Chuck Pool, MD, sat in the student study area of University Hospital in his tie and white medical coat flipping through his hand-held organizer.
His head was bowed in deep concentration as the light reflected off the salt-and-pepper strands of hair on his head.
Pool, who could be taken for one of many veteran doctors roaming the Academic Health Center, appears to be out of place as he sits among the 20-somethings.
But, in reality, he’s right at home.
“I began medical school in 2003, and I was 43 years old,” he says laughing. “That would make me—47.” A former surgical assistant, Pool was the oldest member of the newest class of UC medical students four years ago.
Today, he’s an anesthesiology resident who has a great desire to help the older population.
During medical school, Pool served four years as a geriatric medical student scholar in the department of family medicine. He also received the Ohio Department of Aging Award in Geriatrics at his graduation ceremony this spring.
“With a background in surgical assisting, I saw the effects of anesthesia and long hospital stays on the geriatric population,” he says. “The bewilderment of an unfamiliar setting and the constant bustle often causes older people to have hallucinations or may cause a greater amount of delirium and misperceptions. “I decided that anesthesiology was my calling and the best way I could serve the older population.”
Pool says there is a lot of ongoing research relating to ways of categorizing health for the elderly and associated risks of delirium. He says the goal is to optimize delivery of anesthetic and postoperative pain management to reduce adverse drug reactions.
“I’m sure that as our surgical population ages, more research will be classified as ‘geriatric research,’” he says.
The National Institute of Aging estimates that by 2030, more than 70 million people in the United States will be over 65. Unfortunately, according to data collected over the last decade, the number of certified geriatricians in the United States has declined from 8,800 to 7,100.
Pool says he’s bucking the trend because he feels geriatrics is the most comprehensive field in medicine. “Most geriatric patients have multiple illnesses,” he says. “As a geriatrician, you must have a grasp on all conditions the patient is facing, as well as all of the medications the patient is taking. We have the time and opportunity to see the big picture, whereas many specialists don’t—they must provide focused care.”
Pool says that geriatricians also explore the social settings of patients to allow optimal care—a time-consuming step that isn’t always feasible in other areas.
“We’re concerned for the caregiver’s health, capabilities and support system too—not just the patient’s ability to function,” he says. “All of us are able to discharge patients to nursing homes for ongoing rehabilitation when appropriate, but geriatricians have a practice that gets paid to assess the social support system and advise family and institutions in ongoing assistance needs.”
Pool says the main reason he chose geriatrics was because of the strong ties he felt with patients.
He smiles as he recounts one special connection he made with a heart patient, a World War II veteran going to surgery.
“He was 80 years old and his blood pressure was up,” he says. “I asked, ‘So, in what theater did you serve? European or Pacific?’ The man looked at me for a second and then responded, ‘I was one of Patton’s men—it was the coldest winter of my life.’ This man had fought in the Battle of the Bulge.”
Pool says he continued to talk to this patient about his experiences and thanked him for his contributions to our country.
“While we talked, his blood pressure went down,” he says. “Often, the bright, sterile, stainless steel environment scares patients, but this gentleman felt like he had a friend, and he went into surgery calm. That’s exactly why gerontology is important to me.
“The elderly often feel ill at ease in our offices or hospitals. They are bewildered when you present anything more complicated than a stethoscope to them. They trust us, but they don’t understand all of our new electronic testing equipment. I want to bridge that gap.”
Pool says his age has nothing to do with his interest or his patient relationships.
“Yes, I connect with these people, but there’s no difference between oldsters and youngsters beginning the practice of medicine,” he says. “As an older student, I’m just more focused on the humanistic aspects.” Pool will continue learning alongside his wife, who is also an “older” student in the UC College of Pharmacy, but he says he won’t forget his purpose.
“In the 20-odd years I’ve been around surgery, I’ve been exposed to a ‘fix-the-problem’ type of mindset,” he says. “I’ve learned that the care doesn’t stop once the problem is fixed. The forest is more than just the one tree directly in front of me that needs treatment.”
“With my training in geriatrics, I see myself as an anesthesiologist with benefits.”