This is the transcript of an interview that Adina had on Dec. 12, 2003 In Efrat, Israel, with a gerontologist . The man who agreed to answer our questions and post them on our website is Dr. Tzvi Dwolatzky: 

A: What, in your eyes, is the greatest medical achievement of all time? 
T: In my opinion, the greatest medical achievements are the development of antibiotics and of vaccinations. 

A: Do you feel that all new medical technologies are for the best?
T: Generally, technology is for the best, especially medical technology, which is geared to improve peopleâs lives although it must be closely supervised and controlled with strict rules.

A: Can you please state your specialty? 
T: Geriatrics, which means the care of old people. 

A: How has your job changed over the years? 
T: There have been no significant changes over the years. Geriatrics is one of the youngest specializations, in Israel, with no major changes for the last ten years. 

A: What machines do you use that make your work a lot easier? 
T: We use whatever is available- electric scans, and equipment that every doctor uses. We rely mostly on clinical examination, which is basic doctor work.

A: Why the age difference? 
T: Actually, women are just generally stronger and healthier.

  A: What was the average life expectancy forty-fifty years ago? 
T: In Israel, life expectancy has increased from about 50 years to 80 years, almost a thirty-year difference.

  A: What has made human life longer? 
T: Surprisingly, the main cause for longer life is not modern technology, but basics - good hygiene, less infections, use of antibiotics, and good nutrition from early childhood. Children ages one, two up till ten used to die from diarrhea, tuberculosis, things that we now know how to treat but did not back then. All the homecare programs, physiotherapists and physical therapy, and kupat cholim (General Health Services) treatments donât actually do much to increase human life expectancy, but do a lot for the quality of life - improving happiness and strength. 

A: Do you think we should continue to give immunizations today?  
T: No doubt, people must continue to have immunizations. I believe it is harmful, even criminal, not to have immunizations, it is definitely the right thing to do. 

A: Is life expectancy the same in countries around the world?  
T: Every country has a different life expectancy. For example, in Italy, the oldest country, where 18 % of the population is old, the life expectancy is just above 65. In Sweden, it is over 80 years, and in India, only 55 years. Every population is vastly different. 

A: What is the quality of senior life?
T: Generally, seniors have good healthcare, as they are entitled by law. The major problem is financial. Many old people donât have enough money for heating during the winter, for fruits and vegetables and healthy foods.

A: Make a guess- what will future illnesses be, and how will they be treated? 
T: I canât really know that, but diseases like cancer and AIDS are considered fairly new. About 20-30 % of the African population dies from AIDS. New conditions will no doubt appear. Every generation has its conditions. Tuberculosis, a lung infection, killed off millions of people some eighty-to-twenty years ago, but is now scarce .In Israel, people sufferfrom a large number of strokes, heart conditions and cancer. 

A: Is it better for elderly people to be treated for illnesses at home or at a hospital? Why? 
T: Home is a more natural, familiar environment, but unfortunately not everything can be done at home. We try to have as many treatments as possible at home, for the patient/seniorâs comfort. Hospitals should not be seen negatively, however, even if hospitals have not always provided the right treatments or the right cures. 

A: Is life expectancy going to drop/rise in the next few decades? 
T: Drop, it probably wonât, unless some dramatic disaster occurs, such as an atomic bomb or an earthquake or an epidemic. In fact, it will probably continue to rise, but very slowly. 

A: What are new, recent medical achievements? 
T: Alzheimerâs - a disease that makes people forget everything, the brain degenerates, is the fourth largest cause of death for seniors in America (three million deaths). A cure would make a major difference. Heart disease is another example - there has been a large decrease in recent years. Cures for both of these illnesses are expected to be developed within the next ten years, or at least ways to improve the level of care for them.  

A: What are the effects of genetic diseases? 
T: Genetic diseases shorten life, beginning with young children. Most are even born with these diseases. An example for this is down syndrome - those infected with it are expected to live no longer than 40 years. Genetic conditions affect the number years of life, cause a decrease in bodily function and mental retardation, while genetics can also cause long-life expectancies. It is genetic for some families to live longer, such as most members reaching close to 95, even 100 years of age. 

A: Do we know anything about the specific genes that cause long life?
T: The biggest achievements in the study of the body consist of discovering the human genome - the human makeup of chromosomes and genes - that happened only two or three years ago. These discoveries have led to the possibility of alteration, maybe removal and replacement of damaged or defective genes. This is a wonderful option for all kinds of cures, namely Alzheimerâs

A: This is a fascinating subject, on which your knowledge is very extensive. Thank you for sharing some of it with us - I learned a lot from this conversation.