Every year, students at the Icahn School of Medicine write Op-Ed articles about topics in health care and advocacy to culminate InFocus 4. Eric Silberman’s article, “Let’s Not Forget About Alzheimer’s” was one of the 10 exemplary articles selected to appear in the 2016 issue of Physicians as Advocates—InFocus 4. We share his story.
My grandmother died from Alzheimer’s more than ten years ago, but the smell of her nursing home still haunts me today.
Grandma Esther died when I was thirteen. Going to visit her was a confusing, frustrating, scary experience. Over just a few years, a woman who once held us so close completely forgot us. She was a Polish Holocaust survivor whose first language was Yiddish, and by the time she was in the nursing home, Yiddish was all she remembered how to speak. I felt helpless.
It was hard to relate to anyone there. Some patients would yell; some would steal each other’s belongings, and others would patrol the hallways with stern, grimacing looks. The dining room, where these and more would gather to eat—or refuse to eat—the uniformly brownish food, was a scene of complete chaos. And the smell—that haunting smell—was something of the worst combination of body odor, soiled garments, and disinfectant.
Seeing all of this so young was deeply upsetting. No child should have to watch the horrifying erosion of a loved one’s mind, and nor should any adult, for that matter. Currently, Alzheimer’s disease is not a funding priority in our country. But with our changing demographics, more and more will suffer through experiencing or witnessing this disease. If we are to protect current and future generations from Alzheimer’s, we need to act now to increase government funding to find a cure.Alzheimer’s, which is ultimately fatal, is the fifth leading cause of death for individuals above the age of 65. But, unlike heart disease, cancer, and the other leading causes of death, it is the only one for which incidence is not decreasing, but rapidly increasing. It is America’s most expensive disease, costing the government $200 billion annually, and the only one of the nation’s top 10 causes of death that can’t be prevented or cured.
Over 5 million Americans live with Alzheimer’s disease. With our increased lifespan, that number could increase up to 13.5 million by 2050. Not only would this put a significant financial burden on even more American families, it would also put a possibly crippling burden on the Medicare system: the Alzheimer’s Association predicts Medicare costs could rise to $589 billion annually by 2050.
Unlike in other diseases that receive much public attention, those with Alzheimer’s do not have the opportunity to speak up about the experience of the disease; there are no survivors of Alzheimer’s. Therefore, it is up to the rest of us to speak out. And there are many of us: 73 million voters in the upcoming presidential election have or have had a close friend or family member with Alzheimer’s. 82% of voters are concerned about Alzheimer’s. So why isn’t this an issue candidates firmly address?
Some progress has been made recently. In December of 2015, Congress increased funding for Alzheimer’s to close to $1 billion from $586 million. But advocates say it’s not enough, that we need $2 billion annually to find a cure. And, though it is true that many of the leading presidential candidates of both parties have spoken in about increasing Alzheimer’s funding, it has been mostly in vague terms. Only Hillary Clinton has promised the $2 billion. But this should not be a single-candidate issue, or a partisan one: all candidates should be giving concrete attention to this critical disease.
Cancer research receives more than $5 billion annually and HIV research receives more than $2 billion. But as we continue to treat, cure, and eventually eradicate diseases like cancer, heart disease, diabetes and others—as we should—people live longer. With the only risk factor for Alzheimer’s being age, as the rates of the other diseases drop, the rate of Alzheimer’s can only rise.
We need to anticipate the economics of our current setup and act before it is too late. Too late means that by 2050 the number of people with Alzheimer’s disease triples. By then, fundraiser after fundraiser will not slow the course of the disease. As much as we need to consider Alzheimer’s a medical condition, we need to view it as a societal condition. We have an opportunity to avert an impending public health crisis, but we need political leadership to be proactive, and to take action while we still have the luxury of foresight. Our presidential candidates need to focus on Alzheimer’s, so that no person—patient, caretaker or loved one—has to experience the devastating effects of Alzheimer’s.
When asked about writing “Let’s Not Forget About Alzheimer’s” for InFocus 4, Eric says:
In the day-to-day experience of medical school, we learn and hone our skills practicing medicine, but rarely have the time to step back and think about how we practice, why, or for whom. Writing an op-ed gave me the chance to pause and consider the issues I care about and realize the fact that by sharing my thoughts in this medium, I can have an impact outside the doctor-patient and doctor-doctor relationships —I can have an impact on the broader practice and experience of medicine, for all involved. This enriched my education and empowered me to continue serving as a physician-advocate going forward.
ABOUT THE AUTHOR
Eric Silberman is a third-year medical student at Icahn School of Medicine. Originally from Chicago, he graduated from Princeton with degrees in molecular biology and creative writing. Before medical school, he spent a year in Poland on a Fulbright, working in a museum and writing about his grandparents’ Holocaust experiences.
