Is it Possible to be Equally Happy and Sad at the Same Time?

The Mixed Emotions of Goodbye

When it comes to major life events, we pretty much know how to react and what kind of emotions will be stirred up inside us. If there’s a wedding in the family, a graduation or a new baby, we know these trigger happiness and celebration. With divorce, death or illness, we know we’ll experience sadness and grief. But a retirement—specifically my retirement, has brought up many equal and opposite feelings at the very same time, sometimes entangling them so much that I don’t know what I’m feeling at all.

Often, retirement comes at the end of a long career, where the overwhelming feeling is one of relief; of finally getting to the end of a long (and sometimes monotonous or uninspiring) road. The exit is the goal—it’s the reward for having stuck it out and working so hard for decades. Physicians often retire because they are burnt out; exhausted from a system that increasingly takes so much and (lately) feels like it doesn’t give much back. Covid did a number on physicians: those that were even contemplating retirement took that opportunity to exit. Some got sick, and some found it impossible to keep their practices running and solvent. But my retirement after three decades as an Ob Gyn physician is not due to any of these things. Of course, running a solo private practice has been one of the hardest things I could have chosen to do eleven years ago.

The thought that I had then was that the benefit of running my own business would be so no one would be able to tell me what to do. However, the reality is that everyone tells me what to do: the insurance companies, the government, my equipment suppliers, other community doctors, the hospital, and even sometimes my patients. In the end I still feel that the benefits of opening and running my own practice, even with all the hiccups and difficulties, have far outweighed the drawbacks. I can honestly say I still love my job.

Now that I have an absolute exit date that is measured in weeks, not months, a swirl of emotions has begun. Patients have been so overwhelmingly kind, and the popular sentiment seems to be, “We are so happy for you—but we are so sad for us,” followed by flowers, and gifts and cards that make me cry, and wine—so much wine! (A benefit of living in working in the Napa Valley.) Every day is emotional and exhausting.

I have arranged my appointment schedule so that for the last six months of the practice, every patient slot is at least thirty minutes. Sometimes, patients don’t even need the visit for an exam; we are using that time to talk about their medical history and what their current plan is. Many of my patients are on combinations of hormonal and non-hormonal menopause plans, along with weight management medications and various supplements—plans we have spent months perfecting so that they feel their best. We also talk about what medical office they may go to after I retire. They feel better knowing they may be able to find someone who can be a good fit, with no gap in care.

These visits have very much reminded me why I went into medicine in the first place: my intention was to empower women so they have good reliable evidence-based information in order to make informed decisions and also advocate for themselves. This is exactly what has happened. My patients are aware that their hormone plans, their mental health and self-care plans and their weight management or fertility plans are well thought out, and should be able to be continued in someone else’s care. Their perimenopause or menopause plans are clear and make sense. These plans were created with shared decision-making and discussions of alternatives. They know what feels right and when to seek an adjustment in their treatment.

My patients know there is no arbitrary time that they need to discontinue their hormones. They know the schedule by which they should have mammograms and bone density tests and pap smears. They know how to keep their bones strong and they know how to seek care if there is a side effect or symptom that worries them. My goal was always patient empowerment. In this I feel I’ve been successful. These patients really don’t need me anymore, and so I can retire knowing that they’ll be fine.

I’m happy. And sad. But mostly, satisfied. After years of telling my patients to rest and care for themselves above all else I’ll finally be taking my own advice. The scales may be even for now, but I suspect that sometime soon happiness will quietly tip the balance.