I know a few others who have taken this gamble, though never exchanged updates. At the Endocrine Society Annual Meetings, there are certainly people senior to me in attendance, largely men with successful research careers suggesting that the glory of science may be more alluring than contemporary exam room EHR medicine which requires a more defined end point. While the daily pageant of the hospital and multispecialty Physicians Network goes on without me, though I still get an occasional phone request for some guidance, the interests pursued and the experiences acquired over most of my adult lifetime continue to express its imprints, sometimes in unanticipated ways.
My journals still fill my mailbox, one paid subscription, one as part of a professional membership, and a few others unsolicited. I actually read more New England Journal of Medicine articles now than when I was working, not having the distractions of office appointments, lab reviews, phone calls, commuting, et al. I especially enjoy the many endocrinology studies and reviews along with the opinion perspectives and Case of the Week. The Cleveland Clinic Journal and the Mayo Clinic Proceedings get some attention most issues. The authors are more my colleagues in absentia perhaps.
Grand Rounds, which was too inconvenient for me most weeks while juggling patient responsibilities, has become a destination. I am on the notification list of the center from which I retired and a closer one nearer to my home. Having attended those that interest me, more about the practice of medicine than endocrinology or any other clinical subject, the audience has changed. People at mid-career seem woefully under-represented at both institutions, likely for the same reason that I rarely went. In its place I see residents in a swarm of white coats who would get a demerit if they read charts or examined patients in this alloted time and physicians of late career or post-career. To restrain my often wandering mind, I jot down some questions as the presentations proceed and usually ask one after the lecture. The answer from the speaker may be all the professional verbal interaction I get for quite some time.
Professional society memberships pose a dilemma, since they cost money that exceeds tangible benefits. I was going to let the Endocrine Society Membership lapse. They do not publicize their post-retirement discount which I learned about only after sending a note to their membership VP that I could no longer afford renewal. Their retirement age exceeds both Medicare's and mine, so they will likely be forced in the near future to adapt to physicians who call it quits prematurely as burnout creeps into Endocrinology as it has with ER or primary care. We came to an agreement, pony up full dues one more time and then half-dues. I receive their Journal, not read much beyond titles, and some on-line updates that are especially well done. Philadelphia also has the first regional Endocrine Society in the USA. That one I maintain. Nominal membership, great presentations each month, OK buffet dinner with a glass of wine, and most importantly colleagues to entertain me with the travails of being a doctor, for which I can now be fully sympathetic.
And when I take a class at the Osher Lifelong Learning Institute, I find myself frequently the useful doctor in the room, that person who understands the difference between vaporized nicotine and combustible tobacco, how AIDS in Africa affects the population differently than AIDS in America, and why their prescriptions have become prohibitive in price.
Among my most valued possessions as a functioning physician, not adequately appreciated at the time, was my privacy in the form of a big desk in an office with a closable door and mezzuzah on the doorpost, that personal Holy of Holies. It took six months of decluttering and rearranging furniture but My Space has become a reality at home too.
While it can be difficult for physicians who were challenged by the demands of their careers to escape its imprints, a certain amount of cerebral decluttering needs to occur. This begins as retirement is being prepared. Marie Kondo of popular streamlining culture asks, "does it spark joy?" ABIM modules and the fear of a high stakes exam did not. Phone requests for peer to peer reviews when the right thing to do was rejected by somebody less capable than me never sparked joy. It's hard to think of anything less a source of spiritual ecstasy than our office Electronic Record. All delegated to the professional shredder.
Even after exiting the medical workplace, the clock and customary waking times remain the same. Some physicians developed passions rationed by their clinical responsibilities. Fishing or the motorcycle could easily expand. I suspect, though, that most people are like me, the medical identity remains paramount, though not exclusive. There are limits to how much I want to visit my kids who have first entered the medical orb. If I wanted to see Australia, my job provided me vacation time and ample funds. Not going there had nothing to do with my work schedule. As consuming as professional obligations were, I never felt that other interests were seriously neglected as a result. I have maintained my two blogs, each started years ago: http://consultmaven.blogspot.com for the medical thoughts and http://furrydoc.blogspot.com for the non-medical, neither expanded in a meaningful way. This makes replacement of the daily schedule, once largely specified, now not so much, all the more challenging. When I would head home on the interstate each evening, I knew I accomplished some very worthwhile things through my diligence. That forced accomplishment transitioning to voluntary achievements may be the most difficult element of retirement for me this first year, and likely for many other physicians.
Would I have it any other way, though? Not a chance.
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