What to Expect as You Age - a gerontologist's viewpoint with Rosanne Leipzig, MD

Disclaimer: Unedited Ai Transcript

Larry (00:07):

You are listening to specifically for Seniors, a podcast designed for a vibrant and diverse senior community. I'm your host, Dr. Larry Barsh. Join me in a lineup of experts as we discuss a wide variety of topics that will empower, inform, entertain, and inspire as we celebrate the richness and wisdom of this incredible stage of life.

Larry (00:40):

Our guest today on specifically for seniors, Dr. Roseanne Leipzig, is internationally recognized in the field of geriatrics. Dr. Leipzig is the Gerald and May Ellen Ritter, professor and vice chair emerita of the Brookdale, department of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai in New York City. Dr. Leipzig's latest book, honest Aging and Insider Guide to the Second Half of Life describes what to expect physically, psychologically, functionally, and emotionally as you age, and what you can do to adapt to your new normal. She has been repeatedly named as one of the best doctors in America, America's top physicians, a New York Times Super Doc, and one of New York magazine's, top Doctors for Geriatric Medicine. Dr. Leipzig has appeared on the Today Show, CBS Evening News, CBS Sunday Morning, CNN, and a a RP webinars and has been published in Time Magazine, the New York Times, the Wall Street Journal, bottom Line Health, A A RP, the magazine and American Medical News among others. It is an honor and a pleasure to welcome you to specifically for seniors Roseanne.

Rosanne Leipzig (02:12):

Well, Larry, it's a pleasure to be here.

Larry (02:15):

I learned something recently. There is a vast difference between geriatric medicine, the philosophical difference between that and what we consider is normal internal medicine. Can you talk about that a little bit?

Rosanne Leipzig (02:34):

Yeah, I can, and I can tell you I wish there weren't <laugh> such a difference. Okay. I think what has happened as the world of medicine has gotten more specialized, corporatized, et cetera, is that when you go to the doctor, you kinda get a review of organs. Okay. It's very disease and organ based, and when you're 50 and you have one problem, that's fine, okay? But if you develop more disorders or as you get older and more things are going on both physically, mentally, psychologically you need somebody who takes the big picture approach, you know, a holistic approach. And so we very much try and understand what matters to the patient. If we were to go by the recommendations for everything, our patients wouldn't have time to do anything else. Okay? We'd be sending them here and there and here and there, and as you get older, it becomes less clear what's beneficial and what the risks are of some of those things. And what you want for your healthcare becomes more important. So, as I said, I think all doctors should be operating this way, so to speak. But in geriatrics, we really stress this.

Larry (04:07):

So do you recommend that if people age they transfer to, to a geriatric physician?

Rosanne Leipzig (04:16):

I would hope that's not necessary. It's not possible at the moment because the number of geriatricians is relatively small for a lot of reasons. I think of it that we should have doctors in all fields who are what I call little g geriatricians. They know the basics, okay? They know that as you age, you become more sensitive to medications. There are certain medications you should be taking, you know, things like that, that certain diseases present differently as you get older, that you have a heart attack, you don't necessarily have chest pain with it, and other people have lots of things going on. The term we use is multi complexity, you know, for whatever the reasons may be. And they need the care, the primary care of the rare resource, which is a geriatrician.

Larry (05:14):

You credit your Bobby, and I'll explain that for our listeners who were not Jewish, that's grandmother in Yiddish with a commitment to treating older adults.

Rosanne Leipzig (05:26):

My grandmother was amazing. Okay. she was from Russia came over in I think the late 18 hundreds, early 19 hundreds. By the time I came around <laugh>, she had had seven children and a lot of grandchildren, and she developed colon cancer. And at that time, the bags and everything that were used with the colostomies were, didn't work well at all. And it was a mess. And she really couldn't live by herself during that time. And she came to live with us when I was about three or four, and she lived with us for seven or eight years. And I absolutely loved having her there. So even though she had all of these medical problems, she was so vibrant. She went to the, the community center. She had her friend. She baked Chas, she, you know, she volunteered. She told, talked about the old people in the old people's home, even though she was one <laugh>, you know? And then when she turned 75, she was able to deal with all of these things much better. And she actually went out and got her own apartment back where her friends were living. Not that we did anything wrong, we still saw her a lot, but she wanted her own life again, you know, and that taught me a lot about aging. So I credit her with, you know, my enjoyment of older people and also showing me how vibrant you can be as you get older.

