Geriatrics: a love poem to duality, ambiguity, and whole-heartedness. Thread 1/8

As our society age exponentially, why are only 1/3 of geriatric fellowships nationally get filled? Agism, low-pay, but most importantly, the rare combination of LOVE for uncertainty and complexity in the face of mortality and decline 2/8

An innate tension between preservation of independence and grief over loss; a joy that the whole person is always more than the individual organs and diseases 3/8

We don’t fit neatly in ICD billing codes, not captured well in electronic medical records, missing from quality metrics; A promise land lies in the narrative of one’s experience, support network, layered like a good novel, crescendo and decrescendo over time 4/8

A thirst to understand our complex medical system: in homes, offices, nursing homes, SNFs, and hospitals; Medicare, Medicaid, long-term care insurance, and the donut holes where real lives suffer and thrive, because of AND in spite of agism, sexism, and racism 5/8

Geriatricians belong everywhere yet nowhere: hidden in leadership and missing from covid task forces. 6/8

Our American society loves the shine of individualism over collective decision-making, procedures over cerebral, cures over care, reductionistic single diseases over the imperfect wholeness 7/8

2020 has been the hindsight of things always there: the un-mattering of Black, brown, poor, and old lives. May 2021 be a new beginning, a true shift toward our messy, beautiful, broken, mosaic world 8/8

@HealthInAging @Atul_Gawande @LouiseAronson @vivek_murthy @BarackObama @NYTHealth @JAMAInternalMed @AnnalsofIM @AGSJournal @washingtonpost @GeriPalBlog @sharon_inouye @drjohnmorley @BreneBrown @kevinmd @BreneBrown #ThisIsGeriatrics