I retired from clinical practice some years ago, after the better part of four decades in harness as a general surgeon. To be sure, there were forays into research and administration, but these were part-time, and I didn’t miss out on that bugbear of practice: taking call.
I looked forward, accordingly, to the prospect of a life unfettered with middle-of-the-night phone calls and the business of running an office. For many, though, retirement is a fearsome prospect. The grizzled colleague whose locker was next to mine explained that he wanted to be carried out with his boots on, a common enough perspective. Time moves along, though, and most realize eventually that laboring on is a losing proposition and its best to plan an exit.
There isn’t a good way to leave practice, especially if its lucre, money, a pay cheque you’re still after, and this may account for those stalwarts who soldier on, seemingly oblivious to the young surgeons who’ve finished training and are eager to pick up OR time and access resources. Some retirees find that assisting in the OR can be a partial answer. They’re advised to look for a discipline different from the one they toiled in for years to blunt any inclination to be impatient or judgmental. It’s not a bad plan. Assisting keeps the dollars coming in, after all, and provides a place to go, workdays, for those with strong backs, good bladders and an appetite for chitchat with old buddies. Other retirees look for new prospects and amble out of hospital with plans to build a boat, learn Mandarin, or try fishing in the Seychelles.
There’s an inescapable rush with retirement, escaping the constraints of practice. Relief is short lived, however, as the changes involved are massive and tantamount to moving from a swift-flowing stream to the brackish backwaters of inactivity. It’s tough on the ego, finding one isn’t the fellow that one’s practiced being for so many years. The sense of nostalgia is powerful and surprising, strangely reminiscent of the early appeal of summer holidays decades earlier, so soon replaced with the tedium of inactivity. Chores, or going to the bank, or waiting for lunch don’t quite measure up.
It can be an awkward time. The trick, a nicely retired doc told me, is to get comfy with the notion that you’ve moved on. Practice saying things aloud. Don’t say to yourself, I’m a general surgeon (or whatever), but say rather, “I used to be a general surgeon.”
These tribulations come along when one is no longer a stripling, when one is getting on, as they say, when it becomes apparent the path is either an obstacle course or a race that’s been fixed so there aren’t winners, yoking diminished activity on one hand with age-related declension on the other. There isn’t an easy way to make sense of this either, perhaps accounting for the compulsive jokiness that attempts to deflect advancing age on birthday cards and in retirement speeches.
Dealing with the aged has long been a social issue, reverential tales of wise, respected elders notwithstanding:
According to Carl Honore in Bolder: Making the Most of Our Longer Lives: “The Hopi abandoned them in special huts; the Samoans and Paraguay’s Ache’ Indians buried them alive; the Bactrian people of Central Asia fed them to dogs; the Turco-Mongols favored suffocation; the ancient Sardinians tossed their elders off cliffs; the Ojibwa of Lake Winnipeg and the Massagetae and Padaei peoples of Africa went in for ritual sacrifice; in Northern Siberia, a man too old to hunt was expected to commit suicide by walking off into the snow.”
Our progress, such as it is, has replaced the more distressing practices of yesteryear – abandonment on ice floes and so on – with enthusiasm for retirement villas, lodges and homes; with patter about aging in place, group field trips, TV nights and singalongs.
To the cynical, this may seem a long and hazardous road going nowhere: a bummer. Lately, a few feel-good authors have gone on to note that maybe half of early oldsters can still touch their toes and follow an argument, and these folk are urged to seek new vistas while they can, embracing significant adventures in old age. The authors’ point is well made: Why not? Indeed, why not.
Buttressing their argument, we hear lots about remarkable oldsters: Picasso’s lifelong creativity, Tolstoy writing his best works as an aged man, the continued artistry of Georgia O’Keefe, the social pioneering of Bertrand Russell. These and many others are equally remarkable, but the truth is they’re risky, high-wire acts. Recall the truism: nobody can trust their organs after the age of 50 (or 60, or 70). Thereafter, well, anything goes.
“Old age is a shipwreck,” said Charles de Gaulle, and for sure it can be. Actress Bette Davis was on track when she remarked, “Old age isn’t for sissies,” later improved upon by Carol Burnett: “Old age isn’t for wimps.”
They’re right. Surprisingly, though, the aged are often happier than they should be, all things considered. Physiologist Dr. Walter Cannon introduced the concept of homeostasis into medicine, and the organism’s efforts to maintain constant conditions in its internal environment. Adaptation is an allied notion, in which individuals become better suited to external change. Think adaptation to bright lights or high altitude. There’s something analogous going on (or possibly going on) in coming to terms with the fraught circumstances of elderhood.
Many younger folk, most often hale and hearty, regard the varied plights of seniors compromised by illness – a stroke, an amputation, or a disabling illness – and speak of “quality of life” regarding others’ circumstances and offer up, “I couldn’t live like that. I’d rather die.” These opinions are interesting but generally invalid since much experience suggests otherwise. Many of the wounded and much aggrieved adapt to their circumstances to lead lives they judged worthwhile.
Human growth in the face of adversity can be paradoxical, though it isn’t rare. At times when we’re poleaxed by fate, past wisdom can prove foolish, replaced by unexpected strength and the small epiphanies that can come with age. This may be the most remarkable phenomenon – that the loss of agility, beauty and vigor can, per times, be followed by unexpected calm, acceptance and even happiness.
There’s no guarantee, and many go on to suffer mightily. Some sufferers take comfort in faith and promises that relate to the hereafter. Others are bolder, or less sanguine, about the possibility of anything beyond. Consider 89-year-old American poet laureate Donald Hall, who wrote:
To grow old is to lose everything …
Let us stifle under mud at the pond’s edge
and affirm that it is fitting
and delicious to lose everything. (Affirmation)
It is unlikely that many of us will travel this far in our thinking, but the diversity of our attitudes and beliefs, and our inescapable, final acquiescence provide us with abundant stories that have a beginning, a middle and an end. We take meaning from our stories; there is comfort in recognizing that we belong to a collective, and are, after all, quite ordinary.
Dylan Thomas said we “rage against the dying of the light,” and indeed we mostly do, perhaps tragically, but that is merely the concluding part of the story.
It’s time to move on.
Ready or not, here I/we come.
Recommended reading
Making the Most of Our Longer Lives
Wisdom at Work: The Making of Modern a Modern Elder
References available upon request.
Banner photo credit: Rudy and Peter Skitterians, Pixabay.com