This is a children's book, about how little Leonard, whose grandfather is The King of Beasts, and now going senile. I think it's meant to encourage understanding of the phenomenon and to care for your frail grandparents, but I found it very depressing. I kept thinking about my father, and his dwindling to nothing. Then I kept wondering about how long I have. I know I talk about "not retiring until I put the kids through medical school," but really not that many people can keep up the pace, or even be functional that long. I do have one colleague who is still going strong in his late 80's - well, at least going reasonably - but the "super seniors" are still the exceptions to the rule. Some time ago, ravensron did point out to me that we really don't know what the "normal" is for people in their late 80's and older, because this is the first generation where we are having large numbers of people live that long. I do see many patients that old, but truly being hale and hearty at that age is the exception.
Warrior Rising by Chris Linford.
Initially came across this book referenced in another excellent book, Marc Dauphin's Combat Doctor. Dauphin was a Canadian Forces Medical Officer, and had been the company commander ("officer commanding" as opposed to "commanding officer" in Canadian parlance) of the last Canadian roto for the Role 3 NATO hospital in Kandahar Afghanistan. That book was impressive enough, and the volume of casualties they saw in one roto - heck, in 1 month - is more than I saw in my entire career. To be honest, most careers are nothing like war movies, probably even if you're special operations, you don't see as much "action" in your whole career as is packed into a 2-hour war movie. Most people don't see even that much, most of the military life is routine, and many people, even in wartime, don't see a shot fired in anger. Even understanding that intellectually, it does make me feel a little insignificant to read about how much Marc Dauphin had seen and done. And that, wasn't a patch off what Chris Linford had seen and done. He was a Canadian Forces Medical Office at the Role 3 in Kandahar, which was his last assignment. He'd also been in Rwanda, Bosnia, and several other places. He was eventually put out of the Canadian Forces on a medical discharge for severe PTSD. Considering what he'd seen over his career, he was entitled to enough PTSD for 5 people. Much like combat, very little PTSD is anything like you see in the movies, but he had a textbook case of the most severe form. Very humbling to consider what he'd done and what he experienced.
* Actually, they didn't have my coordinates, so traced down my sister in NYC, who was mentioned in the document. She called me to say had an odd message on her answering machine from 'some lawyer's office in NH,' who wanted to get in touch with me.
** Rather a grim title that, sounds too much like executioner, but not much better in Quebec where it's a liquidator. Seems like you want to hire Arnold Schwartzneger for the job.
I realize, with some of my older patients, that they do require more patience (no pun happening here!). What is sad, with some of them, is that I've known them for 20+ years, and seen them go from "older but vigorous," to "elderly and decrepit and confused." I realize too that what sometimes seems just an annoying character trait is in fact their trying to cover for no longer being with it mentally. Not completely gone, but worse off than they seem at first glance.
One problem I noted today, is that some of them were frankly annoying when they were younger. Becoming elderly doesn't make you saintly. If you were a total pain when you were 25-35-45, if you haven't worked on yourself (whatever that could mean), then you are still a total pain at 65-75-85. Some people were just annoying for their whole lives, plus they pick up more annoying character traits to try to cover for their losing it. I'm training myself to see past the annoying to what really needs doing.
Gray outside; it was raining on-and-off all day. At least it broke the heat.
Gray inside, as this was my last clinic at the Veterans Hospital. As mentioned in prior posts, it is no longer a purely Veterans Hospital, and there are fewer and fewer veterans still there. Moreover, I just have too many things to do, and I'm trying to drop the more peripheral ones, so I don't want to drive out there even once/month.
Still, it was sad to leave. I think I've been there for 4 years, and gave me some military connection, so it is closing at least a small chapter in my life. Things moved slowly today and I finished late. Slowly partly because my heart wasn't into it. Slowly partly because we wanted to make sure I got the waiting list cleaned up, and did any procedures that needed doing because there is unlikely to be a "do it next clinic." There are a few that will need follow-up. It looks like things are going ahead with their bringing on board one of my recent graduates in October (finally, after their sitting on it for months). If that is definite, than can defer the follow-up until she is there. If not, we'll figure something out. Maybe I'll go there for a couple of hours one more time. Maybe they'll put them all in a van and come to my office. Those are details, but I'll make sure I won't leave the patients stranded.
It was emotional for me to be there. I think these two posts state my feelings about the Veterans there the strongest:
I'll be okay by tomorrow, but feeling very blah tonight.
This thoughts inspired by a friend's posting (https://jillianpage.com/2018/07/22/
"Retirement," like many labels, seems to be all-inclusive in its description, whereas it really just means "ceasing to work at a certain well-defined job." I think that goes hand-in-hand with defining yourself as what you do for a living (farmer, lawyer, journalist, etc).
