I just love my grandmother. She’s pretty awesome. No, sir, she does not let her oxygen tank get in the way of her casino days.

The country is getting older. People are living longer, and those Bob-Dylan-listening-peace-loving hippies are all going to be hitting the Medicare age in the next few years, if they haven’t already.

In my experience, there are two types of geriatric patients. Some are kind of helpless, reliant on family and friends, needy and anxious about everything. The other type is the tough-as-nails-I-survived-the-Depression-dammit patient, who is strong, stubborn and has a hard time realizing she needs help.

I have had some personal experience with both of these types of patients.

My mother’s mother was the first type. God love her, she was a hypochondriac who was always afraid of something, so much so that she rarely went to bed before 5 a.m. because she couldn’t sleep. Momsey (that’s what we called her) was the daughter of a physician, the only one of four children who married and had a family. She was the baby of the family, and, from her own description, kind of spoiled. I mean, the woman went to private school during the Depression.

According to her, she was a bad and willful child. “I don’t know how they let me get away with all the things I did,” she would say. Her escapades included making fun of nuns, setting her house on fire then proceeding to have it covered up by the maids, swallowing a rosary (not sure about that one), and breaking her arm trying to catch passing trees while riding a street car.

I loved her dearly, but she was highly dependent on others – to a fault. She never worked a day in her life, she never drove a car, and my grandfather did everything for her. Partly because of that, my mother encouraged me to be a strong, independent woman and “do something so you don’t have to depend on your husband.”

I see patients like this all the time. They want to tell you their entire life story even though the ED is crashing all around you. You feel bad and want to spend that kind of time with them, but you also secretly wish you’d get an overhead page from a nurse to get you out of the room. They may not have much medically wrong with them, but they show up at your ED often, mostly lonely and wanting someone to talk to.

Recently I had an older patient who reminded me a little of her. Although my grandmother was sweeter, I could tell this lady was lonely. She was on the call button every 2 minutes to tell the nurse that she was dying.

When I went to see her, she looked at me and said, “I’m dying.” I looked her in the eye and said, “Not tonight.”

After a DuoNeb and some pain meds, she was feeling much better. As it happened, it was her birthday. As our tech wheeled her out to her daughter, we all sang “Happy Birthday.” I think that was better medicine than the morphine.

Another lonely lady visits us often. She’s kinda crazy. I’m always sweet to her, but the last time she was discharged from the hospital, she asked the EMS crew how long she had to wait to call them to bring her back.

One day she came in complaining of shortness of breath (she always has this, she has COPD and is on home oxygen). Some ding-dong got a D-dimer on her, and, of course, it was elevated, so we were waiting on a V-Q scan. This is when I took over.

After the V-Q scan, she came back to the ED and started pitching a fit about her glasses. “Where are my glasses? Somebody stole my glasses!” She started to blame the nurse, and then proceeded to accuse the nuclear med tech of stealing her glasses. I turned to the tech and said, “Nobody stole her glasses; she’s probably hiding them down her pants!” About 20 minutes later, the tech emerged from my patient’s room with a smirk on her face. “I found her glasses.” “You did?” I replied. “Where were they?”

“They were in her panties.”

Holy cow, I was totally kidding when I said that. Maybe I do have telepathy. “What did she say when you found them?” I asked our tech.

“She just grinned and shrugged her shoulders.” Seriously.

The other type of older patient is just like my gambling-loving Grandma (my father’s mother).

A little about my Gram: She’s 87, has horrible CHF from a crappy aortic valve that’s probably about to fail, loves really bad movies like ‘Snow Dogs’ and really good ones with John Wayne. She also is known for the saying, “I’m still kickin’.”

My Gram did NOT grow up the daughter of a physician. She was the youngest daughter, but she worked most of her life. She worked the night shift at Charity Hospital in the department that cleaned all the instruments, needles, and stuff they used to reuse. After that, she was a telephone operator.

This lady is tough. While fleeing New Orleans from Katrina, she spent the 9-hour drive from New Orleans to Hattiesburg (usually an hour and a half) in a full blown CHF exacerbation. She had taken a ton of Lasix before hitting the road with her bedside commode in the back of my dad’s car. One of her biggest complaints after Katrina destroyed her house was that her prosthetic bras (she’d had a mastectomy for breast cancer) had been ruined. “Those damn things are expensive!” she lamented.

Sometimes I wish I could take her to work with me so she could tell all the whiney 20-somethings with the sniffles what to do with themselves.

One 90-year-old lady sticks out in my mind. She had tripped and hit her head on a doorjamb, effectively scalping herself, with at least a 10-cm laceration on her head. Oh, and of course she was on warfarin. She and my Gram would have been buds.

She had a huge hematoma, and once I cleared that out, I discovered that she had cut herself right down to the skull. “You must have a hard head,” I joked with her. She just laughed. I then proceeded to explain to her that she’d probably have a visible scar. Without hesitation she told me, “I ain’t enterin’ no beauty contest! Just sew me up!”

All righty, then. And so, after 30 inner sutures, 30 outer sutures, 30 staples, multiple sutures and cautery to ligate bleeders, she was done.

A week later she came back to have her staples taken out, and she saw me as I was getting off that morning. “Come give me a hug!” she called. And so I did.

I miss my grandmothers. One because I don’t live that close to her, one because she died 9 years ago. Both of my grandfathers have died as well. So I just have my Gram.

And when I see my older patients, I see her, my Momsey, or my grandfathers. I think of it as my job to get them back to their lives, so they can enjoy their grandchildren and maybe a trip to the casino. Yes, of course, with their oxygen tanks.

Dr. Bundy is an assisting medical director at Baptist Medical Center East in Montgomery, Ala., and a former photojournalist, who not only sings in the car, but talks to herself, is addicted to diet drinks and shoes, and thinks emergency medicine is the greatest specialty.