‘‘Once a Doctor, Always a Doctor?’’ 239
In sum, illness forced many physicians to struggle with the deepest
meanings of their careers in their lives. Many described themselves as
‘‘workaholics,’’ due to high job satisfaction, demands of doctoring, boosts
to self-esteem, prior psychic traumas, degree of illness, or magical
thinking—beliefs that work would somehow immunize them against
illness. Such magical thinking persisted side by side with scientific atti-
tudes. Disease could augment, rather than reduce, these doctors’ moti-
vation and ambition.
Against this backdrop of workaholism, these physicians had to con-
template reducing or ending their careers, whether as a result of disease,
feared or real dementia, or the prospect of having to disclose their disease
to others. They faced disturbing questions of when and how to retire,
and debated pros and cons. They retired at different points, from too early
to too late. Many continued to seek ways to use their skills, or longed to do
so, but that goal often proved elusive. Ordinarily, patients’ views of doc-
tors and doctors’ perceptions of themselves reinforced one another. But
for these physicians, that was no longer the case.
These struggles highlighted the importance of doctoring in these phy-
sicians’ lives—how they integrated their professional identities into their
most profound senses of self and their lives; and how and why they en-
countered difficulties in surrendering that role. These phenomena raise
fundamental existential questions: to what degree one is what one does,
and what one is when no longer practicing one’s profession. In the cur-
rent age of increasing corporatization and outsourcing, many individuals
must reinterpret and reconstruct their identities in the world, and face
problems in doing so. Recently, identity has been examined through the
lens of ‘‘identity politics’’ based on broad ethnic, religious, or cultural
groupings—such as being Islamic, Christian, black, or gay. Yet here, iden-
tity based on work, education, and profession also shaped views of self,
others, and the world—and outsiders’ perceptions. Self-conceptions can
fluidly shift, molded by a range of internal and external factors. For each
individual here, some aspects of the self changed while others remained the
same. Identity thus can be not only political, but also professional.
Concretely, more attention to these issues, and clearer guidelines and
professional opportunities available for potential retirees—how they can
continue to use their vital skills and find meaning—can assist countless
individuals in medicine and other fields.