Memory Lessons: A Doctor's Story

Because we are all human, because we all age and die, this book applies to all of us. It is a startling reminder of the importance of family and community. How choices we make in our youth can come back to haunt us or improve us and it is important to realize that choices are important because we lose our control to choose as we age. It is important that time and again in this tale those who have the happiest old age are not necessarily wealthy or even healthy but they have been wise in their acceptance of love and support and in accepting and supporting others when possible. This biography of his father's last years has so many lessons that we should take to heart. I am fortunate to live in a rural community where the elderly are treated with respect and given support. We have a community center where the social interaction, so lacking in many large cities, is available. Where groups meet daily, to eat lunch,play cards, plan their lives. Yet we still see those who isolate themselves, take the meals on wheels and assert that they are independent, do not need social discourse over lunch. I worry for their mental health. My father (an Alzheimer's victim) lived at home much longer because of this place and having people who were kind and supportive of someone with his condition. Why? Because in a town with a large elderly population, they are very familiar with the disease. Everyone has a relative or friend who has been victimized. All the suggestions made in this book are realized and available in my small town in a poverty area. From medical support from caring professionals to the everyday residents, this book made me apprecite the community I live in so much more. I recommend the book so highly, I think it should be required reading for anyone with the ability to read, If you pay taxes, if you breathe, if you and your family are not immortal, you need this book. Dr Winakur hits the nail on the head with his explanation of the health care crisis and how we really need reform to save ourselves.

While Marcus Welby, M.D. was a fictional character, his dream of how doctors were supposed to care for patients, may have occurred with the old-fashioned country doctor named Dr. Jerald Winakur. Winakur is a country doctor (who practices in an urban setting) in the finest sense. His book Memory Lessons, using the allegory of his father's aging process, to show both the perils and delights of modern medicine. Winakur asks the reader to question the mire of Medicare; the focus of insurance companies and how they influence the process of medicine; to think about end-of-life issues (how do we go down that slippery slope?); the affordability for long-term care for the aged and finally how aging affects all families. It is rare to read a book of such fine caliber, one that is so finely written, about such a difficult subject. Winakur has done so. I'd give this book 10 stars but I can only give it five.

This is a wonderful book on so many levels. It is primarily a memoir of a doctor dealing with his father's descent into Alzheimer's disease. Along the way we learn of what is wrong with health care in America, the coming challenges, and some possible policy changes that could help. It also emphasizes the importance of talking to family members about their thoughts and wishes concerning end of life decisions early in life instead of too late. This book is both heart-rending yet hopeful. It hit quite close to home to me, as my father is along the same path too. The author deftly weaves together birdwatching, pawn shops, family relationships, loss of memory, and the health care of the growing senior citizen population. There are end-notes to support the quantitative information, and the author doesn't claim to provide any answers to how to solve the health care cost and quality problems, but he takes square aim at some causes such as "pay for procedure" mentality versus taking the time to spend 30 to 60 minutes getting a detailed health history for a patient. He notes that a ear-nose-throat doctor will be reimbursed much more for the "clean the wax out of the ears" procedure, that he will for spending time with a patient. The pharmacy industry also comes under fire for its sweetheart deal for Medicare drug coverage - the U.S. Government cannot try to negotiate for lower drug prices from the industry. I was also shocked to hear that the committee that helps set Medicare reimbursements for various procedures is staffed primarily by physicial specialists that would stand to benefit by the current system. I wish I could send a copy of this book to all the government policy makers. The book guides us through the history of end of life decisions, from the early 1970s when removing a respirator was considered murder, through the headline-grabbing stories such as Terri Schiavo, through today's philosophy of dieing with dignity. He illustrates this clearly through some of his patient's cases during those periods. And he acknowledges it is a tough decision, always, to determine whether it is best to go into the hospital for an operation, when the chances of getting an infection, or having deleriums, are so much higher for the oldest-old patients.

This is a well written, honest book about a flawed medical delivery system and the factors that allow it to continue unchecked. Doctors do not practice in a vacuum and their increasing reliance in procedures, tests and boiler plate treatment that may ease pain but fail to touch the suffering is rooted in an overall societal reluctance to take the time, resources or risk necessary to see people as individuals who are, in sickness and in health, interdependent. To see beyond the surface to the heart and soul of each person. Jerald Winaker speaks as a respected M.D. and Geriatrician but his credibility stands on his personal journey to provide compassionate care to his old, old father. Not only does it challenge the conventional wisdom of doctors, but calls everyone to reevaluate their relationships with parents, children and spouses long before the cognitive decline begins. Poetic and informational, "Memory Lessons" offers great insight as to the mental, emotional and physical reality of dementia, both from the standpoint of the person who gives care and the person who is on the receiving end. An essential addition to the curriculum of every medical and nursing program in the country.

This was a wonderful read. A story from a geriatric physician about his life and how he dealt with the age old question many of us will face, "What do we do about Dad?" As we grow older, so do our families and the roles start to change. Not only was this an insightful story about caring for the elderly population but it was also an insightful story into the lives of the families and physicians who care for them. The reader gets a sneak peak and some insight into our health care system, the tole's of being a doctor, and the stresses of being a caregiver. This is a story, warmly written, about aging, death and dying, and how we chose to deal or not deal with it. A beautiful story about many of the lives the author cared for and the loses that are inevitable. May we all be as fortunate to have such a thoughtful and compassionate physician caring for us and our loved ones.