The Golden Goniometer

When I went into practice in 1989, patients used to comment about my youthful appearance. "I thought the arthritis doctor had to be old," they told me. The years rolled by, and those comments became much less frequent. Nowadays, patients are more likely to ask me if I have arthritis, rather than comment on my youthful appearance.

Sometimes patients come back to the office after a hiatus of several years and compliment me that I have not aged in the interval. One bit of blarney deserves another, so I deflect the compliment by telling them I’m well preserved, because my patients are so nice to me. One lady became sentimental and insisted that she had been seeing me for 30 years, and I had to disabuse her of this fantasy by reminding her that I have only been at my current practice for 19 years, although it feels like I’ve been here forever.

No matter how much I love my work, I have to face the fact that one day I won’t be able to inject creaky knees or mash on fibromyalgia tender points. All good things come to an end, and I’ll have to face the frightening specter of retirement. Although I feel great, my heart tells me that I am approaching old age. If I had my choice, I would tarry in middle age forever, but that isn’t one of the options on the multiple-choice test of life.

Petite reminders of my rusty vintage pop up all the time. Just the other day, a family practice resident with whom I was seeing patients, let out a small exclamation of horrified surprise when I pulled my beloved Palm Pilot out of my pocket. I use it for reminders as well as the handy epocrates program. The resident remarked, "I had one of those when I was a medical student," with the tone of voice of someone recalling some distant epoch. I’m the last holdout on the planet without a smartphone, and I could tell from his slightly shocked demeanor that I looked completely "retro" sporting a gadget more suitable for the last millennium. I might just as well have pulled a slide rule out of my pocket.

I’m aging, but I have plenty of company for the journey. One of my colleagues is a silver-haired neurologist. Anytime one of my patients has an EMG, and tells me the doctor was old, I know exactly who they mean. He’s a sharp cookie, but younger patients are suspicious that older doctors are out of touch with cutting-edge medicine. That attitude bothers me more these days, and I know it is only a matter of time before my younger patients view me with the same prejudice. Put yourself in the place of a younger patient visiting a senior doctor. You ask a question, and the doctor consults a Palm Pilot instead of an iPhone. Does that shake your level of trust in the old codger’s answer?

Are senescence and retirement inevitable features of old age? Does chronology rule my destiny? My patients have taught me many valuable lessons, but perhaps I wasn’t paying attention when they taught me the "indications" for retirement. I often remind patients that they need to do something meaningful after they retire. Many of my retired patients are quite content with their hobbies or tending to their grandchildren. Parenthetically, when I see patients who are new to the neighborhood, I can usually guess their motivation for moving. Young people move here for jobs, and older people move here to be closer to their grandchildren. Grandchildren are the tail that wags the dog for seniors.

A retired factory worker who gets bored sitting at home can take a part-time job driving a truck, or work as a greeter at Walmart, but that won’t cut it for a physician. It’s much harder for a doctor to come to grips with the end of a career than it is for other professionals. A thousand daily seductions beguile us into believing we are indispensable, but how can our lives remain meaningful, if our patients no longer need us? During our careers, patients clamor to see us, and they are petulant when we are not available. Smartly dressed drug reps line our hallways and wait patiently for a minute or two of our time. Like it or not, all of this attention goes to our heads. We may strive to act humbly, but we understand that we are very important in the lives of many people. We use our skills to heal, and that gratification, which is unique to the medical profession, is very addictive. I realize that the world will not stop turning if I am not there to refill prescriptions and give technical support for the human body, but how do doctors bow out gracefully?

For some doctors, retirement is a punishment, like solitary confinement. I remember one orthopedist who retired early, while I was knee deep with things to do at the office. Later I heard through the grapevine that he died young from cancer, so that curbed any feelings of jealousy I may have harbored. I’m not suggesting that if he had continued to work he could have dodged the bullet, but I’m suspicious that the secret of youth is acting the role. In my mind’s eye I picture the fearful spectacle of my retirement party. Other professionals get a golden watch for a retirement gift. A golden goniometer is more appropriate for a rheumatologist, but I’m deathly afraid to accept it. Don’t grab the scepter of purpose and meaning from my doddering old hands a minute sooner than you need to!

Another colleague is retiring to Arizona after many years of family practice. He’s planning on working 3 days a week in a friend’s practice. I think his concept of retirement is much healthier, and I wish him well. The way I see it, work is like prednisone: You have to taper off very slowly, and sometimes you have to stay on a little bit forever.

Dr. Greenbaum is a rheumatologist who practices in Greenwood, Ind. E-mail him at rhnews@elsevier.com.

