My best friend Esther is one of the most special people I have ever met. She is kind, creative, bright, stubborn and extremely witty. She’s also 86.
Esther and I were paired through a local program called One Good Deed, which partners volunteers with older adults at risk of loneliness and isolation in the Atlanta community. From the first, I realized this would not be a “typical” volunteering assignment where the intrepid individual provides an altruistic service to a disadvantaged individual. Esther was determined to teach this young medical student what it means to be old and disabled, yet fiercely independent.
And she succeeded.
In our first meeting, we sat down on her driveway (which Esther meticulously sweeps herself) in plastic lawn chairs and chatted for hours without noticing the time slipping away, relaying more and more shared interests, life histories and values. We are both Israeli and yearn to return to our homeland, we both have attended protests for social justice causes and love to discuss current events over sweet treats.
My three hours with Esther every other week became a respite from the stress of my studies, and I became a shoulder for Esther to lean on when she needed to unload her struggles as a disabled individual living completely alone, navigating the complexities of healthcare and various social services, or simply conflict with a neighbor.
Esther has become one of my dearest friends here. She is the first person I tell when I get my exam scores or when I complete a challenging anatomy dissection and she always emphasizes how proud she is of me. When she tells me how she got the mail on her own or made a pulley system to move l things up the stairs easily, I cheer her on, too.
One of my most memorable experiences of the year happened during the Jewish high holiday of Rosh Hashanah. Esther’s children live far away, and she told me she was going to be alone for the holiday. I decided to bake her a challah (traditional Jewish bread) and bring it over to her house with my boyfriend. When we got there, she had set the dining room table and lit the ritual candles. We sat and ate and talked for more than two hours. If it weren’t for us, she would not have celebrated the holiday. My boyfriend and I don’t have family in the area, so Esther has become our family, At the end of the night, we joked about how we “adopted” each other.
Despite her physical limitations, Esther is independent and determined to stay that way for as long as she can. Yet many people in her life – from her neighbors to her physicians – underestimate her based on her appearance and tremulous voice. They don’t see the “sabra,” the strong, stubborn Israeli pioneer, the immigrant to a new country who had to learn English on her own, the mother of two successful children, the accomplished teacher and speech pathologist. Too often in our lives, we underestimate the older adults around us and patronize them.
During a recent hospital shift, we admitted an 82-year-old woman after a non-fatal suicide attempt. In the emergency department, this woman was diagnosed as having “dementia,” a label that threatened her autonomy, limiting her ability to make decisions surrounding her own care.
Yet, when I entered her room, I encountered an alert woman updating her address book. Through talking with the patient, I formed a clearer picture of her emotional and mental state and our team struck the dementia diagnosis from her chart. I still think about her and wonder what would have happened had no one taken the time to sit with her and listen with an unbiased perspective, rather than accept a faulty label.
A recent poll of 2,035 older adults found that 93% of individuals – nearly every participant– experienced incidents of “everyday ageism.” These incidents include verbal and non-verbal hostility and are associated with poorer well-being and health outcomes among older adults. Yet the population of older adults in our country continues to rise.
Even as we advance through the ranks of medical practice, we can allow ourselves to be mentored once again, to learn from others with different backgrounds and lived experiences.
During my time rotating in a primary care clinic, I have been able to form deeper relationships with older patients and understand the unspoken hardships of navigating the health care system because of my time with Esther. I have been able to have frank, deep conversations about incontinence post-menopause and the fatigue that comes more easily when you’re an older adult with a chronic illness.
When I work in the movement disorder clinic, I make the effort to laugh with our patients with Parkinson’s because I can see my grandfather’s experience in their eyes. As health care providers, we can work to understand the challenges older adults experience before they reach the examination room.
Through taking this time to listen and understand, whether from our own relatives or just a brief conversation with a neighbor– we can realize that we are more alike than different.
Every day I spend with Esther, I learn this lesson all over again and every day I am so grateful for our friendship.
Natalie F. David is a medical student at Emory University School of Medicine.
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