The Matzo Chronicles: Medical Ageism. Don’t ‘Live with It’

By Karen Galatz

RENO, Nevada — As I grow older, I know to expect a certain number of aches and pains. As my late, stoic cousin Martin wryly said at 92, “If it weren’t for my legs, I’d feel like I’m 80.”

But while I expect some health challenges, I didn’t expect problems with my health care providers.

Yet, after a recent summer-long, not-so-merry, merry-go-round of tests and doctors’ appointments, I was blindsided by blatant ageism in the medical community.

I’ve always had a bad back, but in recent months I’ve started having extreme difficulty and pain walking up stairs. With each step, it’s like I’m teaching my right leg (and my brain) the “art” of limb lifting. I practically need to lift my right leg with my arms. It’s slow. It’s painful. It’s no way for an active person to function.

And it’s not like I lead a sedentary life. I work out with a skilled trainer twice a week, and I’m a Pilates class regular.

The stair problem was on abundant display this spring when my husband and I traveled to Spain, a step-climbing, steep-hilled tourism country if ever there was one. At the Alhambra, I hobbled up breathtaking vistas, barely taking them in. In the historic, restored Jewish quarter of Girona, I stumbled along steep streets, and, in Barcelona, even the few steps at the famed Sagrada Familia made me debate my zeal for viewing the stunning kaleidoscopic interior.

And, in Cordoba, aching, numb, and sweating, I stood in front of a statue of Maimonides and wondered not about the great man’s achievements, but instead what medical advice he might have offered me!

Once home, I immediately scheduled an appointment with an orthopedic back doctor. After waiting five weeks to see him, I was ushered in. After three minutes, he ordered a battery of tests and referred me to a hip specialist.

After seeing that doctor, who ordered more tests, I spent almost three months being poked, prodded, needled, bent this way, bent that way, questioned, and re-questioned. I was EMG-ed, MRI-ed, and x-rayed so many times I was sure my skin, bones, and internal organs were fried.

Finally, the big week arrived! I had back-to-hip appointments scheduled. The two ortho-docs had allegedly consulted (a technical term for plotting torture), and I was going in for the big treatment plan “reveal.”

I had already told them that I had tried physical therapy to no avail and that I was taking anti-inflammatory medication.  So, what was next, I wondered.

Happily, I knew beforehand that there was no horrific surgery-required, mega-problem, or solution on the menu. I presumed the ortho-duo would recommend — shudders —some number of nasty steroid injections into my hip and/or back.

But instead of a compassionate plan …

I was greeted by indifference, a lack of responsibility, agism, and most likely, a nasty side of agism’s sister, “ism,” sexism.

First up, the back doctor: “It’s a hip problem. Go to the hip doctor.”

“But …,” I tried to interject with a few questions.

But the back doctor was done and halfway out the door.

I pressed on. But answers to questions I didn’t get. Instead, he dismissed me with a referral for PT AND a lecture that began with the words “As we age” and ended with “live with it.”

The next day I went to see the hip doctor.

“It’s not a hip problem.”

“Uh, but how do you explain the test that showed nerve damage? The doctor who conducted the nerve study felt that it was a significant problem requiring attention,” I said. “What’s causing the nerve damage?”

“I don’t read nerve study tests,” he declared. “Go back to the back doctor. He’s the guy for that.”

“But …” I sputtered.

He handed me a PT referral AND a prescription for an anti-inflammatory.

“I told you PT isn’t helping, and if you reviewed my chart, you’d see I’m already taking that medication.”

Without missing a beat, he jumped to the “aging/live with pain” speech and walked out.

When I got home, I related all this to my husband, who observed, “I never have doctors reference my age, and I’m five years older than you. Why do you think that is?”

We both knew the answer — sexism.

In the weeks since then, I keep wondering … If I had been a 16-year-old or even a 36-year-old, presenting with a similar complaint about being unable to walk up stairs and in pain, would the doctors have summarily dismissed me with the “live with it” line?

Clearly, it doesn’t require the wisdom of Maimonides to know the answer. It’s obvious. Of course not.

What I experienced was a classic case of ageism in the medical profession. Studies show that older adults experience this type of prejudicial and harmful treatment between 20 and a staggering 50 percent of the time.

According to the World Health Organization, medical ageism includes a wide variety of misconceptions and stereotypes about older people having depression, loneliness, immobility, cognitive decline, anger, and stubbornness.

As a result, they assume older patients are frail or incompetent and offer limited or sometimes excessive treatment options based on age versus individually tailored needs, use condescending elderspeak language (sweetie, dear, young lady), and fail to provide adequate pain management at the end of life.

Ageism in medicine can also result in missed or delayed diagnoses, more emergency room visits, more frequent hospitalizations, a shorter lifespan. and reduced quality of life.

All in all, it’s a prescription for disaster!

To combat ageism, medical professionals should — among other things — challenge their own stereotyped assumptions, treat older patients with respect, and include them as partners in developing treatment plans.

As for us patients, we should not tolerate the behavior I suffered. Go in prepared with your questions. Write them down, if need be, and consider bringing an ally with you.

Somehow, although I did all that (minus the ally part), I failed to get the attention and care I deserved. Since then, I wrote a letter of complaint to that medical group’s CEO, and I’ll be seeing a new doctor.

Meanwhile, I can only echo my cousin Martin: If it weren’t for my back and hip, I’d feel like I’m 80. Of course, I’m only 71, but still …

*

You can read more of Karen’s work at Muddling through Middle Age or contact her at karen@muddling.me.