What is the single most important thing in life for you? if we ask the whole world they will say “Mum and Dad” and that is the truth, we love our parents no matter what happens. The other day I was watching a movie where the mother was clueless, drunk, abusive, and single but when she dies her daughter (who is a doctor) was devastated, she would do anything to have saved her. This is applicable to any person in this world. The love of parents comes naturally, no matter what happens we will continue to love them, cherish them and hope that they will stay alive to see the marriage of their grandkids and great grandkids.

In Quran there is a verse specifically for what we should do to our parents:  وَقَضَىٰ رَبُّكَ أَلَّا تَعْبُدُوا إِلَّا إِيَّاهُ وَبِالْوَالِدَيْنِ إِحْسَانًا ۚ إِمَّا يَبْلُغَنَّ عِندَكَ الْكِبَرَ أَحَدُهُمَا أَوْ كِلَاهُمَا فَلَا تَقُل لَّهُمَا أُفٍّ وَلَا تَنْهَرْهُمَا وَقُل لَّهُمَا قَوْلًا كَرِيمًا (23), in this verse we are commanded to love, cherish and do good to our parents. We are asked not to shout at them, never to tell them off, or do them harm. Notice what the article says: when they become of age! which means especially when they grew older, we are supposed to love them even more and always speak softly to them.

Now imagine this scenario: your mum and dad become of age, and you want to help them stay alive, but you have no idea how, what would you do? who would you call? which doctor should see them? the answer is a Geriatric doctor needs to see them and check on them. but let’s start with the story.

Why am I saying all of this now, that I am also a mother and of age? well you know what I do, I help students study abroad for a long time now, and when I started this work, we sort of specialised in sending students for medicine, it is my passion after all, I love the field and always wished to be a doctor myself. Believe me when I say this: non of those students had become a geriatric doctor? and if we check the statistics around the world, we will be startled as there is a huge shortage in Geriatric doctors if compared to the increased numbers of older people around the world. This means that the correlation is inversely linked, why? because geriatric doctors are not paid that well and we all look for higher income obviously. In the chart below the number of plastic surgeons are not mentioned, and you know why? they are the highest numbers and the most paid.

what brought all of this to my mind?

I started reading a book called Being Mortal written by Atul Gawande. Its suffices to say that I was startled and couldn’t sleep reading about the changes in our bodies as we grew older. Here are some of these signs:
rising blood pressure, diabetes, arthritis, collestrol, cancers, bone density problems, easily bruising problems, hand and feet problem, hair grows grey (not to mention thinning down like mine), calcified veins, stiff heart, the brain itself becomes smaller (hence we start to forget things easily) the eyes deteriorate badly, the teeth start falling and darkens as the gum recedes, the ball gladder becomes loose so we start urinating all over ourselves or end up wearing adult nappies, this is just a few of the symptoms. If we talk about diet, that will be a non stop discussion, starting from soft food. see what the book says:

“If our genes explain less than we imagined, the classical wear-and-tear model may explain more than we knew. Leonid Gavrilov, a researcher at the University of Chicago, argues that human beings fail the way all complex systems fail: randomly and gradually. As engineers have long recognized, simple devices typically do not age. They function reliably until a critical component fails, and the whole thing dies in an instant. A windup toy, for example, works smoothly until a gear rusts or a spring breaks, and then it doesn’t work at all. But complex systems—power plants, say—have to survive and function despite having thousands of critical, potentially fragile components. Engineers therefore design these machines with multiple layers of redundancy: with backup systems, and backup systems for the backup systems. The backups may not be as efficient as the first-line components, but they allow the machine to keep going even as damage accumulates. Gavrilov argues that, within the parameters established by our genes, that’s exactly how human beings appear to work. We have an extra kidney, an extra lung, an extra gonad, extra teeth. The DNA in our cells is frequently damaged under routine conditions, but our cells have a number of DNA repair system.

If a key gene is permanently damaged, there are usually extra copies of the gene nearby. And, if the entire cell dies, other cells can fill in.
Nonetheless, as the defects in a complex system increase, the time comes when just one more defect is enough to impair the whole, resulting in the condition known as frailty. It happens to power plants, cars, and large organizations. And it happens to us: eventually, one too many joints are damaged, one too many arteries calcify. There are no more backups. We wear down until we can’t wear down anymore.
It happens in a bewildering array of ways. Hair grows gray, for instance, simply because we run out of the pigment cells that give hair its color. The natural life cycle of the scalp’s pigment cells is just a few years. We rely on stem cells under the surface to migrate in and replace them. Gradually, however, the stem-cell reservoir is used up. By the age of fifty, as a result, half of the average person’s hairs have gone gray.
Inside skin cells, the mechanisms that clear out waste products slowly break down and the residue coalesces into a clot of gooey yellow brown pigment known as lipofuscin. these are the age spots we see in skin. When Lipofucin accumulates in sweat glands, the sweat glands cannot function, when helps explain why we become so susceptible to heat stroke and heat Exhaustion in old age.”
“The eyes go for different reasons. The lens is made of crystallin proteins that are tremendously durable, but they change chemically in ways that diminish their elasticity over time—hence the farsightedness that most people develop beginning in their fourth decade. The process also gradually yellows the lens. Even without cataracts (the whitish clouding of the lens that occurs with age, excessive ultraviolet exposure, high cholesterol, diabetes, and cigarette smoking), the amount of light reaching the retina of a healthy sixty-year-old is one-third that of a twenty-year-old.
I spoke to Felix Silverstone, who for twenty-four years was the senior geriatrician at the Parker Jewish Institute, in New York, and who has published more than a hundred studies on aging. There is, he told me, “no single, common cellular mechanism to the aging process.” Our bodies accumulate lipofuscin and oxygen free-radical damage and random DNA mutations and numerous other microcellular problems. The process is gradual and unrelenting.
“I asked Silverstone whether gerontologists have discerned any particular, reproducible pathway to aging. “No,” he said. “We just fall apart.””https://www.goodreads.com/book/show/20696006-being-mortal?ac=1&from_search=true&qid=I4RHXLYLmK&rank=1

(I had to copy for you this part in total, as its so scary and I didnt want you to just brush old age out)

So, what I would like you to do today is to go to your mum and dad, check their feet, wash it and clip their nails, make sure to use a nice cream and rub their feet with it.

What I would like you to do too is to think of old age when you study medicine, thing Geriatric medicine and not only plastic surgery.

I am not trying to say that we should neglect the other fields of medicine, but that we should focus on what is happening to our world, we do have an increasing number of old people still living (in china alone there are a 100 million of us).

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