Dr. James Kvale, M.D. is an educator, a clinician, a researcher, and an academic administrator at the University of Texas, Houston Medical School. In the midst of his busy schedule in the Texas Medical Center and the Houston community at large, University of Texas, Houston medical student Victoria Walker had the privilege of spending a day with Dr. Kvale. During this time, she asked key questions about Dr. Kvale’s personal experiences with geriatric medicine. Here is a synopsis of Victoria’s findings:

A: While practicing family medicine in rural Minnesota, I began to notice my patient demographics shifting to a more and more elderly population. Before long, 75% of my office visits were senior adults, and I realized that I needed to learn more about geriatrics if I were to continue to treat patients like these in such high numbers. Shortly thereafter, I applied for and received a grant to do a geriatrics fellowship in Manitoba, Canada.

Q: "What is the most rewarding part of geriatrics?"

A: Two elements of geriatrics combine to make it a rewarding profession for me. First, I enjoy the complexity of the patients. Their difficult medical cases are intellectually challenging and exciting. Second, elderly people have a coming-together of life experiences, rendering them more at peace with life, and they are better able to accept conditions and illnesses that are out of their control. This is a beautiful thing, and their peace makes them a privilege to work with.

Q: "What are some qualities you think a geriatrician needs to have or to develop?

A: Overall, maturity is the most important characteristic that I look for in residents aspiring to a career in geriatrics. In relating to elderly patients, it helps to have had some difficult and/or painful experiences yourself as a clinician, and these come through maturity. In addition to maturity, a geriatrician must be excited about being a primary care doctor in an ambulatory setting because geriatrics is the ultimate primary care specialty, and much of the clinical interaction takes place outside of the hospital setting.

Q: "What misconceptions do you think people have about the field of geriatrics, and how would you respond to these misconceptions?"

A: In medical school, teachers program students to cure patients. In geriatrics, however, a cure is often not a reasonable or acceptable goal of patient care. Rather, the goal in caring for the elderly patient is to keep them reasonably well and comfortable so that they can interact with the people they love. In short, geriatrics is not curing, but caring. Another misconception students often have about geriatric medicine is that death is a continual and depressing aspect of patient care. This notion also stems from misrepresentations in medical school. True, everyday I either have a patient die, or I attend to a patient who is near death. However, again pointing to the peace of most elderly patients, end of life care is far more than a somber ordeal, and palliative care means much more than just opoids. It is caring for and connecting with patients by focusing on other aspects of their lives than physical illness.

Q: "We’ve heard that "a geriatrician wears many hats." Do you fit this?