The Secret Life of a Geriatrician
This new BGS blog series shows how passion for a career and extra-curricular activities can share fascinating qualities.
Desmond (Des) O’Neill is a geriatrician and cultural gerontologist in Dublin. He is also the local lead for the IAGG-ER Congress in 2015.
Last week was even more fun than usual. In addition to my current day job in the Acute Medical Unit, I was involved with a concert of works by our composer-in-residence; my first time speaking at a book festival; a talk to emergency physicians on traffic medicine at IAEM 2014; sitting in on a cracking competition in geriatric medicine between Irish medical schools, the Jack Flanagan Prize; and attending a study day on architecture, design and medicine.
Working as a geriatrician is fun in general: it remains one of life’s mysteries to me that this seems counter-intuitive not only to the general public but also to some (albeit increasingly fewer) of our medical colleagues, especially since entry to training in geriatric medicine has become so highly competitive in Ireland.
From an early age I was exposed to a very positive world-view of older people, including the presence of dementia and other illnesses. My own parents engaged fantastically with their parents, aunts and uncles, frequent visitors to our house.
All four of my grandparents developed dementia, my paternal grandfather making tea from the tobacco tin while my maternal one, a veteran of Gallipoli and the Somme, reverted to some unsavoury practices from the trenches.
For us as children they remained remarkable, and while I now realize I registered my parents’ distress, I also took in their complete acceptance and immediate assumption of caring as a part of life.
My journey to becoming a geriatrician, and working with people at the most complex and enriched stage of their lives, was greatly facilitated by a volunteer year spent between pre-clinical and clinical studies in Marseille with a volunteer organization looking after older people.
Fate also had a hand: a romantic entanglement found me in a tiny town in Hesse in Germany, Hofgeismar, which also happened to be the cradle of German geriatric medicine.
My subsequent engagement with the arts and writing in medicine flowed naturally from both the practice of geriatric medicine – the most holistic of medical specialties – and a desire to evangelize the good news about older people, our own ageing, and the excitement of research in ageing, a veritable Klondike of unanswered (or misanswered) questions. In this I am abetted to a major extent by late-life creativity, a brilliant metaphor for what we have gained with age.
Several other factors helped – the involuntary altruism of a wonderfully supportive and tolerant wife and family, and fantastic geriatrician colleagues in Tallaght Hospital in Dublin who completely buy into the big picture. Collaborators in our National Centre for Arts and Health have been many and varied, ably curated by our Arts Director, Hilary Moss.
From the writing perspective, I write a monthly column in the Irish Times, generally devoted to ageing and its wonders. In addition, I contribute regularly to the BMJ Blogs, sometimes sharing the material between the two. The more I write, the more I enjoy it, with ageing, neuroscience and the humanities the key themes.
Equally, I also am increasingly dissatisfied with the gap between what I want to say and what I write, as beautifully described by Gustave Flaubert: “I am irritated by my own writing. I am like a violinist whose ear is true, but whose fingers refuse to reproduce precisely the sound he hears within.”!
In academic terms, it has also been a rich seam, with our first PhD completed, and an evolving research portfolio based on aesthetic deprivation in health care settings. In addition, the juncture between arts and health, medical humanities and cultural gerontology has been illuminating and synergistic.
The high point of the week was the concert, Synaptic Serenades, in paneled Victorian splendor of the Corrigan Hall of the Royal College of Physicians in Ireland. All were deeply touched by this triptych of works on stroke, dementia and Parkinson’s disease, and I will need more time to marshal my thoughts and feelings after the event.
My immediate impression is a strong sense of vitality, life and colour mingled with trauma and challenges, allowing to see the fuller picture of the person and lightening the often gloomy discourse around neurological diseases of later life. The power of this music to reassert our intrinsic humanity is a tribute to to the composer, Ian Wilson, and the performers.
From the architecture and design session, the stand-out element was the presentation by Shelley McNamara on the new building for the medical school in the University of Limerick, combining vision, mysticism, pragmatism and style: building and presentation were both truly vessels for learning! Tom Grey of TrinityHAUS, the lead on a project on design in dementia in domestic settings with which I am collaborating, also gave a wonderful talk.
The book festival event was a stimulus to create a new talk on writing for the public as a doctor, sparked by a book I wrote on Ageing and Caring. A novel aspect was to combine the talk with our usual Friday Grand Round, opening one of the central academic, professional and social forums of the hospital to the general public.
So, as I write this blog on the Sunday, in moments snatched during one son’s soccer match, and the after-dinner calm, what message would I have for fellow geriatricians and trainees? Could it be alert them them to Juvenal’s observation that “An incurable itch for scribbling takes possession of many and grows inveterate in their insane hearts”? Or George Orwell’s view that: “All writers are vain, selfish, and lazy, and at the very bottom of their motives there lies a mystery”
To a certain extent both are true: but I have also gained huge solace and pleasure from writing. I would be ultimately more in sympathy with Graham Greene’s view that: “Writing is a form of therapy; sometimes I wonder how all those who do not write, compose or paint can manage to escape the madness, the melancholia, the panic fear which is inherent in a human situation”.
In other words, have faith in yourself, and get writing!