The retirement glidepath

I’m not entirely sure when it hit me. My career in medicine had rushed on by so quickly—make note, all you young’uns who come behind. Thoughts of retirement, so easily banished before, become more prevalent with advancing years. How many patients have I asked the question, “And how are you liking retirement?” Most, if not all, say “It’s great, don’t know how I managed to find time to work, too.” I smile and think, ‘How will I fill my days, starved of patient contact, of diagnostic challenge, or collegial interaction, of therapeutic success?’ Or will I, like an old soldier, just fade away, a ‘used to be’, a soon forgotten memory?I think we all—at least in this profession—crave for those brief moments of wonder. Saving a life, when death has your patient by the throat. Wrestling with the demons that threaten a stranger’s life-journey. Making decisions others can’t. Making a difference to grandma’s breathing. Contributing to wellbeing of your local community, or society in general. Remember, we might have one patient in front of us, but an extended family and friends benefit from what we do.Rob was 29 when I diagnosed his critical angina (not heartburn) and got him stent. He went on to build houses and be a successful contractor. Mark was 53 when his MI was thrombolyzed in a small-town ER: he enjoyed his children and his grandchildren for another 24 years. The multiple trauma in Bay One, intubated-lines-shocky, who pulled through and got to ride his Harley again. Gwen, 95, in an out-of-town nursing home, was weighed down by heart failure. She sent me a thank-you card soon after her recovery, telling me she felt she could dance on the table. I don’t think I simply added a paragraph to their stories: I helped re-write their epilogue. What a privilege to have been part of their lives, with the help of some remarkable colleagues.I looked for a way of describing the process that awaited me. I Googled ‘How to land a plane when the pilot has a cardiac arrest.’ I learned a few things, some of which translate well into to the Retirement Glidepath (I’m assuming this ‘plane has no co-pilot or ‘qualified other’).It starts with “Sit down, take a breath, and do not panic.” Good start, I thought.“Find a headset, and set to channel 121.500RT.” Okie dokie.“Mayday, mayday, mayday, passenger on flight AC906 flying to YYY.” Y-indeed!“Set transponder to 7700 Squak.” Now I’m getting nervous: do I squak?“Fuel 4.5 tons, altitude 3000 holding.” Holding on to dear life.I should report my heading, put my feet on the rudder pedals, and put my seatbelt on (eh?)I fiddle with the communications panel, putting RT on talk, and set ‘ILS 100.50 autoland.’ Oh, I like that word, ‘autoland’.From then on it is mostly about losing speed (flaps) and losing more speed (auto brake), and finding the approach/autopilot buttons. Once I’m on the glidepath, it’s all about control of speed and height (and, yes, remember to lower landing gear). When the wheels make contact (at 140 kph), I’m supposed to apply breaks and kill the fuel supply. I don’t think I’m up to reverse thrust. I taxi to a stop, and hope I can find the ‘OFF’ button. So, what happened recently to contribute to the success of this glidepath? COVID was a process. Advancing years (and an atrial-flutter ablation). My twin brother dies of a brain tumour at 65. Office overheads increase dramatically. Hospital work recedes and my value as a team-player softens. My wife deserves a life. My kids have left the nest.Maybe a flight glidepath is an analogy that is appropriate to retirement. After all, I need to slow down, not jeopardize passengers, and have the wheels touch tarmac without too much of a bump. My dad flew DC3s in the war, and told me a few stories. He landed safely every time, otherwise I wouldn’t be writing this.Not too surprising, communication is the first thing that must take place. Where are you headed, and when will you be there? You have to make sure those who have been keeping you aloft know your plans, and that your passengers know to have chair-backs upright, tables stowed, and ‘brace.’ Communication happens with your accountant, your bank, your financial advisor, your office manager, the College, your referral network and your secretarial team. Losing altitude and fuel and reducing airspeed is about slowing down your pace of work, or at least the intensity, to improve you prospects of good outcome. After all, you want to exit with everyone smiling, with good memories, with a reputation intact.So how am I doing, 10 months into retirement? I did some locums for a few weeks. Oh, well, maybe not flying big birds, but gliders. Looking for thermals. Getting work—even when the public are in need—isn’t easy. So, you need to have another career lined up for when the first one dies. Writing, painting, travel, kayaking . . . one you can share with family if you’re your patients.

The retirement glidepath

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Hector Baillie

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