A Bethesda Geriatrician Finds Inspiration From His Elderly Patients
Dr. Gary Wilks talks about hidden dangers, tough decisions and caring for older people
Dr. Gary Wilks with a 92-year-old patient at Maplewood Park Place in Bethesda. Photo by Tai Randall
When one of Dr. Gary Wilks’ patients told him she felt isolated because she could no longer drive, they stopped talking about her high blood pressure and turned the conversation to her social life. The 85-year-old woman had just moved into a senior living community. After much cajoling, Wilks says, she agreed to start going to an aquatics class, where she eventually made new friends and felt better because she was exercising. “It’s much easier to just focus on the blood pressure—it can take a lot longer to explore how they’re really feeling overall,” says Wilks, a geriatrician who’s been practicing in the Bethesda area for 18 years. “There’s no easy prescription pad for that.”
Wilks, 55, lives in Bethesda with his wife, Madeline, a family doctor practicing in D.C. (they met during their medical residencies), and their son and daughter, both in high school. In 2008, Wilks and another geriatrician, Dr. Roy Fried, created Premier Senior Care, a small practice that treats patients at senior living and assisted living communities, including Maplewood Park Place in Bethesda. They also make house calls. “There are so few geriatricians that we’ve really focused on what is called, in an unscientific term, the ‘old-old,’ ” says Wilks, whose interest in the field stemmed in part from his close relationship with his grandparents.
The average age of Wilks’ patients is 86, and he typically sees 11 or 12 a day, about half as many as a doctor treating younger patients. “A lot of people think geriatrics is just really sad,” he says, but some of his patients are 90 years old and still working or playing golf. “A lot of people are very frustrated about what they can’t do anymore, but working with patients and trying to reframe what they’re faced with—it’s amazing their resiliency. They can still find things that give them joy.”
In Dr. Wilks’ own words...
“A new patient came in saying his main problem was that he was feeling really tired the last few months. It turns out he started taking something because he had soreness in his shoulder, not realizing that [the medication] had interactions with other medicines he needed. He was extremely ill, extremely anemic and he was in renal failure, all from an ‘innocent’ over-the-counter medication. A little while longer, it’s not an exaggeration to say, he could have died.”
Quality of Life
“A big part of geriatrics is palliative care, taking care of people’s chronic illnesses. What can we do to make you comfortable? Not necessarily what can we do to just make you live longer, because you might live longer if we take this avenue of care, but what will your life look like? We want to prolong people’s quality of life as they define it, whether it’s a few months or a few years.”
“I’ll say, ‘this test from the cardiologist or the neurologist [is] suggesting you have certain procedures done, and [that] might lead to a surgical intervention.’ What are the ramifications of that? Do we even know that this is worth doing in someone who is 88? That’s one of the challenging things about geriatrics: Frequently we’re extrapolating data based on young adults, and then it’s being applied to people who are much older.”
“[My kids] definitely do not want to be doctors after hearing their mom and dad talk about various ailments at the dinner table too much. They do love hearing some of the stories that my patients have told me. When a 90-year-old woman tells you that she actually went to graduate school and got a degree in chemistry? Back when she was [young], for a girl to be one of two or three girls majoring in chemistry at a university, that’s just fantastic. It’s inspiring.”
“Attending a patient’s funeral is often a very profound experience. It’s wonderfully gratifying. Sometimes I’m surprised that I’m at a funeral and people call out, ‘Oh you’re Dr. Wilks, I’ve heard so much about you, thank you.’ I thought I was doing a small part—sometimes you don’t realize that your role has been bigger than you ever imagined.”
Associate Editor Kathleen Seiler Neary can be reached at firstname.lastname@example.org.