Am I Really the Forrest Gump of Geriatrics? The Upside of Having an Average Intelligence Quotient.

Abstract

A few years ago at a Beeson Scholars meeting, my close colleague Mary Tinetti, who led development of the distinguished academic geriatric program at Yale University, introduced me as the “Forrest Gump” of Aging. This prompted chuckles from the crowd of promising, aspiring clinician-scientists, who recalled the hero of the 2004 Oscar-winning film starring Tom Hanks as the somewhat dim-witted chump who nevertheless seemed to be in the right place at the right time but haplessly flubbed the chance to become famous in the process. Ever since, I've chewed on this introduction, asking myself, “What did she mean by that? Was she right? Am I really the Forrest Gump of Geriatrics?” Well, first, although no dummy, I am certainly not the brightest star in the sky, and although I almost always managed to finish in the top tier of my classes in the Ann Arbor public schools in the 1940s and 1950s and was well above my grade level in achievement tests at each stage, the only time I took an intelligence test, in the 9th grade, I received a score of 107, barely above the average of 100. That clearly surprised a lot of my teachers—but not me. Because even then I knew myself pretty well. For I was blessed and challenged as the last of five kids (and only boy) reared without a spare penny in the family budget, and from early on, I realized that to meet the family standard of at least graduating from college—both of my parents had PhDs from Cornell—it would be up to me to support myself through merit-based scholarships. How to accomplish that seemed clear—by generating a spotless academic record as a chronic overachiever driven to try harder and succeed that way. (Remember the old Avis car commercials, “We're #2, we try harder”?) But growing up as a boy in a sports-crazy, academically renowned town, I also realized that to have any friends, I needed to avoid the dreaded label of a “brain,” “teacher's pet,” or worst of all, “brown-noser.” So I compensated by spreading myself thin across multiple extracurricular domains as a “well-rounded kid,” notably in sports, choral music, student government, and student clubs and publications. This clearly paid off in my college applications, which allowed me to escape my hometown and to go Cornell on scholarship, where I continued the same pattern of academic overachievement, including senior honors in laboratory-based research, with a broad range of extracurricular campus activities. This combination led to a full scholarship to the Cornell Medical College in New York City, given by a grateful patient who wanted to support a medical student who “wasn't just a grind.” What a precious and liberating gift that was—to be able to graduate from medical school with no debt! I chose internal medicine as the most intellectually challenging specialty, where I survived a punishing internship at New York Hospital and 2 years of real-world experience in primary care medicine as a conscripted naval general medical officer (in the women's clinic at Camp Lejeune), 10 years in medical residency, fellowships in endocrinology and metabolism, and junior faculty development at the University of Washington, before finally abruptly moving into gerontology and geriatric medicine! All this in spite of having just a marginal intelligence quotient (IQ). Can there possibly be an upside to having only an average IQ and becoming the Forrest Gump of Aging? Clearly, like Forrest, I had lucked into being in the right place at the right time through all of the above experiences that prepared me to become an academic physician in an era when the National Institutes of Health was still the fount of research money, and the National Institute on Aging was brand new. Through all of my training, I came to realize that my favorite patients were generally the oldest ones because I loved their stories and the many challenges they presented. Beyond that I posit that a by-product of having an average IQ (especially when combined with an Avis complex) may be an enhanced emotional intelligence quotient, a concept that Peter Salovey co-developed at Yale and psychologist Daniel Goleman popularized. It seems as though general, primary care internal medicine, and especially geriatrics, may be central to success in practice and research in the care of elderly adults—bringing a greater breadth of vision, insight into, and appreciation of the roles of time, rate of change, comorbidities, and complexity in the design, analysis, and interpretation of data to advance the field in our “supraspecialty.” So yes, Mary, you were right, and I am proud to be considered the Forrest Gump of Aging. Thank you, my friend. Conflict of Interest: The author has no competing interests to disclose. Author Contributions: The sole author of this essay is responsible for all elements of the work. Sponsor's Role: None.