In just a few days, I turn another year older, 77, to be precise.  I have actually stopped celebrating birthdays because I don’t really want to be 77 and see no reason to celebrate being closer to death one more year. I would rather be 37 again, if I could.  My father retired at age 70 as a physician.  This birthday will mark my full retirement as my contract with the residency terminates on my birthday.  At age 70 I closed my private practice as a surgeon, but started a new job as a professor of surgery.  I founded a residency with one resident that quickly grew to 15, three in each of 5 years, the current requirement to become a surgeon.  It was the most exciting, fun, and rewarding job I had ever had.  To see young doctors mature into competent surgeons was an honor and a source of great pride for me, especially knowing that some of their success was attributable to me, the legacy I have always wanted! 

When my first resident graduated, I decided age 75 was old enough to stop doing clinical surgery, although I continued to teach.  Commercial pilots have the mandatory retirement age of 65. Flying a 747 at 35 thousand feet I always imagined would be similar to taking out someone’s pancreas.  It requires book knowledge as well as practical knowledge and manual skills that need constant retraining and adding new knowledge all the time.  I believe that both cognitive knowledge and manual skills have a time stamp on them.  There comes a time when an individual just doesn’t have skills to the same extent as when he was younger. When is that time? It comes at different ages for different people.  I asked one of my mentors when that is.  His answer, “You will know!” Indeed I did know.   Running up and down hospital stairs to get to the ICU to render care for a patient in dire straits was a physical challenge. That midnight call from the chief resident that the patient we had operated on that morning didn’t look all that good gave me heartburn, or was it chest pain.  My residents asked questions, the answers to which I had to lookup more and more often. However, I still, on occasion, could bewilder them with a question the answer to which they should, but didn’t know, which gave me mischievous self-satisfaction.

Surgeons need to pass a final test after they finish their residency.  It is composed of a qualifying written exam they must pass to be allowed to then take the oral exam, administered by the American Board of Surgery (ABS). It is usually composed of three teams of two surgeons each that makes them board-certified to perform surgery upon passing both exams.  To practice for these, I had “mock orals” for them and had a lot of fun attempting to stump them with questions they would experience in the real orals.  I participated in those exams, not only with my residents, but jointly will most of the surgery residencies in Southern California.  I had the chief residents of several of the more prestigious residencies as my examinees.  I was surprised how easy it was to mislead the smartest and brightest among them while under stress. Of course, that is the idea.  Surgery can be quite stressful at times. 

Since I have experienced some of the trials and tribulations of age, I can’t ignore the upcoming national elections with both candidates in their seventies, but Biden has about four years on Trump. Our oldest presidents have been 69 for Ronald Reagan and 70 for Donald Trump at their swearing-in.  Reagan developed Alzheimer’s disease after leaving office. Still, there were some signs that may have started before with symptoms in 1984 during his second term, which were pointed out by his son Ron, and Lesley Stahl, the CBS reporter, although cognitive tests failed to show anything. 

Being President of the United States is probably similar to doing surgery or piloting a 747, at least in cognitive thought processes.  Biden will be 78 years old in November.  You can’t help but notice that there are times when he loses his train of thought and jumbles his words to where he cannot finish his sentences. I empathize with anyone who has those issues. I feel quite fit mentally, but I can tell I am not as sharp as I was ten years ago and do not think I should be doing surgery anymore. As we enter our election for the next president, I have concerns about electing a man one year older than I, for the most crucial job in the world. A man who has his finger on the nuclear trigger with a lot more lives at risk than a 747 pilot or a surgeon operating on one patient. He likely has early dementia, but refuses to be tested as Trump has been! If Reagan is an example, the deterioration goes fairly quickly, and Kamala was not the best choice for VP. Just saying!