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Physicians Aging Well…or Not

Simone, Joseph V. MD

doi: 10.1097/01.COT.0000411544.48719.5d
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In one of his recent columns, David Brooks of the New York Times asked people over 70 years old to send him “Life Reports” about their own lives and what they had done poorly or well. From that pool of responders, Brooks “tried to extract a few general life lessons.” Since I am in that age bracket (76) I was curious about any similarities I have with the responders. I also wondered if there were physicians in the group (don't know) and if the responses might particularly resonate with the professional career track of us doctors.

JOSEPH V

JOSEPH V

The first observation was that the unhappiest people saw their time as an unbroken flow carrying them along as a spectator, a cork bobbing in the water but “not a player or participant; an aimless grasshopper, not a purposeful ant; a dreamer, not a doer; a voyager, not an adventurer.”

The happier ones divided time into (somewhat artificial) phases. They wrote things like “there were six crucial decisions in my life,” that they then organized their lives around these “pivot points.” By seeing time as divisible, they could more easily stop and self-appraise, and had more control over their fate.

Doctors' lives can go either way, and we probably could name a few in each category from our own experience. In a recent column, I interviewed several senior oncologists who made dramatic changes in their careers (9/10/11 OT). They saw it as an opportunity to revitalize and energize their professional lives. It was a chance to learn and do some new things, albeit still in medicine.

One commented that many of his colleagues seem frozen in their initial setting and professional practice; they were afraid to change or saw no reason to change. It would be interesting to find out, when they are in their 70s, whether their lives were happy or not. Brooks found that many more seniors regret the risks they didn't take than the ones they did.

Brooks's second observation was that responders who wrote long and finely detailed essays describing each passing event microscopically often did not lead particularly happy or fulfilling lives. They were self-obsessed about every thought, habit, or emotion, seemingly trying to escape past events.

“The most impressive people, on the other hand,” he said, “were strategic self-deceivers. When something bad was done to them, they forgot it, forgave it or were grateful for it.”

I have had colleagues who never got over being wronged, disrespected, or passed over for a higher step in the professional ladder. They usually blame their unhappiness on a person or persons (me, on occasion). It often paralyzes their ability to look around and see that everyone, sooner or later, suffers misfortune not of their own making. Most people are able to grieve, but then move on and find their niche. A chronic whiner is unpleasant to be around and, in the worst cases, isolates him/herself from colleagues and even family members.

“Brooks found that many more seniors regret the risks they didn't take than the ones they did.”

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Steady Progress Each Decade

Brooks says the best essays were by people who made steady progress each decade. He described a woman who took menial jobs, tolerated demeaning treatment by superiors, and lost two husbands by premature death. But she kept at it and gradually grew, went to night school and, at 56 she obtained a college degree. She has a good job and a wide range of interests; “a story of relentless self-expansion.” The bottom line: measure people by their growth rate, not by their talents.

“I have had colleagues who never got over being wronged, disrespected, or passed over for a higher step in the professional ladder. They usually blame their unhappiness on a person or persons (me, on occasion). It often paralyzes their ability to look around and see that everyone, sooner or later, suffers misfortune not of their own making.”

I have known physicians and nurses who are not gifted with exceptional talent. But in this category are some physicians and nurses that I admire most. They may work harder, are more thoughtful and compassionate with patients, or they simply get things done without fuss or excuses. They are capable of learning new things developed by others and are grateful for the opportunity to improve. Often, they are a pleasure to be around because of a sunny disposition in a sometimes depressing medical environment. These people are the salt of the earth and are worth their weight in gold by their positive effect on morale and team building. And patients usually love them.

“I believe that we have only so much emotional energy and that it becomes more precious as we grow older. But kindness to others, whether they grow away from us or not, is the right thing to do.”

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‘The Art of Living’

On a trip to Sicily several years ago with 14 other members of our family (whew!) we were having a conversation about what was different about life in Sicily. The food, of course, but we were reaching for something more fundamental and pervasive; we could not quite grasp it. So we asked one of the owners of our villa about this. Carmelo paused, looked up, dramatically smacked his lips in preparation for his answer, and said, “It is the art of living.” He meant that Sicilians are more committed to the art of living than many other aspects of human behavior. They often take the time and “trouble” to fully enjoy each meal, enjoy each wine, and enjoy family and companions and flowers and the sea and just being alive.

That brings me to Brooks's final observation: “People get better at the art of living. In their 60s many contributors found their zone.” Although few writers hewed to a specific theology or had any definite conception of a divine order, “vague but uplifting spiritual experiences pepper their reflections.”

They learn to walk away and move on from people who, over time, grow apart from them. The quandary is whether this is selfish or hard-earned realism.

Here is where I differ from some respondents. I believe that we have only so much emotional energy and that it becomes more precious as we grow older. But kindness to others, whether they grow away from us or not, is the right thing to do.

I do not mean we should squander emotional energy on people who are habitually destructive or mean to us. The wisdom that (we hope) comes with aging can help us make those distinctions. Call me old-fashioned but the default position, in my view, is kindness, civility, and compassion toward others, even (and especially) those you don't like very much or who themselves often are not civil or kind or compassionate.

You only go around once in this life and spewing negativity wastes perfectly good emotional energy that is better lavished on spouses and grandchildren.

© 2012 Lippincott Williams & Wilkins, Inc.
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