A retired GP — looking back with thanks and forward with compassion

Amar Rughani is a retired GP from Sheffield and leadership mentor and is currently Provost of RCGP SYNT. He is on Twitter: @AmarRughani

My mother-in-law, Grannie as she was known to us, taught me a lot. I learned (again, but how quickly I forget) that empathy is no substitute for reality. Just as becoming a parent made me understand why a child up all night with earache is a family emergency, not a medical irritation, becoming a carer for Grannie showed me how the barbs are part of the beauty of love. I had cared about parents and carers before of course, even foolishly thought that I understood them, but the reality was so much richer than I had imagined. So it was with retirement. Being close to it helped me see what is was, but not understand why it was. I could see the edifice, but not the purpose.

My wife, as so often, helped me without even knowing. Sue, a much better GP than myself, had patients queueing round the block in the rain when she retired to say how much they loved her for how she cared for them. She gave such personal continuity that it became unsustainable and I daren’t tell you what time she got home at night. She couldn’t cut her cloth, become more efficient or however else you want to say ‘give patients less time’ because to do so would have taken away what made her work meaningful. Sue used a phrase that really struck home when she said was leaving because ‘My era has passed’.

  The penalty that we pay as doctors in prescribing for the living, is that our living is prescribed for us.

It made me think about the state of our profession; how could it not? However, it also made me move beyond that and consider the natural arcs in our lives and the importance of moving with grace, not rancour, between them. It made me think about not overstaying our welcome with one community only to join late with the next. An era is a big thing, but more than the concept, it’s about the people who embody the beliefs, values and assumptions of the age. For a new culture to move in, maybe those who embody the era must move on? And to do that with grace, maybe we need a zone, not a boundary. Maybe we need symbols and customs that are less acknowledgements of the past than anticipations of the future and a mindset that is less our physical disappearance from one community than our spiritual appearance within an enhanced community.

The penalty that we pay as doctors in prescribing for the living, is that our living is prescribed for us. We sacrifice our person on the altar of our persona and are happy to do so, fuelled by the motive of living up to what is expected of us. And then comes retirement when if we are fortunate, we have the scary prospect of directing how we use our time. Let me share, from my experience, a couple of realisations with you.

From schooldays I remember that the Welsh poet WH Davies said “What is this life if, full of care, we have no time to stand and stare?” It was a line that held little interest for me before, as I was enjoying being busy. Perhaps it was also because of the quality of my stare; what I couldn’t or wouldn’t see. Now, Davies means more to me because I stare less blankly than I did and I savour each day and savour each relationship. At times I may be brisk, but I’m not hurried.

The insight that we gained through helping patients experience better health can now help us all to live better lives.

My second realisation is around the feeling that Life is the gift of engaging. But just at the time that I am told I have the prospect of engaging on my terms not on those of others, I also find that I have no wish to. Like many others, ‘I’ have no meaning without ‘us’ and the challenge that helps me to grow is to learn to be valuable to the community when I am no longer important. I feel close to my identity through being a helper and my personal path is to help in some way through others, and not for others. By this I mean not being a guide or teacher, but a facilitator and supporter. I mean helping a new era to emerge whilst honouring and also not denying the past. It’s not for us to determine the future, but we have a valuable role in encouraging those younger to engage confidently with the world, just as we were encouraged to do by those who made sacrifices for us.

Ours is a great community. A sign of that is that I am encouraged to write some reflections and that you, if you’ve got to this point, are interested to consider them. That’s amazing and shows that we share a journey of the spirit, which in itself connects us to an even greater community. I look back with thanks, but forward with both compassion for the world and belief in our ability to be better than this. And in a deeper parallel, just as we as individuals consider our era, our transitions and re-birth, so must a profession consider its own, prompted by time or the times, to move on.

To me, retirement from one phase is the gift of entry to the next, where the insight that we gained through helping patients experience better health can now help us all to live better lives.

I wonder what it is for you?



Featured photo by Illiya Vjestica on Unsplash

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