I'm gonna introduce Dr. Thomas Lee, who has been a fantastic mentor of mine, has given me great advice through these years as well. I actually thought of him right away as being the moderator for this session because I know you can entertain us very well. And this is, I thought, titled very well for Louisville, it's the ninth inning, and I thought we would just get a different perspective from everybody on how we thought about when we were done, what made the decisions for it, what has, you know, what have we replaced it with, what fulfill us, and stuff like that. So take over, it's all you. Thank you, Becky. You know, when Becky and I talked about this, I thought I had recommended that this be the seventh inning stretch, but no, Becky decided to turn it into the ninth inning, so we sort of know where we all are on this panel. The format will be exactly as you see in the program. Jeff will go first, but at the end of each speaker, I do have just a couple rapid-fire questions that I would like you to answer, because I think even though everyone here in the audience knows who you all are, I think they might want to get to know who you are better as you are now. Ninth inning, how do you slow down and quit an academic practice? Well, you know, the ballgame is not always over at the ninth inning, and lots of times they go into overtime, so I'm not here to tell you today that I've retired, but I'm in overtime, and I do have some disclosures, but nothing relevant to this. So first, you have to ask yourself, why do you want to slow down? Do you have burnout? I don't even know what burnout is. People keep talking about this, and you read books and stuff. Does that just mean you've lost your desire, you're anxious? I honestly don't understand that, but I do understand physicality. That's a word that got made up by the sports announcers, and are you tired, or you just don't have the energy that you used to have? And I can tell you that it's pretty hard to operate for 12 hours when you're 75 years old, and then the cases, maybe they're just not interesting anymore. Maybe you've gotten to the point where you're just plain old bored with what you see coming in, and you know how annoying it can be to try and teach residents and fellows, and maybe that's just gotten to be so difficult you just don't want to modify that lecture again, and then you're financially secure, so you don't need to work, so why would you work? And anybody here who's doing research know that it's gotten incredibly difficult. There's so many rules, there's so many different requirements, that it can make anybody but the most avid person to think, I don't want to have to do this. So why did I decide to close, slow down? Well, I felt like I was financially secure. My CPA said, yeah, if unless you change your life, you won't run out of money, but I have great partners, and I have great fellows and residents that actually keep me young by asking me very difficult questions, and it's great to be able to bounce cases off partners. As far as I know, I'm in good health, and so the answer is, well gosh, I began to think more about my family life and less about work. So there's probably nobody in this room, and maybe I am the oldest, but I've been in academic practice at Duke University for 48 years, 48 years, the same place constantly. Yes, well thanks, and I just celebrated my 50th wedding anniversary a week ago, so I said, man, I need to start spending more time with my family. You know, I've been blessed with 10 grandchildren, and they run in ages from 4 all the way to 22, and I enjoy being with my grandchildren, and they seem to enjoy being with granddad. At least they asked me to do a lot of stuff. So I missed a fair amount of my kids activities, you know, working 80 hours a week, which is a minimum for the, you know, first 30 years of my practice. I didn't want that to happen again with my grandchildren. I wanted to go to those soccer games, and I wanted to spend more time with my wife and do some more travel. So how did I do it? Well, I went to the chairman, and I said, I want to slow down. I only want to work three days a week, but I want you to cut my salary. I don't expect to make the same amount of money. He said, okay. So I saw patients one day a week, and I performed surgery, and I worried that by working less, I might interfere with my wife's activities. So, you know, your wife of 50 years, she's got an activity every day. Cards here, mahjong here, golf here, this, and so if I was around, maybe my marriage wouldn't be so good. Well, I was amazed that after one year of working three days a week, she said, Jim, I really enjoy having you around. So I said, okay, I'm not interfering with her, so maybe I can even take the next step. So then the next thing I did was I said, I'm not going to do any more difficult cases. This life is stressful enough, and so I'm just going to do the simple ones, and I'm going to send the difficult ones to my partners. And then I moved to two days a week, which was even better. So the next thing I did was I said, well, I'm only going to work two days a week, one day seeing patients, and I'm only going to assist in surgery. I'm going to assist in surgery. You know something? I don't have a single non-union in my clinic. I don't have a single infection, a wound breakdown, and no one asked me for a narcotic. Now, how can you not have a great practice like that? So I still enjoy teaching and providing lectures to the residents. I do run a cadaver lab for the fellows, and that's sort of like doing surgery, except you're not responsible for how it turns out. And I still do research, so when I decide to give up everything, it'll be when it's no longer fun. Thank you very much. Thanks, Jim. Real