Four more sleeps (and three more work days) before my mini-vacation to NYC with my friend Patti Steelman. The tickets are all purchased for an opera, two new musicals, and two revivals (one of which I have seen before). It should be a good time, even if the forecast is for rain this next weekend. Rain doesn’t bother me. I’m a Seattlleite who has walked, hiked, played soccer, and shot off Fourth of July fireworks in the rain during my Wonder Years. Just wear a rain jacket and go on about life as usual. I will report on the city and the theatrical offerings in my usual fashion so be prepared for some more frequent posting.
This last week was psychologically a bit hard. One of the more difficult aspects of my job is the need for me to walk through very difficult decisions and journeys with my patients. Something eventually goes seriously wrong with everyone and I sometimes find myself having to help someone I’ve known for decades as a patient or sometimes as a friend, through devastating health news or a sudden decline due to a fall and an injury or a rapidly accelerating dementia. I’ve been able to do this over the years because I’ve lived a life with its tragic moments and had to learn caregiving from a practical rather than a theoretical perspective during those two years that Steve was so sick. My choice of specialty allowed me to place a certain distance between myself and my patients. They were of a different generation. They were parental or grandparental figures, not peers. This was reinforced as so many of my friends and acquaintances brough me their parents or other special senior adults over time.
Now, nearly forty years after I first entered the rarified world of American medicine, I have aged. More and more of my patients are within a few years of my own age, some are younger. It’s harder for me to insert that distancing and instead I have to take a brutal look in the mirror and recognize that I too cannot do all of the things I once did due to the relentless body and brain changes that age brings to us all. This is why I’m seriously contemplating retirement and have set a date. My physical and mental health need some decompression and there is none forthcoming in the trenches of outpatient medicine. The demands go up, the respect goes down. As I rapidly head towards my later sixties and seventies, it’s time for younger people to step up and take care of Generation Jones. I just have no earthly idea of who those people are going to be or where they’re going to come from. Geriatrics as a career choice remains in free fall.
One of my oldest Birmingham friends died unexpectedly this past week. Barry Austin was someone that Steve and I got to know in our first year here. Our routine, before Steve’s health declined. was for us to go to the downtown YMCA after I finished work and before dinner a couple of times a week. Barry was on that same schedule and we would often chat. He never made a big deal out of his legendary local theater career and I wasn’t involved in the performing arts scene of Birmingham at all other than as an occasional patron. Steve’s illness, death and the aftermath took up most of 2000-2003. Barry and I saw each other socially a few times during that period but I don’t have much recollection of it due to my high stress levels and mistaken feeling that I would soon be departing Birmingham and head back to the west coast. Tommy and I got together in 2003 and started to throw ourselves into theater the next year and I got to know Barry again after having not seen much of him for a while. He was always, gentle, kind, humorous, and dedicated to giving the best performance he could craft. We started to move routinely in the same social circles and much to my surprise I started to share the stage with him over the last decade or so. We were both cast in Chitty Chitty Bang Bang this summer and I was looking forward to being able to spend some more time with him. Not to be.
I wonder sometimes if I’ll drop dead for one reason or another in the next few years. I hope not. My to do list is way too long and my family won’t be able to make heads or tails of my affairs. The will is done but i want to take a few months at retirement to really put everything in order and make it as easy as possible for my siblings and nieces who will probably be saddled with much of the legwork. I have some ideas about how to use my estate to benefit the local music-theater community but I have to get into retirement living and get a sense of money flow before executing any of them. Here’s hoping I hold together for another three years. There’s no guarantees. And my division has a long history of having faculty retire and then developing health related disasters within the next year and I would rather not join that club.
Next week should be easier and, if nothing else, I’ll get the taxes on Wednesday and have some clue as to what sort of vacation I can afford to take this fall. I’ll sick my travel agent on it once I know if it’s a refund or a payment year. It can go either way. I’m in one of those weird places where a few hundred dollars more of income knocks me up a tax bracket and all of a sudden I owe thousands more. I have no particular aversion to paying taxes (its part of the social contract and I believe in pooled resources doing things beyond what we can accomplish as individuals) but there are times that they can be murderous on the cash flow.
Life, The Universe, and Everything 