Rewriting the Book

I’m doing what I said I would never do. Rewrite my book. I completed my manuscript late last year, sent it out to 20 small presses and one agent. While I have been waiting for the results to trickle in—those returned so far have been rejections—I’ve been troubled by a lingering discomfort that I have left something out. Something significant. Something that I couldn’t, shouldn’t ignore.

So for the past few months I have been having an internal dialogue:

“Leave the book alone. You did the best you could do.”

“No, something isn’t quite right. I’m not happy with the final manuscript.”

“You could be rewriting this book for the rest of your life. Let it go. You don’t want to be that writer who never submits her book because it ‘isn’t good enough’.”

“Aha! I know what it is that’s troubling me.”

My book shows how I managed a Senior Clinic in a Chicago Housing complex. I was a new nurse practitioner (not a new nurse). I show the role of the NP. However, in writing the book, I had totally overlooked the fact that while I was indeed a new nurse practitioner, I was also practicing in a new specialty—Gerontology. I say this but I DON’T SHOW IT.

Why is this important? Well, because when I became a Gerontological NP in the early 80s, studying old folks was a rarity. Older persons were generally ignored or worse, discounted and ill-treated. The 1978 best seller House of God by Samuel Shem, an irreverent book about medical interns in an renowned teaching hospital first coined the derogatory term GOMER, meaning “get out of my emergency room.” A term used frequently to classify the old person as someone without worth to cure, much less treat in our medical facilities. Some believed most old folks disengaged from life, deriving no pleasure in longevity. The fact that elders over 60 would still be interested in sex was shocking. And in this same time period the groundbreaking book: Why Survive? Being Old in America by Robert N. Butler, M.D. discussed whether or not to introduce geriatrics in postgraduate medical education.

Nursing was early to recognize geriatrics as a specialty but thought that the medical definition—specializing in the treatment of existing disease in older adults—too narrow.

Nursing developed a much broader vision and used the term gerontology rather than geriatrics.

Gerontology encompasses the following:

• studying physical, mental, and social changes in people as they age

• investigating the biological aging process itself (biogerontology)

• investigating the social and psychosocial impacts of aging (sociogerontology)

• investigating the psychological effects on aging (psychogerontology)

• investigating the interface of biological aging with aging-associated disease (geroscience)

• investigating the effects of an aging population on societyapplying this knowledge to policies and programs, including the macroscopic (for example, government planning) and microscopic (for example, running a nursing home) perspectives. (Wikipedia)

In 1981, the American Nursing Association certified me as a Gerontological Nurse Practitioner. A Board Certification was developed by the Medical Community 7 years later.

After I rewrite my book, you will see a Gerontological Nurse Practitioner in action.