Where were you born and raised?
I was born in Cleveland in 1924 raised in the Buckeye Road area. It was called Little Hungary then. My family was small, and we relied on ourselves. There was a distant cousin, my sister, mother, father and me.
My father —who started out when he came to America as a peddler, and eventually had a number of dry goods and clothing stores and became very successful—was a descendant of a long line of rabbis that dates back to the 1500s, though I didn’t know this until more recently when my children did research through the Mormon records and other records.
My mother was very educated. Her oldest brother was a Colonel in the Austro-Hungarian Army, and he believed that women should have good educations, so she went to what would be called today an accounting college. At one point she served as an accountant for the Prussian Army. She did all the bookkeeping in the family business. She was a master crocheter, too. She was called on two times by the Cleveland Museum of Art to reproduce lost patterns … and she was able to do that just by looking at available fragments.
As a child, I was very quiet. I worked in the family store learning by example from my father—and took care of my sister. I was at the library every Saturday.
I went to Harvey Rice—I was in the major works program—and then to Alexander Hamilton, and then to Glenville. In school, I kept to myself and was a good student. But I was very socially aware, and people knew that. (Laughs) I think I got some of that from my mother. One day, she was reading an article on feminism in Readers Digest and she said to me: “This should have happened in my day.”
What made you decide to become a doctor?
(Laughs) It really wasn’t my first choice of a career. I wanted to be a mathematician, but my mother kept saying: “You’ll be a doctor, not a mathematician.”
I don’t know why. She was a mathematician herself.
You went into the Navy in 1942. How did your service during WWII alter your life?
It changed the form my life took.
I signed up after I’d finished two years of college at [Western Reserve University] and was sent to Great Lakes Naval Training Station, where I was made a corpsman in a 600-bed nose and throat surgery hospital. This was the first time I’d gotten close to a ‘medical’ situation, though I’d actually applied for medical school before I went into the service.
While I was corpsman, I was doing work and taking tests that moved me up in terms of skills. Eventually, I was functioning as a specialist in nursing surgery. After my first year, I was sent to Purdue University [in Indiana] as a corpsman, to run the health services department there for enlisted men. While I was there, I was taking courses and earned credits toward my undergraduate degree.
And, while I was there, the dean [of Western Reserve Medical School] wrote to me that when I got out I would be accepted into the medical school.
During the summers, I did research in immuno-chemistry and virology and protein purification under good teachers and imminent scientists here in Cleveland. They were wonderful mentors.
You were awarded a Bronze Star after the Korean War. What was it for?
I volunteered to go to Korea … and when I was there I was learning all the time.
There was an epidemic, an infectious disease—hemorrhagic fever—that hit the kidneys and shut them down. It was a very local outbreak; a thousand men got the disease and 100 had died. Three of us—one from Akron, one from Philadelphia, and myself—were responsible for MASH unit for emergency treatment of the condition. We were treating it, but we were doing research on it too, because it was an unknown [disease] in the US.
I worked to understand what the virus was and how it worked—and eventually we cut the death rate from 10% to 1%. Later I was made head of a 300-bed rehabilitation hospital to take care of the wounded men. That’s what the Bronze Star was for.
When I came back, I went to Walter Reed Hospital [in Washington, DC] and did work there on hemorrhagic fever, and wrote technical bulletins about it.
There was a Plain Dealer article, and one in Time [Magazine] at that time on me. They said “doctor cures hemorrhagic fever.” Not true. I didn’t cure it; I described it and improved care for it.
You have been a geriatrician since before the term was coined. What drew you to the care of the elderly?
When I got out of the army, I wanted to continue the kind of research I’d been doing, so I came back to Cleveland because Western Reserve had one of the best preventative medicine programs in the U.S.
But there was a real lack of fulfillment in working in a lab: I hadn’t become a doctor to work with test tubes, I was a doctor who valued contact with people.
