March 14, 2023

Dateline – Augusta, Georgia

I’m away from home but I can’t say I did any traveling today, unless one counts the four miles from the Doubletree hotel to the Augusta VA medical center and back. The VA, a large national organization, is broken down regionally into subgroups based on geography. Alabama, Georgia, South Carolina and Northern Florida together make up the 7th region and it’s a conference regarding the issues surrounding the house call, geriatrics, and extended care (nursing facility) programs. It’s the first time in several years that such a conference has been held in person rather than on zoom. I was asked to participate due to my many long years of work with the rural house call programs in Alabama and because folk at the regional office had read the first volume of the book and had liked it and thought a wider audience should be aware.

So I came, I spoke, I read from the book, and I finished it off by falling over when I stepped back from the lectern. I had made the mistake of locking my left leg for better standing balance as I had to refer from notes to book I was reading from and back. Doing so irritated my sciatic nerve and when I went to put my weight back on the leg, it gave way and down I went. The irony, especially as one of the entries I had read was one on fall prevention. I was unhurt, other than bruised dignity and the audience was woken up and likely to remember what I had to say a bit more. We shall see if it translates into any sales. Sales of the first volume have been reasonable. Sales of the second volume have been a bit anemic but I haven’t had a lot of energy to put into promotion. I’m thinking I’ll get the third volume out and then I’ll spend some time really trying to push it. Perhaps a commemorative box set with a free Covid bookmark…

The issues that came up today were familiar and universal. Lack of staffing, lack of resources, increasing service needs from an aging population. Heck, they’re the same things we were dealing with more than thirty years ago when I first went into geriatrics. Le plus ce change… I have to face it, it’s a dying specialty. No one wants to go into the field and there’s minimal institutional support for the kinds of work we do. The Baby Boom has decided that aging simply doesn’t apply to them and therefore programs dedicated to aging are irrelevant. I’m not sure how I’m supposed to feel as my life’s work is pretty much written off by society. I guess I just have to wait fifteen or twenty years when I’ll be able to say ‘I told you so’ as the Boom generation finds that it is unable to prevent its die off and the pieces of the medical system that might have been helpful have disappeared through neglect. Palliative care programs will be around and functioning. Most of the younger physicians who would have been attracted to geriatrics in the past are now entering these programs instead. They aren’t quite the same but there is a lot of overlap. I guess when I hit my dotage, there won’t be anyone around to created a decent care plan for my dementia, but there will be someone to make sure I don’t suffer while I go through it. It’s something I suppose.

I was looking forward to a quiet weekend but I received an urgent missive looking for help with a performance happening this weekend so I’m going into a Saturday only performance after rehearsals on Thursday and Friday. Fortunately it’s on book but I still have to become familiar with the material and, as it’s got music involved, figure out what the cues are supposed to be. More on that later…

In the meantime, I ate too much (ribs and loaded mashed potatoes) at the Texas Road House with the VA gang so I am going to lie down and digest for a while before sleep. Another half day of conference in the morning and then the trek back to Birmingham, broken by a late lunch/early dinner with an old friend in Atlanta. If it all works out properly, I’ll be back in time for church choir rehearsal which will make my choir director happy. We are singing an anthem on Sunday – either an old Shaker hymn or selections from ‘Hair’. UU music is nothing if not eclectic.

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