Larry (07:06):

I never realized that with my own mother. What she was talking about, what she was complaining about, what she was fetching about until I got to the age she was Mm-Hmm. <Affirmative>. Now I understand <laugh> fully your outlook changes the way you see the world changes.

Rosanne Leipzig (07:33):

Yes. I tend to actually see that as one of the best things of aging. I'm not sure if you do or not, but for me it's, you know, the end, you know, the end is in sight. It's not forever. And time becomes more precious. There are studies that actually show that we, most people don't concentrate on the negatives as much as they used to. You know, there's less road rage, so to speak. Mm-Hmm. <Affirmative>. It's not that we don't get angry. It's not that we don't get irritated, it just doesn't happen as often. And when it happens, it's not for as long. And so, and it's, it's an amazing time that we have and we actually have it in a little better shape than our parents did. Just because of modern medicine and electrical devices that can give you routes so you don't have to figure it out in your head, <laugh> and things like that. But if you don't have a positive outlook about aging, you're not gonna have a good aging <laugh> because that negative feeling permeates everything. And it's everywhere in our world as well. I mean, we're a very ageist society.

Larry (08:46):

So it's not just me that says, Hey, Siri, where am I?

Rosanne Leipzig (08:49):

<Laugh>? No.

Larry (08:56):

Then there are physical changes. Mm-Hmm. <Affirmative>. And we, we all experience them. We need glasses. Hearing aids, nouns do not become our favorite part of speech. Absolutely. and some of these changes are normal, some are not. Mm-Hmm. <Affirmative>, how do we distinguish between the two?

Rosanne Leipzig (09:19):

Well, the thing to remember is that if something's normal, it doesn't mean that it's good for you or that you don't, you, there isn't something that can be done to make things better. So you develop cataracts. But if you have them out, your vision gets much better. You see colors more vibrantly, you know, you can read with less light. 90% of people who are 90 and older have high blood pressure. That's normal. But it doesn't mean it shouldn't be treated. And in fact, when I was in training, it wasn't treated because they thought it was normal. And then the studies were done. And we realized that you can decrease strokes and heart failure by a third by simply treating high blood pressure in older people. So if it bothers you, okay, then you should be seeing someone about it and get an idea as to whether it's normal or not. I mean, there's some things you're gonna walk more slowly as you get older, okay? There are lots of reasons for it. You're gonna go to the bathroom more at night, whether you have a prostate or not. You're gonna get up <laugh> and have to go more often. You know, it's a trick in, in our endocrinology that occurs. But there are other things that you really can do a lot more about. So, you know, don't, don't blow it off. Find out

Larry (10:51):

Like what

Rosanne Leipzig (10:52):

The patient of mine <laugh> who had problems going up and down the subway, okay? But he'd done this for, you know, 70 years and he was 90, and he went to see the orthopedist because his left knee was really bothering him. And the orthopedist said, what do you expect? You're 90? And he said, you know, my right knee is 90 years old too, and it's doing pretty good, <laugh>, that kind of thing. Don't let anybody else blow you off either.

Larry (11:21):

Some of the concerns in which a gerontologist may differ from a family physician, one of the points you bring out is question your medical provider.

Rosanne Leipzig (11:34):

Oh, always <laugh>. I think it's important that you understand what they're saying and why they're saying it. And they should be able to tell you in language that you can understand what the purpose is Okay. Or what they're looking for. You know, it's always a little bit of a, a dance because you don't wanna scare people. You wanna make sure everything's okay though, you know. But I think that the things that geriatricians really look at, we call them the five ends. Okay? And the first is what matters? What matters to you because your medical care is in service to you. It's not in service to that hemoglobin A1C <laugh>, or to what the number is for your cholesterol. It's so you can do the things that are important to you for you. Okay? So you kinda have to think about it that way.

Rosanne Leipzig (12:32):

Is it worth it or is it not? And then the next three things we spend a lot of time on are mind, okay, everybody's concerned that they can't remember those nouns. And does it mean they're about to become demented? People get confused all a sudden when they have an acute illness. Is this gonna last forever? It's very scary for family members. Depression or loneliness, you know, those are, are big things, undermine. The second is mobility. You gotta get around. And as you get older, your balance is not as good as it was. If you're not exercising or getting up and walking, you know, you're gonna have more of a problem getting around. And so that's a really important piece. And the third is medications. Because medications can be a miracle and they can also be a curse. And as you get older, there are lots of changes that occur in how you handle medications. So you really, you know, have to have a doctor who understands how to change your medic, your medications based on your growing older and the other medications you may be taking. So those are, you know, really important things to be thinking about.

