“A Reason to Retire?”

Posted on by

N Berman. NEJM 2023; 389: 1354-1355. A Reason to Retire?

If you regularly read the NEJM, what did you think about this article? Personally, I could relate a lot to the commentary.

The article starts off with the author, at the time in his 40s, chiding a colleague who was considering retiring at age 64 despite being very capable. His colleague responded: “My patients’ illnesses are starting to get to me.” Now, the author in his 70s has a different perspective.

Some excerpts:

Having just retired myself at 71, I now understand exactly what he meant…As a young physician, I was able to compartmentalize illness: it was something that happened to my patients, not to me. I could understand their illnesses, but I never saw myself in their place. I would try to alleviate their suffering, but my primary task was to diagnose and treat their condition. 

I needed the distance from their suffering to be able to face the same situation with the next patient. Empathizing was not considered “professional,” but I think the real reason for avoiding it was that it undermined our defenses against the disappointment of failing in our mission to cure disease…”

Objectivity helped me cope with the stress of dealing with my patients’ life-threatening and life-changing situations. It enabled me to see my work in a more intellectual and less emotional light…

But as I grew older, this distinction became harder to maintain… My patients and their problems became more difficult to compartmentalize as separate from me. I started to feel the “extra-medical” aspects of their illnesses much more acutely than I had when I was younger — the unfairness of disease, the inevitability of age and the breakdown of the body.”

My take: As I have become older, it is harder to compartmentalize some of the suffering that I have witnessed. Even though this can help with empathy, I would rather forget a few of these experiences.

Related blog posts

Castelo de São Jorge in Lisbon