I just finished reading a book, Into the Blue (2004) by Susan Edsall, a stellar example of internalized ageism and the power of positive perception and action to overcome expectations. It describes how stroke survivor Wayne Edsall defied doctors assertions he would never live independently again and with the help of his dedicated daughters reclaimed his right to independence, and his pilots license. It is both a tremendously uplifting story and a seriously sad commentary on our medical model of care. In essence, every step of the recovery required dedication and effort on the part of Wayne and his family plus a continuous fight with medical personnel to get them to see him as a whole person rather than just as a stroke victim.
There is no question the medical model of care is entirely disease/injury focused. Their approach is to treat the physical disease/injury which leaves the emotional, social, spiritual, and intellectual well-being to someone else. Unfortunately, deeply entrenched expectations actively suppress well-being. Susan reports her frustration with knowing her father should receive immediate rehabilitation only to still be waiting after day 5. More frustration when she tried to get therapists to share materials with her so she and her sister could assist recovery after discharge. And the final insult at a followup appointment, no acknowledgement or congratulation for Waynes recovery after much sacrifice and unbelievable levels of effort by he and his family. In fact there seemed to be a thinly veiled resentment at being proven wrong.
Another revealing aspect of the recovery story was the ageist and negative expectations demonstrated by rehabilitation therapists in the hospital. Telling Wayne and his family he would never fly again but could play checkers, etc. and providing activities to "fill time" but connecting no meaning or purpose to their completion. And here’s the final rub, if Wayne had been a 30 year old stroke survivor rather than an older adult the response would have been entirely different. Medical staff would have focused on getting him fully functional as a contributing member of society—not just imposing a negative "script" telling him what he could do and be as a stroke survivor, and offering the corresponding "time fillers" to cope with empty days stretching out before him. Positive beliefs internalized and acted on by he and his family rescued Wayne from the negative script and replaced it with a real life, joyfully flying through the skies of Montana.