He got into theater while in high school, first in stage management, then eventually directing and performing. He remained involved during college and medical school. But, he says, “I pretty much gave up everything when I hit residency and fellowship. Theater and every third night on call is not a good combination.” The theater buff managed to keep his toes in by writing plays.
After receiving his undergraduate degree in biology and theater from Stanford University, he received his medical degree from the University of Washington. Residency and fellowship at the University of California Davis followed. He then served on the faculty at UC-Davis before coming to UAB in 1998 where he is professor of clinical geriatrics in the division of gerontology and the medical director of McDonald Clinic, UAB’s geriatric outpatient branch.
Duxbury began his career in internal medicine but changed to geriatrics. “Most of medicine is very left brain,” he says. “There are specific scientific answers to problems in which you parse a problem down logically to arrive at a diagnosis. Geriatrics doesn’t work that way. Geriatrics is about somebody with multiple interacting medical issues. The usual tools don’t help you arrive at solutions.”
Instead, the geriatrician and medical team consider the context of the patient’s life and the patient’s family, often going on house calls to get a more accurate picture than an office visit can provide.
He recalls one desperate family with an elder who had Alzheimer’s. She retained her desire to help with laundry but, in so doing, ruined their clothes and linens. No medical textbook provides an answer to such problems, Duxbury says.
“You have to realize that the patient is trying to help,” he says. “She had a good sense of personal self and autonomy, and that’s got to be respected.” The solution? Lock away the good clothes and linens. Buy used colorful sheets and clothes and a bright laundry basket, easily seen by the would-be laundress. Replace the bleach with water and the detergent with cheap powdered milk. Viola! The elderly woman’s efforts keep her feeling useful, but the family’s good fabrics remain intact. “The best definition of geriatrics that I’ve ever heard is that it is creative solutions to unsolvable problems,” Duxbury says.
Sometimes that’s an apt description for theater as well. The thespian arts require “an innate understanding of how human beings work together.” Duxbury has written two plays for the Seasoned Performers, a local senior theater group who tour the state and perform in such venues as senior centers and schools. His first play, Grimm and Bear It, featured villains kicked out of their own fairy tale because modern society regarded them as old, ugly and antiquated. “They have to fight to regain their proper place,” he explains. His second, Night Call Nurses: What the Health, takes place in a radio station where former actresses in a medically-themed radio soap opera return to do a special program. “Again, they have to show the young folk what the old folk can do,” he says. He’s also written and performed for Politically Incorrect Cabaret, a Berlin-style company. “I play the emcee figure,” Duxbury says. “Think Joel Grey in Cabaret.”
He’d been involved in theater for years before deciding to try his hand at on-stage performance. “I can hit the notes but I will never sing solo in the opera,” he says. Yet the voice he discovered in lessons begun in his early 40s proved good enough to be in the opera chorus. His rich baritone also handles musical comedy leads just fine. “I really like the juicy character parts that usually have one or two scenes or a song that everybody remembers.”
Directing, writing for, or performing with a cast of characters on stage is not all that different from supporting and communicating with a geriatric patient and family members. In both cases, the person must watch for cues, listen to dialogue, and help create scenes that satisfy complex conflicts. Duxbury manages to make simultaneous mastery of both the worlds of theater and medicine look easy.