quick, quick questions, rapid fire. Jim, what time do you get up in the morning? What? What time do you get up in the morning? Well, if there's a 6.15 lecture, which we have two days a week, and I'm up three days a week, I'm up for that, and the rest of the time I get up at 7.30. Wow, that's pretty late. Name one thing you eat all the time. What? Name one thing you eat all the time. Oh, geez, that's an incredible one. Well, there's one thing that I would eat every day if I could, and that'd be pizza. Do you social media? Do you do social media? Absolutely not. I stopped using Facebook, and I don't ever even turn it on. Name your favorite operation you missed. That would have to be bunionectomy forever. And name a hospital ritual that you miss. Oh, that's a good one. So we get together in between cases and have coffee and shoot the bull with a bunch of the other surgeons that are there, and I miss that camaraderie. Yeah, I agree. Steve Haddad, you're up next. Hello, everybody. We'll start. There's really no disclosure for this talk because it's an incredibly lightweight talk, as you might guess, and I was kind of trying to figure out how I got stuck in the old man section here because these are all old person talks, let's face it, as they reflect on their careers as their last stand for relevance. That's not my game. So I thought about my own progression towards retirement, and I realized this goes way back when I was a lot younger because I had a lot of failures in high school. I was not able to make a professional rock musician. I failed in my audition for the village people, and I even couldn't hold a job at Godfather's Pizza. So it was pretty clear that there was no way I was going to hold a job for a long period of time in my later life. So we're also supposed to talk about our biographies and career accomplishments. I'm not talking about that. If you want to do that, go ahead and read my CV. Anyway, one thing I did want to impart, though, is when you get older, you start to read obituaries of famous surgeons, and when you start to read them carefully, what you'll find is they all actually look very similar. They talk about how they published 800 papers and wrote 90 textbook chapters and did 8 million surgeries, and so when you sit back and start thinking about it, how do we define ourselves? And in medicine, we tend to define greatness by numbers, which really isn't who the person is, and you have to start thinking about that when you think about what you're doing with your career. So I thought about this carefully, and I was thinking, you know, I've got to keep helping people. I do all these complex ankle replacements. No one's doing this stuff, and your ego gets out of control. My wife said to me, you know, when you stop, there's always going to be more. There's always one more patient with one more problem. So your argument that the reason you need to keep going is to help one more person really goes out the window, and when you think about it, a lot of athletes retire at the top of their game. Bobby Jones, Bjorn Borg, even Jim Brown did, and most recently Ashley Barty, great tennis player out of Australia, number one in the world, retired at the top of her game. Amazing feat for her to do, and then there are those athletes that stick around too long, those that go to other teams, those that just try and desperately act for relevance for long periods of time, and even this guy, no name necessary. So I realized at some point I didn't want to be that guy, that guy that they said, yeah, he used to be okay, but now he needs to go somewhere. And the fundamental tenet, of course, occurs. Can you surrender your ego? And the place you see the egos are not being surrendered is clearly all over the world, and all of these people, they're 80 plus years old, that simply can't get rid of their job and move on and do something else for the rest of their life. So in the world of private practice, things are a little bit different than when Jim just taught you in academics, because in private practice you really can't slow down well. You've got a certain amount of money you have to make just to maintain your overhead, and that became a problem as I tried to cut back my practice a little bit. And economics really aren't a great reason to decide you want to retire from practice, but it is there in the background all the time, because I developed this boutique practice doing all these major surgeries that took five and six hours to do, and I was barely making my overhead, and I was paying myself less than anyone in my group. So it became a situation where it almost got a little bit ridiculous. So the question then became, with all this put in the league, is what do you do next if you decide you want to drift off into the sunset in some sense? And I really read a lot about this, because I retired at 57. That's a little bit younger, and the question is, what is the pivot? It's not retirement, it's pivoting to a new form of a profession. So when you start thinking about what you worry about, you're gonna give up what you've done most of your life, and do I have enough hobbies to sustain this? And if you're under 65, what do you think about health insurance? Because Cobra can't go on forever. And finally, income post retirement. Well, you don't really think about that, because if you're thinking about that, then you're not ready to retire. But there are other worries that go along with that too. Will you lose your friend group? Look around the room. You'll see here some of your closest friends from all over the world that you've made doing this job, talking at places, meeting people in meetings. They're great people, and you don't want to lose touch with that, because