Admittedly, what you do for a living, for most people, is how they spend the majority of their waking hours, and often an important part of their identity, but the be all and end all of their existence, if they don't want it to be.
Another reply to that posting (regb1957) gave a good list things one can "do" in retirement. If your health is good, you can carve out another career for yourself, if you want to. If you want to be at the beck and call of someone else that is. Retirement means you won’t have to, you can do things you want to do, when you want to do them. Write a novel; start a business; campaign for xxx rights; get more deeply involved with local politics, whatever.
All good points, but even that begs the question of if we should define ourselves by what we "do" rather than what we "are."
I think in general people retire later when they enjoy their work. As you know, I'm not going to retire anytime soon, having 2 kids to put through medical school (and they are not even in kindergarten yet). Even if that were not a factor, I like what I do, so can't see giving up doing it any time before 80-? 90-? The key is to recognize when you are no longer capable of doing it well, and stepping down at the height of your game (at least when still in good form), not been pushed out for incompetence. In another 10 years will likely slow down a bit, but not stop.
Even that, again, pushes the question of "who am?" to be answered by "this is what I do for a living." As you know, Gentle Readers, I am a professional (in the older meaning of "learned profession") and that does come with a sense of identity more than most jobs, but I get to largely keep that identity even after retirement. I have multiple identities (as we all do), but sometimes have to remind myself that father/husband/family man is as much my identity as what I do for a living.
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( Random Thoughts/Comments )
About 4 days ago woke up with achilles tendonitis in my left foot. No reason, just woke up with it. Makes walking difficult. Just falling apart. Maybe that's why people eventually die, they either just fall apart one bit at time, or they just get tired of dealing with it.
Add to that everyone here has been sick on-and-off (most "on") for the past month. I've been that in-between state of not quite sick, not quite well.
Good stuff has been happening too, but this is a whiny post and I'm going to just whine, and am hereby doing it. (So there!)
Back: We had reason to go to the old condo. Still not sold. Grrr. Anyhow, we ended up giving the kids a bath there. (Sounds strange, but sort of made sense, however too complicated to explain.) I got all nostalgic about giving them baths there, Hedgefund especially adored taking a bath with her Papa with more bubbles than water. Partly nostalgic for the condo itself; I'd lived there for over 10 years, had many good memories (and some horrid ones), and that is where we first lived together and had our children. Partly nostalgic for when the kids were little. Yeah, I know that at 4 and 2-1/2 they are still little, but little-er.
Was talking a few months ago with a colleague. He is newly on staff at McGill. Already had a PhD when he got to us, finished our residency program few years ago, was faculty elsewhere for a bit, and now is back on staff with us. He is interested in research, very hard-working, and also very astute politically/socially, so he'll go far. We had dinner to talk about his taking over some of my administrative teaching duties, and also talking about projects we could work on in common.
Years ago, when I was even more neurotically obsessional than I am now, I had not only a "to do" list, but several of them: (A) to do top priority, (B) to do soon-ish, (C) to do sometime this year, and (D) to do sometime this lifetime. I still keep to do list(s), because you can't be this busy and get stuff done without tracking things, but I'm not that bad. I suppose the 'to do this lifetime" list still exists, but only in the back of my mind. There are things that have already dropped off of it, for example, I'm not really going to go back and take music lessons again (last time was grade school). Still had several things that I was going to do, some starting when this current time crunch (the one that started before Hedgefund was born, and will end when house and office properly set up).
Now, I'm not so sure. One thing that already had faded into the background was intense French lessons (and possible even other languages). I can get by, but nowhere near as good as I'd like. Had always been planning on improving it "when I had time." However, since I am, and have been, good enough, I always had higher priority things to do. At this point, and not going to take weeks-months off for French immersion somewhere, or even devote xxx hours/week to it. (Although reading childrens books to HF & WS might be helping a bit.) I had definitely been thinking that would like to get more involved in teaching and/or research. In fact, am already as involved in teaching as I'm going to get. Research? Right now, it feels like just opening another can of worms, and I've spent so much time the past few years (decades?) herding enough worms. Do I really want to bother? Not sure. Some part of me still does, but after listening to my colleague bubbling with plans, energy, and enthusiasm, I'm thinking going to work, then coming home and biting toes seems about all I want to do. Admittedly, soon enough they'll be too old for toe-biting, but there will be other things. We'll see. There are lots of political games and paperwork involved in research also, and I've had enough of the latter, and was never very good at the former. Right now I'm tired, and thinking that the roads not yet taken will just have to be traveled by other people, not me.
Not really big on daycare as a concept. I think kids overall do best being with, and being raised by, their parents. However, I think that worked best when we all lived in the little tribal group / village. They, Hedgefund especially, need socializing. Better to do it a little bit at a time now, then wait another few years and drop them in school full time.
