Life after retirementBMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39419.431944.AD (Published 20 December 2007) Cite this as: BMJ 2007;335:1323
In 14 months I will be 80. I retired 21 years ago from my full time position as vice chancellor and president of Queen’s University Belfast. Ten years was long enough on that ever steeper treadmill, and I took a reduced pension and entered the fee-earning market, as I still had a family to support. I gave up the fee-earning world at 75, when I couldn’t find anyone still willing to pay me. Since then I have continued with the good works that have always been part of my working portfolio and the usual privileges and chores that fall to professionals put out to grass: producing book reviews, invited lectures, and content-free articles on topics such as “Whither medicine?”
Adjusting to change
The first two shocks of retirement were entirely predictable. For 10 years my wife, four children, and I had wallowed in the domestic luxury of one of the grandest mansions in Belfast, with spacious gardens, three full time gardeners, two lakes, and a boathouse. With this came a chauffeur driven limousine, generous hospitality allowance, domestic helps, first class business travel, and all the other trappings that were considered essential to the life of a university vice chancellor.
Now I was unceremoniously dumped on the sidewalk and had to rediscover the doubtful joys of economy class flights, fuelling and parking my own car, and buying my own drinks. Worst of all I had to re-enter the housing market, although fortunately this was depressed at the time owing to Belfast’s little local difficulties. Buying a family house in a safe area took all my tax-free “lump sum” and with it went the world cruises, the holiday house, and all those other little plans for a life on easy street.
The second shock had also been foreseen, but inadequately. At work I had three personal assistants, five full time secretaries, numerous assorted minions inhabiting rooms full of the latest technology, and some of the best brains in Ireland within hailing distance. Now I had to take on, and pay for, a confidential secretary, who worked in her child laden home, 12 miles away, and all long before email and mobile phones. Deprivation was to prove more stressful than plenty, and I soon started to have the first of my clinically mild but nevertheless irritating psychosomatic symptoms.
The third shock was to my wife rather than to me and was unforeseen—at least by me. For 30 years I had gone out at 8 00 am and come home at 8 00 pm, Monday to Friday. Saturdays were often equally busy, although more anarchic. Now “retired,” I came and went irregularly and often didn’t go out at all. The habit conditioned automatons that my wife and I had unwittingly become couldn’t take this. Irritation followed, which worsened my psychosomatic health. My wife felt downgraded to diary secretary because the phone now never stopped ringing for me, whereas previously it had been invariably for her.
Like most recent retirees I was advised to take a long break, preferably abroad, to break the treadmill rhythm and weaken the emotional bonds with Queen’s and the Royal Victoria Hospital, where I had slaved for over 30 years. They predicted dire emotional problems if I didn’t. Well, I didn’t—in fact, the day after surrendering my seals of office I walked past Queen’s and, for good measure, the Royal Victoria Hospital without a backward glance. And ever since I have felt absolutely no undue emotion at the sight or sound of Queen’s or the hospital. This gave an early clue as to the true basis of my psychosomatic symptoms if only I had had the sense to see it.
So what happened and why? But first of all, like the dog that didn’t bark in the night, what did not happen? Physically, organically, chemically, and cognitively I have remained well—better than I had expected and far better than I deserve. I feel as bright and as energetic as ever. My intellectual processes remain OK and so does my memory for recent as well as for remote events. My body responds well to the modest demands I put on it. But I can no longer handle stressful situations. It’s as if my nervous capacity was a finite quantity that I used up in the line of duty, and now there is none left over.
I certainly didn’t expect that. On the contrary, I had visualised myself at 80—admittedly with failing faculties—at peace with myself, possessed with the wisdom of the ages and offering words of calmness, tolerance, understanding, and comfort to a younger generation beset by the worries of the working world. But it turned out to be the very opposite—my sunny disposition and not my mental and physical health had deserted me.