Larry (13:55):

You mentioned in your book or on your website, I forget where I read it, unprotected sun exposure as an older adult is different than what you recommend for a younger person.

Rosanne Leipzig (14:12):

Yeah. for several reasons. One is that sun is very helpful for mood. It's helpful for sleep to get at the right times of day. And it's helpful for getting vitamin D. So I'm not saying go out and be in the sun between 10 and four, you know unprotected. But you can have 15 minutes a day unprotected, and you can get a lot of benefit from that. So I suggest that to people. And especially after the pandemic, just getting people outside again, <laugh> is really

Larry (14:51):

Definitely.

Rosanne Leipzig (14:52):

Yeah.

Larry (14:54):

And the importance of exercise. You stress a lot. Yes.

Rosanne Leipzig (14:58):

You know, if there's one anti-aging pill, it's exercise. It has been shown to decrease cognitive impairment, to increase your energy, to make you sleep better. I'm sure there are four other things I just forgot <laugh>. Okay. But it really makes a huge difference in how you feel and what you're able to do. It decreases falls, you know,

Larry (15:28):

And one of the things you brought up, I noticed, were Kegel exercises. Absolutely. And that's not mentioned very much.

Rosanne Leipzig (15:36):

Yeah. And Kegel exercises are for men as well as women. And that's a really important thing. So what is a Kegel exercise? <Laugh>. It's an exercise of your pelvic muscles. So some people have what is called urge incontinence, where, you know, those ads that say, gotta go, gotta go, okay, <laugh>, that's urge incontinence. You feel it and you're like, oh my God, where's the bathroom? I can't get there in time. And there are other kinds of incontinence, which more women get, or men who have had prostate surgery get, which is stress incontinence, where you laugh or you get up and you you lose, you leak a little, okay. Lose some urine. So what one of the things you can do to help with that is to strengthen the pelvic muscles so that they close off the urine flow. And you know, you can do it when you're going to the bathroom. You, you know what those muscles are to be able to stop things. You don't wanna do it, then you wanna be doing it at other times. But it's a muscle that really, if you do these exercises, you know, 10 times 10, 10 in a row, three times a day, over a couple of months, you'll begin to notice a difference. So they're definitely worth doing. And they also help if some people get fecal incontinence and they help with that as well.

Larry (17:12):

One of the things that I've noticed since I started using a geriatrician myself, there is a, and we talked a little bit about it before, a completely different take on medications. Mm-Hmm. <Affirmative> over the years, one doctor recommends a medication, so you get a side effect. So your other specialist me recommends a medication to get rid of that side effect. But that brings us back to the first <laugh> as <laugh>. And it gets to be a, a, a real problem as far as timing, what time of day with food, without food. Yeah. What is your take on medications with older adults?

Rosanne Leipzig (18:02):

So my take is every medication you take should have an indication for taking it at that point in time. Okay? So a lot of us were told to take something years ago for the rest of our lives, and we don't really, the medicine has aspirin's a good example of that. Okay? For years, take aspirin. Take aspirin. Then the studies were done a few years ago. Updating all of that, saying that basically with the way in which we are able to treat heart disease, now adding in aspirin doesn't do anything to it to decrease your heart problems, but it does increase your bleeding problems. And all of a sudden we said, okay, off aspirin, everybody off aspirin. So you really have to look at each medication I, with my patients. I do it every time I see them. It's kinda my way of knowing what's been going on since the last time I saw them.

Rosanne Leipzig (18:58):

They tell me I'm on a new medication and I say, oh, you saw that doctor? Okay, <laugh>, let's talk about what that was about. But at least once a year, go through with your doctor what the medications are and that there's still an indication. The second is try and be on the fewest medications you need at the lowest doses. And I'm not talking about supplements here because I, I have a whole other take on supplements, which is basically if you're eating a good diet in this country, you probably don't need it. Okay? <laugh>, you might need it for vitamin D if you don't get out enough. That kinda stuff. But in general, we don't need a lot of supplements in this country. But the medications themselves, as you get older, the same medication that you've been taking for years, you may need a lower dose of because your body becomes more sensitive to it.

