My mother turned 90 the other day. Her birthday brought all her immediate descendants to Jacksonville: my son and daughter and daughter-in-law, my brother and his wife, and his daughter. We ate her favorite foods, I made a chocolate cake, and we remembered or mis-remembered family stories from long ago.
A couple of weeks ago, I wrote about uncertainty, the many important things that we don’t know, but would like to know. My mother’s major uncertainty is her health. At 90, every day begins with the question, how will I feel today? Is this a headache or the first signs of stroke? If my legs are weak today, will they ever get better?
Any day can bring a crisis. A good day is when nothing happens.
My mother lives at the Jacksonville Skilled Nursing and Rehabilitation Center. She is happy there, because she receives extraordinarily good care from a knowledgeable, friendly, and helpful staff. The parking lot is rutted with potholes, but every day my mother is greeted, asked how she feels, and helped to live a dignified life.
Once a month, nearly a dozen women from all phases of JSN’s operations come together into my mother’s room and report on their observations of her health, mood, accomplishments in physical therapy, and eating habits. They ask for her opinions about her care, and whether she wishes to have any changes made. On the basis of their combined knowledge, they plan for the next month’s care.
The medical and scientific uncertainties connected with my mother’s health are a very immediate concern. Although most days are similar and uneventful, sometimes crucial decisions must be made within hours. Everyone must be ready to think about all the evidence we have, all the alternatives for action or inaction. I and all the professionals at JSN are prepared at all times to make significant decisions to keep my mother healthy.
Medicine is a highly developed branch of science. In other kinds of science, there is usually much less pressure to come to a decision. I believe that the more distant a particular kind of science is from our immediate needs, the more resistant people can be to reaching potentially unpleasant conclusions. Global warming is a good example. Thus far, warming has had little effect on most people’s lives, and it will be years, even decades, before the consequences of climate change affect our daily lives, or those of our children and grandchildren. So the necessity of paying attention to all the evidence, of applying careful logic, of reaching careful conclusions, can easily become subordinated to wishful thinking and unwillingness to abandon comfortable assumptions. Even when 97% of the world’s scientists engaged in climate research (yes, 97%) agree that global warming caused by human actions is occurring now, it’s easy to close our eyes for one more day, to remain skeptical even in the face of overwhelming evidence, to refuse to believe.
When all those health care experts gather in my mother’s room and lay out the evidence they have gathered about my mother’s condition, I listen carefully. If they all said that they thought my mother had a particular ailment which should be treated because it could get much worse, I would take notice. I might expect that there would still be some disagreements among them, some uncertainty about exactly what the causes were and how to treat that condition. Practicing medicine, as in every scientific field, is not like following a cookbook recipe. We expect some uncertainty.
If one of the experts said she disagreed with all the rest, and argued that my mother was fine, that there was no problem, and that we should do nothing, I would listen to her, too. But the consensus of the experts would be a powerful persuader. There’s no room for delay, no luxury of putting off uncomfortable decisions. In this case, thinking that the majority of experts were perpetrating a hoax, had some selfish agenda, were lying about my mother’s health would be irresponsible.
My mother’s health is too important for such political games. So is the health of our Mother Earth.
published in the Jacksonville Journal-Courier, May 15, 2012