As I reach the end of my career, I empathize more with my patients

As I contemplate retirement from clinical practice as a general surgeon, something I’ve been doing for over 41 years including residency, I’ve been having some unsettling thoughts.

Like many physicians, I’ve tried to stay somewhat emotionally detached from my patients. You must maintain some distance in order to be able to make tough decisions and to keep on doing surgery for so long.

I have written in a previous blog about the effect of complications on the psyche of a surgeon, realizing of course, the patients and their families suffer even far more than I do. I’ve always taken complications personally, but lately I’ve been more acutely aware of this issue.

As I reach the end of my career, I find myself empathizing more and more with the plight of my patients, especially since many of them have somehow become younger than I am.

There are things you don’t think about when you are 40 or even 50 years old. I find myself making a long mental list of diseases that I hope I never get. Lately, I’ve been pondering a real conundrum. Which is worse, growing old and becoming demented with a body that still has many miles left on the odometer, or having the body break down and remaining lucid enough to realize what a mess you are in?

I haven’t settled that issue yet but I’m leaning toward dementia as long as I’m pleasant. Unfortunately having been a cranky bastard for pretty much my entire life, I think I’m more likely to be a disagreeable if dementia sets in, so maybe the sound mind/unsound body option would be a better deal for my family. Too bad they don’t get to choose. Nor do I.

I would prefer neither. In an attempt to postpone physical deterioration, I’ve been exercising regularly and am in the best shape I can ever recall, including when I was in high school.

If you’ve been following me, you know that for mental gymnastics, I’ve been blogging about three times a week for the last two years. I plan to continue writing for long as I can coherently put two sentences together.

Perhaps it is the end of summer that has made me melancholy. Or possibly it’s realizing that very soon the way I have defined myself for the last 41 years will no longer apply. Let’s look at the bright side. At cocktail parties, people who used to ask me for medical advice will probably think twice knowing that I’m retired. Instead maybe they’ll start asking when does “its” take an apostrophe.

“Skeptical Scalpel” is a surgeon blogs at his self-titled site, Skeptical Scalpel.

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  • carolynthomas

    Great post. Wonder how we can somehow get that empathetic response to kick in a bit sooner in one’s medical career? Good luck in your retirement adventure!

    • Skeptical Scalpel

      I always had empathy. I just have more now. Thanks.

  • Bonnie Speeg

    I appreciate knowing your empathy is growing (and may serve you in some other capacity after retiring) as you round the bend to not doctoring soon. I worked in the ob-gyn field as an educator and birthdoula with several doctors. I could tell their empathy strains were greater toward the ends of their careers (3 in particular I remember). And a note: at the cocktail parties folks may think you’re twice as available after retirement to discuss the myriad of ills they present to you over the cheese and olives.
    I retired in January, and people think I can drop in and give consultations on numerous women’s health topics. While grateful I can take care of myself with my greater medical knowledge, and the females in my family, I plan on other wonderful adventures on the horizon.

    • Skeptical Scalpel

      Thanks for the comment. It’s good to know that others have had the same sort of experience. Sounds like you are doing just fine.

  • John Ballard

    Thanks for your candor. You seem to be made of the right stuff to make appropriate decisions and follow through, so quit being so hard on yourself.

    I’ve been in retirement now for ten years after a forty year career in the food business. During that time I was able to observe literally thousands of the public, in many cases over two or three generations of a family group. A cafeteria serving two thousand meals a day during the week and over three thousand on weekends and holidays gives one a very large cross-section of humanity, and of that number many customers eat several times a week, so you get to know them pretty well.

    I used to think that getting old made people more disagreeable but I changed my mind. There are too many sweet-tempered, gracious old people. Age does make us more brittle, whatever we are temperamentally, but that is not necessarily in the wrong direction. Those cranky old people were once cranky young ones. They just got worse with age. And those who were polite and accommodating as younger people will continue to be as much the same with age as their circumstances allow.

    That’s not to say that the ravages of age don’t take a toll. As vision, hearing, digestion, circulation — and worst of all, mobility and cognition advance, life can be pretty grim. My post-retirement work for the last fifteen years has been with “seniors” first in a retirement community (both independent and assisted living) and now as a non-medical care-giver through an agency taking care of (other) old people. Several hundred examples in the retirement community and some forty or more individual assignments has confirmed my earlier assessment.

    I have taken care of a man almost a hundred years old who cannot see or hear well and lives with a catheter 24/7. But he remains ambulatory, eats with a good appetite and is unfailingly polite and appreciative of all who come around him. It is a sharp contrast to someone else with advancing dementia who after a year in a facility still calls no one by name and whose otherwise varied vocabulary never included any of the ordinary words of politeness (please, thanks, excuse me, etc.), always barking orders but never accepting any, even in the form of suggestions.

    From the reflective tenor of your post I can assure you as an experienced layman that you will be fine in your declining years.

  • Dr.Joseph Birnbaum

    As an octogenarian Optometrist who is semi-retired,I can tell you that it’s important to stay current and involved in those many aspects of health care and it’s delivery that can benefit from your years of experience.
    This can include mentoring younger practitioners ,teaching and being involved in the professional organizations that you were always active in.
    It is a crime to waste the knowledge and skills you’ve acquired by a total cessation of your involvement in Medicine.

  • disqus_IxCmhaKhtQ

    If you haven’t already, pick up (download) a copy of David Guterson’s “East of the Mountains,” his novel from 1999. You will probably really enjoy his story that very much involves a surgeon with your concerns.

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