you're throwing your whole patient interaction out the window. So people always say to me then, sure Steve, you've stopped, but what do you actually do all day? What do you do all day? And there's different things you can do if you kind of get away from patient care, that aren't necessarily involved with patient things. And what was always obviously important to me, those that know me, is that I do always going to have something in my background, keeping my orthopedic chops in some way. Because even though people say, oh you stopped operating, you must not know anything anymore, I didn't immediately forget what I did for the past 30 years. I'm three and a half years out and forward, I still can remember a thing or two. So what I decided to do is parlay this a little bit differently, helping the younger generation of surgeons in some ways. For many years, I lectured at the Miller Review Course, part one. Amazingly still do that for now 13 or 14 years now. And with that, that helps them pass their part one in some way. And I actually won Lecture of the Year this year, which is crazy again at this stage in my life. But besides that, I did something a little bit better, I thought. And this was, Miller Review also has the opportunity for younger surgeons, if they're prepping for their part two boards, to do a three-hour session individually with a surgeon, more experienced surgeon, they call it a platinum session, where you go through all their cases carefully. And you not just critique them, but you explain to them how you might leverage that to get you to pass your boards, and what you're supposed to talk about in the boards themselves. And with that, I had seven surgeons this year, all seven passed, two of them who had not passed last year. And that's a helpful thing that makes you feel really good about yourself, because you're actually helping that younger generation. And in Stryker, I work for them, as you probably know. I do these Ask the Institutes, which actually helped me to help the surgeons that are in practice now, they want to actually tackle more challenging ankle replacement cases. I write up these three or four page things on how I would handle it, whether they listen to it or not, it does help them in some way. And I still couldn't get rid of some tie to some organization, so I'm still the CME courses chair for the AOS, running all their courses, which actually is a lot of fun, too. And I have corporate involvement. Obviously, I became a chief clinical officer for extremity medical in 2022, because I had a great relationship with Matt Lyons, who runs that. What this did for me more than anything else, it gave me health insurance. Because one thing you realize if you're not 65, you cannot buy good health insurance. We were spending all this money, my wife's like, we have crappy insurance. It was getting, fulfilling yourself with a corporation in some way that gave you that benefit. And also, I still continue my design and development thing. Fortunately, Stryker has some interest, something I've been doing for the past 15 years. So those are orthopedic things, but I didn't quit my job to continue my job. What have I always wanted to do, but simply haven't had the time? That's the question you have to ask yourself before you decide to stop working. I refused to give up on music. I built myself a music room, bought a couple more guitars, and still work on that. But I thought I'd leverage my orthopedic heritage of being in someone, a carpenter, a little bit better. I built, I contacted the studio that teaches you how to become a luthier. And in that case, then I built a little studio workshop, and I'm working now in developing to building my own guitars and moving on from there. And, well, after 25 lessons of golf, I still suck at that, so that's not really what I'm gonna do for the future. But around the house, I have an autistic son. Some of you know he's nonverbal, and I have a lot more time now to work with him at home, which I never had in my day job. And this is really rewarding for me to be more of a dad, something that sometimes we surrender in our world as an orthopedic surgeon day to day. But my best free job ever is clearly this one. I trained for six months to become a docent for walking tour guides for the Chicago Architecture Center, and I was doing that for a while until I decided to up the ante. And then I became a river cruise guide, which took another six months of training, harder than passing any boards, I can promise you that, making my river map and making this to the point where I'd leveraged this so much that I'd become like in the television stuff, they wanted to actually record my cruise and talk about it, and it became a lot. So with that, as you can imagine, I obviously have to take this to the next level, and now of course I'm running for docent counsel. So that's me, that's what I'm doing in my life after retirement, that's some of the things that went on behind it. What I've learned, though, from all this experience is it's just as rewarding to be relevant to a few surgeons by helping them during their stressful times in their careers as it is to be relevant to all surgeons. That's something we should all take home with us. Secondly, you can still help patients in some way without operating on them by development design of product generations and next generation of orthopedic products. It's a different way to help our patients in some way. And finally, and probably the most important, not everything you do in retirement has to be spectacular. The things you do in retirement are important to you. They might seem meaningless to others, but they matter to you in the end. Thank you very much. Steve, thank you. Rapid-fire