My brother turned 60 a few months ago and he had a big celebration. His sister-in-law, a recently retired school teacher at the age of 64, comparable to my own age, asked when it would be my turn to retire. I murmured some vague answer.
Then she popped a fantastic question: Have your skills diminished? What a thought-provoking, timely and somewhat scary question. My knee-jerk response was “no” with no follow-up.
However, I spent a lot of time thinking about her question. As physicians, without getting too technical, there are basically two skill sets, if you will, that we use on a daily basis. The first is our didactic/clinical knowledge. The second are our motor skills, which we rely heavily on in almost every patient encounter.
Now I have already recognized every so often that I miss a beat and my didactic/clinical recall may be gradually diminishing. I recognize this especially when interacting with the residents and students, and it takes a few more seconds to recall a pertinent article or have that classification system right there on the tip of my tongue. This by no means happens every time but when it does occur, it can be annoying.
Knock on wood, my manual dexterity in the clinic and operating room is still there. There is no shaking, slowness or sloppiness. To date, my surgical decisions are still crisp with what I perceive to be total recall and integration of didactic parameters.
Obviously, these thoughts have generated two salient questions. Will I recognize and acknowledge when the skills are decreasing? At what point, with my complete honesty, do I say I pose somewhat of a “threat” to achieving maximum patient outcomes?
I think we don’t want to be told by anyone that we just don’t have it anymore. To my thinking, this would represent everything already going too far in a negative direction. But will I be honest with myself when I see deterioration and say it is time to say goodbye? And how much is enough?
As I write this, I’m 32,000 feet in the air winging my way back home from teaching a course on AO fixation. Although the pilot in my eyes looks to be no more than 30, I do know that he has a mandatory retirement age of 60. Yet as a surgeon, I can literally go on forever. Figure that one out.
At our institution, we have various physicians well into their 70s and some even past 80. How are their skills? A disclaimer: If I am doing this in my 70s or 80s, it is purely due to financial reasons and not “love of the game.”
As you can see, there are no easy answers. When we approach the end of our careers, our dedication to heal ankle and foot pathology will still be there, but there will come a time when we have to evaluate our skills and decide when they are not up to par to our own specifications, whatever they may be. Unlike the pilot, we have no one telling us when enough is enough. You owe it to yourself and more importantly to your patients to say it is time to throw in the towel, and enjoy the fruits of all your many years of labor.
However, there is a big elephant in the room. What does one do when the desire is gone? I’m still thinking about that one. My sister-in-law never asked that question.
To the young DPMs, you read all of this and think it is very far off. So did I way back when. Then in a blink of an eye, you are there and will be faced with the same questions. In the meantime, take a patient one at a time and enjoy the ride. Try to smell the roses and hug someone every day.
For further reading, see “A Few Memorable Quotes After More Than 35 Years In Podiatry” in the September 2017 issue of Podiatry Today, “Observations And Realizations From A Recent Conference” in the June 2017 issue, and “Forging An Identity Beyond Medicine As Retirement Looms” in the May 2017 issue.