I am now in the twilight of my psychiatric career. Yes, I can write that without wincing now, almost, well, maybe just a little. I have made decisions in the last twelve months that have changed my daily schedule, my work life, and my relationships profoundly. Everyone around me, including friends, family members, and even some of my coworkers, thought that I was retiring. It’s not working any longer. Quitting. Hanging up the spikes. Of course, that has not been true at all.

I am working totally at home now. There are weeks that I literally do not leave my house except for going out on the porches or in the courtyard for a week at a time. I am still trying to figure out whether my increased time at home makes my wife (who travels the world for a living) happy or simply perplexed. I work two jobs, an average of about fifty hours per week. I have a full-time emergency room telepsychiatry job that I love, and I still see new patients coming into the mental health center two days per week just to help out, you know. I am still working this hard by choice and will be sixty-seven years old in less than half a year. Yes, I have passed that vaunted full Social Security retirement age, but I am not putting my hand in Uncle Sam’s cookie jar quite yet. Our financial advisors, smart young lads, and lassies, have told us that we can retire at any time, but neither of us is quite ready to let go yet. The last time I ran the numbers, I figured that I could probably make more money retired than I make working like this. But one thing nags at me. Have I done enough? In my long, satisfying career, could I have done more? Pushed harder? Gained more skills, met more people, networked harder, served in more positions, mentored more younger folk? I wonder, now, in the twilight and the calmness, if any of those things are true.

There are some young people in my profession whom I admire greatly, some at arm’s length and some from afar. They are in training or just out of it, and they attend all the meetings, volunteer to serve at large, get elected to offices, attend assembly meetings, and listen to the boring parts of annual conclaves that most of us were never part of. They thrive on this kind of hands-on, in-the-weeds, roll-up-your-sleeves kind of work that takes them away from their primary work focus and adds time and effort to their professional life. I envy them now, sitting in this very busy but much quieter, calmer life that I have come to. I wonder to myself, should I have put myself out there to sit in one of those assemblies? Should I have stepped out of my comfort zone and presented a paper or two along the way? Should I have run for office in my national organization? I never did those things, and now, at almost sixty-seven, I really don’t have the drive to do so. But I wonder. Should I have done those things? Have I done enough? Have I made the best of my expensive, time-consuming, soul-sucking, life-changing training that put the letters MD after my name forever and lit up my internal ID card with the neon word DOCTOR?

She came in to see me with her husband, transplants from up north to sunny South Carolina as are so many nowadays. She told me her history, with her husband gently but firmly correcting and adding and clarifying the things that had faded from her own memory over time and several courses of electroconvulsive therapy. They had a provider already, and she was quite stable on medications, but they were feeling just a bit unsettled and wanted to get another opinion about her treatment and prognosis. I listened to her fascinating story (those of you who have read my writings over the last three decades know that I do love stories) of pain, heartbreak, trial and error, resilience, and resignation, followed by triumph and stability.

I assured them that the medication regimen her provider was monitoring with her was spot on, almost perfect for her, in that her mood was stable, she had no psychotic symptoms, she was eating well, and she slept well at night. She had a wonderful husband who was her helpmate and obviously loved her dearly. They had a system at home that kept her healthy, happy, and busy, and I could not improve upon it at all. They had several concerns, not the least of which was that she had been on a couple of “old” medications for some time, and maybe it was time for something new. I smiled at that one and quipped that I was an old doctor who had cut my teeth on those medications and that they were backed by decades of data and did not need to be changed just because they were old.

They both sighed and smiled, visibly relieved to get this feedback from me. The husband leaned into the picture beside his wife so that I could see him better and said, “You are a very nice, knowledgeable fellow with a great sense of humor and a very easy manner. We have really enjoyed speaking with you. Might we change doctors and come over here to see you for a follow-up?” I told him that I was flattered but that I had just retired from my thirty-three years at the mental health center and was now just seeing folks like them for their very first appointment, then shepherding them to the next clinician who would take it from there. I assured them that their current provider was giving them excellent care and it would be fine to continue there if that was the decision they wanted to make. They left assured, happy, and satisfied. I smiled when they left. I basked for just a few seconds in the compliment the husband had given me. Then, I suddenly had the answer to that fundamental question that the elder me was badgering the younger me, long since gone, with.

I do what I do now because I am not quite ready to stop being a full-time doctor. I am not ready to stop hearing the stories. I think I need a few more to keep my mind sharp, my imagination active, and my soul nourished. When that day comes when I close the lid on the laptop for the last time, turn off the screens, and walk out the door, I will be able to smile and know that, yes, I have done enough.

Greg Smith is a psychiatrist.