question. Steve, same questions. What time do you get up in the morning? Now? Yeah. This is awesome. I get up anywhere from 8 to 8.30, man. It's great. Wow. Name one thing you eat all the time. Potato chips. How many times a week do you exercise? How many times what? A week. Do you exercise? Every day. Do you social media? No. And name an operation you miss most. Complex revision total ankle replacement. Wow, I knew you were going to say that. Oh, and hospital ritual you miss most. Putting my lead in the warmer and then putting it on because ours are so cold. Mark, you're up next. All right, so first of all, my only disclosure is that I had an anterior cervical fusion. My recurrent laryngeal nerve was bagged, and I have a vocal cord paralysis. So Jim Nunley shat all over me, as he always does, because it should have been done on the left side, not on the right side where the nerve is. He's quite right. Anyway, so what I decided to do here is to talk about what I've done in the past seven years since I've left hospital practice. And of course, as many of you know, this has to do with developing our humanitarian organization Steps to Walk. You know, for us as surgeons, correction of deformity is really what we love. We love fixing things. We love straightening things. But very soon I began to realize that in the context of humanitarian service, this is not really nearly enough. When you look at this youngster with bilateral untreated foot deformity, we don't tend to think enough about the impact of this deformity on this boy, his inability to be educated because he can't walk to school, his family, his future, his potential for employment. It's very easy to correct the deformity, and you can see I've fixed the one side. You can see that on the right-hand side there. And then what impact have you made? This is just one patient. This was an epiphany for me in a very important time in my life about 15, 16 years ago when I was on a mission in Colombia, and this child had been bitten on the front of the ankle by a snake at the age of one and then developed a slough and then very much like a burn contracture, this terrible calcaneovalgus deformity. And when you think about your resources that is available on these type of programs, you really have to learn to think out of the box to be able to be a little more innovative and creative. And of course, I had to close this, but there's no dermatome available in these, many of these locations where we work, and I had to take a skin graft from her groin in order to cover it. And yet this is one patient. Here again, this is a patient in Sri Lanka I treated with this untreated bilateral club foot deformity, one patient. We need to do much more. And you realize that in the setting of humanitarian service, it's not about the patient. That's very much, of course, for us it's so engaging, it's so gratifying. But in the long run, it's not sustainable. And what makes it sustainable is education. And without education on these humanitarian programs, you will never have a sustainable practice or sustainable organization. You must educate. It's really terribly important and in order to do so we've engaged our international surgeon volunteers and currently we have well over 200 surgeons from around the world who participate in the activities of Steps to Walk Globally and it's through their input and our involvement of surgeons wherever we go that this becomes very much more meaningful. And our mission of course has to be surgical care but far more important is the education that goes along with it. These are the countries where we are currently working and we have a plan in 2025 to be working in 26 countries. We expand by about two to three countries a year depending on resources and where we are and where we want to work. Each humanitarian program is very similar. It's a one-week program which consists of day one which is didactics conferences and they're generally about 25 to 30 surgeons from that region, from that country or region in the auditorium. They're learning from us throughout the course of that week. Day two we examine patients and generally there will be about 40 patients with very severe deformities we examine but it's not about yes we'll operate on you and we can fix this. It's about bedside education and teaching so that there's very much involvement of the surgeons who are attending the program to teach them how to examine the foot, how to think, how to think about deformity correction. We involve the local and regional leadership. It's very, very important. You cannot go into any region of the world thinking that you are the expert, that you know more than they do. You're headed for trouble. There are so many cultural factors to take into consideration and it's very important to engage the local leadership in all the work that you do. In the next two days are live surgeries which are broadcast from the operating room into the auditorium with feedback in the language in which we are working between the moderator in the auditorium and the moderator in the operating room. And it's very important after the surgery to engage those surgeons again and whoever is the team leader in that operating room goes into the auditorium for further discussion about that particular surgery. And then on the discussion, this is a very, very difficult topic, is who do you operate on? Here's a child from Pakistan with a very bad calcaneovalgus deformity which is fixed. Yes, of course, he will benefit from the surgery. He will really, his life will change. But remember that we are teaching, we are educating the local surgeons. Are they going to be able to do the surgery? It's very important that we find a balance between the work that we do, the people