Rosanne Leipzig (19:55):

That happens with thyroid medications. It happens with insulin. There are certain medications that tend to cause bad effects in older people much more than in younger people. And there are other medications you can take that don't cause those effects anymore. So you should be staying away from them. You know, the old drug il for depression is just a terrible drug in older people for the most part. And it can cause falls, it can cause vision problems lots of confusion, things like that. Benadryl, the same way. So I think, and your kidney function changes, which means the dose needs to change a bit if the drug is excreted by the kidneys. So you really should be watching what you're taking and asking, do I still need this and do I still need it at this dose? And for many medications you can try. I mean, this is what I do with my folks. We, okay, let's go down to half the dose. These are the target symptoms, this is what we're looking for. If this comes back, you need a higher dose. And if this happens, okay, then you're probably just fine. So that's, that's my take on medications. It's kind of the Goldilocks take. Not too much, not too little, just right.

Larry (21:19):

Yeah. I found that even on a personal level with a dose of atorvastatin. Mm-Hmm. <Affirmative> from 40 to 20 to 10.

Rosanne Leipzig (21:28):

Yeah.

Larry (21:30):

And recommendations not to worry so much about lower levels of cholesterol.

Rosanne Leipzig (21:36):

Right.

Larry (21:37):

One of the things you recommend to older adults is to name your healthcare proxy. Oh yeah. Why is that important?

Rosanne Leipzig (21:46):

So I don't just tell older adults. I tell kids to do the medical students to do this. 'cause You never know what's gonna happen to you. We have no control. We think we're driving the bus, but we're not. Okay. A healthcare proxy speaks for you when you can't speak for yourself. That person doesn't speak for you if you can speak for yourself. Okay? So that's a very important thing. So as long as you're capable, you direct your medical care, but things happen where you might not be capable for a short period of time or for a long period of time, like we were talking about, you might get confused when you have a pneumonia or something like that. And somebody else is gonna have to help with making medical decisions. So you need to have somebody you trust and you need to talk to them about what you want and what you don't want.

Rosanne Leipzig (22:40):

And the truth of the matter is, you will never cover every possibility <laugh>. It's really getting a sense, okay. There's some people who have very strong feelings. I saw my mother go through this, I don't wanna go through it. Okay. I don't ever wanna have my, you know, CPR done on me. But it's really important because you might get a pneumonia that just needs a few days of intubation and they can do a trial and you can say to this person, you know, give it three days. If I'm not getting better, then it's over, you know? But it's the way that you'll get the best care and it's what you want. You know, the problem with being a healthcare proxy without talking about it, is that you substitute what you want for yourself, not what the person wanted for themselves. And that's really your job as a proxy, is to know what that person would have wanted, you know, and that you're doing, giving a gift by allowing them to have that.

Larry (23:50):

And in some states, like Massachusetts, there's a form that's filled out and the choices are either or, rather than the shades of gray in between.

Rosanne Leipzig (24:06):

Yeah. That's a tough one. Okay. That's a tough one. There is something, if this is what you're referring to, it's called a m or A Pulses and it's medical Orders for Life sustaining therapy. And you should be able to put something in there that's a little conditional. 'cause I know the one that I've seen in New York has a place for give it a try. <Laugh>. Okay.

Larry (24:32):

Yeah. The one in Massachusetts does not.

Rosanne Leipzig (24:35):

Ah, okay.

Larry (24:36):

And it's either take me to the hospital or I just prefer to drop right here. Now <laugh>. So

Rosanne Leipzig (24:43):

Now there's no way you can know that. I mean, maybe if you're at the end of a long, long illness and you've had it, you don't ever wanna go to the hospital again. I understand. But, you know, other than that, it's really hard to be able to say in advance.

Larry (24:58):

It, it's, it's a problem, I think. Yeah. 'cause I, I've talked to people about it. Yeah. In Massachusetts anyway, your activities for the last 20 years, you've been editor in chief of Focus on Healthy Aging, a newsletter produced by the Department of Geriatrics and palliate of Medicine at the Mount Sinai School of Medicine. Tell us about the newsletter.

