When It's Time to Retire: Notes From the Afterlife

David Loxterkamp, MD


Ann Fam Med. 2018;16(2):171-174. 

In This Article

House of Cards

The one mirror in my home is attached to the front of the medicine cabinet. I visit it each day to brush my teeth, shave, and splash a few handfuls of cold water on that lovable face. The morning ritual re-introduces me to the wide grin and twinkling eyes of the 31-year-old doctor who opened his medical practice in Belfast, Maine more than 3 decades ago. The town has changed. My patients are older and dying. The kids have left home. But the wife and I plod along, fixed in our relationship.

I was recently invited to speak in a distant city, which required an overnight stay in a hotel room with a full-length mirror in the bathroom. Travel had been long and cramped, so I was desperate for a cleansing shower. Afterwards, with only a towel draped around my waist, I glanced in the mirror as I left the bathroom… and was astounded to discover a grandfatherly figure who had slipped into the bathroom undetected. He was slightly bent, shorter than me by an inch or 2, with an unflattering jiggle to his chest and buttocks. Yet he seemed amicable, curious, and not at all startled to see me. He turned when I turned; scratched his ear when I scratched mine. Above his right clavicle was the same mole that I possessed. Could it really be me trapped inside that old man's body?

Our sagging bodies remind us to relax our grip on life, just as our skin has relaxed its grip on us. Let's let a few things loosen and slip away. Appreciate that life is only a temporary stay of execution. For God's sake, engage the man in the mirror! Chat about the people we've known, the ideas that lit our mind and heart. While the exterior may look weathered and worn, the interior values—tested and articulated over 33 years in general practice—glisten and shine. Look around! See how much there is to do outside our chosen profession. We have chanced upon a moment steeped in mystery. Blessed it with the spiritual exercise of plowing under and dredging up a lifetime of memories and artifacts.

I have come to know freedom—the freedom of acceptance. Of knowing that my community no longer needs me in the way that it once did—or I once did. Others will capably care for my patients, love them, remember their place among the generations. Let's welcome this gift, celebrate and cherish it. It is the gift of the Sabbath, as Oliver Sacks described it at the end of his life:

Eighty! I can hardly believe it. I often feel that life is about to begin, only to realize that it is almost over… And now weak, short of breath, my once firm muscles melted away by cancer, I find my thoughts, increasingly, not on the supernatural or spiritual but on what is meant by living a good life—achieving a sense of peace within oneself. I find my thoughts drifting to the Sabbath, the day of rest, the 7th day of the week, and perhaps the 7th day of one's life as well, when one can feel that one's work is done, and one may, in good conscience, rest.[2]

I may not be prepared for the Sabbath, but I am tired of the status quo. Tired at the end of each tiring day. To "re-tire" describes both my emotional and transitional state. But I am also eager for something new. Ready to break out of the humdrum. Dismantle (from Middle French, dismantelier) the castle of my career. The word's etymology deepens its meaning: to tear down the walls of the fortress; to remove one's cloak or mantle. To live happily uncloaked. Yet we all know coworkers who have disappeared without a cloak, becoming ghostlike in their retirement. How important, then, it is to know for whom we wish to remain visible.

Not long ago I sat down inside a giant, walk-in camera obscura at our local history museum. As my eyes adjusted to the darkness, a new world emerged in front of me. Cars and people, buildings and street signs floated upside down and backwards. Perhaps this is how we can look at our new lives now, as a world refreshed, reimagined, through the lens of retirement.

We are all pulling on the oars in a crowded boat—me, the former employees of the Verso paper mill, the visiting doctors, and my former patients in the Life After Work group. We are dealing with the same sweet sorrow of leaving jobs of a lifetime. Losing our social footing. Waiting to be forgotten, like my poem at the office Christmas party.

Once when I was young, I felt called to the practice of medicine. Therein lies the hope that I will be called again. Sure, it is harder now to wait and listen, or to appreciate the "lesser" opportunities that everywhere abound. But I have no doubt that I can loosen the cloak of my career, or "reshuffle the house of cards," as a friend of mine once put it. To play my hand one card at a time, mindfully and deliberately with those I love. Or play it with joy and abandon, letting the tricks fall where they may. Yet play it we all must. Friends, the hour is later than we think. It is time to play whatever hand we hold.