“Concordance.” That means doctor and patient wanting the same thing. In psychiatry we call it a “therapeutic alliance.” We work for it — assuming we have the time. But if the time is not there, on some level we all know that nothing will happen.
Leave it to the pharmacists to at least touch on a reason for “lack of concordance” that nobody seems to discuss. “With increasing numbers of medications shown to do more good than harm when taken as prescribed, low compliance is a major problem in health care,” reads an unpretentious sentence in the abstract.
And people wonder why there is no “trust” between patient and doctor. Read more on Trusting Your Doctor…
I don’t care if Dylan Thomas was drinking himself to death while that was being written. It is a sentiment close to my heart, and undoubtedly the stanza of poetry I quote most often.
I will not accept the allegedly inevitable “cognitive loss of age.”
I suppose my mother did me a service at age 10, when she dragged me fairly close to the oversized window of an oversized ladies room, and told me never to linger trying to make myself attractive, for it would be a waste of time. I was – in the opinion of my parents – destined for brains, not beauty.
Time lost in fixing my appearance would be noted sardonically by my father, and bother him, as we wasted his time.
But my strong suit was my brains, and even I agreed that I should work on them — working very hard in school — and that way I could win in life. I actually took my mother seriously, for a very long time. It was not until my late fifties that I started to be anywhere near a fashionable woman’s size, finding to my amazement that people found me attractive, and taking more notice myself than ever in my life.
But even now, I don’t give a damn if they call it “cognitive loss for age” or “dementia,” I want nothing of it.
Nothing at all.
Gail Sheehy, author of the groundbreaking book “Passages,” (and 15 subsequent spin-off books) is still using that way of looking at life to make a living. I certainly give her points for having figured out how to do that.
The reason is because one of the immutable laws they give you in marketing class is that it is essentially impossible to sell “prevention.” If you do not do “fill in the blank” something horrible will happen.
Something like illness.
When I thought I had diabetes (I don’t) and followed the directions I was given, I told my beloved husband — as well as my parents of blessed memory, who thought that since I was always thought of as a healthy and reliable one and couldn’t possibly be REALLY sick — that I would take good care of myself so that my old age would see me being strong. And comfortable. And of course, reliable to others.
That was when I really believed things that doctors told me., Especially the things that academic doctors told me. They were the people who had taught me, after all, be that in one country or another.
Even I – a supposed expert — have only scraps of information on this drug.
I remember a wonderful professor in medical school, who introduced me to her mother, who had some problems with dementia. Mother had improved greatly, it seemed, in a loving homey institution on a medication called “Centrophenoxine” – which I have since learned is also called “meclophenoxate” or “Lucidryl.” Read more on Mostly Harmless “Smart Drug” — But No Endorsement (Yet)…
She was a friend. Other people sometimes live their entire lives in one place and keep friends for life, but she was more distant, clinging to me loosely, trying to live off free advice. Like almost all the friends I have in one particular region, she was a therapist. Not a bad thing to be, and I believe her to be a competent therapist. But she had the same problem most people in my age group have. She wanted help fighting it.
I suppose the name for it these days is “cognitive loss for age.” Not Alzheimer’s, that “presenile” (the earliest cases described by Kraepelin himself was in mid-fifties) dementia, but getting older.
Mainstream medicine comes up with names and categories and prescriptions, that may or may not offer significant clinical improvement. The human spirit comes up with, well, at least a little good anger. If there is one piece of poetry I quote more than any other, it is Dylan Thomas “Do not go gentle into that good night/Rage, rage, against the dying of the light.” Of course this brilliant Welsh poet, the way I heard it, died of alcohol poisoning in New York; not exactly how I plan to rage against the dying of my light. Oh, how many people who have tried to feed me alcohol I have told I cannot afford to lose any brain cells by that method. I need everything I have to continue to live by my wits. Read more on Advice From A Poet About Memory Loss…