Rosanne Leipzig (25:26):

I love the newsletter <laugh>. It's really, first of all, it taught me how to talk like humans talk and not like doctors talk. Okay. <laugh>, help me get rid of my jargon to, to a large degree. But what we try and do is keep people up to date on the new things that are coming out. You know, medicine has become a billion dollar industry and people are, it's on tv. They're trying to get you to try this, try this, ask your doctor about that. Making up diseases that don't really didn't used to exist. You know, like being shy is a social phobia. I mean, <laugh>, you know, it's, it's tough to kind of navigate all this. So what we're trying to do is look at the big things that people care about and what can they do to adapt to their new normal or their loved one's new normal.

Rosanne Leipzig (26:21):

And then what's coming out as new information and should you buy it yet or not? Is it ready for prime time? Okay. and the third thing we're really trying to do is give people things they can do for themselves and resources that they can use for themselves. Because there are an enormous number of resources out there for older adults that are underutilized. People just don't know about them, you know? And doctors don't know about them. You know, the social workers are, are heroes here, <laugh>, you know. But we all need to know to be able to get people what they need.

Larry (27:05):

So how does somebody get the newsletter? How do they subscribe?

Rosanne Leipzig (27:09):

It's a subscription. You can just, you can go to my website or you can go to focus on healthy aging, just Google it. And there's usually a introductory price, and then there's a price per year.

Larry (27:25):

What's your website address?

Rosanne Leipzig (27:28):

RO roseanne md.com. R-O-S-A-N-N-E MD dot COM.

Larry (27:38):

Now, the other part of your writing activity is your new book. Yes. Martha Stewart said, of your book, honest Aging and Insight is guide to the second half of Life that it is. And I quote, full of clear, practical advice that will make the second half of your life safer, more productive, and more enjoyable. It is essential reading for anyone who is growing older or whose loved ones are growing older. In other words, for all of us, walk us through the book. Sure. What we'll learn, what we'll read is learn about.

Rosanne Leipzig (28:15):

Sure. So the book is divided into three sections. The first section is really kind of what I call aging one oh one. It's what you should know about aging in general. So I talk about the fact that aging is something new in our society. That there always been one or two people who get to older age, but never before have we had the numbers that we have now, which explains why we don't know what to do with this generation. <Laugh>. Okay. We don't have the services in place, we don't have what's needed. But also about the psychology of aging and how to navigate the world when you have a world that doesn't, that thinks old is a four letter word. So kind of talking about that. And that this is another stage of life, you know, and we are very lucky to have it. Then I talk about that 80 year olds are not the new 60 year olds.

Rosanne Leipzig (29:17):

That no matter that yeah, we're, we're, we are better, as I said, than our parents were at these ages, okay. But we're not the same. And a number of the things you and I have just talked about are things that happen to everybody. Okay. and the walking more slowly, you know, the urinating, all that kinda stuff, the medications, you know, if you're 80, this is happening to you. And, you know, eighties is not 79, it's not 81. It's just as you get older. Okay. and how to think about that in the care that you get. The third chapter's all about medications. The fourth talks about how do you make decisions, because there are so many decisions that need to be made as you get older. And these are mainly how do you make medical decisions. You've got 15 doctors, one's telling you one thing, one's telling you something else, how you, how do you decide what to do?

Rosanne Leipzig (30:24):

And kind of giving you my way of looking at it and talking about a new initiative called Patient-Centered Care that has a website and is really very thoughtful for, for people to go through with their loved ones about what really matters to me and what's just a pain. And I don't wanna do it. Okay. I'm done with mammograms, so to speak, <laugh>, you know, that kind of thing. And then the fifth is talking about prevention and screening and how that changes as you get older. And it changes because anything you do for prevention and screening for the most part takes years before you get the benefit. But if there is a side effect to it, then you get that right away. So if you, you know, find out that you have prostate cancer, a little little bit of prostate cancer, and you have a treatment, you at that moment are gonna be prone to having the side effects of the treatment.

Rosanne Leipzig (31:20):

Okay? And you may have lived another 20 years and that prostate cancer may never have affected your life in any way. And this is tough stuff to negotiate because anytime anybody hears the word cancer, get it out to be, I don't wanna live with this <laugh> Mm-Hmm. <Affirmative>. So it's really, you know, it's an approach to thinking about what makes sense, what doesn't make sense. And recognizing that vaccines make a lot of sense because they work right away a couple of weeks, and quitting smoking works right away. And of course, wearing your seatbelt, if you live in New York <laugh> very, very important. Or in Florida. Or in Florida, yes, <laugh>. Absolutely. the last section of the book is talking about more of these decisions. How do you make the decision if you're gonna move or not? And what do you need if you're gonna stay where you are, how do you decide what to do about driving?

