There’s a hill that crests across the Interstate 20 as I drive back to my apartment. In early spring, the side of the road is flush with green grass and trees no longer barren, blurred by both dust brought by the Texas winds and the steady speed as my foot pumps the gas. For a moment, I am transported back home.
The beauty of California is something I remember fondly – the mountains that surround my home that fade from emerald to ochre and back again as the seasons pass by, the rolling fog that is later cleared by a summer air.
There’s a hill on which my grandmother’s skilled nursing facility is housed. The last time I spoke with her was her birthday over a Facetime call. I was in Texas studying medicine and she turned a momentous 100. She did not remember who I was.
My grandmother had a stroke when I was a child. We were never close, and I hate to admit that I cried more when my cat went missing for two days in the same time period than when my grandmother was admitted to the hospital. There was not much I could understand about what was happening at the time, but there were cords and wire, and maybe a ventilator. Her room was at the end of the hall, and the nurses would come and go through a key-padded room – the pin for the door remains my phone password. Now, however, I can come up with differentials like vascular dementia to understand what I couldn’t then.
I remember the hills of my home, the same hills in which my father grew up, and where my grandmother resided for much of her life. While these slopes hold so much weight for me, I question whether the view that my grandmother sees from her nursing home is simply just a view.
Where do we go when we grow old?
I saw a patient in the psychiatric emergency department recently who could not remember how she got to the hospital. She remembered details of her home, of her old jobs, but not why the police found her pulled over on the side of the road. Without support systems in place, she was left to wander. This is not a unique story.
For the elderly, social isolation is a growing health concern. In my college research group, we read a paper about a heat wave that rampaged through France in 2003. While many were affected by the lack of infrastructure at the time, the majority of the death toll was made up by geriatric population. Soon the crisp spring air and my hill across the I-20 will transform into Texas’ typically bleak and dry summer landscape. The days become longer as the temperatures become taller – what is to stop the same tragedy in France from happening to the people of these plains?
There is beauty in aging. The majority of my family medicine clinic consists of a geriatric clinic. With my patients, I hear stories of a city transformed, of a life lived long. Across state borders on my rare trip home, I see the lines around my mother’s eyes and the gray hair growing in my father’s mustache. To me, these are signs of wisdom and lessons learned over the course of a lifetime.
However, there is a part of me that aches with knowing that age is anything but a number. A train of thought will sometimes fall off its tracks when I talk to my parents on the phone. Sometimes, I think nothing of it, but sometimes I wonder if one day hills will be nothing more than hills for them too.