we're going to help, and the surgeons we need to teach so that we generally break the program up into fairly basic surgeries and those that are a little bit more complex. And on the last day, we have a cadaver lab which is important because it reinforces everything that has been done during the course of the week. So in summary, what do we do? We educate international surgeons, we engage our volunteer surgeons, and then in order to be sustainable, you must go back. And we do that a minimum of once a year. Very, very important. We want to have and create an impact in the lives of the people we are helping, and it's a lifelong impact. How do you go about this? Well, it's very much as I've outlined already. It's through education, helping those in need. Here I'll show you a case. This is a disabled child who's never walked. She can shuffle a few steps. She has a profound bilateral, bilateral unstable calcaneovalgus. And the standard procedure, of course, for this would be tendon transfers. But you have to take into consideration the cultural context, the social context. Is this child going to be able to ambulate? They may never be able to come back for treatment. So I did bilateral TTC arthrodesis with a tendon transfer in this 15-year-old, and here she is walking. This is another example of a patient with a fairly profound deformity. This is, of course, a bad neuromuscular deformity. And we know we can help them. We can realign everything. But it's not just about the surgery. You must understand it's about education. It's about, for us, we love this. I mean, I personally love being able to correct deformity and then seeing the results the following year when we go back to see how this child or adult has really improved. A young lady with osteomyelitis treated, went back to do the actual surgical correction. And you can see here quite a bad, unstable deformity as a result of myelo, fixed with tendon transfers, a triple, and so on. And this is what is so wonderful, is to be able to follow up with the patient and see them in person how they benefit from this. Our goal is to reach those individuals who are most in need. And I leave you with a few thoughts. Mahatma Gandhi said, the best way to find yourself is to lose yourself in the service of others. And that really applies to humanitarian service. The meaning of life is to find your gift. But the purpose of life is to give it away. And then something that I really believe in very strongly, and that is, you cannot appreciate the value of something that you do until you do it for someone who can never repay you. Thank you very much. Mark, thank you very much. And also, in the interest of time, I'll forego the rapid-fire, but also congratulations on receiving the AAOS Humanitarian Award this year in recognition for your work. Jeff, we'll see how we can do. So, this is going to be a great, I think, ending talk, because it's going to, I think, touch on a lot of the themes and points that we've already made. And some of the speakers up here have already made many of these points as well. So, I'm going to give you some of my thoughts in retrospection on my transition and whether your early, mid, or late career. Hopefully, some of these thoughts will give you some ideas about how you might want to time your retirement and how you can do it to thrive. There we go. What this talk is not about is the nuts and bolts of retirement. It's not about financial planning, health, or long-term care insurance options, or wealth protection instruments. And the reason for that is we're just all so different. There's just so many different options out there, and you really want to get your financial advice from a professional, not another doctor. But the retirement reality is this, and it's not if you're going to retire, but it is when. And it's a really important decision that affects you, your patients, your practice and its company's bottom line, your staff, and your significant others. And for surgeons, it's not just what we do, it's who we are. So that is the problem, and our ego is so attached to being a surgeon. There's a lot of societal admiration that comes with accomplishing what we've accomplished. And it's deeply rewarding to help people with surgery, and you get a lot of positive feedback from patients, staff, and colleagues. We're well compensated for what we do, and we enjoy this complex network, which is right here today, of social and professional interactions that are centered around our work. So when you stop, you are letting go of a profession that answers for you, who am I? And there's a certain sense of loss with that, and part of you is essentially dying. What I kept saying to myself is, what will I do that's as deeply rewarding as orthopedic surgery for patients? And there's always the concerns about loss of income, and then this isolation from that network of social and professional interactions. One of the things to consider, though, is it's always better to retire when your colleagues are surprised and not relieved. You don't want to be that person that's sort of there too long. We've all seen those people in our lives. The other thing a former colleague that had retired ahead of me said once, that I thought was really good, was that if you want to do something else, you need to stop doing what you're doing now. You can't just add it to the list, which is what we all do every day in practice. Oh, I'll do that. I'll add it to the list. You can't do that. In terms of retirement timing, I think it's really important to consider this idea of opportunity costs for each year you work. In other words, for each year you work, there's an opportunity cost for not doing those things that you would want to do after you finish