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Key points
- Life has its seasons, including retirement or an ending.
- Pursuing happiness requires making adjustments during each phase of life.
- During older age, giving of your wisdom and experience is often a source of satisfaction.
- Retirement can be an opportunity for continued personal growth.
For over forty years, Dr. Freed was a family doctor in a local community. He made house calls. He knew the children of parents he’d treated as children. You’d see the lights on, sometimes, late at night when somebody had an emergency. He was always there for his patients.
But he was over 80 now, and his life had taken a turn. No more bustling about. He was laid up in a wheelchair after a nasty fall, which, not surprisingly, had triggered depressive feelings from persistent postsurgical pain. He came to see me to explore what he termed his “uncertain future.”
The problem, as he explained it, was that it was hard to examine patients if he could hardly move. “They end up asking how I feel. It’s kind, but it makes me feel old.” Dr. Freed continued to keep up with the latest research, and he was mentally sharp. But he feared that patients would attribute to him the wish not to let go despite an obvious physical decline. He thought maybe it was time to retire.
What we had to discuss, therefore, was the effect that retirement might have. “Medicine is my life. If I give it up, what’s left?” On top of his concern that patients might stop trusting him was the equal and opposite concern that leaving the profession would leave him bereft. My concern was to help him, even at this late stage of life, to navigate what felt like an existential crisis. If he was to remain happy, and adjusted to his newly troubling situation, then he would have to grow beyond it.
The key, I thought, was for him to continue to see himself as a vital part of the community, however his function might change. Thus, if he ceased to practice medicine, he’d have to feel that he was still helping the people whom he’d served over two (sometimes three) generations.
As we began to consider his retirement, it seemed crucial—for his peace of mind, if not sanity —that he remain involved with people who needed the comfort of a reassuring presence. It was important that Dr. Freed never disappear into Mr. Freed, somebody who was disengaged from the healing arts.
His family thought he should do something different altogether, which was not what he needed and not what would make him happy. It was a question of degree, not kind. It meant switching gears rather than taking another road. It is often the case, as we pursue happiness, that less is more—that is., we don’t have to overturn everything we love if we can just make accommodations. Of course, radical change is sometimes necessary, and we shouldn’t shrink from it. But neither should we rush into it, especially when it doesn’t feel right.
We inched towards a solution. It was surprising how it occurred. That is, it’s rare for a patient (let alone one in a wheelchair) to move during a session. So, Dr. Freed’s pivot toward my bookshelf was amazing. It was proof, I thought, that he’d bring every resource to bear in designing a possible future. He gestured towards my copy of Shakespeare’s The Tempest, which, for many physicians, is an iconic text, concerned with the magic that we wish we could perform and the need to finally acknowledge that we can’t.
“Can you take it down,” he asked? When I did, he found Prospero’s famous lines about his departure: “I’ll break my staff . . . And deeper than did ever plummet sound I’ll drown my book.” It’s a stunning farewell. But how did it apply to a man, like Dr. Freed, who didn’t want to leave off casting spells? He told me. “I’m going to rewrite the part about the book.”
What?
Dr. Freed said that the idea came to him while we were talking, while he sat in his chair gazing at my shelf (one of the benefits of in-person therapy as we transition back from remote). He thought that if the great magician could bury his book and disappear, then lesser mortals, like himself, would have to keep writing and teaching if they were to do any good.
“Maybe my role now is to pass on to the community what I’ve learned. Other doctors should know, and my patients.” I marveled at Dr. Freed’s process of association from Prospero through himself to the wider world, all of it without my prompting. I thought he’d had this notion in him all along. Maybe it was just waiting to burst out.
In fact, writing a book or, rather, a sort of memoir of his life in practice, was a terrific idea. He embodied a type of medicine that had disappeared and was probably rare even when he’d set out to practice it. Maybe the personal attention that he provided was re-emerging in concierge practices, but these were limited to wealthier patients. They were high-tech. They had nothing to do with dedication to an unwavering ideal of service.
It would be good for doctors to learn about a different form of practice, if only to try to emulate elements of it when they could. It would be good for the community at large to realize that medicine is, fundamentally, about being there for someone and taking the time to listen.
It was a plan. When we got down to talking about whether he’d dictate his stories or actually write them out, and whether he might need someone to help shape them into a book, it seemed like he was on his way.
We can learn a lot from Dr. Freed’s experience in pursuing happiness through personal growth. First, of course, it’s that you’re never too old. Any biology text will state that growth is fundamental. It’s what living things do. It’s built in. The trick, however—at least in humans—is to pull it off in ways that are not entirely programmed but that fall under our deliberate control.
The fascinating part of Dr. Freed’s case is that while, in the end, he took control of the process (and even wrested control from an officious, fretful family), he also possessed the capacity to grow without making radical changes. He simply entered the next phase of who he was all along. In effect, he found himself, and it counted for growth.
