Old and Sick in America: The Journey through the Health Care System

By Muriel R. Gillick | Go to book overview

CHAPTER ONE
Going to the Doctor

Every so often during my years as a primary care geriatrician, a new patient landed in my practice who hadn’t seen a doctor for forty or fifty years. Sometimes, the last direct personal encounter with a physician had been during childbirth. I faced patients like that with a shiver of dread because they usually turned out to have something terrible wrong with them, like the woman who had been healthy all her life, who exercised regularly and ate a good diet, and who came to see me because she’d woken up one day feeling as though she’d been hit by a Mack truck. She might as well have been hit by a truck: she proved to have widely metastatic cancer and would be dead within six weeks. Or there was the 82-year-old woman who had never been sick a day in her life and, according to her, still wasn’t. She was dragged into the office over her vociferous protests by her son and daughter because she went out into the snow wearing sandals and left the teapot burning on the stove long after all the water had evaporated. She had Alzheimer’s disease which had progressed to the point where she could no longer safely live alone. Her judgment, markedly impaired by her dementia, didn’t allow her to grasp her situation. She refused to accept the various creative compromises her family and I devised to provide support for her while allowing her to maintain a mea sure of autonomy. I thought that if only I had known her for years and been able to establish a relationship with her, I could have chipped away at her denial. She might have trusted me and let me gradually arrange increases in the amount of supervision she had, allowing her to stay at home. Instead, she lost her zest for life after her daughter, at her wit’s end, placed her in a nursing home.

These health care virgins were the exceptions that proved the rule—almost all older people have a long history of interactions with the health care system, and most of those interactions take place in the doctor’s office. Even the outliers, like my patient who had stayed away from the medical profession for decades, sought help in the outpatient setting when they finally developed problems that either they or their families could no longer ignore. The doctor’s office, for the vast majority of patients, is where the journey through the health care maze begins. And the tour guide, the person most likely to accompany them through sickness and through health, is their personal physician.

-3-

Notes for this page

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this page

Cited page

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited page

Bookmark this page
Old and Sick in America: The Journey through the Health Care System
Table of contents

Table of contents

  • Title Page iii
  • Contents vii
  • Prelude ix
  • Abbreviations in the Text xxi
  • Part I - The Office 1
  • Chapter One - Going to the Doctor 3
  • Chapter Two - The Lay of the Land 23
  • Chapter Three - From the outside in 41
  • Chapter Four - The March of Time, 1965–2015 61
  • Part II - The Hospital 79
  • Chapter Five - Entering the Palace of Technology 81
  • Chapter Six - The Varieties of Hospital Experience 97
  • Chapter Seven - The Hospital through Other Eyes 113
  • Chapter Eight - The Transformation of the American Hospital, 1965–2015 133
  • Part III - The Skilled Nursing Facility 151
  • Chapter Nine - Going to Rehab 153
  • Chapter Ten - Different Snfs, Different Miffs 169
  • Chapter Eleven - Movers and Shapers 184
  • Chapter Twelve - Now and Then 202
  • Finale 223
  • Acknowledgments 245
  • Notes 247
  • Bibliography 267
  • Index 293
  • Studies in Social Medicine 301
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this book

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this book
  • Bookmarks
  • Highlights & Notes
  • Citations
/ 302

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.