One of the researchers I was working with [George Badger] suggested that I visit the former Benjamin Rose rehabilitation hospital—and talk to [Dr.] Austin Chinn. He was looking for someone to help him figure out if vitamins would be a good addition to the diets of the elderly people: And he needed someone to design a study to that end.
Besides the research I was doing, I also headed the University’s health service. Talking with Austin, I said: “I don’t know enough about older people.” He said: “Why don’t you spend time here, doing rounds, taking care of patients, reading up on things, talking to me? That’s the best way to learn.”
In the next six months I learned about the care of older people. It was so much more satisfying than what I’d been doing. I felt like I’d taken a leap into a chasm, and knew it was definitely the right thing for me to do.
(Laughs) Only later did I realize I was going where few people had been, out on the frontier where psychology, sociology, medicine and many caring professions met.
You are credited with developing the Activities of Daily Living (ADL) Assessment, which is used all over the world. How did you develop it?
When I finally had a feeling for geriatric care, I got started on Austin’s project and consulted with George Badger. He said: “You know, what you are talking about is something not generally talked about in medicine. I would call it function.”
With the participation of a sociologist, a nurse and the patients at the hospital—that was in the mid-‘50s when you could do that kind of study—we collected data and information and did follow-up interviews of people who’d left the hospital. Using that information we designed an assessment that would help measure function, and predict outcome. That progressed to what we now call the Activities of Daily Living assessment.
In truth, we didn’t invent anything. We pushed things a bit further than they had been pushed and we codified the observations others had been making. We did what we were able to do because we were able to stand on the shoulders of others.
It seems, from what you’ve said, that you have had many mentors in your life.
Always! The story of my life is a story of collaborative work with others.
Granted, there has always been a theme—usually it’s related to the social aspects of medicine. Working with others has always been a transcendent value in my life.
And, speaking of working with others, you and your wife, Beverly, seem to be a team. How does that work?
We were married while we were in college. She’s very nurturing—it was always wonderful to see her with our [four] children—and she’s very good with people. She’s really interested in them, and people respond to that.
She reads everything I write. She’ll say: “This is ambiguous,” or “this could be simplified.” Our alliance has grown steadily over the years. We work together in the small things and in the big things.
You have been doing ground-breaking geriatric research for more than 50 years. Which areas of research have you found the most stimulating, and why those areas?
That’s hard to answer, because things that stimulate—what some call passions—change over time.
I must be doing things that I like to do, but at the same time, I must be doing things that are meaningful and useful. Increasingly, I’m interested in alliances that give people vehicles to communicate and serve as bridges and seeds for social good.
Alliance building requires a certain amount of introspection that leads to maturity and openness … that allows one to find the validity in someone else’s view and viewpoint.
I’m doing that—looking for points where discussion can begin and bridges can be built more and more consciously in my teaching and my lectures.
At 80, you are co-directing a center at Columbia University in NYC, doing research here in Cleveland, writing a book, and doing a fair amount of consulting and speaking. How do you keep all the balls in the air?
I’m good at managing things, but other than that I don’t have a prescription: I just do it. And sometimes not as well as I should. I have a hard time saying no.
A lot of times, when I get off the phone with someone, Beverly will look at me and just smile, and I know what she means: I need to be more conscious of balancing things, of knowing when to say no.
In the early ‘90s, you had a stroke. What impact did it have on you and your work?
The stroke was in 1993. And it’s impact? Well, it didn’t make me want to quit.
I was in bed, and I got up to go to the bathroom, and I knew what was happening. I lay back down, and we had a few minutes where we could talk—Beverly and I. Then I was hospitalized.
I was a good patient in one sense, but I had rehabilitation goals, too: to regain as much mobility as I could, to drive, to continue using the computer. I would climb over the side rails at night and use stretch bands to do muscle strengthening exercises. One night, I fell and the nurses came and said, “You can’t do that alone. You have to have someone with you.”
I did it again, and I fell again. The physical therapist approved of my commitment to my own rehabilitation.
