A plastic surgeon retires

“Retired is being tired twice, I've thought; first tired of working, then tired of not.” ---Richard Armour

A discussion in the Plastic Surgery Yahoo group elicited several interesting viewpoints on retirement of a Plastic Surgeon from his surgical practice. One extreme view was that ‘A surgeon never really retires; he may retire from active practice, but the die-hards would like to die with a knife in their hands’. If a highly skilled Plastic Surgeon or, for that matter, any Surgeon or highly rated professional contributing towards healthcare of the public at large, were to retire when he has a great deal more in him to offer, it does seem a waste of precious talent. His retirement would apparently be a huge loss to the community. It is said that his vast clientele would suffer as they miss him badly! Even if he is physically not at his best for doing delicate surgeries, he can still be part of the system as an adviser, as an administrator or a guide to younger generations. He can participate in discussions and conferences and share his vast experience and wisdom with the younger surgeons.

But the argument against this view is that ‘when I am old, my hands tremble and my feet can barely hold me up, I don't want to totter into a hospital, stagger around the OT, struggle to get my clothes on and off, and draw ECG's on a patients body rather than straight lines; nor do I want to sit in a corner while I direct a younger Plastic Surgeon to do my cases for me to keep my meter running’.1 Many Plastic Surgeons, particularly in India do go on and on till they are forced to retire for one reason or other. This would be a sad moment for a once highly rated professional to be literally forced out of surgical practice and banished into retirement. But then what prompts such well known Plastic Surgeons, some of them stalwarts in their hey-day, to delay the step into a dignified retirement? The reasons seem to be several, but mainly the fact is that many such stalwarts know nothing else in life except Plastic Surgery. If they do retire from surgical practice they don't know what to do; they would die of sheer boredom! In addition, quite a few have monetary and family problems compelling them to continue working.

Can we therefore take the view that a Plastic Surgeon should contribute to the profession and the community either as a full fledged active practicing surgeon or in some other capacity as a teacher, research guide or a health administrator for as long as possible?

Unfortunately in this fast moving world where changes occur almost on a daily basis it is not so easy to survive in an atmosphere of intense competition. Many will be left far behind in the race. To be up-to-date with the cutting edge of modern technology and developments it is necessary not only to run but to keep running. If they cannot catch up they will sooner or later be forced to retire with a big dent in their dignity and stature.

What would be an ideal solution to the ageing Plastic Surgeon? Should he keep going at the risk of being forced out sooner or later or like good Plastic Surgeons, plan in detail various steps towards the penultimate stage of life and do reverse planning too to ensure that the final outcome, life as a senior citizen, is one of high quality. Let me give an example in real life. My own.

I'm now 70, but retired about 3 years back. At the time of retirement I was performing all kinds of Surgery within my field of expertise, including ‘major’ operations. Physically I had no problem and could potentially continue to practice for much longer. However, several years earlier, I had decided to retire when the going was good. Hence I had several years to plan my retirement. I would rather have people say ‘why did he retire; he was good’ than ‘why has he not retired; his hands are shaking and he is making mistakes’.

It was my ambition to retire to a large, peaceful farmhouse with plenty of trees and flowers in a place with good weather conditions and relatively free from the hustle and bustle of city life. I was fortunate to get a place of this type at Mysore, where I have now settled (Fig. 1). I was keenly interested in Music, had played Veena for several years and now practice Karnatik Classical on Keyboard. I'm into early morning Meditation, Relaxation, Pranayama and take a morning walk in a pollution and noise free environment. I spend quite a bit of time in my kitchen garden (Fig. 2). I administer and run our Chennai Hospital's interactive website and answer a wide range of queries from clients and the public. I also eagerly read all the interesting interactions in our Plastic Surgery group.

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Figure 1 (a,b) The kitchen garden.

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Figure 2. MMR in the kitchen garden.

Retirement I feel, is an individual viewpoint. If one is motivated enough to work and is fit to work till 70's or 80's it would be fine. But it is incorrect and vain to believe that if one were to retire there would be no one to look after one's patients and there are no doctors good enough to take care of patients. The truth is that no one is indispensable; the world goes on whether you retire or continue!

But remember the message; “Don't simply retire from something; have something to retire to”.--- Harry Emerson Fosdick

Finally, do seriously think over and plan for your later years well in advance, probably as soon as you settle in a more or less orderly surgical practice. It is probably never too early to plan for one's retirement. Do all the planning for complete financial independence including medical insurance, have a vision of what exactly you would like to be in your later years – lifestyle planning – taking care to do your duty towards your children and even grandchildren and lead a peaceful, happy, contented retired life. Dealing with time by engaging in pleasurable and satisfying activities and social networking to maintain healthy human interactions with a wide spectrum of people around you are important to keep one's sanity. Carefully maintaining one's physical health by suitable physical activities or even workouts and a well planned diet with plenty of fresh vegetables and fruits is essential. Even to lead a retired life, you need to be disciplined in all your activities.

And talking of a dignified final departure, make a living will about your wishes, giving clear instructions to your close relatives when you may be terminally ill and not in a position to take important health decisions. This will would indicate whether or not to use life sustaining medical equipments to keep you alive like a vegetable and your wishes regarding disposal of your physical remains. To be allowed to die peacefully, you have to make proper documentation too. And a will to divide and give away your assets for a smooth hassle free and rancor free transfer to your nearest and dearest is another step to be taken sooner than later. Whatever the decision, plan it meticulously like a good Plastic Surgeon and execute it step by step and enjoy a life of fulfillment and happiness.

Ultimately it is a personal choice. It is possible that you are one of those who like to die with a knife in your hand or may be a watering hose in your hands at the kitchen garden in your retirement home. Whatever the choice, meticulous planning is vital.