I am Dr. Howard Tucker, a 101-year-old neurologist and the Guinness World Records “Oldest Practicing Doctor.” I have been practicing medicine for over 75 years, am a WWII and Korean War veteran, received my law degree at 67, and am the subject of ...

What were the most exciting developments in medicine for you, over the duration of your career, and what are you currently most excited about for the future of medicine?

“I began practicing medicine before CT and MRI. Modern imaging is easily one of the most exciting developments I have witnessed. However, it can come at a cost. While imaging studies are a great resource, doctors should be careful not to solely rely on imaging studies and I emphasize the importance of taking a thorough patient history to fully understand the clinical picture.”

What can we as patients do to be heard when we feel our doctors are prioritizing modern medicine over patient history, asking as someone who was reprimanded recently by their psychiatrist of 3 sessions. I feel my doctor is treating a diagnosis and not me.

“This is a real problem and is unfortunate. If you are not satisfied with your provider or the care you are receiving, you have every right - and should - request a referral to another provider.

While I am not actively treating patients in a hospital setting at the moment given the recent closure of my last hospital’s unit, if a patient ever said to me, “you know, Dr. Tucker, I would prefer another opinion from a younger neurologist,” I may not agree with their reasoning, but I would certainly refer them to receive a second or even third opinion - I would never dismiss them. You as the patient have every right to be heard. Unfortunately, it sometimes takes two or even three doctors to find a caregiver you are satisfied with.

That being said, I would not advise seeking numerous opinions from multiple doctors if you are looking for a diagnosis you “like.” If you respect and trust the physician(s) that are treating you and feel all of your concerns have been addressed and nothing has been missed, you can usually feel comfortable with what they are telling you.”

Hi Dr. Howard

Do you teach any medical students? If so, what do you try to make sure they never forget?

Signed, A medical student interested in neurology

“For medical students and neurology residents, I would emphasize the one controlling medicine they should know by heart is a specific medication for status epilepticus (seizures that continue at the interval of at least one every four minutes). It is important to know how to save the brain from as much hypoxia or oxygen deprivation as possible.”

Hello Dr. Howard, thank you for this AMA. You certainly have lived a fascinating life and the independence you have at your age is nothing short of incredible. I can only hope to age so well. So that leads into my first question.

Do you have any advice about keeping your mind sharp as we age? Also, we know that chronic stress can have detrimental effects on mental health and cognitive functioning (in addition to associated physical health issues from stress). How do you manage your stress as a medical professional?

Also, do you have any dating advice for us younger folk? Especially for someone who is going into a demanding field such as medicine (I'm a doctor veterinary medicine student and an aspiring neurologist)?

Thank you very much for your time and I look forward to your responses.

“Engaging socially and keeping the brain active, whether through work, a hobby, volunteering, or taking a class on a topic you enjoy, is critical as we age. The mind must be stimulated and exercised like a muscle. When you stop stimulating your brain, research has shown there may be an association with an increased risk of cognitive decline. I am not suggesting everyone follow my path and continue working into their 70s, 80s, and 90s, but I cannot stress enough the importance of staying engaged and stimulating the mind.

Stress is the nature of our profession. Good stress will keep us on our toes and help us to perform our best, but as you noted, too much stress can lead to burnout and less favorable outcomes for our patients. I believe choosing to enter a specialty or profession in which you are passionate about can greatly help with stress. While it certainly will not eliminate the stress completely, doing something you love gives you purpose and helps to ground you during stressful moments. I would also like to emphasize the importance of finding a balance in your personal and professional life. Continue to build strong friendships and relationships, both inside and outside of your work. Having a support system, and even knowing you have the support system in place, can greatly reduce stress.

Great question!”

Dr. Howard Tucker, it's an honor to have you alive and well. Thank you for doing this AMA. Could you give us your best piece(s) of advice for living a happy and healthy life?

“I believe the keys to a happy and healthy life are everything moderation, no cigarette smoking, and having no hate in one’s heart. I also believe that retirement is the enemy of longevity, but understand that some people do not have the luxury of working in a job that provides satisfaction. Keeping your mind active, whether that be through work, a hobby, or volunteering can do wonders.”

☝This. Are you/were you a drinker, smoker or drug user? Do you have a family and if you do, do you feel it contributes to your longevity? Congratulations to all your successes in life.

“I do not smoke nor use drugs. I do enjoy an occasional drink. When I was a teenager, I told my father I wanted to take up smoking cigarettes. He told me, “that’s alright with me, but why would anyone want to put anything but fresh air into one’s lungs?” And that took the fun out of it for me. I absolutely believe that not smoking contributes to my longevity and prevention of various cardiac, pulmonary, and peripheral-vascular diseases. Thank you for the kind words.”