When I went into practice in 1989, patients used to comment about my youthful appearance. "I thought the arthritis doctor had to be old," they told me. The years rolled by, and those comments became much less frequent. Nowadays, patients are more likely to ask me if I have arthritis, rather than comment on my youthful appearance.

Sometimes patients come back to the office after a hiatus of several years and compliment me that I have not aged in the interval. One bit of blarney deserves another, so I deflect the compliment by telling them I’m well preserved, because my patients are so nice to me. One lady became sentimental and insisted that she had been seeing me for 30 years, and I had to disabuse her of this fantasy by reminding her that I have only been at my current practice for 19 years, although it feels like I’ve been here forever.

No matter how much I love my work, I have to face the fact that one day I won’t be able to inject creaky knees or mash on fibromyalgia tender points. All good things come to an end, and I’ll have to face the frightening specter of retirement. Although I feel great, my heart tells me that I am approaching old age. If I had my choice, I would tarry in middle age forever, but that isn’t one of the options on the multiple-choice test of life.

Petite reminders of my rusty vintage pop up all the time. Just the other day, a family practice resident with whom I was seeing patients, let out a small exclamation of horrified surprise when I pulled my beloved Palm Pilot out of my pocket. I use it for reminders as well as the handy epocrates program. The resident remarked, "I had one of those when I was a medical student," with the tone of voice of someone recalling some distant epoch. I’m the last holdout on the planet without a smartphone, and I could tell from his slightly shocked demeanor that I looked completely "retro" sporting a gadget more suitable for the last millennium. I might just as well have pulled a slide rule out of my pocket.

I’m aging, but I have plenty of company for the journey. One of my colleagues is a silver-haired neurologist. Anytime one of my patients has an EMG, and tells me the doctor was old, I know exactly who they mean. He’s a sharp cookie, but younger patients are suspicious that older doctors are out of touch with cutting-edge medicine. That attitude bothers me more these days, and I know it is only a matter of time before my younger patients view me with the same prejudice. Put yourself in the place of a younger patient visiting a senior doctor. You ask a question, and the doctor consults a Palm Pilot instead of an iPhone. Does that shake your level of trust in the old codger’s answer?

Are senescence and retirement inevitable features of old age? Does chronology rule my destiny? My patients have taught me many valuable lessons, but perhaps I wasn’t paying attention when they taught me the "indications" for retirement. I often remind patients that they need to do something meaningful after they retire. Many of my retired patients are quite content with their hobbies or tending to their grandchildren. Parenthetically, when I see patients who are new to the neighborhood, I can usually guess their motivation for moving. Young people move here for jobs, and older people move here to be closer to their grandchildren. Grandchildren are the tail that wags the dog for seniors.

A retired factory worker who gets bored sitting at home can take a part-time job driving a truck, or work as a greeter at Walmart, but that won’t cut it for a physician. It’s much harder for a doctor to come to grips with the end of a career than it is for other professionals. A thousand daily seductions beguile us into believing we are indispensable, but how can our lives remain meaningful, if our patients no longer need us? During our careers, patients clamor to see us, and they are petulant when we are not available. Smartly dressed drug reps line our hallways and wait patiently for a minute or two of our time. Like it or not, all of this attention goes to our heads. We may strive to act humbly, but we understand that we are very important in the lives of many people. We use our skills to heal, and that gratification, which is unique to the medical profession, is very addictive. I realize that the world will not stop turning if I am not there to refill prescriptions and give technical support for the human body, but how do doctors bow out gracefully?

For some doctors, retirement is a punishment, like solitary confinement. I remember one orthopedist who retired early, while I was knee deep with things to do at the office. Later I heard through the grapevine that he died young from cancer, so that curbed any feelings of jealousy I may have harbored. I’m not suggesting that if he had continued to work he could have dodged the bullet, but I’m suspicious that the secret of youth is acting the role. In my mind’s eye I picture the fearful spectacle of my retirement party. Other professionals get a golden watch for a retirement gift. A golden goniometer is more appropriate for a rheumatologist, but I’m deathly afraid to accept it. Don’t grab the scepter of purpose and meaning from my doddering old hands a minute sooner than you need to!

Another colleague is retiring to Arizona after many years of family practice. He’s planning on working 3 days a week in a friend’s practice. I think his concept of retirement is much healthier, and I wish him well. The way I see it, work is like prednisone: You have to taper off very slowly, and sometimes you have to stay on a little bit forever.

Dr. Greenbaum is a rheumatologist who practices in Greenwood, Ind. E-mail him at rhnews@elsevier.com.

