The spry nonagenarian wears his veteran’s hat proudly as he makes his way down the hall. No wheelchair, walker or assist needed. ready for this new experience….since he has “seen and done everything else!” His darling petite wife of seventy years provides all the answers from a lifetime of love perspective, almost wistful at times. Victor and Bella are as adorable as this seems, what isn’t is the story ramping up to the visit which finds this new doc to his team fuming.

With a year of signs and symptoms, Victor has received no work up or treatment for a cancer because of his age….not covid. He was discouraged from having procedures until now and Victor is starting to suffer. He has minimal co-morbidities, cares for his wife and himself and is barely on any medication. He is an excellent physical specimen at his advanced age except for this cancer. Ageism in medical care. You might think this is a one-off. Guess again.

Here is my cautionary tale to you my friends, because we all aspire to reach the centenarian years. Healthcare management has changed little by little. Subtle age-related directives are being made in caring for seniors, not in your favor. Screening for common cancers is discouraged after 70 or 80. You are advised to get less checkups and you may think you’ve somehow escaped to a new nirvana of wellness. Bologna. They want to avoid having to give you care because you have become expensive. (Read Zeke Emanuel in “the Atlantic” who suggests no care after 75).

Thank goodness Victor has a family of children who advocate for him and now a team of medical, radiation and surgical oncologists to help rescue him. It is true that the highest cost of healthcare occurs in the last months, if not days, of life and Medicare cannot be sustained with these costs. Yes, you paid into the system since your first job at 16 but that was used to treat others- not put away for you. You will be denied procedures by your insurer now. Yet their stocks soar. They are “gatekeeping” your care and promising you “value” to protect their investment.

Demand the treatment you deserve. Do not give into receiving less due to your age. As I told Victor, “You didn’t live into your 90’s by being a wimp.” He likes that. There is no doubt that many people should not receive aggressive care late in life, but find doctors who are on your side and help you to choose. If they balk at treatment, get another opinion. As Victor said, “Doc, I don’t expect to live forever but a few more years with my bride would be nice”. Bella smiled sweetly. Remember, like Victor, do not be dismissed. You are all tougher than you look.