A Short History of Tractors in UkrainianBMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c1082 (Published 24 February 2010) Cite this as: BMJ 2010;340:c1082
- Linda Kearney, Centre for Ageing, Neuroscience and the Humanities, Trinity College, Dublin
Elder abuse is a complex area of clinical practice and differs hugely from child abuse, as the older person consents to, and partners in, the assessment process. Even as older adults we have the right to behave in ways that may seem injudicious or foolish; and deciding at what point such situations might constitute elder abuse is one of the most complex areas of geriatric medicine. Artists can often handle complexity in a more approachable way than less articulate clinicians, and Marina Lewycka’s debut novel provides thought provoking insights into elder abuse. Written with acerbic wit and humour, this short novel is a hugely entertaining comedy of colourful characters. It also succeeds as an unexpectedly moving account of vulnerability in later life.
It has valuable insights into the variety of presentations that elder abuse can take, the difficulty in highlighting cases of elder abuse, and the complexities of caring for an older relative who denies a need for help.
Lewycka weaves the tale of Kolya, an elderly Ukrainian widower who lives in Britain and who falls hopelessly for a 36 year old voluptuous Ukrainian divorcee, Valentina, who is in search of a visa and Western wealth. The lonely Kolya is easily persuaded by Valentina into using his pension to buy her three cars, while he remains blind to her blatant disregard for him. His two daughters put aside a lifelong sibling rivalry to join forces and break up the marriage, to free their infatuated father from the tirade of physical and psychological abuse that ensues.
Although the book is a comedy, the deep shame of elder abuse pervades the story and stays with the reader for days. We feel Kolya’s humiliation and his daughters’ helplessness.
The loss of dignity is exposed in one vivid scene, where Valentina strikes Kolya with a wet tea towel and slaps him as he backs away from her, his glasses knocked from his face. Even more upsetting is the account of Valentina trying to lock him into his bedroom, dangling the keys out of his reach and taunting him as he feebly tries to jump up to get them. He is an “imbecile to be locked away,” a “dried shrivelled relic of ancient goat turd.” His lack of strength renders him helpless.
The challenge of drawing attention to elder abuse is emphasised in the demoralising account of the visit from the local police at the request of Kolya’s daughter. She finds him upset in his room, naked from the waist down, having soiled himself, while the policeman and Valentina sit at the kitchen table sharing a joke over coffee. In another incident Kolya needs to be brought to the hospital emergency department after a particularly violent push. He repeatedly tells the nurse that Valentina is trying to murder him, yet, after a night in a residential hostel, he is escorted home, without any further probing into any possible underlying abuse. The relentless efforts of Kolya’s daughters to protect their father are impeded by his shame in admitting his situation. His desire for companionship is so great that he excuses the affairs, the insults, and the demands for money. Despite his realisation that she might eventually kill him, he would rather “die at the hands of someone he loves, than die alone.”
Original in style and subject matter, this absorbing narrative is a valuable addition to the reading lists of geriatricians in training.
Cite this as: BMJ 2010;310:c1082
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A Short History of Tractors in Ukrainian