much of the problem is driven by drug companies and hospital networks.
Too often, each profession sees the other as fighting separate battles, and sometimes against each other. Doctors blame nurses, and vice versa, for the failings of a system that punishes us all, and our patients.
Instead, the two of us are suggesting that nurses and doctors try something unusual. Let's put our differences aside and work together to achieve real change, starting with a pernicious problem that drives so much of our mutual discontent: electronic health records.
The current system is pushing both doctors and nurses to the breaking point. Enough doctors in the United States commit suicide every year to fill two large medical school classes. A 2019 MedScape report found that 44 percent of physicians feel "burned out," driving many to alcoholism and depression, or to leave the profession entirely.
Nurse suicides are not systematically measured and reported, but a 2017 study in England found a suicide rate among nurses that was 23 percent above the national average. Half of all nurses are considering leaving the profession, according to a 2017 study by RNnetwork.
Clinicians are notoriously overworked, but ask anyone on a hospital staff, and he or she will tell you that workloads have become heavier the last several years thanks almost entirely to the arrival of electronic health records — detailed reports about a patient's medical history and care. Originally intended as a work-saving tool, the records have gone in the opposite direction, taking time away from patient care in the name of electronic box-checking.
More ...
https://www.nytimes.com/2019/12/31/opinion/doctors-nurses-and-the-paperwork-crisis-that-could-unite-them.html?
Too often, each profession sees the other as fighting separate battles, and sometimes against each other. Doctors blame nurses, and vice versa, for the failings of a system that punishes us all, and our patients.
Instead, the two of us are suggesting that nurses and doctors try something unusual. Let's put our differences aside and work together to achieve real change, starting with a pernicious problem that drives so much of our mutual discontent: electronic health records.
The current system is pushing both doctors and nurses to the breaking point. Enough doctors in the United States commit suicide every year to fill two large medical school classes. A 2019 MedScape report found that 44 percent of physicians feel "burned out," driving many to alcoholism and depression, or to leave the profession entirely.
Nurse suicides are not systematically measured and reported, but a 2017 study in England found a suicide rate among nurses that was 23 percent above the national average. Half of all nurses are considering leaving the profession, according to a 2017 study by RNnetwork.
Clinicians are notoriously overworked, but ask anyone on a hospital staff, and he or she will tell you that workloads have become heavier the last several years thanks almost entirely to the arrival of electronic health records — detailed reports about a patient's medical history and care. Originally intended as a work-saving tool, the records have gone in the opposite direction, taking time away from patient care in the name of electronic box-checking.
More ...
https://www.nytimes.com/2019/12/31/opinion/doctors-nurses-and-the-paperwork-crisis-that-could-unite-them.html?
When the Surgeon Is a Mom - The New York Times
As a health care professional, Dr. Erika Rangel is trained to know when things are going wrong. That alarm went off one day in her fourth year of surgical residency. Her son, just 3 months old, had developed a fever. She couldn't be late for her operating shift, but his day care wouldn't accept him if he was sick. So she did what desperate mothers do and got inventive: She slipped liquid Tylenol into his bottle, in the hopes of lowering his temperature, and dropped him off.
Later that day, she stood in surgery with her eyes continually checking the clock, willing the operation to finish in time for pickup. She prayed that the day care wouldn't realize he was feverish. Had they noticed that his milk had turned medicine pink?
"I felt like I wasn't being a great mom or partner or resident," said Dr. Rangel, 42, now an assistant professor of surgery at Harvard Medical School. "Something had to give. I thought about quitting a lot."
When Dr. Rangel was in medical school, she searched diligently for a specialty that she liked as much as surgery. Her friends cautioned her that if she became a surgeon, she would never have a personal life. She wouldn't have time for children, they warned — and what man would want a spouse who was constantly in the operating room?
"It became a tug of war between choosing a lifestyle profession versus something I truly loved with all my heart," Dr. Rangel said. "I chose surgery in spite of all the warnings, and I've spent my whole life navigating that balance."
More ...
https://www.nytimes.com/2019/12/20/science/doctors-surgery-motherhood-medical-school.html?smid=nytcore-ios-share
Later that day, she stood in surgery with her eyes continually checking the clock, willing the operation to finish in time for pickup. She prayed that the day care wouldn't realize he was feverish. Had they noticed that his milk had turned medicine pink?
"I felt like I wasn't being a great mom or partner or resident," said Dr. Rangel, 42, now an assistant professor of surgery at Harvard Medical School. "Something had to give. I thought about quitting a lot."
When Dr. Rangel was in medical school, she searched diligently for a specialty that she liked as much as surgery. Her friends cautioned her that if she became a surgeon, she would never have a personal life. She wouldn't have time for children, they warned — and what man would want a spouse who was constantly in the operating room?
"It became a tug of war between choosing a lifestyle profession versus something I truly loved with all my heart," Dr. Rangel said. "I chose surgery in spite of all the warnings, and I've spent my whole life navigating that balance."
More ...
https://www.nytimes.com/2019/12/20/science/doctors-surgery-motherhood-medical-school.html?smid=nytcore-ios-share
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