Spark [Robert_Klitzman]_When_Doctors_Become_Patients(Boo | Seite 242

‘‘Once a Doctor, Always a Doctor?’’ 231
Going ‘‘Cold Turkey’’: When to Retire
Dilemmas arose not only about whether, but also when and how, to retire
or decrease their work—whether to give up their role abruptly or ease
out of it more slowly, over time. Dangers could result from quitting work
either too early or too late. Finding the appropriate time was hard.
On the one hand, diagnosis could mean instant retirement. For Ma-
thilde’s husband, one piece of paper was ‘‘both his death sentence and his
pink slip. . . . One day, you are told you have an illness, you are going to
die, and at the same moment you are unemployed.’’
A lack of preparation could exacerbate grief. Juan left work abruptly.
He felt he was going ‘‘cold turkey,’’ and grieved.
When physicians abandoned their practices suddenly, colleagues and
patients were usually unprepared, and found themselves having to re-
act quickly. Stuart said:
Two docs in our on-call group just abandoned their patients. A
letter went out to us and their patients. But how do patients get
their medical records? What do they do? It was very chaotic and
unprofessional. These two docs reached a point where they just
threw up their hands, and said, ‘‘I’ve got to get out right away.’’
Though delaying retirement could lead to problems, so could retirement
that was too early. Some HIV-infected physicians quit practice early and
later regretted doing so. Others thought of retiring and going on dis-
ability, but in retrospect were glad they hadn’t—observing others who
did so and then became bored. Dilemmas arose in finding the ‘‘right
time,’’ though none may exist.
When the Doctor Is Sicker Than the Patient
Doctors who found they were more ill than their patients faced poignant
questions of retirement. These physicians felt they had to be healthier—
that if their patients were healthier, the physician had de facto passed a
certain boundary between the roles of doctor and patient. It was then hard
to integrate the roles of patient and healer, and to continue to treat patients
without potentially compromising the care provided. At that point, phy-
sicians felt they should permit themselves to surrender the stoic mantle of
the healer, and be healed. Doctors had not only to treat patients, but also to