Rosanne Leipzig (32:18):

And who do you ask to speak for you if you can't speak for yourself? And then the whole middle section are things that we call geriatric syndromes. These are things that happen more commonly to older adults, and they can happen to anyone, but it's more common. And they tend to be due to several different factors. It's not like, you know, you get the flu because you got the flu bug. You know what it is. If you fall, it could be your vision, your hearing, your weakness, your toenails. I mean, there's, so the medications you're taking, there's so many things that could be involved. And so it's to get you to understand what happens, what you can do about it, when to get worried about it. And each of those sections in the back has a check, a checklist. So if you're going to the doctor because you're concerned about your memory, there's a a couple of pages back there that you can fill in for your doctor and say, this is what's been going on. This is what's going on with other things that might be causing this problem. And so these are sections on memory, energy falls, sleep, weight sex, you know, things of that nature.

Larry (33:32):

You mentioned making the decision to move or not. Mm-Hmm. <affirmative>, this becomes critical. Do you advocate for either side of the issue living at home or moving to a senior facility?

Rosanne Leipzig (33:50):

I don't because number one, it's, there's a big personal feeling to it. The second is, we as a country are in no way ready for everybody to live at home. Because at some point you're gonna need help. And that help is not cheap. Okay. And it becomes more and more difficult as you get older to do that. The other problem is you can become very isolated as you get less functional. And I mean, I have cousins who are actually in great shape. They're 80 and he's a guy who actually had a major heart attack at 36 and became this exercise nut <laugh>, you know, does bike rides all over the place. When he comes to visit, he brings his bike and they just moved, they downsized, moved into one of these independent living places. And they are having the time of their lives because they're all these people there. They're meeting new people, they have new things to do. And I've seen the same thing when people have moved into memory communities or into nursing homes. You know, that that new socialization, assisted living is very, very important. On the other hand, there are people who are gonna wanna stay at home forever. I actually had one patient I wrote about in the book who not only did she wanna stay alone at home forever, she didn't want anybody in there. And she was very clear if she fell and died fine.

Rosanne Leipzig (35:24):

And we had a whole conversation with her family where it became very clear that that's what she wanted. You know, so I'm not on one side or the other at all.

Larry (35:35):

And that gets us back to the initial talk we had about the difference between geriatric medicine and routine internal medicine. Yeah. That it is patient centered rather than doctor centered. Yeah.

Rosanne Leipzig (35:54):

It's very patient centered. Yeah. We work for you. <Laugh>

Larry (36:00):

And, and, and that sort of, that sort of emphasizes the philosophical difference in the approaches of the two forms of medicine. Yeah.

Rosanne Leipzig (36:11):

You know, we're much more like the old fashioned doctors, if I can say it. We spend more time with our patients. We accept the fact that, you know, we may not make as much money in this world of fee for service medicine because we're not gonna see as many patients, but there's a lot more satisfaction. And you really get to know the people, you get to know their families and you know, you can make a difference. And the thing about geriatric medicine is it, it doesn't have to be rocket science to make a difference. There's some very small things that I've told patients that have made huge differences in their lives. Little habit changes. You know,

Larry (36:54):

I'm a retired dentist, <laugh>. Ah, and, and I had a patient I remember very well. She came into her into the office in her late eighties, did an exam, and I said Sylvia, you, you need to have the four anterior lower teeth root canal treated. There was a little abscess on each one. No pain, no problem, no infection. But you could see that there was something going on, right. And she said, I don't wanna do that. She passed away at about a hundred with the four anterior teeth. Still untreated. Still asymptomatic.

Rosanne Leipzig (37:45):

Yeah.

Larry (37:46):

And at that time in my career, I didn't understand. Now I'm in my late eighties, and I understand. Yeah,

Rosanne Leipzig (38:01):

Absolutely.

Larry (38:02):

And it's too bad as we get older, we cannot pass that on to the younger generation either in medicine or dentistry. Yeah.