Great to hear that. Hopefully I will have a healthy long life as well. I, myself, have never smoked.

Social drinking, yes.

“Never underestimate the value of a good martini, in moderation of course :)”

I’ve always wondered why neurology and psychiatry continues to be completely separate disciplines as opposite to psychiatry being a sub speciality of neurology. For example I recently found out major depression can cause cognitive damage, perhaps irreversibly so, shouldn’t there be more overlap and coordination between the two?

“This is a great question. The board is called The American Board of Psychiatry and Neurology. Some of the most famous psychiatrists started out as neurologists, such as Sigmund Freud. While there is an overlay, both specialties are so complicated that they require experts who specialize in either neurology or psychiatry, though some do practice neuropsychiatry. It is important for both neurologists and psychiatrists to understand the other’s speciality and be able to refer patients to an expert to treat in the opposite field.”

What are you surprised has not changed yet, either in terms of medicine itself or people's attitudes toward medicine and their health?

“40 years ago, I would have hoped there would be a cure for HIV by now. While we do not have a cure, we do have the medicine to keep HIV under great control and without transmission of the virus, which is an enormous step forward.”

Hello sir, I have 2 questions if you don't mind.

1. What is the greatest change you have seen in the field of neurology.

2. Any advice for a new neurology attending?

Thank you for doing this AMA. Wish you all the best!

“1. The CT scan and MRI are the greatest changes. They have changed the sophistication and attitude of many doctors history taking because they are becoming increasingly reliant on the scans rather than on the patients. But they have also brought us out of the Middle Ages and into the 20th and 21st centuries in terms the information they provide.

1. My advice would be to emphasize to medical students and residents the importance of taking a thorough history.”

How can we fix peoples brains so they don’t struggle so hard for recognition in this selfie/influencer culture? It is clearly going to have devastating effects on their futures, but they don’t see it now for what it is. How can we help them?

“Thank you for your question. The social media platforms and “influencers” are likely not going away anytime in the near future. The platforms have incredible reach and I would like to see influencers in the future use their platforms to educate and inspire. I am still trying to fully grasp the enormity of social media, but hope to have a better answer for you in the future.”

What’s the most interesting neurology case you’ve ever had? Anything Oliver Sacks worthy?

“This is an interesting question. One that comes to mind is in the early 1960s, a young girl presented to the hospital after swallowing hair tonic. As hair tonic is just mineral oil, she was discharged and told she would be okay. Later, she arrived back at the hospital in coma. My colleague and I could not figure out why she was in coma with no signs of injury or disease - and knew the hair tonic likely was not the cause. We sent her to New York for observation at Columbia’s neurological institute where I had previously trained. My old bosses and colleagues there could not figure out why she was in coma, either.

The girl returned back to Ohio and by this time, her older sister went into coma too. My colleague and I were able to rule out additional causes and suspected the sisters may have been poisoned. We set a trap by drawing blood from the girls before family visiting hours and after family visiting hours. Sure enough, the blood from after visiting hours showed the girls had barbiturate poisoning - it was discovered that the mother was ultimately poisoning them through a drop feeder during visiting hours.”

what was the worst thing you experienced in your time practicing?

“When I began my career, I treated many pediatric neurology patients. It was difficult seeing so many young patients with their lives ahead of them dealing and struggling with debilitating illnesses. It was even more difficult knowing many of these patients could not be saved.”

that’s such a sad story. i would like to thank you for all the work you have done

“Thank you. I will add that not all pediatric cases were tragic. In fact, one was quite miraculous. In the 1960s, a 3 year old patient walked into my office and I discovered she had a brain tumor, the same tumor another 6 year old patient of mine had and unfortunately passed away from shortly after diagnosis. Local newspapers published “Last Christmas for 3 Year Old” and Christmas gifts poured in for the little girl. I had assumed she passed away. 15 years ago at my office, in walks this woman. She’s alive and thriving!”

Hello Dr. Tucker, it’s a privilege to ask you this question.

In your career were you ever recommended to perform a lobotomy and if so, what was your reaction? If not, what was your reaction in the procedure’s hay-day and your opinion now?

Thank you for all you’ve done.

“When I was training in New York, we thought lobotomy was inappropriate, though I knew a man who had a prefrontal lobotomy and lived the rest of his life in a nursing home. At that time, there was another nearby hospital that performed lobotomies. I never recommended or was ordered to perform a lobotomy, thankfully.”

