In the small towns of America, the choices are often stark and simple. For young people coming of age in these places, the paths forward can feel predetermined, as if laid out by geography and circumstance rather than ambition or desire. In the town where Cate McCarty grew up, there were two options for employment: the nursing home or the cup factory. She chose the nursing home, not because of any particular passion for eldercare, not because of a vision of her future self as a gerontologist or brain health specialist, but because it was simply there. It was the only job available. The banality of this origin story is, in its way, what makes everything that followed so remarkable.
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McCarty began as a nurses' aide, performing the physical labor that forms the foundation of all care work. The bathing and feeding, the lifting and turning, the endless small dignities and indignities that constitute institutional life for the elderly. It is work that can numb the spirit, work that society undervalues despite its necessity, work that many people do while dreaming of being somewhere else entirely. But something happened to McCarty in that nursing home that changed the trajectory of her life, though she might not have recognized it at the time as a transformative moment. It was, on the surface, an ordinary encounter with an ordinary sadness.
There was a patient, a woman who was depressed. In their conversations, this woman mentioned Black Eyed Susans and their beauty. It was a small disclosure, the kind that can be easily overlooked in the rush of tasks and the pressure of institutional schedules. But McCarty heard it. More than that, she remembered it. The next morning, on her way to work, she stopped and picked some Black Eyed Susans. She brought them to the woman.
This gesture, simple as it was, created what McCarty describes as a personal link that made all the tasks more meaningful. The flowers were not medicine in any conventional sense, not part of any care plan, not something that would appear in the woman's chart. But they were a recognition of personhood, an acknowledgment that this depressed patient in a nursing home had once had a life in which she noticed flowers and found them beautiful, and that this life, this sensibility, still existed within her. The act of bringing the flowers was a way of saying: I see you. I remember what you told me. Your inner life matters to me.
What began with Black Eyed Susans became, for McCarty, a methodology. She found herself wanting to know the residents in any way possible, to understand who they were beyond their diagnoses and dependencies. This curiosity, this hunger for connection, eventually led her beyond the nursing home in that small town, through advanced degrees and into the field of gerontology, where she now works as a specialist in brain health and positive aging. She earned her PhD. She became a Certified Dementia Practitioner. She built a career on the foundation of that first intuition: that care without knowledge of the person is incomplete, that treating bodies without honoring biographies is a kind of blindness.
Now, when McCarty thinks about what makes an excellent healthcare professional, she returns to this principle. An excellent healthcare professional, she believes, sees the whole person and recognizes the role of the environment and the individuals' biography. It is a deceptively simple formulation, but one that challenges the fragmentation and specialization that dominate modern medicine. To see the whole person is to resist the reductionism that treats patients as collections of symptoms, as problems to be solved through discrete interventions. To recognize the role of environment and biography is to understand that health is not merely a matter of physiology, that who we are and where we come from shapes how we experience illness and aging, and what we need in order to flourish.
For those considering entering the field of eldercare or any helping profession, McCarty offers advice born of hard-won experience. Look for what makes your heart sing, she says. Not all jobs or all programs are right for all people. Find the role or program that will get you through the more daunting times. This counsel acknowledges the reality that care work is difficult, that there will be moments of exhaustion and despair, that burnout is not a personal failing but a structural reality. The only protection against these forces, imperfect as it may be, is finding the work that connects to something essential within yourself, the work that feels like an expression of who you are rather than a betrayal of it.
Yet McCarty's vision extends beyond individual fulfillment or even individual excellence in practice. She longs for systemic transformation. She imagines a day when care is truly interdisciplinary, when healthcare information is truly portable, when professionals are granted the time and resources to see the whole individual. This longing is not naive. McCarty has worked within the current system long enough to understand its constraints, the way insurance reimbursement shapes what care is possible, the way electronic health records can facilitate information sharing yet somehow deepen the distance between providers and patients, the way time pressures force clinicians to focus on the acute and measurable at the expense of the chronic and relational.
The distance between the world as it is and the world as McCarty envisions it is vast. But it is the same distance that once existed between a young nurses' aide in a small town and a PhD specialist in gerontology and brain health, between someone who took a job because it was the only one available and someone who found in that job the beginnings of a calling. The transformation happened not through a single dramatic revelation but through accumulated moments of attention, through the practice of seeing patients as people with histories and preferences and inner lives that deserved honoring.
In Owings Mills, Maryland, where McCarty now practices, she continues the work that began with Black Eyed Susans in a nursing home whose name she might not even remember. The particulars have changed, the scope has expanded, the credentials and expertise have deepened. But the essential gesture remains the same: the choice to connect, to remember, to recognize the person within the patient. It is not the only way to practice gerontology or to approach eldercare. But it is McCarty's way, forged not in spite of that small-town beginning but because of it, because she learned early that meaning could be found in unlikely places, that a cup factory job avoided could become a vocation discovered, that the work we stumble into can become the work we were meant to do all along.