Friday, March 29, 2019

Staying Sensitive

In retirement, I have latched onto an arm of our state university directed to the 50+ crowd, though the number lacking a Medicare Card seems few.  Among my course selections was an advanced writing course.  To my surprise, of the fifteen or so registered participants, I am the only one who does regular public submissions and the only one who does medical writing as an offshoot of journalism.  Most do memoirs, some exceedingly well written, with an audience of family or vault.  A few attempt short stories or anecdotes.  Each of us is asked to submit for class scrutiny 2-3 submissions of under 3000 words over the course of the semester.  My turn arose and I submitted the tribute to my teacher The Zipe.

https://consultmaven.blogspot.com/2019/01/the-zipe.html

This bridges medical writing and perhaps eulogies.  The Zipe takes credit for showing me the intricacies of a formal mental status exam, described in the essay.  I submitted it for distribution two classes ago for discussion at our next class.

Unfortunately our class has an elderly gentleman whose mental acuity has obviously declined since the beginning of our semester.  At the last class it was his turn to present.  We read an interesting essay written in 2010 describing his devotion to fitness limited by an arrhythmia.  His dementia had progressed to where he could not follow his own submission.  With that background, I thought it insensitive to proceed with my essay on the evaluation of very early dementia before it becomes obvious.

Finding an alternative paper to submit was easy.  Submitting it has not been so easy as there are errors on the class email list.  We have a week off so I will continue to work on it. 

Derech eretz kadmah l'Torah

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Wednesday, March 13, 2019

Meeting Old Friends



Image result for retired doctorDoctors by our nature do not handle idleness well.  We value our vacations, of course.  I never sought out a study to see if doctors vacationed differently than others.  Some probably hang out someplace warm, others seek out the best eats of the place they are visiting, some cannot wait for the cruise ship to dock so they can disembark for a tour of a new place.  Vacations, though, are an interlude between doctoring activities which inevitably return.  Retirement is different.  Travel is possible, durations more flexible yet it is permanent.  There is no doctoring looming ahead.  Professional activities consumed a lot of waking time.  Lack of professional activities leaves that same amount of time unstructured.

Most of us probably had mixed emotions about our careers.  Most retired voluntarily, anticipated over a number of years, financial stability arranged in advance, but time utilization and talent utilization not nearly as meticulously planned.  Our appointment schedules disappear, our minds and our interests do not.  With some combination of luck and clean living, vitality gets preserved.

Being a doctor has its predictable imprints.  While we may not hit all twelve elements in the Scout Law, many of us becoming irreverent in a jaded way and less loyal or kind than we once were, trustworthiness and a default toward helpfulness usually remain. The activities of our Golden Years would not be entirely fulfilling were that not true.  Not only are our phones smart, but so are we.

In my area, the state university sponsors a program for seniors as part of a national Osher Institute of Lifelong Learning.  It is a place where we can avoid isolation, in the smaller classes exchange ideas or recapture familiarity with the musical instrument we used to play or take a literal and figurative stab at woodcarving or some other activity we thought we always wanted to try but didn't.

For some seniors, the week's highlight might be the doctor's visit.  For me it has become OLLI, even though I have only been enrolled for a month.  My classes keep me there most of Tuesday and on Wednesday mornings.  One class is a large lecture, not very interactive, one a writing seminar with scheduled critiques, one a current topics discussion group where everyone is really an amateur about the weekly topic but verbal anyway, and one wood carving session where everyone else has been there before and has sharp implements that cost a lot more than my beginners gouges from Goodwill.

While the classroom is the focus, minimizing social isolation so damaging in the post-workplace years counts among what Mr. Osher had in mind as he funded these programs.  Classes, including mine, are not always in consecutive time slots, leaving a lot of time for people to be mingling in the common rooms.  The library is small but with soft chairs, a table and charging stations.  The dining area seems too large to ever fill but last time I peered inside there were no totally unoccupied round tables.  Musical performances take place in the lobby.  For those up to a power walk in good weather, the grounds seem spacious, attractive and generally safe.

With that background, physicians once separated have reappeared.  I left the mainstream community eight years prior to retirement.  The others all stayed in our community, dominated by a single central mega center.  It is these people who reappear in the halls, either in transit to the next class, hanging up their coats on arrival, or just in line at the popcorn machine.  We all wear name tags, but I didn't need that except once to identify each retired physician.  All were senior to me.  Some I expected to just plod onward professionally until their significant other gave an ultimatum that Florida would be better or they appeared in the local newspaper's obits.  But they really did retire.  As I greet each one, I am starting to establish a routine of reacquainting.  My questions include the duration of their retirement but never the circumstances.  Most have been attending OLLI from the onset of their retirements.  A few engage in medical education as Grand Rounds.  And I like to know what courses they chose.  As I get more experienced and need to choose a new list, I will eventually ask for their recommendations on what they have taken previously, but so far I haven't asked that.  We don't ask about health, though one fellow volunteered a recent knee replacement to explain his cane.  No beards that weren't there before.  No ties either.  No talk of prostate trouble.  We have an intercession approaching so what old colleagues, most more highly paid than me, are planning to do with their upcoming week off will add to my insight of what docs do when the patients are no more.

I do not know if there are any formal studies of doctors in retirement, what we do, how we fare, correlations between health and those who use their time to travel, visit grandchildren, or keep their intellects afloat.  OLLI has shown us that we have minds, and as the commercial for another fund-raising purpose reminds us, "a mind is a terrible thing to waste."  The docs at OLLI seem to keep our minds challenged voluntarily.