work. You also want to be aware of how physically active you want to be in retirement. If you retire much later, you may have fewer options for these things. The patients, it dawned on me one day in the office, I can remember the day, patients helped me decide. The 60 and 70 year olds that dawned on me, they want their foot surgery. They want to improve their quality of life because they have things they want to do. The 80 plus year olds, they were pulling back from new things. They were doing less travel. They're concerned about complications and the length of that post-op recovery. So I did the math. It took 80 minus my age at the time and I said, I don't know if that's enough years. And so I started thinking about this idea of retirement. If you're an econ major like I was, you know, you might want to graph this out and your curves are going to look a little bit different than mine. But basically, we're looking at desire and or zest for orthopedic practice. That's putting up with all the stuff that we have talked about and keeping up with practice and learning and Epic and all that other stuff. The white line is the dollar line. In other words, this is your need to make an income and ultimately if you save enough, that need will go down. The yellow line is the opportunity cost and as you go through life and the farther you get towards, you know, retirement age, that opportunity cost curve starts to really climb very, very steeply. And so in my case, where those intersected was essentially where I said, okay, the opportunity cost is too high. I think I should retire at this time. Also in terms of timing, you know, our schedules often drive the family agenda. Our spouse or significant other, they've delayed a lot of stuff and they haven't gone to the next phase of life either. Maybe they waited long enough. Arthur Brooks, who's a professor, a Harvard Business professor, has written a lot of stuff about this. He wrote an excellent article, I would refer you to it, Atlantic Magazine 2019 about professional decline. And here's a few things from that that I thought was really good. He coined this term, this principle of psychoprofessional gravitation and that's, he coins it here as saying, the agony of professional oblivion is directly related to the height of professional prestige and to one's emotional attachment. So in other words, the more your ego is attached to this idea of being an orthopedic surgeon, the more difficult time you're going to have to transition away from it. He also goes on to say that giftedness and achievements early in life do not provide any insurance policy against suffering later on. You can win all the Roger Man Awards, Kappa Delta Awards and all these things that you want and other accolades and it won't insure you against feeling a decline or feeling a certain way of a loss when you retire. He talks about this crystallized intelligence and that seniority really has a silver lining and that is that we have learned some things along the way and we have this knowledge that we've gained throughout time. And based on our experience, we have a certain wisdom. This is crystallized intelligence and there are certain careers that require crystallized intelligence that peak much later, such as being a poet, a historian, a college professor. And I think surgeons are in this. We get better every year that we do things. And the article is really about how the young people are, and if you haven't made it by age 40, you're not going to make it. But the idea really is that maybe the most profound insights might come from the 30 and 40 year olds. But the best synthesizers and explainers of complicated ideas are in their 60s and some in their 80s. So that's an opportunity for us. And I think probably the best thing out of the article was it said, biggest mistake of professionally successful people is attempting to sustain peak accomplishment indefinitely. And I think that's what we've been talking about today. A lot of people also focus on, okay, if I'm going to retire, will I be happy in retirement? There's a lot been written about this and I've read some of it. And I think these are some books and things that are here that I might refer you to. But the common themes generally are, and this comes up a lot, is the feeling of purpose or meaning. Finding something in this next phase of life that has purpose or meaning to you. Also carrying an attitude of gratitude. This is an idea of I have gratitude or I'm grateful and I appreciate things that I find of value. It's important to continue learning new things and having social connectiveness. I think also the other thing is being part of something larger than yourself, like what Mark just talked about in his humanitarian work. And also being in the service of others. These are things that we have all done throughout our career and we may not have been able to decide which of these things we're going to do. But now in retirement you can choose. So in terms of transitioning from orthopedic surgery, it's not about stopping something that you love, but rather it's about starting something else that could be just as important. So for me the big change was October 2020. I transitioned to Professor Emeritus at Washington University. It's an honorary position, which I figured I didn't realize till later. They kind of keep you at arm's length. There's no salary. There's no clinical involvement. They don't carry malpractice insurance. But I can teach. I can attend conferences. I do research. I got to keep my Wustel email so that I could communicate with my colleagues. And that was actually perfect for me. I think that one of the first things you need to do though is to become comfortable with this idea of retirement. I