A professional athlete’s take on retirement (part 2)

In the last post, Roberto Luongo’s retirement was described as a good example of both internal and external factors that firmly contributed to “pushing” him out of his long career. For Luongo, these factors were obvious, objective and measurable, and perhaps even reflected a poignant watershed moment, the end of a life chapter. He was honestly acknowledging his progressive inability to take on the robust challenges of a professional hockey career.

Of course, these similar factors also eventually appear in the trajectory of a physician’s career, albeit a couple of decades later. Physicians will also become aware of the progressive mismatch between the needed abilities and the demands of the career, a clear signal that it is time to hang up the shingle.

But does every retirement necessarily require such difficult acknowledgments?

A younger person’s take on retirement.

Probably not. Enter Canadian world champion and 2-time Olympic ski cross medalist Kelsey Serwa, who announced her retirement on July 4, 2019, just a couple of weeks after Luongo, at the ripe old age of 29.

Perhaps it was because she was 10 years younger. Or perhaps it was because she had not been worn down by an extra decade of fierce competition, tough losses or a critical press, although she had had her share of significant injuries. But either way, the tone of her press conference was decidedly different.

She was actually excited about the next stages of her life.

“I love racing. I love that feeling. But now, for sure, I’m like ‘OK, my time has come and I’m ready for the next stages of my life,”’ Serwa told The Canadian Press.

“Finishing second in Sochi (in 2014), that was kind of my decision-maker to go one more Olympics…The Olympic gold medal (in PyeongChang) is just the cherry on top of it all.”

She reflected positively on all of the ups and downs of her international racing career, her injuries and surgeries, and even the relationships that that contributed to her development.

“Each has a role in shaping the athlete you become. The different people on the team during different Olympic cycles, each one played a particular role in challenging me or supporting me or giving me the confidence I needed in order to let me become my best. It’s never always happy rainbows and butterflies all the time,” Serwa said. “You butt heads with some people. You get along really well with others.

“I think maybe throughout my career, whatever the team environment it was during each Olympic phase and quadrennial, I made it work for me in the best way that I could.”

With the Olympics well behind her, her young life was now consumed with writing exams to become a physiotherapist, planning a September wedding (to a professional skier) and preparing for a six-stage mountain bike race. She is already looking ahead to the kinds of clients she would like to have, and the kinds of opportunities she may have as a retired Olympian and physiotherapist as she continues to develop her skills.

Serwa vs. Luongo: What is the difference?

Sure, Serwa is younger than Luongo. She is still working on her degree and looking forward to career opportunities, and very excited about building a married life, some of which Luongo has already experienced. But the tone in her voice was different.

Is there a message here for the weary physician contemplating retirement? You could say that most physicians have had a ton more life experiences by age 60 than either Luongo or Serwa, and therefore unable to get excited about what the nature of the next chapter(s) in life will be. But perhaps that is the crux of it: As you get older, your imagination stagnates, you get set in your ways, you are less likely to think of things that would find both interesting and meaningful. Medicine, which reliably never has a dull moment, and no two days are ever the same, is interesting and meaningful, and it can seem difficult for anything else to compare.

And this is where physicians often have a reluctance to permanently leaving their profession, even when they have long built their retirement nest egg, and their kids have long left the house. They may continue to say that they love what they do, and that it is meaningful, and it may even be true. But are they really saying that they cannot find happiness anywhere else? Making a difference in someone’s life is possible outside of the realms of medicine. Learning new skills, a new language, traveling, reconnecting with friends and family, renewing a commitment to personal health and vitality, are all interesting and meaningful, especially for a well-educated and resourceful person such as a physician.

If you are struggling to sort out or outright avoiding the topic of what the hell you are going to do with yourself once you leave your career, you need only restimulate your imagination, and/or get in touch with who you once were before you ever started medical training. Consider listening to a couple of TED Talks by Jane Fonda and Tim Tamashiro (links are near the top of the “Useful Links” page of this website) to get you started. As the Apple advertising slogan used to suggest, you need to “Think Different”.

Finding the pull factors for the decision to retire.

Without anything attracting a physician to retire, and without as much as talking about it, there are no “pull” factors to help accelerate the process, and this is often where physicians are caught flat-footed. So ask yourself just a few basic questions:

1) What is it that you still want to do before you die? The older you get, the less time you have for it.

2) What are the activities outside of medicine that fulfill you, that make you tick? What was it about medicine that initially attracted you to the profession, that you could find somewhere else? What is your “Ikigai”?

