Uninvited Stress

Uninvited Stress

By

Leonard Zwelling.

I am frequently asked what retirement is like by those for whom it is rapidly approaching. Thus, I have given this a lot of thought.

First, I say, you need to have two things—something to do and enough money to do it.

Then, there’s a terse description of what retired life is like.

When I was working, I was subject to two types of stress—invited and uninvited.

Invited stress is that which comes with the job. So, when I was caring for patients, it was a recurrence of a long dormant malignancy in a patient for whom I had cared, or a new admission at midnight, or the branch chief volunteering me to present at the next mortality and morbidity conference. These are all part of the job. You took the job. You invited the stress.

When I became a lab doc, it was papers to write, annual reports to submit, and presentations at national meetings. Again, part of the job.

Later, when I became an administrator, there was endless paper work and the complaints of faculty and new regulations from the federal government. These, too were part of the job. It was what I had signed up for and thus invited.

Then there’s the uninvited stress.

Another fellow is taking off, and you have to pick up his clinic and all of his in-patients.

The NIH has put a hold on new purchase orders because there is budget freeze down on Capitol Hill and now I cannot buy a reagent I need for my next experiment.

As a vice president, uninvited stress was the job. The great Rabbi Sam Karff said the “interruptions were his job.” That was once my job as well. Rarely was there a day of peace during my nine years overseeing clinical and basic research infrastructure at MD Anderson. Someone always needed a protocol approved by the Institutional Review Board in a hurry. A grant needed to be approved and submitted that day. One of my favorites was when one of the chimpanzees escaped its pen in Bastrop and one of the guards shot it dead. That was a good one along with a leak in the Xenopus (frog) tanks or mice being mishandled by a post-doc.

There was always something and I actually enjoyed most of it. The uninvited stress became fun—pleasure, engagement, meaning. I felt like I was participating in the performance of important research.

Of course, there’s always the allegations of research misconduct that necessitated an inquiry, empaneling three faculty to judge the behavior of one of their colleagues. That was not so much fun. That was stress!

Even in my nine months as the chief medical officer at Legacy Community Health, there always seemed to be another crisis needing a cool head that was supposed to be mine. It was not always the case when patient care was being compromised or the doctors were not being serviced by the support staff.

But these uninvited stressors became part of my job, too. Now, they are not.

I think retirement is the minimalization of uninvited stress. There are still bills to pay, cars to repair, and dishwashers that go on the blink. That’s life. The uninvited stressors are surely fewer now and I cannot say that I miss most of them.

But the time my associate vice president and I spent on a Saturday getting clearance from the Food and Drug Administration for an MD Anderson doc to use a drug on a bone marrow transplant patient with a systemic worm infection was exciting. The drug had been reported to be effective in the literature, but was not yet approved for such use in the US. We worked for hours to find someone in Washington to allow us to move forward. We did. It was gratifying, but stressful and uninvited.

Or the occasion when the press went wild because the president of MD Anderson was on the board of the sinking Enron and the company ImClone that was making his drug violated Security and Exchange Commission rules (remember prisoner Martha Stewart). That was a huge stressor that I surely had not asked for, but had to deal with.

That doesn’t happen anymore. I’m retired. Most of the time, I don’t miss it. But some days, when I’m alone…