probably talked about it every day with my wife Nan until she was so sick of it that she didn't want to talk about it anymore. But the idea was that I had to try this suit on, this suit of retirement on, every day or so and go is it feel feel right? Doesn't feel right today. Okay take it off. And so I kept thinking about it until it felt right. I discussed it with my department head 18 months ahead of time. Not sure that was a great idea, but it was something I thought I should do to help the university prepare for my exit. I did a financial analysis and it confirmed my ability to have our savings support us. And I think that's a very comforting thing to do. And you can do it numerous times along along your path. And it's very helpful. But it's not until you tell someone that you're retiring that it really becomes real. Once I told my nurse it was real. I was going to do it. And as soon as you tell somebody you're doing it. I think it's important to find an outlet for the things that you find important. Especially if you can use your crystallized intelligence, volunteer teaching, research with fellows. I mentor our junior faculty. I try to stay active in our national organizations. I wanted to do some medical legal consulting. So I recertified till 2031. And I keep my medical license. I did a mission trip. I'd never done one before. I've heard Mark talk about it so much. And I know many people in this audience have done these trips. I've never done before. It was very gratifying. I went with the group that I knew well from Washington University and our two children's hospitals. We were there eight days in the Caribbean. We saw 70 kids in clinic first day. And then we did 28 cases over that week. And it was very gratifying. I know a lot of people have done way more than this. But it was just my first voyeur into that. And I would like to do it again. In terms of other things. Keeping a connection to nature has been something actually that's been written a fair amount. There's a fair amount of science about the positive physical and psychological benefits of having a connection with nature. I enjoy farm work. We have a farm. We're doing prairie restoration. And it really combines a lot of things. This nature thing plus exercise. Here is the entrance to our farm. It's about an hour north of St. Louis. And when I open that gate and walk in, I can just feel my heart rate and blood pressure drop. My cortisol levels drop. And I just feel like this is a great place to be. We've had it for over 20 years. And we've enhanced things over time. We now can stay in that building if we want to overnight. Errol Bailey talked about buying himself a Porsche. Well, I bought myself a tractor. That's kind of the Missouri way of doing it. But it's been great. We've learned a lot. One of the main efforts out there is to restore tall grass prairie. It's a big effort nationwide to do that. These are native warm season grasses that were there prior to European settlement. And we're trying to restore those. And it's actually learned a lot about it. It takes maintenance. Here we are doing a big prairie burn. Which is a really impressive sight to see eight foot tall grasses on fire going across your property. And you know, you need a team to do that. So we've been able to share the farm with people that are like-minded and come out and help us do these burns. Here I am kind of explaining the plan. In terms of learning new things, I've had a hobby for 40 or 50 years restoring old cars. And they continue to come up with problems that you have to solve. And so in addition to learning about prairie ecosystems, this is something that it kind of keeps me going. This year I'm teaching myself to weld. And I'm just to do rust repair on these old cars to cut out the rust and weld new patches in. And so that's a learning thing. In terms of connections with others, I have these clubs. Model A club, Buick club, the home brewing group. And my daughter and I actually have been doing...these are some home brews that we've done. We've had a lot of fun learning how to brew beer. And then the fun of doing the labels and giving it to friends. It's also important to pay attention to your health. It's easier to get better sleep and eating habits when you're retired because your schedule can be more your own. It's important to get regular exercise. And I think that's the nice thing is it punctuates the day and creates a bit of a routine, which I think we're used to doing. And I think the exercise can do that. I found a master swimming group to swim with three days a week and that's been really helpful. So it's a great time to reconnect with your spouse or significant other. I think it's important to pace yourself when you actually leave for that day, for your last day. And it's easy to get over committed with taking on other responsibilities. And don't sweat it. If you don't have a plan and you haven't figured it out right away, give yourself six months or a year to really kind of figure this out. So in terms just to state again, it's not about stopping something you love. It's about starting something that could be just as rewarding. Thank you. Jeff, thank you very much. No quick fire. I'm gonna just, we're seven minutes over, but I would like to open it up to the audience if there are any questions. I think I was mentioning before we all got started, it's a very common question I get about when to retire, how did I retire, and these these talks were very helpful. Are there any questions from the audience? All right, barring none, we're seven minutes over. I'll conclude this session. Thank you very much.

retirement

orthopedic surgery

academic practice

burnout

transitioning

purpose

hobbies

contribution