Today, how do you stay active and fit?
I’m better at balancing things and I do a lot of walking on our property. I don’t think of it as exercise, I get a kick out of it. I move logs and build stone walls. I don’t mind a few bruises. [Laughs] Beverly is always complaining about all my black and blue spots.
From your research and your own personal experiences, how do you define successful aging?
Aging is not a product or an endpoint; it’s a process. The quality of the process of aging is far more important than the end product. To age successfully, you find answers to questions about yourself. You come to know yourself, and then you act on that knowledge. But you don’t just accept that you are getting older, you consciously and actively find meaning—your own meaning—in getting older.
You can write a prescription for successful aging only in the broadest sense because it’s going to be different for each person because each has individual values and backgrounds and personal experiences. But all have one thing in common: People who age successfully are self-nurturing, which does not mean they are self-centered.
How do you get people interested in their own aging process … in actively aging?
You get them interested on a personal level … and you present them with options, with the notion that they can rephrase where they are in life, in terms they understand.
[Laughs] And you get people interested in the process of aging successfully by talking about it in the context of their life story … not some abstract principal, such as ‘aging.’
Where do you think the field of aging is headed?
Aging is here to stay. There’s a growing awareness that it starts before we usually think about it. For instance, the child in the womb is changing and maturing—in effect, aging.
But, as far as the field of geriatrics goes, like all fields, it’s going die or evolve into something we wouldn’t even recognize. What we know about aging today is merely existing ‘knowledge.’ When we move beyond existing knowledge—and we will—we will create another horizon of human thinking, helping us reach forward into the future.
I think we probably destroy disciplines—like geriatrics—when we make them rigid, constricted paradigms that do not create new ways of thinking, that do not encourage ways to communicate at places where humanistic endeavors conflict and diverge.
You have met many powerful people—the Pope, the ‘father’ of Medicare, Wilber Cohen, the presidents of many nations and globe-wide corporations. Of all the people you have met, who has impressed you the most, and why?
Hmmm, another tough question. But, the Pope is one, and an old African lady I met when I traveled in Africa, for US-AID is another.
She hobbled out from her hut and showed me around her property. There were lots of children around and I asked—through the interpreter—why there so many children. The villagers regularly sent their children to live with her. She was a no-nonsense person, a wise person. One of her sons was a pharmacist in Freetown, and the other was the Archbishop of the country. I asked if she’d been hobbling for a long time. She said “Yes. Do you know what to do about it?”
In my mind I wondered: Maybe it’s gout. Maybe it’s infectious arthritis. I asked her if she’d talked to her son, the pharmacist. She said no. I asked if she knew what aspirin was. She said no.
I asked more questions. What she said finally was: (speaking to the interpreter about me) “He doesn’t really understand. When the tree gets old, the bark gets thick and it sometimes cracks.”
Changing the subject she said: “Come inside and eat.” I got the feeling that she thought that I didn’t know much and there was no point in talking further about her knees. She’d put everything together in a way, that for her, and her culture, worked. She knew who she was and where she was—and she acted on that knowledge. When you think about it, that’s what successful aging is: Knowing who you are and acting on that knowledge.
You have had a long and productive—and personally rewarding—career. What is the one thing you want to be remembered for?
(Laugh) I don’t think like that. When I do bow out, however, I want to feel that I’ve seeded something. And that something is not perfection.
In the natural course of humanistic evolution and involvement, I want to feel that someone will have done something—that I can’t even envision now—that will have incorporated something that they have learned or gained from knowing me.
That something will be creative for them. It won’t be what I have done; it will be what they have done with what they’ve learned through our relationship.
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In a career spanning 55 years as physician, scientist, teacher, mentor, author, and public servant, Dr. Sidney Katz has pioneered the concept of active aging, championed the development of the field of geriatric care, and been responsible for the creation of local and national programs to enhance quality of life and improve long-term services for the elderly.