There is an image used to describe physician retirement that has stayed with me.
A Jenga tower stands upright, one block protruding from its center. Imagine that block represents medicine. Pull it out, and the tower collapses.
The metaphor is meant to illustrate what can happen when physicians retire. After decades of being defined by patients, schedules, decisions, responsibility, and the simple but powerful title of doctor, remove medicine and something fundamental can disappear with it.
I understand the metaphor.
I am simply not sure it describes me.
I spent more than half my life in medicine. That is an extraordinary amount of time when I stop to think about it. Medicine accompanied me through much of adulthood. It provided a livelihood, certainly, but it also gave me purpose, friendships, responsibility, intellectual challenge, and the privilege of entering people’s lives at moments when they were often most vulnerable.
I eventually moved beyond caring for individual patients into leadership, where the decisions were different but the responsibility remained. Medicine shaped how I thought, how I solved problems, and probably how I still look at much of the world.
And yet, when it was time to leave, I left.
I did not experience an existential crisis.
I did not wonder who I was without the title.
And, perhaps most surprisingly, I did not miss it.
For a while, I wondered whether there was something unusual about that. We hear so much about physicians who cannot quite retire—those who reduce their hours, continue teaching, maintain their licenses, volunteer in clinics, consult, or find some other way of keeping one foot inside medicine.
There is nothing wrong with that. For some, medicine remains a source of enormous joy and meaning long after formal practice ends.
But there must also be room for another story.
There is a difference between losing an identity and completing a season.
I think I had completed mine.
By the time I walked away, I did not feel that medicine had been taken from me. I felt that I had given it what I had to give. I had cared for patients. I had led. I had made mistakes and learned from them. I had accumulated stories, experiences, friendships, disappointments, victories, and lessons that could only have come from spending decades inside that remarkable profession.
I was grateful.
And I was finished.
Those two feelings can coexist.
Perhaps that is why writing became so important after I left.
I had begun blogging before retirement, but with time, writing became something more. It gave me somewhere to put the years.
There were decades of experiences stored inside me—patients I remembered, people who had shaped me, decisions I had made, places I had traveled, questions I had never stopped long enough to ask. Medicine had required movement. Writing invited stillness.
I began to understand that I wasn’t trying to preserve my medical life.
I was processing it.
Writing became release. Reflection. At times, therapy.
Photography did something similar. So did travel. They asked different things of me. Medicine had trained me to look for what was wrong and decide what needed to be done. Photography asked me simply to notice. Travel reminded me how enormous the world was beyond the familiar corridors in which I had spent so much of my life. Writing asked not What should I do? but What did all of this mean?
None of these things needed to become a second career.
That realization mattered.
We spend so much of our working lives measuring ourselves by productivity that we can carry the same habit into retirement. We retire from one demanding occupation and immediately begin searching for another sufficiently important thing to justify our continued existence.
But perhaps usefulness does not have to be proved.
Perhaps purpose is larger than occupation.
I sometimes think the Jenga metaphor has the architecture wrong.
Maybe medicine was never the block holding up the tower.
Maybe it was an entire level of the tower.
It helped build what came afterward: discipline, resilience, curiosity, perspective, gratitude, relationships, leadership, financial security, and the confidence to enter unfamiliar places. Removing the daily practice of medicine does not remove what those years built.
I carry those things with me.
But carrying medicine with me is different from needing to remain inside it.
Our lives were never meant to be one-act plays.
Medicine was an extraordinarily long first act in mine. It was demanding, consuming, consequential, and deeply worthwhile. But the importance of the first act does not require the second act to resemble it.
Photography does not have to become medical photography.
Writing does not have to become writing about medicine.
Travel does not need to become medical volunteering.
Wisdom does not have to become mentoring physicians.
Some things are allowed simply to be new.
Perhaps that is one of the freedoms of this stage of life: no longer needing every new interest to justify itself by connecting to what came before.
I can remain proud that I was a practicing physician without needing to practice.
I can be grateful for medicine without longing for it.
I can acknowledge that it shaped me without believing that it defines me.
And I can say something that might sound strange after giving more than half my life to a profession:
I don’t miss it.
There is no bitterness in that sentence.
Quite the opposite.
There is gratitude.
I had my time.
I lived that part of my life fully, and when the time came, I was able to leave without feeling that something essential had been taken from me.
Maybe that is what fulfillment sometimes looks like—not desperately wanting one more year, one more title, one more patient, one more opportunity to prove that we still matter.
Maybe fulfillment is being able to look backward with gratitude and forward with curiosity.
Medicine gave me more than I could ever adequately describe. But it was never the whole story.
And when the curtain finally came down on that long first act, I did not feel the need to remain on the stage.
There were other stories I wanted to tell.
Simply O.
