A 90-year old friend engaged me in a conversation the other evening about treatment for her recently diagnosed anemia. She knew I was dealing with iron deficiency anemia also and thought we could at least commiserate.

 We shared that our primary care physicians had freaked out at the blood test results identifying our low blood iron levels. Each of us had been prescribed a round of iron infusions while the causes of the iron deficiency were explored. Very cautiously, my elderly friend asked if I would pursue medical treatment for the cause of the anemia should its cause be determined. She shared that she did not wish to go through chemo, radiation or major treatment should the cause of her anemia be defined as cancer or other major disease. At her age, she saw little benefit to the cost of time, money and ill health such treatment might bring.

I confessed to having surrendered to a video endoscopy urged upon me to locate the cause of the anemia. I felt pressured to do something beyond the blood tests already used to rule out numerous mortal blood diseases and this seemed the least invasive and uncomfortable. I didn’t confess to my friend that I had agreed to accept the medical order for yet another mammogram despite significant debate about the risk/benefit ratio. Sometimes, it is simply easier to submit to medical care than hold firm to denial of it. I wimped out, knowing how strongly this physician felt about breast cancer.

Despite my own failure to remain true to my convictions, I support my friend’s desire to minimize the medical care she might be pressured to undertake. As I rationalized to her and myself, physicians are not yet adequately trained to deal with the elderly, nor yet sensitized to the turmoil, confusion and ill-health potential of ongoing testing. Furthermore, health care in our country is filled with financial incentives to conduct medical procedures and testing. It’s a system in which the elderly, even the strongest among us, cannot fight every battle. Sigh. Now to decide whether to pursue that mammogram…..