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Reeling in the years

Yale Medicine Magazine, 2007 - Autumn


A surgeon reflects on the loss of identity that comes with retirement and on how aging can bring renewal.

Doctors who retire must accept the painful fact that they will “no longer be seen as anybody’s healer,” said Sherwin B. Nuland, M.D. ’55, HS ’61, clinical professor of surgery. “Doctors have a great tendency to identify themselves by their calling, their profession, rather than by their humanity. Medicine is their identity.”

Fifteen years after he gave up surgery to write books, Nuland, 76, still feels the loss of his identity as a physician: “I’ve relinquished my technical identity. I’ve relinquished the leadership of a team. I’ve relinquished my role as someone to whom a single individual can look for a healing touch.” Although his writing career has not disappointed—he won the 1994 National Book Award for nonfiction for How We Die: Reflections on Life’s Final Chapter, which has sold nearly a half million copies in the United States and been published in 24 languages—Nuland calls caring for sick people “the most important thing I did in my life.”

In his 10th book, The Art of Aging: A Doctor’s Prescription for Well-Being, Nuland interweaves advice, case studies and descriptions of the physical impact of time’s passage. Growing old, he writes, is “simply entering another developmental phase of life.” While his book provides a scientific survey of the diminishments of age—loss of agility, libido and immunity to disease—Nuland argues that aging can offer its own riches.

“There comes a point, probably in your late 50s, that you ought to start rediscovering yourself, the person you were before you went to medical school or journalism school or business school,” he said. “You’re rediscovering your humanity and beginning to separate yourself from a complete reliance on identification with that profession.”

His own efforts at remaking himself have turned Nuland into “a gym rat.” His workouts paid off when he joined a group of physicians on a trip to Sri Lanka in December 2004 to provide emergency medical care after the tsunami. Nuland said he easily kept up with much younger colleagues. (As a scholar, he may be motivated to exercise in part by one fact that he notes in the book: exercise causes secretion of a brain-derived hormone that adds to the functioning of the cerebral cortex.)

As part of the renewal process, Nuland advocates writing. “You find out about your interests, about how you’ve synthesized life, things that you’d never discover if you didn’t write. Most people have a lot more going on in their heads than they ever dreamed they had.”

One pleasure of aging for Nuland is his love for his three grandchildren (with the fourth expected this fall). “It’s not a question of my DNA continuing,” he said. “It’s a question of what my children have brought to their own lives, which is a great source of pleasure and wonder to me.”

In contrast, the death of friends and mentors causes pain. “My advice is not to think that once that star has fallen out of your firmament that anyone can possibly replace it. … Let yourself grieve for as long as you need to.”

Still, Nuland does not wish that humans were immortal. “Because life is finite, we recognize its value. If life were infinite, we wouldn’t understand anything about this treasure we have been given.”

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