Today we take for granted that there are gerontological specialists who take special care of aging patients, but that wasn’t always the case. These specialists, who run the gamut of professions, provide vital services to patients with age-related health issues.
In the early 1980s, Marianna Crane was one of the first gerontological nurse practitioners and she has put together some of her experiences in her new book, Stories from the Tenth-Floor Clinic: A Nurse Practitioner Remembers.
Crane writes her book as part memoir and part explanation of what early gerontological nurse practitioners had to deal with. The chapters vacillate between being about Crane herself and about her experiences with different patients.
Early in the book, Crane starts working at a senior clinician in a Chicago subsidized housing building. At that point in her career, there were few formal classes that specialized in geriatric practices, and many things needed to be learned on the job. One major area that Crane seemed to be unprepared for was the fact that working with the geriatric population meant more than simply providing medical care. Sometimes it meant juggling traditional health care with unconventional actions.
This is where Stories from the Tenth-Floor Clinic excels, putting real stories to the situations that she had to deal with. During her tenure, Crane did everything from chasing out scam artists and abusive adult children to planning a funeral to even one time signing her own name to Social Security checks. She deals with staffers who work with the seniors’ best interests at heart, but without a lick of professionalism, and a building manager that wants her to look in on people rather than have them come to her. But Crane learns from all of these experiences and realizes that in many ways she has to be both their medical help and their caseworker, finding solutions to their problems, health-related or not.
A prime example is “The Pigeon Lady” who appears throughout the book. Angelika is a woman who enjoys feeding the pigeons, but when other residents complain she takes it upon herself to open her windows and feed the pigeons in her apartment. Her health is taking a downward spiral, but she refuses to be admitted to the hospital. In this era before hospice care, it becomes Crane’s job to try and keep her comfortable in her last days.
While all of this is taking place, Crane’s home life was filled with her own struggles with an aging mother. As many do, she invited her mother to move from New Jersey to live with her in Chicago. However, this led to power struggles and frustration. Crane’s mother was moody and didn’t like that her grandchildren’s friends often joined them for dinner. After enough issues, her mother decides to move out.
While many of these struggles might feel relatable, they didn’t seem to fit into the purpose of the book and left me feeling that Crane lacked emotions. The book itself would have been stronger if she had left her home life out of the story.
For anyone willing to open their hearts to the people nurse practitioners take care of every day, this is a compelling book about the struggles of daily health challenges older adults might face.