Growing Up and Growing Old

One of the problems that folks have presented with since I started practice 15+years ago in Rancho Bernardo is that of retirement. This remains an ongoing problem as more and more face the many years/decades of non-working. We are told to plan for decades beyond 60+ in which to keep ourselves busy and healthy. Retirement, can of course, be a great relief and pleasure. In my experience, it takes some planning to optimize the experience.

Most of the folks I have seen over the years and particularly now, do not experience themselves as 'old'. These individuals have kept busy focusing on children, jobs etc. Hence, people work furiously to raise and take care of families, get ahead or get by and get enough sleep-sometimes. Couples and individuals careen over the decades trying to take care of daily tasks and then find themselves very suddenly without children at home or perhaps the next step, retiring. The particular step of retiring is almost as shocking as turning 30 is for their younger peers. While retiring or turning 30 is not a delightful event, it eventually becomes unavoidable. People make jokes, try to put a good face on it and then take the plunge.

Children, once they leave home, go into some sort of self propelled '20's drift'. They are seeking the world and sometimes parents figure prominently in this process, and sometimes, hardly at all. This leaves the original couple to sort out their relationship, work and the 'rest of our lives'. This can be a daunting task for individuals and couples. Often enough, 'soccer moms' want a stab at ' being young ' again and can start working out, exercising or taking up sports with a vengeance. These 'moms' are no longer shuttling kids around and there may be an amazing amount of time suddenly freed up. No matter who is working, when the children leave and particularly when the end of work comes, there are big changes. Couples can find they have more money as well as time. The question for these couples is often "What now?".

It is well worth the trouble to sort these problems out. Parents while older than they were when they started their family, are still young enough to have many good years together. It is important for couples to find activities that they can enjoy together. This may mean finding a totally new endeavor, or joining one another for an established one. Couples may have to hash out what each want from sex, as the fetters of family are gone. Couples may benefit from coming up with a '5 year plan' and a 10 year plan' that gives them some goals to work towards as a couple. With children gone, couples may feel they are in a drift as well. The advertisements showing glowing older folks cruising or traveling don't speak to everyone. The task of discovering what kind of life a couple wants or what kind of life retirement will be is a challenge, but a worthwhile one. As always, response to couple challenges define a couple's identity.

RateMds.com

Over the years I have had a variety of patients remark to me that they read what has been written on RateMDs.com . This website seems to be run by well meaning individuals who are attempting to empower consumers regarding their choices about doctors. 

Some of the physicians I have seen over the years and do see currently are also profiled. The results make me chuckle. Usually I see a physician because they are a specialist or are recommended, have a good reputation etc. It is interesting to me to see how fellow practioners fare in these reviews. I note that one obstetrician whom I found to be both personable and very caring, was criticized for not returning phone calls. While he always returned mine and always personally, I am sure that for someone, at least once, that was not true. It is a hard business to care deeply for your patients and yet not be able to meet all their needs. 

I suppose all providers labor to keep their patients happy. It is only good business and good sense to take care of those folks who come for help. The trick of course, is how to keep them happy. Some people are remarkably pleased with standard courtesy and responsiveness. Unfortunately, others are not satisfied with what seems like heroic efforts. There is nothing profound in what I am saying.  It has been pointed out by many that one can satisfy many people who  will not say anything; but dissatisfy one who will then make a point of telling everyone. The problem is of course, that you just can't make everyone happy.  I know this physician is very caring not only because of my own considerable experience with him, but those reported by others that I know.

It is my job to be present and pleasant every day to everyone who I work with. This is not as easy as it sounds. If you are one of the people who came away with the idea that I don't care about you, please be assured that I do. I can't please everyone and I don't take everyone as a patient. Some people have a pretty good prognosis for success with me. Over the years, I have developed an algorithm for those with whom I work well, and those for whom I don't. Please understand that I care about  you. Sometimes, it is just that I ask a lot of questions or that I look sort of preoccupied.

Even If I look 'sleepy', it is because I am actually thinking and listening to you.

Even If I frown, I am doing the same: thinking about you

Even if I ask you the same question twice in one hour or twice in 2 weeks, I want to hear the answer again.

I rarely ask questions that are rhetorical. I ask questions because I need to know.

Believe me, if I suggest you see someone else; it is better for you. And no, I won't be surprised when the next therapist you see, you love, not like me.