Appearances

In health care and medical research, as in life more generally, when old people have bad outcomes, a common response is to say, “Well of course, they were old and sick.” But studies show that old people are twenty times more likely to be killed by their medical care than younger people. This presentation discusses why that is and what we can do about it.

Children are 23% of the population but account for 6% of hospitalizations while elders who are 16% of the population make up 40% of hospitalizations and an equally disproportionate share of outpatient visits and prescriptions. Yet the US has 92,000 pediatricians and 7000 geriatricians. Not coincidentally, over the 4 years of medical school, students receive years of training the care of adults, months on kids, and hours to days on elders. Contributors to this socially and individually counterproductive reality include history, perverse health care incentives, medical culture, and geriatricians ourselves. This lecture shows how and why this happened and what we can do about it. 

Discussions of burnout are everywhere, with articles about its impact on millennials, police officers, fast food workers, nurses and doctors. The numbers of affected clinicians are staggering, with nearly half of American doctors reporting burnout symptoms, record numbers leaving practice, and proven dangers to patients as a result. In this presentation, Louise uses the story of her own burnout and recovery to enliven and personalize the statistics and science of this national epidemic, then offers her own take on why it’s happening and what can be done to make things better.

Drawing from both conventional and complementary medicine, Integrative Aging helps older adults live well throughout the decades and stages of old age. It begins with the assumption that elderhood should be approached medically in the same ways we approach childhood and adulthood, recognizing that bodies, lives and priorities change as we move through the sub-stages of each major part of life. It also focuses on health and wellbeing in addition to disease and illness, pays attention to prevention, nutrition, activity, goals, and purpose, and recognizes both the benefits and challenges of growing older.

Many of the key issues facing society today involve health and health care. Whether you’re a patient or caregiver, scientist, nurse, doctor, or anyone else, op-eds and opinion essays are among the most effective ways of sharing your knowledge and experience with a larger audience in ways that can change behavior, policies, beliefs, and where money goes. On websites and in newspapers and medical journals, opinion essays and narratives are among the most read sections. Health care providers, patients and caregivers all have unique perspectives they can use to improve health and health care (or anything else!).

“Withdrawal of care,” “incompetent cervix,” “difficult patient” – each of these expressions is routinely used in health care by everyone from doctors and nurses to patients and the media. In discussing illness and medical care, the words we use, and the ones we avoid, betray our beliefs, assumptions, and biases. They also impact care. This presentation examines how the language we use promotes – or undermines – health and healing, respect and professionalism, and how we can be more thoughtful, kind, and accurate when we talk about things that really matter.

When considering old age, most people look to statistics, medical, sociological, economic data. Missing from that approach are the insights and truths of lived experience. Literature—with a big L, everything from the classics to some of the best, most beautifully written essays and books of today—does just the opposite. It provides social and personal context, helping us question assumptions and enter into the other people’s lives. Using insights from eloquent essays and books about aging by writers in their seventies, eighties, and nineties, as well as little L literature (data), this presentation explores one of the most important and debated subjects of the twenty-first century: old age.

It’s often said that medicine is both a science and an art. But even people who aren’t in health care know that the vast majority of medical training focuses on the science part of that equation. After a brief discussion of the scientifically proven benefits of reading, this presentation looks at how reading widely (children’s literature, fiction classics, cutting edge poetry, illness memoirs, recent award winning novels, biographies, and non-fiction) can make a person a better, happier doctor and human being.

People think they know all they need to know about old age: bodily disintegration, loss of status, ill health, frailty, and death. All those things can be part of old age but a look at the facts and reality of life’s third act tells a much bigger, happier, varied, and more interesting story, one that also includes satisfaction, purpose, relationships, work, health and new opportunities.

Is it different to die in old age, particularly in advanced old age, than to die earlier in life? Should it be? Our chances of dying increase with each year we live and, thankfully, most Americans die in elderhood, not childhood or adulthood. Yet the facts of death in old age speak to different standards of care and attention to dying for older people, even as our country purports to have a single, universal approach. And many of the recent “advances” in care for the dying – from palliative care to assisted suicide – are not set up with the very old in mind. What does death in old age look like today, and what should or could it look like?

Polls find large gaps between what people want at the ends of their lives and what they get. Studies also show that people who live in the parts of the country with the most aggressive care – more specialist visits, more procedures, more time in the hospital – don’t live longer or better than those who receive “less” medical care. How can this be? This presentation explores how the words we use, our assumptions about who and what is worthwhile, and uses the experiences and writings of dying people and their families to consider what questions we should be asking to provide more people with dignified deaths.

Years ago, John Berger showed the many ways so-called objective reality changes depending on how it’s presented to us. He noted that that how we see things, from paintings and TV shows to health, disease and other people, is affected by what we know and what we believe, as well as the context and what information we are given. This presentation uses stories from patient care, medical education, memoirs and the media to illustrate how our tendency to reduce the decades-long phase of life called old age to its hardest moments becomes a self-fulfilling prophesy, and how we can turn that around to benefit us all.

50 minutes. 5 types of stories. 5 tips for telling medical stories. 1 call to action. This multimedia presentation considers how fiction, non-fiction, borrowed stories, personal stories, and patient stories can be used for narrative advocacy, bearing witness, learning, teaching, and transforming health and health care.

There’s a good reason journalists, politicians, fundraisers and businesses use stories when communicating with the public and other target audiences. They work. Stories get people’s attention, are memorable, and can inspire people to action. In this presentation, you will learn how stories can be used for generating empathy, communicating value, and transmitting your message in effective and enduring ways.

The digital revolution has transformed how we learn and communicate. This presentation introduces the new skill set and field that have emerged within healthcare in response these broader societal transformations. Called Public Medical Communication, it includes writing, speaking, and use of social media by health professionals, patients, and caregivers about medicine and health care.

A presentation about stories in medicine, made up of stories from medicine, as well as readings from A History of the Present Illness, photographs, and humor, and including the neurobiology of storytelling and why a doctor would use her precious free time to write fiction.

Op-Ed Writing
Reflective Learning
Writing about Illness
Writing about Healthcare for the public and policymakers
Writing about Science for Non-scientists
Fiction Writing: Telling the Truth with Lies