What's your opinion on the many recent news stories involving septuagenarian and octogenarian U.S. politicians either running for office or spacing out while legislating? Was America meant to be run by retirees? What, if anything, should be done about it?

“The question becomes at what age do we tell people to stop working, whether it be in politics, medicine, law, business, etc. Is the age 70? 80? 92? Sure, instances of dementia and other cognitive impairments are much higher in people who are older, but that does not mean every older individual has cognitive impairment and is unfit to perform a job. Many older individuals may be more qualified than their younger counterparts. Of course the same holds true the other way around and one can find examples of that in any field or industry. I don’t know if there is a solution other than to look at the individual as a whole before deciding they are unfit simply because of how old they are. Very good question, though.”

What advice do you have on making marriage work for 66 years?

“Selective hearing…and compromise.”

Hello Dr. Tucker,

Thank you for doing this AMA!

My question is what do you do to reduce stress/not have burnout in your long career?

“This is a great question. Throughout my career, I have always prioritized spending time with family. With the exception of my early career, I have been fortunate to have the flexibility to provide the best care to my patients while also enjoying activities with my wife and children. It may not be easy or even possible in some circumstances, but if you can find a good work-life balance and have interests outside of your work, this may help reduce the risk of burnout.”

What has helped you to live a long life.

What has helped you to continue learning so far into your long life?

​

Thank you for your service and the work you have done.

You are an inspiration.

“As mentioned above, I believe in everything in moderation. I do not go to any extremes nor do I have any secret diet or workout routine to provide you. I am careful to eat healthy, but do not restrict myself if I’d like to enjoy a piece of cake or steak every once in a while. Genetics certainly play an important role, too.

As for continuing to learn, I am passionate about what I do. My job requires me to take continuing education courses, but I also find them interesting and rewarding. If you can find something, whether that be a job or hobby, you are extremely passionate about, your desire to learn more will come naturally.”

Hi Dr. Tucker from a fellow Ohioan!

I’m curious about your thoughts on fibromyalgia. As a diagnosis of exclusion with no official testing or common experience of symptoms, a lot of doctors don’t believe it to be real, and it’s very frustrating. My rheumatologist told me it’s now being classified as a neurological disorder, but I’ve seen 2 neurologists who both say they are too unfamiliar with it to help with it, and both were incredibly dismissive. Is it difficult to deal with these types of disorders/syndromes that are complicated and unclear?

“It is difficult in that these conditions often present with many comorbidities, symptoms can overlap with other conditions, and there is no gold standard of treatment yet. To your point, it then becomes even more complicated when multiple physicians are involved with differing views. For some patients with these conditions, resistance to therapy is so high that therapy may be unobtainable. This is not to say that the symptoms are not real, but to highlight the complexities with treating and managing these conditions that you’ve pointed out as well.”

Hi Doc! Thanks so much for doing this AMA. I have two questions if that's ok:

1. What development in the world, whether technological or social would blow 5 year old Howard's mind the most if you could go back and tell him?

2. What would you consider the most culturally significant moment you've witnessed in your lifetime?

Thanks again!

“1. Anything relating to technology or the internet. It boggles my mind even today how quickly technology has advanced.

1. WWII as a significant event. The change in morality and behavior as a cultural shift. It has always changed from generation to generation, but still comes as a surprise when it happens.”

How do you keep up with newer technology?

“I must admit that keeping up with technology is quite difficult. But I refuse to give up at it and would like to take a course on it. Having grandchildren helps :) As does working with younger colleagues able to assist me. I am comfortable with email, navigating the internet, taking online courses, and Zoom calls. I would like to understand how it all works.”

I have never been given nor had any ambition in life . Has your ambition been instilled or inside you? What drove your wonderful quest for learning? Does intelligence play as a factor?

“I don’t believe intelligence plays a role in whether or not someone will have ambition in life. My father, who lived into his mid-90s, always had a passion and drive to learn new things. I think that’s where my desire to continue learning and doing comes from.”

Hi Dr. Tucker! As the most experienced doctor in any given room, what's your approach to keeping your knowledge current and incorporating new information or perspectives into your practice? And what influence would you say your professional community (i.e., your workplace, your specialty, medicine in general or any other community you identify with) has on your practice from day to day?

“While I am currently in the process of finding a new hospital as my previous hospital’s unit closed, my professional community (my colleagues, nurses, residents, students) is the reason I continue to do what I do (besides helping patients, of course). I learn a tremendous amount from other doctors and the residents I’ve taught, especially with regards to utilizing technology to access and find information more efficiently.

Medicine still brings me much joy. Unfortunately, many of my closest friends, colleagues, and other physicians that would refer to me loyally are no longer with us. But the next generation of physicians are extremely bright and I look forward to seeing their contributions to neurology.”

