Cornell Weill Medical College was privileged to bring Dr. Carmel Bitondo-Dyer, from the Baylor Medical College in Houston, Texas, to present at Geriatric Grand Rounds on 25 January 2001.
Dr. Dyer pursued her undergraduate studies at Stetson College in tiny DeLand, Florida. She knew she wanted to be involved with medicine, volunteering at a local nursing home while an undergraduate. This experience definitively turned her toward geriatrics. Dr. Dyer graduated from Baylor Medical College in 1993.
Dr. Dyer's work at Baylor was the subject of her Geriatic Grand Rounds lecture on 25 January. Formally entitled, "Linking Medical Students with Community Services in Aging," Dr. Dyer used the forum to speak about her partnership with Adult Protective Services (APS) in the city of Houston. One of the unique aspects of geriatric medicine is its social dimension. Dr Dyer has therefore been working with APS since 1995 in an effort to treat and combat elderly abuse. "Little attention is paid to elderly abuse in med school," she said, "yet there were 2,160,000 cases in 1996 alone!" These shocking statistics mandate a proactive stance on the part of geriatricians, as patients are frequently unable or even unwilling to seek necessary help.
APS has a network of social workers that seek out and visit older citizens, providing a perfect partner for Dr. Dyer's effort to educate medical students in community outreach. Baylor medical students have been involved in a ride-along program with APS for several years. There are several benefits to this "symbiotic relationship," as Dr. Dyer puts it. Firstly, the physicians and students learn a great deal from the APS personnel, who make a career out of visiting, evaluating and intervening in the living-situations of older persons who are abused or incapable of self-care. APS generously offers the physicians a taste of "real-world" experience, as well as social and legal sensibilities that are not ordinarily part of physicians' training. Secondly, the physicians are vastly helpful to APS in their professional medical examinations of the elderly; in particular, they are expert at assessing cognitive changes that may provide clues to why a patient is engaged in the common problem of self-neglect.
In several years of collaboration with APS, Dr. Dyer and her colleagues have achieved notable success in increasing the comprehensiveness of care for the isolated and frail older population in the Houston metro area. Perhaps as important, she has raised consciousness within the local medical community about the problem of elderly abuse, and about geriatrics in general.
This experience, combined with Dr. Dyer's professional evangelism, frequently accomplishes its goal of drawing young student into the world of geriatrics. As Dr. Dyer points out to her trainees, there are many advantages to geriatrics as a field, not the least of which is the burgeoning older population in the United States. "As this population grows, so too will the need for geriatricians," she says. She feels that the primary joy of geriatric medicine comes from the patients: "They really give back to you - in terms of gratitude, and love. They will share so much, and teach you so much, about history, and personal experience."
That evening the Center hosted a dinner for Dr. Dyer, members of Cornell Weill's Medical Student Interest Group, and faculty. Eighteen first- and second-year students had an opportunity to meet Dr. Dyer and learn more about her work, and her professional perspective on geriatrics.