Continuing to be somebody.

For many years, New Year's Day morning has begun in our home with a viewing of California's famous Rose Parade, co-hosted by TV personality Stephanie Edwards. Every time we watch, I’m reminded of a humorous story I heard her tell several years ago when we appeared on a program together. “As many of you may know I have been appearing on television for quite some time now, and recently, as I entered an elevator on my way to the upper floor of a high-rise building in Los Angeles, only one other person got in the elevator with me. As we were going up, this lady leaned over twice and looked at me quite inquisitively. Then leaning over to look at me a third time she asked, ‘Didn’t you used to be somebody?’” Having an experience like that described by Stephanie Edwards, who as a television personality has lived much of her life in the public eye, is something most of us as physicians can likely relate to. We have lived and practiced during what has truly been the “Golden Age of Medicine” and we know what it is like to be well-known, easily identified, and much sought-after because of our abundant knowledge, skills, and experience. For those who have moved beyond our culture's usual retirement age, being asked “Didn’t you used to be somebody?” may not come as a surprise, but neither is it pleasing to hear. The challenge that lies before us–regardless of our age, position or status in life–is this: Should we want to continue to be seen as being “somebody?” Should it be our wish and our goal to achieve this, perhaps it can best be accomplished through continuing to use our considerable educational background and years of experience as physicians and surgeons somewhat differently, but still in ways that will allow us to continue to “make a difference” in the lives of others. Of course at some point in one's career, and especially upon reaching our “senior years,” many people may understandably choose to spend the remainder of their lives doing just those things they always wanted to do earlier, but never had time to do during those busy years in medical practice. As part of the Congress of Neurological Surgeons meeting program in October 2012, one of the Symposium electives dealt with the subject, “What Will You Do With The Rest of Your Life?” Every seat was filled in the room that day, and nearly four hours after the symposium began, it appeared as if they might have to turn off the lights and close the door to end the popular session. It appeared obvious to those of us on the faculty that with people living longer, and often with better health than was true for earlier generations, this subject of how one might choose to spend one's senior years is increasingly deserving of attention. One of the speakers at that symposium seemed happy and fulfilled in spending his retirement years building an airplane. Another speaker seemed abundantly happy with having time to play golf whenever he chose to do so, and without the fear of being called off the golf course to respond to an urgent patient problem. Other speakers, along with a number of other neurosurgeons in the audience, told of the things they enjoyed doing now that they were no longer “married to a neurosurgical practice.” Two very important points that came out of that CNS Symposium were the necessity of having a plan for living one's senior years, and the importance of this plan having been developed early in one's medical career. Also considered very important was having a thoughtful, consistent, and early-implemented plan for reaching financial security. It was emphasized that by having a “life course plan”–and having carefully funded it–one's senior years could indeed be “the golden years,” assuming one is also blessed with reasonably good health and that all important purpose for living. Important to make note of is that as Doctors of Medicine our professional calling is to be of service to our patients who, during their time of illness or need, depend very heavily upon us for the knowledge, skills and expertise we hold that can hopefully restore them to health. Even though we may reach, then live beyond our time of active medical practice, we remain, and always will be, physicians with knowledge and skills that can lead us to amazing opportunities should we wish to pursue them. The dean of my medical school was a brilliant and truly remarkable man. He used to say, “If you attain success in your medical practice during the first half of your life, perhaps a whole new direction will open up for you through which you can achieve success all over again during the second half.” Baseball legend Yogi Berra famously noted “It ain’t over till it's over.” So life need not be over for us just because we have closed our office door. There are many examples of retired physicians who have found successes in the later years of their lives that have even rivaled those during their medical careers. Anna Robertson Moses, known the world over as “Grandma Moses,” became very famous as an artist, yet it wasn’t until she was in her late seventies that she painted her first picture. During her nineties, exhibitions of her paintings reportedly broke attendance records worldwide. Sir Winston Churchill ran for, and was elected to for the second time, the position of Prime Minister of England at age 77. Thomas Edison produced the telephone at 84. Benjamin Franklin helped in the writing of the United States Constitution when he was 81. Claude Monet began painting his famous Water Lily series at age 76 and finished the work at age 85. Elizabeth Arden managed her cosmetics company through her 85th year. Frank Lloyd Wright designed the Marin County Civic Center in California at age 88. Leopold Stokowski signed a six-year recording contract at age 94. Pianist Arthur Rubinstein performed professionally until he was 90. Pablo Casals was playing the cello at age 96, George Bernard Shaw was writing plays at age 91, and Tesichi Igarishi at 100 years of age climbed to the 12,395-foot high summit of Mount Fuji. Dr. Albert Schweitzer was still at work in his hospital in Lambarene, French Equatorial Africa, at the age of 89, and still at work as a Professor of Neurosurgery at age 88 is Professor Gazi Yasargil, one of the most highly respected neurosurgeons in the world, as well as a pioneer in the specialty-changing development of micro-neurosurgery. Suffice to say, people are generally living longer, and with better health than was true in earlier generations. Each one of us therefore is faced with that very important question: “What am I going to do with the rest of my life?” One option those of us in medicine might wisely consider is spending time as a physician volunteer. In developing countries around the world the standard of health care delivery is sorely lacking and opportunities exist through various nongovernment organizations for doing short- or longer-term volunteer work as physicians and surgeons. Those who have made their talents and skills available to others in need in this way almost universally report their work as volunteers having been truly “the experience of a lifetime.” And at a time when the increasing burden of medical record keeping–coupled with the ever-present threat of malpractice suits–casts a pall over our noble profession, being able to practice in countries with great need, and doing so with little risk of either of these burdens, can be very appealing (Figures ​(Figures11–4, showing Dr. and Mrs. Mel Cheatham as medical missionary volunteers in Kenya, Bosnia, and South Korea). Figure 1 Operating at mission hospital in Kenya, West Africa Figure 4 Dr. and Mrs. Mel Cheatham with Maasai Chief and wife, 1988 Figure 2 Wearing military helmets and flak jackets, war in Bosnia, 1993 Figure 3 Dr. Mel Cheatham, Visiting Professor of Neurosurgery, Chonju, South Korea, 1985 One of the most pleasing opportunities available to physician volunteers in our time can be found through engagement in educational programs. Through use of the marvels of the electronic age now available to us, it is possible for us to disseminate medical education information far and wide, reaching via the internet the most remote places on earth. As a result of having heard reports made by physicians upon their return from volunteer medical work overseas, the question is commonly asked, “Is there much risk involved in doing this kind of work?” The answer is “yes”–but the risk is that having served in this way once, you may want to do it again and again and again. If, after having given of our experience, talents and skills as a volunteer physician, a person should ever come up to us and ask, “Didn’t you used to be somebody?” then with a smile, we might answer: “Yes, and I still am SOMEBODY. I am a doctor of medicine who has been blessed through coming to know that ‘life becomes full, when one begins to give it away’.”