Hemingway once remarked: “Retirement is the ugliest word in the language.” Since most surgeons as well as many others would agree with his assessment, I believe it is time to retire the word retirement and look to another, more positive means of depicting the twilight years of our lives. Shakespeare, writing several centuries before Hemingway, considered the world a stage on which the days of our existence are played out.
<[stk 3]>My rather simplistic view of the surgeon’s life is that of a three-act play or a three-course meal. Act I, the appetizer, represents a surgeon’s approximately 33 years of education and may be, at least in the early years, in part directed by his parents. Act II, the main course and also 33 years give or take a few, is our vocational phase during which we deliver surgical care to our patients. Act III, the dessert, and for symmetry’s sake, can also approach 33 years, is what we formerly called retirement. With appropriate planning and foresight, each of these acts can be and should be gratifying and fulfilling. <[etk]>
<[stk 3]>For most of us a great deal of thought and meticulous planning are responsible for whatever success and satisfaction we have gained from Acts I and II. Unfortunately, such is not the case for Act III, that can be suddenly thrust upon us because of illness or disability. The pundits recommend careful preparation for Act III but their counsel is usually limited to financial considerations. This is an important aspect of Act III, but we all know that a secure economic future does not guarantee happiness or fulfillment. <[etk]>
So what can one do during Act II to make it more likely that the years of Act III are filled with contentment and purpose rather than frustration and regret? Realizing that no formula for Act III fits all, some recommendations and observations may be helpful. Most economic considerations for Act III are obvious and well documented. In nearly all situations, it is wise to never live to or beyond one’s income, to maximize retirement contributions, and to allow carefully chosen professionals rather than ourselves to manage our finances. If too much is consumed during the main course, little will be left for dessert.
A<[stk 3]>ll surgeons have spent much of their lives in service to others, and it is important for most of us that this continue after laying aside our scalpels. For some, this need is met by medical missionary work here or abroad or by service in one or more volunteer organizations. Funding a family foundation during the higher income years of Act II permits you to be a substantial player in philanthropy throughout the years of Act III. If this is done fairly early, even rather modest contributions will grow to an impressive sum by the time Act III arrives, permitting you to make a significant difference in a worthy agency or institution or in the lives of people in need.<[etk]>
<[stk -3]>Life as a surgeon can be all-consuming. An essential activity during Act II is to develop interests, even passions, outside of surgery. It is tempting to put this off until one has more leisure time, but this can be a fatal mistake. Suddenly or even gradually confronting Act III with no appealing substitutes for the many hours spent in the clinic and operating room can lead to an unfulfilling existence. Ideally one or more of these interests should be initiated during Act II, but if that is not possible because of time restrictions, ideas should be carefully recorded as they come to mind so they are not forgotten when the time for action arrives. Preferably some of these should be relevant to the significant other in your life to solidify a relationship that may have suffered from years of separation caused by a demanding work schedule. <[etk]>
<[stk -3]>The most difficult aspect of the transition to Act III can be the loss of identity as a surgeon. Nurturing new interests and passions provides the opportunity to reinvent yourself in a new and exciting way that may be just as satisfying as your former professional life. <[etk]>
Most would agree that nothing in life is more important than relationships. Those with friends and especially family can be stressed and even frayed during the rigorous years of training and work as a surgeon. These must be repaired before or during Act III.
One of the joys that can occupy these later years is the luxury of meaningful time spent with your mate, adult children, grandchildren, and friends. If romance with that important person in your life has waned during the harried years of surgery, Act III is the time to reinvigorate it and bring it to a new and refreshing pinnacle.