Retirement: for better or worse?

enjoyed much more than work. “I’m so busy I don’t know how I had time to work!” Others are adrift. One of my physician colleagues, recently retired due to illness, and still adjusting, reported that he met another retired doctor, who summed up his retirement this way: “I used to be important.” Retirement and disability are quite different but may overlap. The person who retires because of a disability is in a very different mindset than the one who has looked forward to stopping work for years in order to do something prized more highly than their vocation. Sometimes disability provides the impetus for a long-considered retirement, a little, or not so little, nudge over the line. Since I deal only with patients with movement disorders I mostly see people with Parkinson’s disease. For those who begin their illness during their working years, which is, in fact, the majority, the notion of retirement or disability is a very big deal. Over all I encourage people with PD who want to continue working and think they can, to continue. Some need job modifications, of course, like the guys who climb utility poles and fix overhead wires, or roofers or firemen, or secretaries who spend a lot of time on the phone but have failing voices from their illness. But, unlike the situation of the patient with chronic pain who needs “work hardening” therapy to live with the pain and restore meaning and financial support in their lives, PD is a progressive disorder. Work now takes longer, is harder, and may not be performed at the same level as before, and therefore less rewarding. Furthermore the most disabling aspects of PD for many are the “non-motor” symptoms, problems such as fatigue, sleepiness, loss of ability to perform two tasks at not to retire. He said that retirement would kill him.” I’m often amazed by what doctors tell patients and what patients believe. Usually the quote is more like, “if you waited another 10 minutes he’d have been dead.” As if we can forecast the future. This quote came from the wife of a patient of mine, a 72-year-old man with Parkinson’s disease who was continuing to work three days a week in his family business, and rather ambivalent about giving it up. He mostly wanted to give it up but his friend, a man of about the same age, had recently gotten the advice quoted above. I told the patient and his wife, who apparently believe that the doctor really does know best, that, “I never said anything like that to you. In fact, I’ve never said anything like that to any of my patients. My patients tell me what they want to do and we discuss what they can and cannot do, and the patient makes a decision. I can’t predict the future. I just try to help you make a decision.” Of course, who knows what the doctor really said? The gap between what is said in the doctor’s office and what is heard has been studied and may be enormous. I often ask my retired patients about their retirement. Some rejoice in their emancipation from the daily schedule and their ability to do things they really the same time. This complements the difficulties induced by physical slowness, reduced dexterity, tremor and imbalance. These problems are impossible to assess from the outside. When a PD patient asks me for a disability or an early retirement letter, I always agree. Most people want to continue working. I’ve often thought about retirement, but can’t actually imagine doing it. I’ve reached “retirement age,” and could get social security now. My brother is retired and a close friend from medical school has set a firm date for his retirement, but I can’t see what I’d do, not just to keep busy and avoid boredom, but how I’d give structure and meaning