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Report from Burnoutville: To Quit or not To Quit

I went to my butchers recently. Our favorite young butcher, Benjamin, looking even more dapper than usual, came up to us with a smile. 

“I have news,” he said smiling.

“Good or bad?” I was apprehensive; worried that he was leaving the store. I really did not want to lose this personable and capable young man from my life. My old friend, Susan Pinker, in her book The Village Effect, writes about the importance of what social scientists call “loose connections,” those casual interactions with people who are not your intimates but with whom you have positive casual relationships for one’s mental health. With my food obsession, the merchants of the Atwater market have been an important part of my pandemic mental health. 

 “I bought the store!” he grinned. I was relieved. “You know,” he continued. “I started working here when I was seventeen. This is the only job I have ever had and now …

“Congratulations,” I said to the young new owner. I turned and smiled at a distinguished man, about my own age, expertly dissecting a lamb leg at the thick wooden butcher table behind the counter. It was Le Patron, the now former boss. “Congratulations to you too!” I gave him a little nod and a wave of acknowledgement.

He looked at me with a combination of fatigue, pride and sadness, a small limp and a new slight facial droop perhaps revealing a reason for his decision. “C’est le temps de passer la flamme. Time to pass the torch,” he said.

I’ve been on vacation the past two weeks and as part of this time of family fun and R&R, I’ve had some long talks with people who know me and love me.

“Why are you still working?” is a recurring theme. So I’m taking this moment to reflect. Should I retire? Why? Why not?

There is an old saying in Yiddish: If one person calls you a donkey, ignore them. If two people call you a donkey, worry, but if three people call you a donkey maybe it’s time to get measured for a saddle and a bridle.

The pandemic is taking its toll on all of us, and the strains on primary care in this country are well documented in this publication and others. I’ve always considered myself to be in the best position possible. I work in a teaching CLSC in Quebec and in a small but very well-run little clinic. I do only clinical supervision and primary care Obstetrics, working three half-days per week, with a twelve hour daytime Ob shift every two weeks. I have access to nurses, nurse practitioners, nutritionists, even social workers and some limited access to mental health care for my patients. 

I love teaching, and I believe I’m good at it. I still get a thrill when I see residents develop into skilled clinicians by integrating the things I’ve taught them. I love the ‘Aha’ moment when the student answers the unasked question and the patient’s anxiety and fear falls away and trust is created. 

I love the crazy lovely environment of Labour and Delivery. I’ve been a birth junkie for a long time and the feeling of a new life coming into the world through my hands is one of my great pleasures. I love that, at its best, L&D is where teamwork is exemplified. It’s a circle of care that surrounds women with love and energy and skill in this most important moment of their lives. 

Frankly, I also like the money. Even with this much curtailed schedule I am able to support my husband and myself without dipping into our savings. This is a good thing for someone who spent most of her career as an academic family physician in Quebec, when that was the physicians’ equivalent of taking a vow of poverty. Having four children in private schools and a full time nanny did not lead to excessive savings in my early career, even though it contributed to our family stability and my mental health. These reasons and a general financial incapacity contributed to my lack of a large retirement nest egg. I also have a deep fear of not making any money. So, even though I am pushing 68, it makes me anxious not to have an income. It was the same when I was on maternity leave, so long ago; having no income for a year was emotionally difficult.

On the other hand, work is getting hard! I’m not as young as I used to be, and to quote Leonard Cohen, “I ache in the places where I used to play.” This, for me, includes my left ankle. I like to have a nap in the afternoons. I particularly find the 12 hours on my feet, that an Ob shift so often is, taxing. It sometimes takes me three days to recover from a busy call. I no longer have the patience to deal with the incivility and entitlement that seems to infest the world right now. So what should I do?

Like a good family doc, I consulted. My financial advisor said if I could avoid withdrawing from my savings for another two years it would make a material difference, but not devastating if I do. I spoke to my colleagues, who thankfully indicated that they would welcome my continued contribution as a teacher. Finally and perhaps most importantly, I spoke to the chair of my department, a wonderful woman whom I taught in her residency. She’s rigorously intelligent, organized and creative— and someone who is unfailingly kind and thinks outside the box. We spoke for two hours. We shared stories, we shared pain. We shared plans and dreams. I felt heard, valued and understood. So like good family doctors we co-created a plan which allows me to keep doing what I love for the next two years while planning to pass on the torch. I feel a lot better now.