To put it simply, Paul Hill is a geriatric psychiatrist because he likes older people. He always has.
When he was a boy growing up in midtown Memphis, his father’s mother lived with the family toward the end of her life. When Hill’s brothers went off to school, his grandmother was his playmate.
“So I had that early-life positive experience with an older adult,” Hill said. “And who knows, maybe other people don’t have those early experiences. But I certainly did.”
After some 22 years in private practice, including 18 with Memphis Psychiatry Group, Hill now is teaching full-time at the University of Tennessee Health Science Center (UTHSC), where he did his internship and where he has maintained an affiliation throughout his career. He is one of a small number of geriatric psychiatrists in the Memphis area.
“What an interesting area to work in,” he said, “getting to know the kind of people who came before me, in terms of helping to make Memphis a better place to live, helping to make the nation the way it looks now.
“So it’s been a real pleasure getting to know my seniors and their families. Almost all of my experiences through geriatric medicine have been positive. I have a tendency to really like older people. I rarely find an older adult that I can’t connect with, that’s for sure.”
Hill counts himself and a small number of others as the only geriatric psychiatrists serving the Memphis area. Hill also would add his chairman at UTHSC, James Greene, MD, who works in parts of Tennessee treating patients by teletherapy.
“Right now the estimate is that we need about 8,000 more geriatric psychiatrists by 2020,” Hill said. “Unfortunately, we only make about 50 new geriatric psychiatrists a year, so we’re going to be pretty underserved in this area.”
The son of an investment banker and schoolteacher, Hill was first impressed with the practice of medicine when he injured his back playing high school football and received treatment in physical therapy. The summer after high school graduation from Evangelical Christian School, he worked at the old Campbell Clinic on Madison Avenue, doing whatever odd jobs they needed him to do.
“By then I knew I wanted to be in the medical field,” he said. “Being around sick people, or being around injured people or handicapped people didn’t bother me at all. It’s really the only kind of work I’ve ever done.”
He went off to college at UT in Knoxville, but he lasted only one semester there. He was homesick and transferred to what was then Memphis State.
“Some people said, ‘Oh, you went to Knoxville and had too much fun there.’ I said, ‘Not really.’ I think I made a 3.75, so I didn’t come back because my grades were bad. I enjoyed living in Memphis, and I was following Memphis basketball, and I wasn’t taken over by living in Knoxville and being a Tennessee Volunteer.”
A turning point for Hill came when he took a course at Memphis State called The Sociology of Aging. The instructor was Graves Enck, (PhD) who Hill describes as “a pretty famous teacher.” At that point Hill was inspired to become a geriatrician. The psychiatry part of the equation came when he did his internship at what is now UTHSC.
His sole concern now is non-clinical teaching, but he plans to turn soon to clinical psychiatric medicine.
“We’re developing some geriatric psychiatric programs at the university,” he said, “and it’s going to be affiliated with some other hospital systems. It’s in the works right now.”
The most common problem that Hill sees among the elderly is depression, followed by neurocognitive disorder, or dementia, and then Alzheimer’s.
“One of my main professors was a guy named Bill Applegate,” said Hill. “He said something that I remember when I was a freshman in medical school. He said, ‘I’m interested in disorders of the aging brain.’
“And that was very intriguing to me, to think that these weren’t illnesses of the brain, they were illnesses of the aging brain that made aging people susceptible.”
Hill sees good things in what he calls the assisted living movement and independent senior living. He believes older people need to be willing to accept change.
“I think the older adult needs to be open-minded to the idea that they may need to have other people live with them,” he said. “They may need to move into what we call a senior living situation, which is not a nursing home. It would be akin to what Trezevant does, what Kirby Pines does and what the Village at Germantown does.
“And the whole idea is that during the course of your lifetime, you have to continue to make new friends. You might have to be involved in a church activity with other seniors where you’re able to make friends. Or go to the community centers here in Memphis like the Lewis Senior Center, the Jewish Community Center – all these places available to them.
“The solution is for the older adult to have an open mind and not just focus on the change being more than they can handle, because they certainly can handle the change. Older adults are much more resilient than us younger folks anyway. Of course, they can handle change. They’ve been handling change their whole life.”
RELATED LINK:
University of Tennessee Health Science Center, www.uthsc.edu