When I went into practice in 1989, patients used to comment about my youthful appearance. "I thought the arthritis doctor had to be old," they told me. The years rolled by, and those comments became much less frequent. Nowadays, patients are more likely to ask me if I have arthritis, rather than comment on my youthful appearance.

Sometimes patients come back to the office after a hiatus of several years and compliment me that I have not aged in the interval. One bit of blarney deserves another, so I deflect the compliment by telling them I’m well preserved, because my patients are so nice to me. One lady became sentimental and insisted that she had been seeing me for 30 years, and I had to disabuse her of this fantasy by reminding her that I have only been at my current practice for 19 years, although it feels like I’ve been here forever.

No matter how much I love my work, I have to face the fact that one day I won’t be able to inject creaky knees or mash on fibromyalgia tender points. All good things come to an end, and I’ll have to face the frightening specter of retirement. Although I feel great, my heart tells me that I am approaching old age. If I had my choice, I would tarry in middle age forever, but that isn’t one of the options on the multiple-choice test of life.

Petite reminders of my rusty vintage pop up all the time. Just the other day, a family practice resident with whom I was seeing patients, let out a small exclamation of horrified surprise when I pulled my beloved Palm Pilot out of my pocket. I use it for reminders as well as the handy epocrates program. The resident remarked, "I had one of those when I was a medical student," with the tone of voice of someone recalling some distant epoch. I’m the last holdout on the planet without a smartphone, and I could tell from his slightly shocked demeanor that I looked completely "retro" sporting a gadget more suitable for the last millennium. I might just as well have pulled a slide rule out of my pocket.

I’m aging, but I have plenty of company for the journey. One of my colleagues is a silver-haired neurologist. Anytime one of my patients has an EMG, and tells me the doctor was old, I know exactly who they mean. He’s a sharp cookie, but younger patients are suspicious that older doctors are out of touch with cutting-edge medicine. That attitude bothers me more these days, and I know it is only a matter of time before my younger patients view me with the same prejudice. Put yourself in the place of a younger patient visiting a senior doctor. You ask a question, and the doctor consults a Palm Pilot instead of an iPhone. Does that shake your level of trust in the old codger’s answer?

Are senescence and retirement inevitable features of old age? Does chronology rule my destiny? My patients have taught me many valuable lessons, but perhaps I wasn’t paying attention when they taught me the "indications" for retirement. I often remind patients that they need to do something meaningful after they retire. Many of my retired patients are quite content with their hobbies or tending to their grandchildren. Parenthetically, when I see patients who are new to the neighborhood, I can usually guess their motivation for moving. Young people move here for jobs, and older people move here to be closer to their grandchildren. Grandchildren are the tail that wags the dog for seniors.

A retired factory worker who gets bored sitting at home can take a part-time job driving a truck, or work as a greeter at Walmart, but that won’t cut it for a physician. It’s much harder for a doctor to come to grips with the end of a career than it is for other professionals. A thousand daily seductions beguile us into believing we are indispensable, but how can our lives remain meaningful, if our patients no longer need us? During our careers, patients clamor to see us, and they are petulant when we are not available. Smartly dressed drug reps line our hallways and wait patiently for a minute or two of our time. Like it or not, all of this attention goes to our heads. We may strive to act humbly, but we understand that we are very important in the lives of many people. We use our skills to heal, and that gratification, which is unique to the medical profession, is very addictive. I realize that the world will not stop turning if I am not there to refill prescriptions and give technical support for the human body, but how do doctors bow out gracefully?

For some doctors, retirement is a punishment, like solitary confinement. I remember one orthopedist who retired early, while I was knee deep with things to do at the office. Later I heard through the grapevine that he died young from cancer, so that curbed any feelings of jealousy I may have harbored. I’m not suggesting that if he had continued to work he could have dodged the bullet, but I’m suspicious that the secret of youth is acting the role. In my mind’s eye I picture the fearful spectacle of my retirement party. Other professionals get a golden watch for a retirement gift. A golden goniometer is more appropriate for a rheumatologist, but I’m deathly afraid to accept it. Don’t grab the scepter of purpose and meaning from my doddering old hands a minute sooner than you need to!

Another colleague is retiring to Arizona after many years of family practice. He’s planning on working 3 days a week in a friend’s practice. I think his concept of retirement is much healthier, and I wish him well. The way I see it, work is like prednisone: You have to taper off very slowly, and sometimes you have to stay on a little bit forever.

Dr. Greenbaum is a rheumatologist who practices in Greenwood, Ind. E-mail him at rhnews@elsevier.com.