Rosanne Leipzig (38:13):

Well, it's interesting. I mean, I have a good time when I'm with my residents and medical students, getting them to think twice about their older patients. Because, you know, they look at us and all they see is who we are right now. Mm-Hmm. <Affirmative>, they don't see our lives. They don't see what we've gone through, where we've been, how this illness fits into that trajectory, you know, and trying to get them to understand that and how long people will live to be okay. They have no idea. They think that life expectancy for a 65-year-old is 70. I'm like, get outta the hospital. Yep. <Laugh>, you know, I'm sitting there, the sickest of the sick, you know? But I, what we as older people can do for them is to tell the stories, make sure they get it. You know? I had somebody say to me the other day was a student, and she said, you know, every patient you say, ask them something at the beginning to get an understanding as to who they are. You don't just start with the medical stuff. And I say, I wanna know who they are. <Laugh>. I mean, that's how they see themselves. And if you don't understand that, it's very hard to help people make these decisions.

Larry (39:33):

You know? And for goodness sakes, when I go to see my physician, don't have the nurse seat me on the examining table, let me walk into the room with the physician already there.

Rosanne Leipzig (39:53):

Yep. Or what we tend to do in geriatrics when we can is walk behind you as you walk into the room so we can see how you walk <laugh>. Mm-Hmm. <Affirmative>. Because that's really, really important.

Larry (40:06):

And that seems to be the difference in my own training with, with the approach to seeing a patient even as a dentist than what is now.

Rosanne Leipzig (40:23):

Yeah. Yeah. It's very different now. I mean, that's, that's a whole other podcast. What has happened to these professions, <laugh> and what is happening? Yeah.

Larry (40:37):

I said to the dean of the school, I went to that a number of years ago, that dentistry has ceased to be a profession, has become more of a regulated trade. And it's distressing. Yeah.

Rosanne Leipzig (40:53):

Yeah. They're jobs, you know. Mm-Hmm. <Affirmative>. They're not callings, they're not, you know. Yeah. That's a whole other story.

Larry (41:02):

Your healthcare provider.

Rosanne Leipzig (41:04):

Right, right. We're widgets. I mean, that's the feeling. I had somebody say to me the other day, it doesn't matter, you know, you walk in, you never know who you're gonna end up seeing. You know, I, my wife the other day went to an appointment called, said she was gonna be five minutes late. They said fine. Went in, they drew all these bloods and then told her that the doctor was off for the week. She'd be seeing a pa And she, she had a very specific question to ask that a PA cannot answer. Mm-Hmm. <affirmative>, what is this <laugh>, you know, I don't get it. And she lost a patient, you know, because of that.

Larry (41:50):

This has been an outstanding conversation, Roseanne. Thank you. Is there anything we missed? Anything we should be talking about that we didn't?

Rosanne Leipzig (42:00):

I think the most important thing for those people who are older or who are getting there, what do you wanna do with this time? Okay. I mean, I keep saying it's a gift, but it really is, what do you wanna be doing? Do you have a, is there a second chance you want at something? I dunno about you, but I felt like, you know, I started, I got into the sciences, I did my bachelor's degree, I did my, you know, medical degree. I've been on a train for a very long time, <laugh>. And there are lots of things that I didn't do because of that. And some of them I probably like to do now. You know, think about what those would be for these years.

Larry (42:40):

One of the things for me is this is what we're doing right now.

Rosanne Leipzig (42:44):

I think that's great. That is great.

Larry (42:47):

It, it is great fun meeting new people, talking, just having a conversation like this. Yeah. With a little structure, but just getting to pick up different viewpoints.

Rosanne Leipzig (43:01):

Yeah. Yeah. It's wonderful. I actually had my second bat mitzvah a couple of weeks ago. It was the 60th anniversary of my bat mitzvah. And you know, when I did that at 13 girls couldn't read from the Torah. It was on a Friday night. There were two of you. I mean, it was nothing like today. And I said, you know, now that I understand this stuff a little bit, I wanna do it over again. <Laugh>. You know. So I did. I studied and I learned. It was wonderful.

Larry (43:34):

I had a very good friend who had a second bar mitzvah. I asked him the obvious question about eight days, but we won't get into that now, <laugh>. Anyhow, this has been fun. It's been informative. Your book is available on Amazon.

Rosanne Leipzig (43:53):

Yes. Yes.

Larry (43:55):

So that's easy to get ahold of, of Absolutely. People who'd like to get

Rosanne Leipzig (43:58):

One. Yes, absolutely.

Larry (44:00):

Thank you again, thank you so much for coming on.

Rosanne Leipzig (44:04):

My pleasure. It's been fun.

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