Meanwhile, today, Mom & Dad are enjoying their new-found freedom, waltzing in the living room, while drinking champagne and eating caviar, to be followed by wild, swinging-from-the-chandeliers with several of our neighbours... Yeah, right. We're sitting around feeling weepy and counting down the minutes until we can go pick them up.
First day or two, the kids will be miserable. Starting no later than next week, they'll hop out of the car with a cheery, "Later old folks. Don't wait up for us, gonna stop and have a little milk with the boys after school."
When our kids are very young, we take care of them. When we're very old, hopefully, they take care of us. (Huge kudos to my sister, WWC, who took care of Dad in his dotage.)
Hedgefund seems to have started the latter phase at the same time as the former is still going on. The other night I was really tired, and she put me to bed. We have our little bedtime ritual: I set out the drinks (scotch for her, beer for me*), then I read her a book or two, then brush her teeth,** then another book or two, then she turns over and goes to sleep. When she goest to sleep, I will either read, or talk to Nom, or do some work at my desk. That night, somewhere halfway through the first book after brushing her teeth, she told me to turn out the light and fait dodo***. I turned out the lights, lay on the couch, and fell asleep in seconds. She apparently decided it was a job well done, got up, went to find Nom, and informed her that she'd put Papa to sleep, and now Nom needed to read to her. I wasn't aware of any of this until the next morning.
*Not really. A bottle of milk, plus a sippy cup of juice & bubbly water mixed for her, and some bubbly water for me. Even if she doesn't always drink it, it has to be set up. Kids are creatures of habit.
** She makes a game out it, which can be either cute or annoying depending how tired I am. First I have to "brush" (with the back of the brush) her fingers, ears, and whatever part of the body she presents to procrastinate actually brushing her teeth.
*** Baby French for go to sleep.
( 1. On call )
( 2. Valentine's Day dinner. )
( 3. Books. )
( 4. Battle of the hair. )
( 5. Contracting out. )
( 6. Is real or is it a film? )
( 7. Big brother is watching. )
( 8. I'm here for the veterans. )
( 9. Better to curse the darkness? )
( 10. Renovations. )
( 11. Nostalgia already. )
That's all the news from warriorsavant, where all the women are strong, all the men are good looking, and all children are above average.
After that, got home just in time to go out again. It was Burns Night, and needed to go sip some scotch and listen to poetry. Nom was feeling a bit under the weather, and her parents were also so they couldn't babysit, so I went solo. After the silliness at the interviews, I got home too late to even change into my kilt, much to my (and other folks) disappointment. My friends don't have that much room, so the party has always been at his father's house. A sad note for the evening was that the old gentleman had died less than a month before. He was the one who always ordered the haggis and made the scotch broth. He had ordered the haggis just before he passed, but in his honor, we specifically did NOT have scotch broth. He was a retired Professor of Biochemistry, and I always enjoyed talking to him. Despite that, people enjoyed themselves, including me, who generally hates parties, although I didn't stay late, feeling guilty about leaving Nom alone with the kids all day.
Gave them a bunch of useful baby stuff we didn't need anymore. (*Sniff* My babies aren't really babies anymore.) They wanted to pay us, but told them not to bother. What would we have done with the stuff otherwise? No relatives pregnant at the moment, and if list on Kijiji, would have to put up with ppl coming to look at it, and ending up paying us next-to-nothing. Better our neighbours have it.
They did get us a nice basket of chocolates. (Annoying thing about those is that all the little boxes are taped together to make a nice display, and take herculean efforts to open, but that is a quibble.) Good chocolate. Unfortunately Hedgefund thought so too. Not a good thing in the evening. She was very happy, well actually wired. Nice to see her so happy, but didn't get to sleep for hours. I've already told both of them "no coffee for babies," ditto beer, and certainly no sex at least until age 87). Would prefer to leave them at least one of the four essential food groups, but might have to only give it in small amounts, and in the morning.
I am the Dermatology consultant on a study of a new Alzheimer's drug. (Seems earlier trials showed some cases of pigmentary abnormalities, and FDA/Health Canada mandated that subsequent trials required a at least two total skin exams.)
By definition, Alzheimer's is early-onset dementia. Well, that was the original definition; there are characteristic histological findings, but that is on autopsy. There are also other causes of early dementia, but these details aren't relevant here. What is relevant is that the patient I was screening the other day (who didn't seem very demented) was only a little older than I am. An slightly uncomfortable feeling, a bit of "there but for the grace of God…"
Later that day I saw a doctor I've known since I was a Resident. Haven't seen much of him lately, but he is someone who is a Part Of My Past. Not much older than I am either. Seems he's having memory troubles now. He said that some of it was related to a blood pressure medicine he'd been on, and has gotten a bit better since being switched to another one. However, he is no longer teaching, and seemed sometimes to have trouble getting to the facts. Part of that can be put down to his manner of speech, which goes with his branch of medicine (few are as crisp and to the point as Dermatology), but some really did seem to be memory loss. Someone I knew well for many years. Someone only a few years older than me. More than slightly uncomfortable. Closer to terror.
