The Immediate Aftermath of Quitting

So, you have decided to cut the cord–you have resolved the important ambivalences around the decision to leave. You have set a date, you have sorted out where your mail will go, and you have found someone who will follow up with your patients. All the appropriate notifications–to hospitals, partners, call groups, patients, pharmacies, licensing bodies, among others–and transitional paperwork is done. For all the anxiety over taking these steps, you will note that it was not particularly complicated. Your last days are at hand. Now what?

And then it is over. A day after your last day at work, and for the first time in memory, you are about to go to bed at a decent hour, having had time to relax all evening (although you probably didn’t) and without regard to a morning alarm. No one is expected to phone you. It feels like the end of an era, perhaps bittersweet, or perhaps with the feeling of having something considerable accomplished. It is, though, the beginning of a new, but an uncertain stage of life. After a few days of this, the realization hits you–that you have really done it. You seem to have more time!–to read the paper, to grab a book, to walk the dog, for some idle conversation, and to catch up on a backlog of projects.

You may or may not feel persisting guilt about leaving, about who and what you are leaving behind. You may find yourself ruminating about any number of things, retracing your logic, and justifying to yourself (again) whether you have really made the right decision leaving. Perhaps you will wonder how your patients and colleagues will cope without you. You may need to reassure yourself regarding your decision; or you may seek counsel of a trusted friend, or colleague, or spouse.

In these early work-free weeks, you will eventually notice that no one has called you “Dr.” for a while–whether you will you miss that personal acknowledgment of respect over time will remain to be seen. The upside, though, is that there have been no new medical responsibilities surfacing, no one addressing you as “Dr.” on the phone by a health professional needing your clinical decisions. Over a few months, you may notice a modest but perceptable change in relaxation. Will it be welcome? Or will you cope by taking your natural type A driven personality to bury yourself in any number of projects at home?

But what, exactly is your retirement going to look like? How are you going to adjust to this new reality? Although the early going will no doubt feel unremarkable, albeit with some mixed emotions, and with many distractions to cloud the momentousness of the occasion, the new professional void will be difficult to ignore. You may ask yourself if this feels like a bereavement. At times, it may even feel like a freefall, complete with anxiety and an amorphous uncertainty–will there be a thud at the end of it all, or is this the beginning of a whole new flight you have never experienced before? You may have no real idea as to how to proceed, without a structure or a plan.

Thoughts during freefall.

I have been through it. There were many adjectives of how this transition felt that came to mind, and occasionally still do. And yet, I survived–at least I am over the worst of it–without any acute anxiety, any need for counseling, or a massive rethink or regret over letting my medical license lapse. But there were many more intrusive thoughts than I expected about my definitive exit. Perhaps some of this will resonate with you.

Staying in touch?

I thought about the professional associates and colleagues that I was leaving. Should I make the effort to stay connected with my (now former) staff and colleagues? How will they see me now? Do they really care that much about staying in contact? Do I? Were these friends by proximity or necessity, or were they more than that? Outside of medicine, do I have any friends that I can, or would like to, now spend more time with? Do I even need more time for friends at this time of my life? I decided I didn’t–I had plenty to keep me busy. But I had no definitive themes within my preliminary plans.

Did my financial planners really have it right?

They better have! I thought several more times about how much faith I had in my retirement planners. What if they got it wrong? What if there is a massive stock market crash? What if I have unexpected legal or medical bills that could derail my best-laid financial plans? I decided that, given that the advice I received had remained consistent (even from independent sources), it was time to truly stop worrying about my financial future; it was reassuring to know that the amount I had set aside was well within the average range that 60+-year-old physicians successfully retired with. And I decided not to hold onto some dark scenarios, that, while possible, were very unlikely; and even if they did occur, they might have other forms of financial recourse. I also thought it possible that I could almost certainly find some other source of income in the coming years if I truly needed to.

No one was calling me “Doctor” anymore.

Yes, I missed this–but only somewhat. It became clear that I was still being called “doc” affectionately by some friends who continue to see me with an admirable skill set (they probably also like having a medical connection to bounce questions off of once in a while). By those who had me as a client–banks, financial management companies, and the like–my “Dr.” title also continues unabated. The only time the “Dr.” title wasn’t being used was when it was part of an implicit medical responsibility–by a nurse, a ward clerk, or a pharmacist–and I didn’t really miss that. And since I could still put the educational moniker of “M.D.” at the end of my name when it suited me, I came to feel more comfortable with a preserved medical identity. This despite my College’s immediate request to remove any reference to anything medical in my incorporated name.

So if I am not a doctor, what am I?

This has been the most persisting and insidious question, one that became even more perplexing over the first 6 to 12 months of retirement. Beyond the title of “Dr.”, it was the feeling of being a doctor–the proud self-identity of being someone who could embrace and solve almost any medical problem, any time–that proved most difficult to shake, especially as there was no new or obvious identity to take its place. What am I now if I am not the reliable “buck stops with me” styled helper I always prided myself as being? How will I replace this feeling? Or will I be unable to? Or will it matter after a while? The introspection needed to settle these uncertainties was deeper and longer than expected (see more in the next post); for me, adequately answering such questions would prove to be the linchpin to a successful transition–to the point where I could look back with a “been there, done that” perspective.

“So how is retirement?”

Variants of the question, “So, what are you doing with yourself these days?” started to surface regularly, and have since continued, sometimes in future tense. Although I initially deflected it with something flippant, such as “…crosswords, sudokus, soap operas and golf magazines”, it has been self-evident at the outset that I really didn’t have an organized “plan” for retirement, nor was I even sure I needed one. But these questions eventually felt less intrusive, as it often seemed that they were as much about a genuine curiosity over what people do in retirement, for which, unfortunately, I had little to add–at least, at the time. I have come to believe that most people really have no idea how to look at retirement, how to prepare for it, or what they will pursue once their retirement threshold is at hand. But that is okay!

Is there a good book on this?

So, I eventually admitted to myself, I really had no good idea of what I was doing, or what I was actively doing in those early days. Ever the one to take an academic interest in the question, I found myself looking for a template, or a set of guidelines to at least steer me in the right direction. (It seems that we physicians have become so used to following academic ladders, protocols and algorithms in our training and working career, that, when faced with the threshold to an apparent abyss–the doorway to retirement–guidelines would be actively sought). The definitive textbook has yet to be written, but I was surprised how much discussion was already in print. Reading a few books and a few articles seemed to help.

After just the first month of not working, I felt increasingly driven to take a more active role in my new stage of life. How I did that, and how I developed the necessary traction to move on in the months and years following my departure date is the subject of the next post.