Desmond O’Neill: Think global, act local

Desmond O'NeillVisiting Kennebunkport, Maine, in winter is a surreal experience, almost akin to playing an extra in the Truman Show. Neat clapper board houses and snow encrusted churches cluster around a serpiginous and sylvan sea inlet. In the grocery cum café store locals cluster over coffee and cinnamon buns amid the general supplies in an ambience with a comforting feel of the 1950’s.

It was my base for participating in the “humanism and ageing” project of the medical school of the University of New England, an informative and stimulating experience at many levels. It was my first exposure to osteopathic medicine, which is very much more mainstream and in seamless partnership with allopathic medicine than in Europe.

The focus on the whole patient and of the link between systems and function resonated strongly with me as a geriatrician: the high calibre of the students and emphasis on family medicine was very impressive. The selection process includes an emphasis on altruism, and this was very evident from my first encounter, a delightful dinner with students from the “geriatrics club.”

Nearly all had worked in a range of occupations between their primary degree and entering medical school, and the combination of the rich life experience and the choice of a course directed towards family medicine (far from lucrative in the USA) resulted in a remarkably fresh, positive, and reflective esprit de corps.

It is not surprising that the school is the focus of some highly innovative educational initiatives, including the radical project whereby medical students spend up to two weeks in a nursing home as a resident. This is the brain child of the dynamic leader of geriatric education in the medical school, Marilyn Gugliucci, and has garnered widespread attention and praise, as well as demonstrating a remarkable willingness by a range of nursing homes to support the costs of the students.

The focus of the humanism and ageing project for this year was on the “art of the longevity dividend.” This is on two levels—the art of discerning the longevity dividend, that which we have gained from population ageing, against the background of an often highly negative public and professional discourse on ageing, as well as the use of the art of later life—from Titian through Verdi to Frank Lloyd Wright—as a potent metaphor for this longevity dividend. The project is interactive: the students develop creative responses to the guest lecture, with prizes for the best submissions.

In a serendipitous happenstance which aided my task considerably, the nearby art gallery on the campus was hosting a group show of women artists in Maine, the youngest of whom were in their late 60’s and most of whom were in their 80’s and 90’s.  The juxtaposition of earlier and recent works was quite astounding, and was proof positive of that which we gain with ageing, as well an invigorating aesthetic experience.

It is almost invidious to pick out any one of the individual artists, but the 85 year old Beverly Hallam was particularly interesting. An early pioneer of experimental use of acrylic paints and airbrush paintings, particularly of flowers, with declining health her painting skills became challenged, and she has progressed to beautiful computer graphics, dispelling any notion that frailty of spirit is paired with corporeal fragility.

And the art of the longevity dividend, for those living in Maine, is the gift which just keeps on giving: the Portland Museum of Art will host a retrospective of the active octogenarian artist Lois Dodd, opening this week. Visiting the I M Pei designed museum and its impressive collection of American and European art, I could catch a tantalizing glimpse over the balcony of the colourful array of paintings being mounted in preparation for the exhibition which represents sixty years of an artistic and engaged life.

What holds true in New England for the education of future doctors in the complexity of ageing is also valid around the world, and almost every art gallery of note harbors a rich vein of late life creativity. Geriatricians and gerontologists should grasp this opportunity: the treasures of their local galleries can powerfully illuminate the logic of age attuning our services so as to protect the longevity dividend in its many manifestations.

Desmond O’Neill is a consultant physician in geriatric and stroke medicine in Dublin, and is a member of the external advisory panel of the age friendly university initiative.