3) If you only had a short time where you are still fully functional, what would you feel you needed most to do, that you would regret if you never did it? (You really don’t know how much time that is, no matter what your age is, so this may be a pressing question).

4) If you could be a fly on the wall at your funeral, what would people be saying about you? Would it only be your colleagues and your patients talking about your clinical acumen? Or are there other things you want to be remembered for (that you are not really pursuing?

5) How much room do you still have in the third major stage of your life to still learn and grow in ways that have nothing to do with medicine?

Medicine as a career is honorable, absorbing, meaningful, and comprehensive. But it can also suck the life and soul out of you, to a point that you have almost nothing left of the tremendous potential you initially brought to your first day of medical school. Retirement can be the time of redress, of filling in the blanks, of reinvigorating your love of learning, and reconnecting with the people most important to you. And for some physicians, the sooner you step out of your esteemed career, the sooner your can rediscover the joys that you once took for granted.

A professional athlete’s take on retirement (part 1)

On June 26, 2019, just months after his 40th birthday, Roberto Luongo announced his retirement after 19 stellar seasons as one of the NHL’s all-time best goalies. He had gone into the off-season with an open mind about coming back. But when it was time, in May, to resume off-season workouts, he noticed that the fire that had always driven him to compete wasn’t there. And when he realized that he was actually dreading getting back onto the ice within a month, the decision seemed academic. “For the first time in my career, I wasn’t excited about it,” Luongo said.

Whether elite athlete, veteran soldier, successful entrepreneur or dedicated health care professional, the emotional, even troubling rationales given when taking the big step away from a beloved career into retirement are often remarkably similar. To that end, it can help to hear how one professional in one kind of career makes sense of this transition for those in another.

Luongo put his thoughts on paper. His heartfelt open letter to his fans explained his reasoning, a description that, with a few changes in reference points, would also aptly fit a physician’s final hurrah. Here is Luongo’s letter (with the medical parallels italicized):

“This is one of the hardest decisions I’ve faced in my life, and it took me a long time to make it. After thinking about it a lot over the last two months, and listening to my (tired) body, I made up my mind. It just feels like the right time to step away from (medicine) the game. I love (medicine) the game so much, but the commitment I required to prepare, to keep my (mind sharp) body ready, has become overwhelming.”

In announcing his retirement, Luongo had, for the first time, realized that the demands of his career were now more than he had left to give. As much as he likely had no clear alternate plans or ready opportunities, it was clear that one big chapter of his life was needing to come to a close.

Athletes are like doctors.

Even though athletes usually have shorter careers than almost anyone else, there are important parallels to other professions, including physicians, when they choose to pull away. Like Luongo, most physicians will have sacrificed much to develop the skills necessary to function in a demanding and competitive milieu, and are therefore deeply invested in their chosen career, But physicians will also eventually come to recognize both a declining appetite to stay in the game, and may even acknowledge their own personal limitations in the face of continued and often increasing demands, albeit usually decades later.

So what are the common substantive roots of the need to call it a day? Call these the “push factors” for medical retirement, the eventual recognition by physicians that the medical milieu is no longer the nurturing pool it once was. These driving factors are both external and internal, and both grow insidiously over a career, to reach a critical mass, a tipping point that eventually becomes the basis for leaving a career.

External push factors.

Externally, these factors are familiar to very physician: Staying “current” and abreast of endlessly changing clinical guidelines and propagating scientific literature; finding time to attend and document continuing medical education; Dodging the increasing vigilance and wrath of licencing bodies and Colleges; Maintaining the 24/7/365 obligation to respond to the needs, demands and increasing expectations of patients; And finding the support and downtime necessary for self-preservation, and to survive arguably the most demanding of careers. The joy of running a marathon does not usually grow.

Internal push factors.

Internally, push factors are often not as easily recognized, but, like Luongo, their eventual acknowledgment is the acceptance of both an irretrievable decline in interest, and the inability to withstand the stressors of the game going forward. For physicians, the long hours, erratic shifts, and recurrent poor sleep contributes to a chronic and debilitating level of fatigue, and may be the root cause of burnout for so many physicians by mid-career. With aging, and in the face of physical and mental abilities noticeably declining, mood changes, cynicism and irritability become common, and often inescapable. Running a marathon does not get easier with age either.

If any of this resonates with you, there is writing on the wall worth reading–it may be time to consider next steps, if for no other reason than self-preservation.

In part 2, another retiring athlete provides an entirely different perspective on retirement, one that is decidedly more upbeat.