That should not have been so surprising, but what of my psychosomatic symptoms? Inevitably, I suspected that they heralded sinister organic disease. So I took myself off to my general practitioner and in the following few years he and his consultant colleagues cured me of some very nasty conditions—gastric cancer (I had indigestion), motor neurone disease (I had some muscular twitching), lung cancer (I had a refractory cough), unspecified but highly malignant brain tumour (I had some headaches), and, naturally, coronary artery disease (I had chest pains almost to order). My only triumph over the diagnostic skills of the local profession was a refractory pain-cum-sensation in my hard palate and posterior nares, unknown to any textbook, and which lasted for over a year. I was heading for some medical Guinness Book of Records when I suddenly got tinnitus—ordinary, unilateral, non-progressive tinnitus. At once all the other symptoms disappeared as some part of my brain now wheeled slowly round like an old battleship to meet the challenge of this new enemy. Fifteen years later, I still have the tinnitus, but l look on it benignly as a useful if sometimes annoying defence ensuring that the other symptoms are held at bay.
Why I had developed these symptoms was not obvious to me. But my wife saw things with her customary clarity. “Look,” she said, “you’ve got yourself into a lose-lose situation. You either work harder to take your mind off the symptoms, which only winds you up more and makes the symptoms worse, or you ease up like the doctors tell you to do and that gives you a guilty conscience, which also makes the symptoms worse. You think that you should be able to go on working as you did and also that you must go on working as you did.”
Everything now clicked into place. I could walk past Queen’s without a backward glance because it was the rhythm and habit of my work there that was the Mephistopheles to whom I had sold my soul. It wasn’t the institution and it wasn’t the content of the work. I was like one of the broomsticks in the “The Sorcerer’s Apprentice” in Walt Disney’s Fantasia, which, like well drilled soldiers, mechanically and inexorably carried the buckets of water that mindlessly flooded the room. So when I retired I continued to serve the unremitting master of work habit and rhythm to the point of psychosomatic disturbance due to reduced nervous resources to deal with them, and contrariwise if I didn’t serve this master wholeheartedly then I felt guilty, which produced much the same psychosomatic result. What I was doing and for whom I was doing it didn’t matter over much.
And now something else clicked into place. A Who’s Who entry comes with the job of vice chancellor. Back in 1976, I had listed my recreations as music, travel, and golf. I was genuinely interested in all three; I was even a good enough golfer to play internationally for Ireland. But I haven’t played golf for 15 years, rarely go to a concert or listen to music, and travel only when I absolutely have to. If I indulged any of these interests I felt illogically guilty. Addiction to work had even squeezed out my hobbies.
Recipe for contentment
I conclude with two comments. Firstly, as we have been taught and as we teach others, moderation and balance in lifestyle are essential: zeal and fanaticism may be useful for some purposes and essential for others but are not normally the best recipe for a happy retirement or enjoying a healthy and contented old age. We teach this to others but we don’t necessarily learn it ourselves.
The second comment is more fanciful. When I was thinking of my being a slave to procedure rather than to purpose, to work itself rather than its ultimate objective, I realised that I had seen something like this before. Was it drug addiction or dependence? Possibly, but it was also something else. It was an image of Adolph Eichmann, Himmler’s trusted lieutenant, who was still boasting on his way to the gallows of how he had organised the trains to Buchenwald and Auschwitz to run on time. He seemed uninterested in what the trains were doing; sufficient that he was doing it for the Fuhrer and obeying orders. The only guilt he felt was when he was not doing it or not getting the trains on time—procedure trumping purpose.
We smile and say, “That couldn’t be me.” Nor indeed (and hopefully) could it: but our autonomic and psychosomatic pathways reach parts of the body our conscious self doesn’t reach, and their symptoms may be a price some of us pay for over-devotion either, in Eichmann’s case, to false gods or, in the case of more normal mortals, to ephemera masquerading as worthy and enduring objectives in themselves.
Based on a talk given to the BMA retired members forum.
Competing interests: None declared.
Provenance and peer review: Commissioned; not peer reviewed.