As of 1st November 2018, this website became superfluous, of historical interest only to an ever diminishing number of people for I formally retired from my full time NHS post - Consultant Neurosurgeon for North Bristol NHS Trust, a post I had held since 1st April 1991. Rather than erase the whole website, for the time being at least I intend to leave the pages posted with an end of careed summary added in due time with this page added to examine the process of retirement
I wasn't sure when I would retire except to say that I was sure that when the moment came I would know the time was right, which is indeed what has happened. Last summer I turned 64 years old, the age that my late colleague and mentor Huw Griffith died of disseminated prostate cancer. That memory more than anything reminded me that life is not a dress rehearsal!
However there was more to the decision making process than that. For some while I realised that I had ceased to enjoy my professional life and therefore to concentrate on it. I was still enjoying the patient contact and using my skills and experience to help the folk I came into contact with but I was finding the increasingy faceless bureacracy of the NHS harder and harder to deal with. As the system was becoming more and more patient 'acentric' and the more powerless I became to do anything about it, the more alienated I felt I was becoming.
A seminal moment came when I arrived at work to carry out a complex epilepsy surgery, involving a team of at least a dozen people who had diarized this particular procedure weeks previosuly, to find that the case had been cancelled the day before by a middle grade mamager tasked with bed management with no reference to me or the team whatsoever! I responded to this, angrily dressing down the manager in public in a way which I more than accept was inappopriate, both generally, but also specifically to me as it was not a way that I would want to behave. Abject apologies on my part prevented a formal complaint of bullying which was fortunate for me, but my patient was still cancelled with all the preparation that they and their family had done amounting to nothing - I was helpless to do anything about it. Time to go.
Further I realised that epilepsy surgery was a field that demanded new skills that I didn't have. My then registrar did, bringing his computer skills to create exciting devleopments to my practice taking the epilepsy surgery service that I had developed to the next level. It was time to make way for the next generation, there being no funding to employ us both.
Finally I also realised that I was becoming more and more risk averse. Neurosurgery, particularly the kind of innovative surgery that I had always been involved with, takes a peculiar kind of courage. I had lived all of my professioanl career to the old adage that "unless you are lead dog, the view never changes". As epilepsy surgery has evolved, becoming more sophisticated with greater demands on surgical precision, I found it harder and harder to manage the risks involved. Again it was time to hand over to someone who could do so.
However I felt it would have been inappropriate just to stop and walk away, leaving my relatively inexperienced successor to take up where I left off without any support. To manage the continuity of care I persuaded the trust to give me a part time contract offering my new colleague a week a month where I could assist him. It also gave me a chance to review some of the many patients that I had looked after for over a quarter of a century and refer them on to the appropriate sub-speciality. This arrangement, planned for six months was terminated after three for lack of funds. I was able to negotiate an honorary contrect (unpaid) that allowed me to continue providing support for another three months. This was actually quite long enough.
In medicine, when one retires many people congratulate you, not for having had a long and illustrious career but for making it to the end without contracting any of the diseases that one has spent a lifetime treating! As I write this looking out a blizzard carpeting one of the most beautifaul parts of Scotland in snow - my new home, I realise just how lucky I am to be able to look forward, having left the epilepsy surgery service in Bristol in very safe hands.
I am updating this page in May 2020. I have been on stand by during the Covid-19 lockdown to return to work if required. That hasn't proved necessary. It seems that overrun of the hospitals in Bristol was avoided albeit at the expense of suspending all but the most urgent of other services. (Thank God i didnt have to endure the frustration of that!) I have to be realistic. if asked to go back now, I could just about manage it. I have made an effort to keep up to date and could rely on my lifetime's experience to provide a basic service if required. I have volunteered both nationally and locally to help out in other ways but again my services have not been required. I took myself off the active clincial list with the GMC at the end of last year. I know that mentally I have moved on. The longer I am away from clinical work, the harder it would be to go back.