Finally

“So what tipped you over?”

I was coming on for my final 24 hour shift as a working obstetrician, meeting with my counterpart from the day before @ 0800 in the doctor’s lounge to pass on the work. He’s the same age as I am, showing no signs of slowing down, but nonetheless, he’s been commenting more and more on how he’d like to find a way to work less.

“Actually, “I responded, “it was the health insurance for my daughter. I’d always said I’d keep working until I couldn’t get her covered any more. She’s only 23, but I have to go on Medicare when I turn 65, and Medicare is only for individuals. I checked, and Medicare specifically has an exemption from the ‘you’re covered by your parents until age 26’ of the Affordable Care Act.”

“Well, that’s something to think about, all right.”
“Uh-huh. It was the straw that broke the camel’s back. There were other things, …

“Sure…” he interjected.

“… of course. I mean, look at my hands.” I showed him my right hand. The little finger splayed out laterally at the last knuckle; the thumb went in the opposite direction, both distorted by arthritic nodules. “Not only do they look like this, but that spinal cord injury means they don’t work or feel the same. I still can’t feel in my fingertips; I never realised how important sensitivity there is for what we do. And some of the muscles in my right hand and forearm just never came back right.”

“Yeah, that would make a difference.”

“C/Sections are OK, but even there, last time I was on, for the first time since I can remember, I had a problem with bleeding at the incision edge, and I just couldn’t get things repaired. I finally had to call the hospitalist to help; it took two HOURS – usually, that’s 30 to 35 minutes for me. I’m at the point where I just don’t want to worry about making a mistake.”

I went on: “Then there’s all the changes. If I had any sense, I would have quit after my accident, but apparently, that thought never entered my mind. But I have found myself becoming less and less tolerant of changes in the practice – computer stuff, new expectations, and all that. And I found, even at five days a month, that going to work was getting in the way, in a mental sense, of all the stuff I wanted to do with my life.”

“Uh, maybe you should have quit last August – before the computer system changed here at the hospital?”

“Yeah, that would have made more sense, I guess. I just wasn’t quite ready, I suppose. By October, though, I realised that I was just not emotionally invested any more in doing the work of a physician. Oh, I still like it when I’m doing it, but it’s really faded into the background in terms of how I define my life. And the work is too important – too dangerous – to not be fully invested in.”

“So what are you going to do now?”

“Well, you know, I’ve only been working 5 days a month anyway for the past two or three years. So I don’t think anything’s gonna really change, at least not right away. We’ve pretty much got the next year planned out already. And my wife is going to be going to work again, now that her year’s re-certification program is done. I am looking forward to be able to get away for some traveling, at some point.”

“What do you do with your stock share?” He meant the one share of Group Health Permanente stock which we each had to buy to become full members of the group. As the signatory on the incorporation papers, I had share Number One, which I’d bought for $2000 in June, 1997.

“You’ve got to sell it back when you retire … kinda like turning in your badge and gun, I guess. I didn’t realise, but it’s appreciated in value quite a bit since then. All our retained earning over the past 16 years. That’s another reason I waited until this year, this January, to quit, so I wouldn’t have to pay taxes on that along with my salary last year. This year, I can use it kind of like a down payment on my pension plan – won’t have to draw anything from that until maybe May or June.” I waited a beat. “And it doesn’t hurt that the stock market is doing so well the last three months.