Hi Dr.Howard, what do you think was done better in medicine when first started that has gotten worse over time?

“I would say patient history taking. It is critical that a proper history of a patient is taken before jumping to order imaging studies and scans. Imaging studies play an important role in diagnosing and treating disease, but are just a part of the picture. Interacting with a patient and listening to what a patient does or does not tell you paints a larger clinical picture and in some cases, you can make a diagnosis before ordering a study.

Medicine is an art form. And while imaging technology has been the biggest advancement in medicine over my career, some younger patients rely too heavily on this technology and forget to take a proper patient history. The two should go hand in hand, not one or the other.”

I’m curious if you’ve handled multiple sclerosis cases and if you think there is a cure or better management of the disease in the near future? Thank you so much for this opportunity to ask.

“I have handled many MS cases and while tremendous progress has been made on the treatment front, MS still remains a mystery. I cannot say that I think there will be a “cure” in the near future, but I do believe our understanding on how to better manage the disease will continue to evolve.”

What is the feeling of outliving your peers? Does it feel worth it- does it seems as though all the sacrifices you made added up/were worth it?

if you woke up in your / an avg. 50 year olds body, what are some if the first things vs long term things you're doing?

“I am very happy to still be here and am blessed to have my health, family, friends, and a career that I love. I am sad that some of my closest friends, colleagues, and even long-time patients are no longer with us. I am fortunate to have younger friends who are in their 70s, 80s, and 90s, too.

If I woke up in my 50 year old body, the first thing I would do is go skiing. Skiing is my lifelong hobby and passion. When I was in my late 80s, a snowboarder cut me off sending me into a tree and I fractured my C2 vertebra. If my physician and family permitted it, I would be back on skis in a heartbeat. But snowshoeing will do for now. It is a good substitute.”

What are some of the things that you have only been able to do since you have both an MD and an JD?

“I wouldn’t say there are things I can only do with both an MD and JD, though I do engage in medical-legal work. While you do not need a JD to be a medical expert witness, having both an MD and JD has given me a unique perspective, allowing me to look at cases, whether medical or legal, in different ways.”

When do you think you'll have practiced enough to be perfect?

“Exactly, you would have thought that after 75 years, some things should have clicked by now :)”

Why did you choose neurology?

“Neurology was a very cerebral functioning. When I began practicing medicine, there were few specialties that required such a deep level of thought process. There is some overlap between psychiatry and neurology and I was always intrigued by psychiatry, too.”

In my opinion I think it’s rare for a medical professional to give a true answer about how antipsychotics affect long term health because they are worried about people stopping their medication, but I think people should have true informed consent.

So with that all said, what do you think about long term treatment using antipsychotics?

(Edited to include everything within these parenthesis, if you scroll through this thread you will find some resources which show why I don’t believe medical professionals give a true answer about how antipsychotics affect long term health.

If you don’t read every source that I link & just downvote me based on preconceived ideas then you are part of the problem.

It should be up to the person taking the medication to decide what risks & side effects they are willing to take.

If a health professional is so scared of true informed consent what does that say about the medication?

Plenty of people know what I know & more people are becoming informed everyday.

Every time a Psychiatrist doesn’t truly inform someone & they find out elsewhere trust is broken that will NEVER be repaired & often this person will go on to tell everyone they know.)

“There is still more research to be done. For the most part, antipsychotics when clinically indicated and at the correct dose are safe to take. I don’t particularly deal in this class of drugs, but have always been of the mindset that if you don’t need it (for any medication), you don’t take it. Any drug is capable of long term side effects so it’s important to make an informed decision with your provider.”

You must have lived one hell of a storied life! A topical question for sure, but are you a Superager00079-X/fulltext) (People who are eighties+ who can recall everyday events and life experiences as well as someone 20 to 30 years younger)?

“While I certainly feel 20 to 30 years younger than I am and many people have noted my memory is sharper than most, I have not been officially designated as a “Superager,” though I would be flattered.”

Hi Dr. Howard - do you regret being a Navy man and instead wishing you had (like so many) joined the Army instead :) ? Seriously though - Have you been back to any of the modern ships in the Navy or in contact with up and coming Navy Drs to see how they are keeping pace with the civilian side?

“I enjoyed my service in the Navy thoroughly and have no regrets. I unfortunately have no contact with anyone who was in the Navy with me and believe many are no longer with us.”

Dr. Tucker, what do you think about the current US healthcare system?

