The Last Shift: Gratitude, Anxiety, and the First Year Beyond Medicine

In my last blog post, I mentioned that I was on the precipice of retirement from medicine.  Well, a couple of weeks ago, I officially worked my last shift. My personal perspective on the transition is still fresh, perhaps still too fresh, but that may be precisely what makes it worth examining. So, let’s dive a little bit deeper into some thoughts as I look forward to the first post-medicine year.  Maybe I will revisit it a year later with the perspective of looking back.  It might be an interesting case study. 

How I felt on my last shift

My transition from medicine was far less abrupt than is the case for most retiring physicians.  And I’m not actually retiring.  I still have a full-time job as a financial planner; so, I didn’t have either the sense of finality or the sudden increase in free time that many retirees experience.

This was actually a moment that I have been preparing for over the last 4 years, when I decided that I wanted to create an exit strategy from the emergency department and enrolled in a master's in finance program.

Since then, I have been extremely busy creating my new career and identity.  Fortunately, I was able to taper down my shift-load as a physician as I ramped up my business as a financial planner.  That exit became nearly complete this past summer when I gave up my partner status with my medical group and cut down to only a few shifts a month.  So, even before these last few shifts, I was essentially a full-time planner, with medicine as a supplement. 

Because I only worked a few shifts a month, I would sometimes go weeks between shifts. So, I wondered if my last shift would feel that different.  Would it feel like the end? What kind of emotions would I experience?

I was a little surprised at what I felt.  Almost all the patients that I encountered that day represented the last time that I would treat that particular condition professionally.  And I couldn’t get that thought out of my head.  How did I feel about that?  Regret? Fatigue? Excitement?

The primary emotion that I felt throughout the day and with every patient encounter was none of those things.  Overwhelmingly, it was gratitude.

I looked back over the thousands and thousands of patients that I cared for over a 30+ year career and mostly just felt thankful for the experience.  Thankful that I had an opportunity to impact that many lives, to be let in during their moments of pain, crisis, sorrow and sometimes joy. For three decades, strangers trusted me at some of the most vulnerable moments of their lives — chest pain at 2 a.m., a frightened parent with a feverish child, a quiet conversation after devastating news. Hopefully for most of those patients I was able to do my job with empathy, compassion and expertise. 

Of course, there were plenty of negative or difficult interactions over the years. That is inevitable when you work in the emergency department.  But those become buried under the overwhelming blessing that it was to take care of so many people who needed me at that moment and appreciated that I was there.

Is it really the end?

One of the stronger emotions that I experienced leading into these last few shifts was some anxiety about whether the time was right to leave.  I think that is a common thing, whether driven by financial uncertainty, identity loss, or just wondering what was next. 

In my situation, I already know what is next.  I have built my second career; it is growing and keeps me plenty busy.  There is still a lot of room to explore, expand, and hone the parts of this new identity as I discover what I am best at and what brings me the most satisfaction.  I look forward to continuing that journey.

As a financial planner, I have run my “numbers” a thousand times.  I know that my financial plan has a high likelihood of success.

And financial planning allows me to continue to do what I have been doing for decades as a physician—helping people navigate uncertainty—just in another arena.  Professionally, I get to keep helping people. (This time I get to choose my clients and develop deep relationships, which is definitely a step-up from emergency medicine in that way).  So, I don’t think I’ve lost my identity—I’ve restructured it. 

And yet, my psychological fallback has always been to just work more shifts.  Leading up to my last shift, and even though I’d really like to be done for good, that quiet voice kept whispering: “You can always pick up a locums contract. Just in case.”

Now that I’m past that moment, how does it feel? 

I am embracing the finality. I’m feeling ready to close that door and to step into a bright new phase of life. 

Life Sequence Risk

In my post about sequence risk, I mentioned three reasons that drive my transition anxiety:

1.      shifting from net saver to net spender

2.      loss of income control

3.      loss aversion near inflection points.

So, now that I have chosen to unlock the golden handcuffs of life as a physician, how am I feeling about these things? 

If I’m being honest, they are still present.  I have consciously decided to acknowledge them but not let them control me.

The more I hear the stories of others who have retired, the more I realize that life does not come with any promises, and that is never as apparent as it is during these supposed golden years.  The only certainty is that retirement will not look exactly like you imagined.  Life never does.  Why would retirement be any different? In particular, health and family needs are huge variables as you age.  I am appreciating that more.

Moving forward

So, it is my goal and my mission to not let those three anxieties define my next decade.  This is when I will likely have the most control over my decisions and my time, compared to any prior phase of my life and, God willing, I will still be in good enough health to enjoy it.  I plan on being more purposeful in spending time and money on things that I have put off for too many years and to create more experiences and build more memories that will strengthen the relationships in my life that bring me joy.  

I also understand that this goal conflicts with my nature as a saver and a worker. I’ll revisit this post one year from now. We’ll see how well I am doing spending my time and resources intentionally to live with the same discipline I have always applied to saving them.  

Thanks for reading.