O wad some Pow’r the giftie gie us To see oursels as others see us! That morsel from Robert Burns’ ‘To A Louse’ has always intrigued me. Not so much because I have perfected the ability over the years… more that I haven’t. You would think that one of the benefits of Age, or at least a long practice of Medicine, might be the ability to focus the lens I’ve perfected, not only on my patients, but also on myself.
Years ago, while I still swam in the deeply churning waters of my profession, I happened upon an elder colleague in a store downtown. I had always admired him for his knowledge and despite the difference in our ages, he had always been helpful whenever I had sought his advice. But he had retired a year or two before, and I had not seen him since. Hoping for some pearls of wisdom from his specialty, general surgery, I asked him whether there had been any advances in wound management.
He stared at me speechlessly for a moment I remember, and then with a twinkle in his eyes and a smile on his face, confessed that he had no idea. “I’m retired now,” he explained, in case I’d forgotten. “I garden now…”
It made me wonder if he actually remembered the years we’d met each other for early morning breakfasts in the hospital cafeteria after long stretches of wakefulness in our respective on-call shifts, or the nights we both waited in the OR lounge wondering which of our competing cases would be considered the priority for the operating theatre. My Caesarian Sections usually won, but investigations of pelvic pain, or management of miscarriages -unless there was extensive bleeding- were usually lower on the list compared to his need for operating on, say, a patient with an abdominal stab wound that had come in through the Emergency Department that night.
But I remember he merely shrugged at me in the store and turned away; it was something I was sure I’d never do, and yet I wonder whether what I actually objected to was not the failure of recognition of a colleague, but rather the indifference to the specialty knowledge we had both spent a lifetime acquiring. Surely I would not be able to resist staying current with new developments in obstetrics, say, or on ingenious new approaches to gynaecologic problems that had eluded our field in the past.
And yet here I am now, seven (or is it eight) years into retirement and stumped by the question of a friend who asked me to explain ‘transdiagnostic modelling’ to her. The explanation given in a course she was taking had only confused her more.
“Actually, I’ve never heard the term before,” I explained to her while trying not to blush. But she merely rolled her eyes.
“I thought you were a gynaecologist,” she said, smiling at my confusion. “In a former life, I mean,” she quickly added when she saw my discomfort.
I rolled my eyes back at her -I try to give as good as I get, nowadays. “Since when is… transdiagnostic modelling -or whatever- either a gynaecological or obstetrical term?”
She shrugged and shook her head. “My instructor seemed to think doctors would all be well acquainted with it.” I blinked, trying to disavow her of it, but she ploughed on. “From what I gather, it’s the need for different diagnoses for the same condition… I mean how could that be?”
“Maybe it’s an etymological thing, eh?” I had to regain at least a modicum of professional pride for my previous acumen.
“Is that a biological term, doctor G?” she said, trying to suppress a giggle. She loved it when she was able to confuse the once seemingly omniscient doctor.
I laughed. “Not entomological, Sarah…” The challenge had awakened something in my head. Perhaps it was a remnant of my role in the pre-retirement ancien régime… I’m not sure.
A look of wariness immobilized her face for moment. “So what do you mean then?”
I shrugged -modestly I hope- and explained. “Well, just breaking the words apart -looking at their origins; the expression seems to mean something that can involve other disciplines, other fields, and whatever diagnostic criteria they might apply.”
She tried hard to mollify her smirk, but I knew her too well for that to work. “I’m not sure I understand you any better than I did my instructor… Want to try it again?”
“Okay,” I said, still trying not to assume the mantle of the expected medical arrogance. “Maybe I can explain what I think it might be with an example.” Her expression still remained doubtful. “Take itching, for instance; I used to deal with in my practice quite frequently. Often it was ‘transdiagnostic’. The patient’s symptoms might well have been related to something in my field -a yeast infection, say -I mean, that’s probably why she had come to see me, after all; but itching could also have been caused by friction from her clothes or a contact allergy from a soap or lotion, as well.” I stopped to see if Sarah was following me; she still seemed interested, so I continued. “But sometimes I had to read between the lines as she was describing (or showing me) her problem; sometimes I was suspicious that something else was going on in her life that was contributing to the itching: a marital problem, maybe, or an issue at work that she was too ashamed to mention…”
Sarah merely blinked at my explanation.
I tried to keep the smile on my face, but that has sometimes been difficult for me when it’s obvious the person I’m addressing doesn’t agree with my opinion. “Look, I’m just trying to figure it out, eh? We didn’t have all these Millennial terms when I was a consultant…” I thought about that for a moment when I saw her eyes narrow, however; I would certainly have been in practice when Millennials were referred to my office for a consultation… women of Sarah’s age, for example.
“You seemed to know a lot more when you were still in practice, G,” she said, a minute smile trying to force its way past the disbelief written on her lips. “Or a least pretended to…” The smile won out and her eyes sparkled as she looked at me. “You don’t even dress like a doctor anymore…”
I was wearing a grey sweatshirt and faded jeans, and I had only come into Starbuck’s for a coffee; I hadn’t expected to see her sitting there in the corner…
But she’d seemed genuinely happy to see me when I approached her table. “You’re a different person now, G…” she said after my feeble attempt to answer to her question, and reached over to squeeze my hand. “I’m glad you were my doctor,” she added, as she let go of my hand and broke off a piece of my bagel to eat.
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Musings on Retirement 