The phrase my childhood self found the most ridiculous was, "I'm cold, put on your sweater." Now that I'm a parent... I still find it ridiculous. I NEVER say that. Alas, Nom, lovely and intelligent as she is, still believes in it. I guess she has no choice; it's in chapter one of The Mothers' Manual: Things You Absolutely Must Say And Do.
The other day, I took Hedgefund out for a walk. It was a bit cool, so I put her jacket on her. At some point, she decided she didn't want to wear it and took it off. I, negligent parent that I clearly am, made no attempt to stop her, even though I was wearing my jacket. After a few minutes, she realized that she was cold, and put her jacket back on. Let me repeat the key point for those Gentle Readers who might not have caught it (eg the mothers in the crowd): she realized that she was cold and took appropriate action.
Putting on my scientist hat, allow me to point out that all organism regulate their homeostasis, which in the case of humans and temperature, includes adjusting one's clothing-wearing. Here endeth the sermon.
When it is time for GM to leave (or if she has already left), we try to explain to HF that GM has to go home to her own house and be with GF and to sleep there. The other night, as I was reading to her pre-bedtime, I think she was trying to process the concept that GM goes home to her own house to sleep, and that was okay. She was repeating something like "Mai (GM’s name) sleep house. That’s okay.” It might never have occurred to her that Mai actually lives somewhere else, rather than wandering the streets or more likely just evaporating at night. She’s never been to GM & GF house, unlike say BIL & family’s house. I repeated it back to her, and told her that everyone goes to their own house to sleep, everyone has a house where they sleep, even birds. Also pointed out that her Papa was here now. Also told her, as I’ve told her many times, that Papa is always inside her (tapping her head and sometimes heart), and I’d always be there whenever she’d need me, and she’d understand when she was older. (I digress a bit, really the amazing and touching part for me was seeing her at least try to process the concepts.)
When I got out of the Army, I knew I would spend more time on academics, or perhaps better to say on academia. I took on being the Director of Undergraduate Medical Education for Derm. (Isn't that a fancy title? Yeah, big whoop.) I thought I'd go on to Dermatology Residency PD (Program Director), then maybe Chief of Dermatology for McGill. Possibly somewhere in there take on being Chief of Derm at my hospital. (Every university medical school has "THE university hospital," and "the OTHER one." JGH is "the other one." Which, of course, is better.) I was offered PD a couple of years ago, but Hedgefund had just made her debut, and I was a tad busy, not to mention enthralled with that job. Then, just as I was getting on track with that, we had Wallstreet. Did I mentioned enthralled? And now renovating a house. Yeah, busy is an understatement. Plus, I looked at the jobs of PD and Chief at McGill. PD is 70% administrative blech, but at least at the end of the day, you know you've helped train the next generation of Dermatologists. It's satisfying. Chief is 70% administrative blech, followed by 30% even worse blech. If I'd been focused on the upward track (much as I had been in the Army), I would have gone for it. Ego usually beats common sense.
Fortunately, I was saved from this fate (although I would have loved it had I done it) by said family life. The prior PD stayed on, but took on a "co-director" (minion). He will likely move up to being PD in a couple of years. Good for him. He's bright and hard working and recently graduated. Yeah, recently graduated. Someone I recently trained is taking on the administrative role I had thought I would go for some day. Even though my choice, and a choice I would not change, there's a bit of feeling by-passed.
Recently we had a get together for the Derm staff at my hospital (we do these about once/month during the academic year - part educational, part social, in varying ratios). Our Chief (at JGH, not McGill overall) said he was looking for a replacement. I do take this with a grain of salt, as he's been threatening to step down since I was a resident, but he's sounding more serious now, which is reasonable with advancing age. We do want to bring on younger staff, but there are only a fixed number of places we're allowed to have. (Part of the meeting was discussing whom we wanted, and how to juggle places.) We suggested a certain resident who will be graduating soon. She's great: one of the smartest and sharpest people to come though our program in a long while, a good teacher, and super-pleasant. Although a bit young to be a hospital chief, she would be great. When she actually graduates. Someone I'm helping train. Taking a position I vaguely thought I might be interested in "later." Again, my choice, and a choice I would not change, there's a bit of feeling by-passed.
Not so much feeling by-passed by "the system," (heck, our current Chief at McGill was one of my residents - which is why it's amusing when she tells me about the "old days"). More feeling by-passed by life. Okay, feeling old. In my mind, I'm still the bright young thing, the youngest guy in the room. Now I'm one of the senior ones, and people I helped train are being looked at for positions I'd thought I'd go for "some day." I still have a lot of "some days" ahead of me, but fewer than I used to.