Reflections from the Editor

ONE YEAR INTO RETIREMENT

By Frank Skilling, M.D.

“You’re telling me that you’re not nostalgic, so give me another word for it…”

- Joan Baez to Bob Dylan in “Diamonds and Rust”

A year ago, I saw my last patient in private practice. It was on March 19th, and I left the office thinking that I would be returning again…sometime. Because of COVID-19, our practice was forced to shut down entirely for over two weeks. Emergency appointments were made, of course, but routine exams and all outpatient surgeries were cancelled. As the practice re-opened, we were restricted to how many physicians, staff, and patients could be inside the building at one time. By the beginning of June, it was obvious that our practice wouldn’t be able to schedule me, even part-time, for several more months. I decided that it was time to retire. I then wondered how I was going to feel being without a profession that I’d devoted over a half century of my life to.

Surprisingly for me, it wasn’t as hard as I conceived it would be. I had already reduced my schedule to a part-time office practice four years ago. Fortunately, my wife Karen and I immediately became quite busy supervising two grandchildren who arrived for an extended stay because their pre-school in Atlanta had shut down. Our son Bennett is a firefighter with DeKalb County, and his department was swamped with calls related to COVID emergencies. He felt it was safest to have his wife and children stay with his in-laws and us in Tallahassee till things quieted down. That stay lasted for three and a half months.

We live in an old neighborhood that’s excellent for strolling, so I started taking a daily walkabout for at least an hour. When the City of Tallahassee re-opened the pools, I started alternating my walk with an hour’s swim. I have been a fitness swimmer for twenty years, so I was happy to resume lap swimming.

Since my wife had grown tired of grocery shopping, I became habituated to going to Publix several times a week, once I got used to wearing the mask that Karen had made. With a mask on, I wasn’t concerned about contracting COVID since I used hand sanitizer frequently and tried to social distance. I am also now familiar with the layouts of Fresh Market and Whole Foods, but I still like Publix best.

Between supervising the grandkids, scooting around Publix, and exercising, I didn’t have time to think about what I was missing. I stopped by the office to check on mail and messages, but the word that I was retired got out quickly, and I received several nice notes from former patients. It took a few more months to dispose of my personal desk and bookcases, which were heirlooms I’d inherited from my father. The desk was burled walnut and probably 130 years old. He purchased it at a second-hand shop in Washington, DC in 1935, and he used it for his personal desk in his private medical practice. I inherited it from him and used it in my office. It now belongs to my son and daughter-in-law in Atlanta.

I was an English major at Spring Hill College, a Jesuit liberal arts school, in the 1960s, and I read many of the classics in the literary canon of the time. However, as I got older, I realized that I had been looking at them with the mind of a twentyyear-old, and I felt that some of them deserved re-reading. At that time, I had been fascinated with the 19th century Russian novelists, but I had no frame of reference to go by. I didn’t know much about Russian history, except that the October 1917 revolution brought the downfall of the tsar and put the communists in charge. So, I took an online OLLI class through FSU on Romanov Russia, which opened my eyes to the complex story of the country and its peoples. This spring, I’m taking another OLLI course on Putin’s Russia. I read a cultural history that explained what I wanted to know about the novelists who were trying to change the traditions of the country before the fall of the empire. Now I’m embarking on a trip with Dostoevsky in Crime and Punishment. His Brothers Karamazov is next, and I’d like to re-read Tolstoy’s War and Peace and Anna Karenina. My fear now is that I’ll die before I get through them again.

So, you ask, do I miss practicing medicine? Am I nostalgic? Yes, in a way. I miss the contact with patients and being able to help people navigate the problems that life throws at all of us medically. I miss the encounters and stories of some patients that stretched out over decades. I read the obituaries to see who has passed away. I’m heartened when someone tells me that I was able to help their child many years ago, and now that child is a productive member of society. But, and this is a BIG BUT, I definitely don’t miss the morass of the electronic health records that controls every aspect of practice; I don’t miss compliance with all the managed care rules that govern physicians’ ability to prescribe medications; and I don’t miss the constraints that compliance with COVID restrictions has placed on all patients and providers. So, in response to Joan Baez’s query, I’m not nostalgic for medicine the way it’s currently practiced, and I don’t have another word for it.

I have volunteered giving vaccinations at the TMH drivethrough facility. I’m inspired and truly impressed with the public health physicians, epidemiologists, laboratory scientists, vaccine manufacturers, nurses, ICU specialists and first responders who have taken up the mantle and waged into this desperate fight. In a way, I’d like to be back in the public health fight as a practitioner, but I know that I have to get through several more Russian novelists before I’ll feel I have accomplished something. One thing I’ve learned from reading them: Russian novels don’t have happy endings. I don’t think that the pandemic will have one either.