" A self-proclaimed "late bloomer," Dr. Patrick Healey '76 brings deep respect and attainable goals to healing and helping the aged."
His experience has shown him how, in one important way, society hasn't kept up with science. In the 20th century, life expectancy has increased more than it did in all the years before 1900. So while science has tacked on two or three decades more than people expected to live, we haven't given people anything to do in those later years.
Magazine
Fall 1998
An Ounce of Function Is
Worth a Pound of Cure
by Erik Dafforn
Ask a child about the tree house he just built, or about
the week she just spent at camp, and watch their eyes light up. Maybe a
little scary at first, but what fun it turned out to be! Thrills, pride,
and a sense of accomplishment now consume thoughts once occupied by a task
they considered frightening and infeasible.
Now ask Dr. Patrick Healey '76 about his work with geriatric patients-the 80- and 90-year-olds who may inch their way across his office, who come to him with enough prescribed medicines to fill a grocery bag, most of whom he readily admits will not be cured of many of their diseases.
Now that's depressing, right? Not to Healey. Remember the kid in the tree house?
A Fresh Perspective
Don't confuse Healey's youthful optimism with childish ambitions. As co-founder of St. Vincent Hospitals' Institute on Aging, Healey has undertaken a world of responsibility, and from it, he's earned a world of satisfaction. His latest accolade came in a recent edition of Indianapolis Monthly magazine, which featured a poll of local physicians listing Healey among the most qualified and respected geriatricians in the city.
"That's a pat on the back for the entire program," Healey says. "It's not just me; it's the whole group." The group he's talking about includes everyone at the Institute on Aging, a collection of specialists who are dedicated to geriatric medicine and who have developed a remarkable process for diagnosing illness.
One of the more notable members of the Institute is Dr. Diane Healey, Patrick's wife, partner, and best friend ("she does what I do, only better"). The two met in their first year of medical school and have been together ever since. They spent their fourth year of residency at the University of Nottingham, England, where they studied geriatrics on a fellowship.
The British, Healey notes, were way ahead of the American medical establishment in terms of geriatric studies in the mid 1980s, and his work there began to answer questions he was having difficulty dealing with in the U.S. "Questions like, 'If you treat a 40-year-old and an 80-year-old that both have the same pneumonia, why does the 80-year-old not get better? Is it aging? Is it the medicine?' We tend to be taught in medical school and residency that you know the person by his or her disease, and that just didn't seem to work."
Calling Plays from the Huddle
What does seem to work, thanks to the work of the Institute on Aging, is what Healey calls "outpatient geriatric assessment." Begun in 1987, the process involves a patient being recommended to the program by either a primary care doctor or a family member. The typical patient is older and has numerous medical, functional, or cognitive problems.
Assessing a patient is similar to interviewing a job candidate at a big corporation. The patient arrives at the Institute around 7:30 a.m. and can spend five or more hours talking with various experts, including occupational and physical therapists, a geriatric psychologist, nurse, pharmacist, physician, dietician, and if necessary, a social worker. Later that afternoon, all the experts meet to present their findings and formulate a care plan, which can then be presented to the patient's doctor and family.
Just due to the amount of time they spend with patients, the group can sometimes diagnose problems that other doctors can't. "Most of these people have seen really, really good doctors before they came to me or my wife," Healey notes, adding that the team approach often sheds light on otherwise obscure facts about patients. But "success is in the details. With older folks, you've got to get the details, because the clue may be buried somewhere very subtle."
Healey also has a different definition of "success" than you might expect from a doctor. "You want to cure the illness, or do what you can for it, but in the end, it's how well they function." In medical school, he says, students are taught to see a patient, make a diagnosis, and expect a cure. Geriatric medicine, though, requires a different perspective. He gets his biggest thrills from restoring function to his patients' lives, like "helping someone with bad arthritis get back on their feet and get back home again. I'll never cure their arthritis; they're always going to have that. But if I get them back home, and they're back up walking, that's my pat on the back."
His experience has shown him how, in one important way, society hasn't kept up with science. In the 20th century, life expectancy has increased more than it did in all the years before 1900. So while science has tacked on two or three decades more than people expected to live, we haven't given people anything to do in those later years. "There's a bias in this society against the elderly. We don't realize what a wealth of talent, expertise, and energy these folks have. We tend to put them on a shelf, and that's a shame."
Depression is extremely common among older patients, due to some obvious factors-- losses of friends, family members, and mobility-but also due to more intangible losses, such as decreased earning power and status in society. According to Healey, "those things add up." Depression also manifests itself very differently with this generation than it does with younger people, and it's often very hard to diagnose. After finding it, however, things can get better quickly. "The medications we have now are so safe and so easy to use in older people that it's a revolution; depression is one of the few diseases that I can cure."
So Biology Is Easier?
The Institute on Aging isn't the first championship squad that Patrick Healey has assembled. While at Wabash, he helped bring the Martindale intramural squad from obscurity to prominence, helping them win a couple of IM titles during his stay. "I spent more time in the gym than in the library the first few years," he laughs, pointing out that professors like Tom Cole '58, Lester Hearson, and Aus Brooks '61 helped him straighten things out. Originally a history major, Healey switched to biology because he didn't think he would be able to pass history's comprehensive exams. His success over the last 20 years and his attention to detail imply that he may have underestimated his talents.
The partnership on which the Healeys rely so heavily during the day doesn't dissolve when they leave the hospital. With three young children, that would be a problem. "We have to be extremely organized," he laughs. Along with the help of "an excellent caregiver," they take turns working late hours so that someone can always be with the kids in the early evening hours. "We make time for kids. We limit our practice, we limit our responsibilities, so that we can be at home. Kids . . ." he sighs, "You've got one shot at them."
While the children are young, the Healeys take rain checks
on many of the national and international opportunities they receive, planning
instead to hit the conference circuit a little later. "You turn down
a lot of the things that you'd like to do, but in hopes of doing them later
on when the kids are older." For now, Pat Healey sums up the key to
a stable home life pretty easily: "You've got to get home. You've got
to."