As nice as Presbyterian Village is, Mike McQuaide’s students learn, it’s still a nursing home. As friendly as its staff, as soft as its carpeted hallways, as open as its grounds—and this, the students were assured repeatedly, is as good as it gets for nursing homes—Presbyterian Village is still a place where most of its residents go to die.

This is not an easy lesson for the 16 students shuttled out to Austell, Ga., on a chilly, overcast day in early January that seems fashioned expressly for the purpose of peeking in on the “soft underbelly” of Atlanta, as McQuaide describes it. All but two are Oxford students (the remaining pair are Emory College juniors via Oxford), and they all enrolled in McQuaide’s “Social Problems” course last fall. This week, Jan. 8–14, they are in town for a unique form of final exam.

Each year for the past 20, McQuaide, professor of sociology, has brought his class into Atlanta for a week to observe in reality what the students had heretofore only seen in textbooks. They stay in a hotel downtown and pack into a van each morning for a different field trip. On this day in Austell, they are visiting the Alzheim-er’s unit at Presbyterian Village, followed by a ride to the Roswell Funeral Home for a primer in the business of death.

And that’s just on Monday. The rest of the week includes jaunts to such Atlanta tourist attractions as the Fulton County Drug & Alcohol Treatment Center, Jackson State Prison, Grady Hospital and, last but not least, the squad car of an Atlanta police officer for an eight-hour shift in one of the city’s most dangerous neighborhoods. They also listen to lectures on female incarceration, guns and public health, Atlanta’s air quality (or lack thereof) and infants born to drug-addicted mothers.

All in all, a normal week of school.

“You know the old adage that emotion gets in the way of intellect?” McQuaide asked, referring to the day at Presbyterian Village, but the sentiment could just as easily be extended to any other day of the trip. “In this case, I think emotion facilitates the intellect. The students can’t deny their own feelings.”

In the nursing home, they listen to Lynn Alvarez describe how Presbyterian Village operates, how much it costs, its different levels of care, the way it tries to engage and evaluate its residents. And, just before they leave, they hear how all of this can be downright shameful.

“This country is weak and anemic in its ability to deal with physical deterioration,” said Jeff Mosier.
Mosier used to work at Presbyterian Village, but now he comes only on occasion, spending the bulk of his time touring the Southeast with his band, Blueground Undergrass. On this day Mosier plays banjo and sings songs for the Alzheimer’s ward while the students watch.

Music, he tells them, is often the one thing to which advanced Alzheimer’s patients respond. Whatever destruction the disease wreaks on their brains, for some reason it usually leaves the part that remembers music intact. Take a great-grandmother whose mind has deteriorated to the point where she forgets she’s eating as she’s lifting the fork to her mouth—this same woman will perk up and sing along when she hears a church hymn she’s sung all her life.

Mosier plays for roughly 20 minutes, alternating hymns like “The Old Rugged Cross” with popular ditties like “Take Me Out to the Ballgame” and “Oh Susannah.” He introduces himself and makes a point to ask each patient his or her first name. Most respond; some ignore him; some say they can’t remember. Mosier keeps his emotions to himself and continues smiling and picking his banjo.

“In other countries, the elderly are put upon a pedestal,” Mosier says during the students’ debriefing session. “In this country, if you’re 65, you’re ‘retired’—which is another word for dead.”

Despite having worked at Presbyterian Village, Mosier makes no secret of his contempt for the American tradition of applying the hospital model to caring for the elderly. He challenges the students to question societal norms, to consider what else might be done when their own parents grow older because—again, they are reminded—Presbyterian Village is as good as it gets. And it doesn’t get this good very often.

The students respond. Some agree with Mosier, some understandably bring up the financial realities of caring for an elderly parent, and some stay silent. But all leave Presbyterian Village with a deeper understanding of the problem, and while they most likely will never come up with a “solution,” they bring a more informed understanding to their studies and, possibly, their future careers.

Still, when asked if the students do attempt to devise solutions to some of society’s most ancient ills, McQuaide chuckled. “Over lunch. In the van. While on the way [to a stop]. At night when we had our little flannel PJs seminars to rehash what we did that day. Those wonderful, spontaneous. Well, let’s try this and If we just took addicts off the street and Let’s just put them all in detox.

“There are times,” McQuaide admitted, “when I have to stifle a guffaw. But what I always try to do is look for the merit in the idea and try to tease it out.”

For McQuaide, the flip side to showing students the reality behind the labels of “Drug Addiction” and “Crime” is watching their teenage idealism take its yearly beating.

“You’ve got to try to come in behind [the experience] with something so it doesn’t leave a gaping intellectual wound,” he said after the week was over. “Because that wound can back up against some sort of nihilism or cynicism, and I put a great deal of effort into guarding against emerging cynicism.

“I spent a great deal of time talking about positivism. I tried to encourage them to not get disgusted or disheartened by what they were seeing. And I constantly point out the effect one person can have. For example, Cafe 458, the drug and alcohol rehabilitation center [and one of the stops of the trip] was the dream of one person who brought that place into existence. So I try to inspire [the students] in a way that says, ‘Yes, your feelings are hurt, but here’s what some people have done in that regard.’”