Never Bulla Shita you Mama

Mrs. Ravioli comes to visit her son Anthony for dinner. He lives with a female roommate, Maria.

During the course of the meal, his mother couldn't help but notice how pretty Anthony's roommate is. Over the course of the evening, while watching the two interact, she started to wonder if there was more between Anthony and his roommate than meet the eye.

Reading his mom's thoughts, Anthony volunteered, "I know what you must be thinking, but I assure you, Maria and I are just roommates.''

About a week later, Maria came to Anthony saying, "Ever since your mother came to dinner, I've been unable to find the silver sugar bowl. You don't suppose she took it, do you?"

"Well, I doubt it, but I'll email her, just to be sure." So he sat down and wrote an email:

Dear Mama,
I'm not saying that you "did" take the sugar bowl from my house; I'm not saying that you "did not" take it. But the fact remains that it has been missing ever since you were here for dinner.
Your Loving Son,
Anthony

A few days later, Anthony received a response email from his Mama which read:
Dear son,
I'm not saying that you "do" sleep with Maria, and I'm not saying that you "do not" sleep with her. But the fact remains that if she was sleeping in her OWN bed, she would have found the sugar bowl by now.
Your Loving Mama

Moral: Never Bulla Shita you Mama

Is ageism prevalent in our healthcare system?

According to a study in the Notre Dame Journal of Law, Ethics & Public Policy called Invisible, Unequal, and Forgotten: Health Disparities in the Elderly, yes, it is. The research focuses on the US but I think the same issue is here in Canada.

The article states that more than thirty years of research revealed that negative and indifferent attitudes towards the elderly exist among educators, medical students, and residents. First-year medical students at the beginning of the academic year were surveyed regarding the care of the elderly. Students were less likely to admit an eighty-five year- old woman to the intensive care unit, intubate her, and provide aggressive care for her than they were to treat an acutely ill ten-year-old girl with chronic leukemia. Male and younger students were more likely to have negative attitudes towards a hypothetical seventy-year-old patient.

In several recent studies, medical students and internal medicine and surgery residents received instruction on the comparable efficacy of breast conservation and modified radical mastectomy in the treatment of breast cancer. The patients in the scenario differed by age and occupation. There were no differences in treatment recommendations based on high- and low-income occupations. A pattern of ageism was observed in responses. Modified radical mastectomy was recommended for 34-38% of older patients and 11-15% of younger patients. Breast reconstruction surgery was recommended to 89-96% of younger patients, compared with only 66-72% of older patients.

Attitudes towards older adults do influence the provision of care to the elderly. For example, the examination of the rates and types of procedures used in the elderly reveals ageism exists in cardiology. Higher rates of life-saving interventions, such as cardiac revascularization, occur in younger patients rather than older patients.

Despite a higher prevalence of coronary artery disease in the elderly, older adults, especially older women, are less likely to receive appropriate cardiac care, including echocardiography and cholesterol testing. Elderly with severe heart disease are more likely to receive medical management rather than surgical intervention and less likely to receive optimal therapy after a heart attack. It is asserted that ageism in the medical profession is a manifestation of ageist attitudes in society at large, a society that gives preference to youth over age; in addition, a proportion of ageism may be due to a lack of awareness of evidence-based medicine concerning the treatment of older adults. Similar patterns of age discrimination exists for numerous health condition, such as stroke, Dementia, Heart Conditions, Cancer to name a few.

End of life, care is also an area where care is lacking, despite heightened awareness of end-of-life care issues, studies indicate that patients receive the care that is not congruent with their wishes and that alleviation of symptoms is inadequate.

 A significant proportion of dying patients have inadequate pain control or are referred for hospice or palliative care services very late in their terminal illness. Some physicians experience ethical issues in providing end-of-life care that conflicts with their consciences.

Death and dying in the United States predominately involve the elderly. Persons aged sixty-five and older account for three-fourths of dying patients in the nation. Older patients are disproportionately impacted by unsatisfactory end-of-life care. Similar to other health care concerns, end-of-life care for all Americans are deficient, but minority groups suffer inordinately from insufficient care. As more and more boomers age, these issues will need to be addressed.

The presumption at all times is...

The presumption at all times and under all circumstances should always be that you are good enough, worthy enough, and lovable enough. And that you are exactly the right kind of person, in the right place, at the right time.

A whimsical look at the future

How'd you like a little peek into the future?

You're sitting around a warm and cozy fireplace surrounded by friends and boisterous laughter. Early-morning snow gently falling across the countryside is visible from the enormous, ceiling-high windows beside you. Everyone is sipping hot chocolate, and reminiscing about the fabulous circumstances that have brought you together, brimming with even more excitement for times to come. And then you chime in, "If only we knew how inevitable this all was, we never would have worried so much. If only we had the slightest inkling that our challenges, lacks, and issues would sooner make possible the whirlwind of events that swiftly followed… we'd have been as proud then, as we are now." 

And then everyone nods and laughs thoughtfully, and starts taking selfies.