“I think the system itself could be better, but also recognize that each generation feels that the previous generation had it better in terms of practicing medicine. Not going into the regulations, red tape, insurance paperwork, and administrative work that add to our existing duties, the practice of medicine today is unfortunately becoming less personal. A careful patient history taking is a lost art. But I remain optimistic.”

Dear Dr.Tucker, As an epileptic, do you think there will be a cure for epilepsy anytime soon? Thank you!

“With proper training, a good epileptologist (or a general neurologist confident in treating seizures) should be able to control the seizures. Our threshold for epileptic spells vary from person to person, so while I do not see a universal “cure,” perfect control is likely in most patients.”

What is your opinion of social media gadgets and technology on the human brain over time - what will your great grandchildren be like as adults?

“Gadgets can deprive the brain of cerebral functionings, thought processes including spelling and arithmetic. People rely too heavily on gadgets to perform these tasks. Though there is no denying the value of having large amounts of information at our fingertips.”

Did you find law easy to study and practice after so many years as a physician? Coming from a place where all the laws are unyieldingly written by biology, chemistry, and physics to one where the laws are written and upheld by people seems to give a lot more flexibility, as you would then have an opportunity to argue over it rather than necessarily have to accept a result for what it is.

“I found law school easier than med school. There was more reading in law school, though. Law school was a new and fascinating adventure!”

Fellow physician here, thanks for doing this!

How has it been for you adjusting to EHRs (electronic health records)?

Edit: My initial question about his most memorable case was previously answered and thus deleted.

“It has been a struggle, but I have persisted. I’m able to go through electronic charts, although I miss handwriting reports. I am capable of holding my own - although I do have close friends that have retired because they could not handle EHRs.”

Have you considered running for Congress?

“Absolutely not. It takes a great deal of effort and time. I would hope that I am more ethical than some politicians…”

Do you think the 10+ years of medical schooling is justified?

“I do think spending 10+ years in medical school, residency program and training is justified. Med school only scratches the surface in terms of subspecialty. And even in a residency program, it takes years to learn what you need to know. Yes, you never stop learning throughout your career, but I believe 10+ years of structured and hands on learning is needed.”

What do you do to take care of your brain and health?

“I am always keeping my mind active. My work provides me an opportunity to think through complex problems daily. I also strive to learn something new each day. As for my health, eating in moderation and staying physically active, I believe, have contributed to my health.”

What is your skin care regimen?

“Genetics definitely contribute to skin health, but staying out of the sun and wearing a hat on especially sunny days will help mitigate some of the devastating impact that UV rays have on your skin. That is my routine. I do not use any creams or moisturizers, but maybe I should start.”

You seem to have given a wide array of topics thoughtful consideration from reading all of your responses. Do you have any views that seem to go against the grain of society, whether it be scientific, religious, political, etc? Please don't share more than your comfortable with.

Thank you doctor Tucker!

“I appreciate this question. My taste in music seems to go against the grain of society today, or at least my grandchildren tell me so. I cannot grasp rock, pop, and the newer music out today, although I do enjoy a select few rock bands and newer singers. I am trying to listen to more of it, but it’s just not something I understand. My parents were the same way when I was young and listening to big band music - they didn’t understand my taste in music.“

Hello Dr. Tucker!

How did you manage to complete your law degree while practicing medicine full-time? Cognitively, what helped you strike a balance between the two; while still learning about a subject that is quite a bit different than medicine?

Thank you for your service! Your journey is super inspirational! Best wishes to you and your family!

“Thank you for the question and kind words. I would study in the afternoon on weekends after doing rounds in the morning. I was fortunate to have professors that allowed me to miss a few of the daily recitations and instead would review the material on the weekends. I ended up taking a week or so off from my medical practice when it was time to take the bar exam.

While I do not currently practice law, I do enjoy taking the continued education courses with my son who is also a lawyer.”

Hi Dr. Tucker, my grandfather is also a WWII and Korean War vet and he is still kicking at 100! He was a navy pilot on aircraft carriers. Were you ever deployed on the USS Hornet?

“I was never deployed on the USS Hornet, though please give my best to your grandfather.”

Hi Dr. Tucker! What drew you to neurology and what has made you stick with it?

“It remains a fascinating subject and you never stop learning. Even after 75 years, I see something that puzzles me and requires further investigation to make a diagnosis. I am not sure we will ever completely understand the brain, certainly not in my lifetime. But treating disease and having the ability to help patients brings me joy.”

Can you please tell us about your upcoming documentary? ;)

“I have enjoyed filming this documentary over the past two years, although I was not expecting it to take this long. Filming a movie is completely new to me, and I don’t yet fully grasp how the film equipment works, but has been a unique experience. More information about the film can be found above.”