ACTIVE RETIREMENT: Live Long and Prosper

For many Americans, the key element of their retirement dream is never having to work again. No more days rising at an unspeakable hour, wolfing down breakfast, commuting in maddening traffic, suffering through meetings, completing mountains of paperwork, enduring relentless stress. Instead of all that, the retirement dream promises days filled with leisure, traveling to distant lands, playing cards and tennis, eating luxuriant dinners--even moving to a retirement community where the sun always shines.

Not everyone thinks that way, however. For some Americans, the appeal of work extends well beyond retirement. Many doctors, for example, seem to have medicine in their bones and continue to practice in one form or another even after officially hanging up their spikes. Two such doctors live right here in Marin County: Dr. Marjorie Belknap and Dr. Filmore Rodich. Both “retired” at the usual age, but each one has stayed remarkably active in the decades since, not only with medicine, but also with community involvement and an enduring curiosity about the world.

To learn more, Marin Medicine interviewed both doctors earlier this year, letting them describe their active retirement in their own words.

Marjorie Belknap, MD

Dr. Marjorie Belknap, 88, had a practice in internal medicine in Marin County from 1955 to 1987. Born in Denver, she grew up in Southern California and received her MD from Stanford University, where she also completed her internship and residency. Since retiring, she has been actively involved with many nonprofit organizations and government agencies, including the William Babcock Memorial Endowment, the Marin County Commission on Aging, and Senior Access. She recently moved to The Tamalpais, an active retirement community in Greenbrae. The following interview was conducted at The Tamalpais on Feb. 5.

How do you keep yourself physically active?

Well, over the years that has changed from time to time. After I retired I played a lot of golf because I had more time. And I played some competitive golf too. But I gave that up a couple years ago. I gave it up because it took too much time away from other things that I was doing. But I have been a hiker and a walker for a long time, so that is mainly what I do now.

How many hours a day do you walk?

I try to do that one or two hours a day. I also do birding--I go out to some of the bird refuges in California for birding.

Do you keep a birding book?

No, I’m not one for keeping records of things. I just remember what I’ve done. But these are often birds that are migrating, including waterfowl.
I think the most interesting one, because of its behavior habits, is the sandhill crane. They’re big birds! They spend the winter down here in the valley. They’re fascinating because of their behavior.

What’s so unusual?

They usually gather in family clusters, so there may be three of them pretty commonly together: the male, the female and the youngster. But the youngster is born up north of here, and by the time November or October comes, that bird has to be big enough and strong enough to fly down to the Sacramento Valley. So it is really fully grown in just a few months, and it’s just fascinating to watch these family interactions with the dances and other rituals.

Do you have any artistic pursuits?

I used to do some painting, but mainly I’ve done photography in the last few years. You may have seen some of the pictures here. But I don’t do very much of that right now. I’m in kind of a transitional phase.

So what are you transitioning from?

I am changing from a whole lot of demanding volunteer activities, and some of the professional things I did, into more of a life of leisure. And more concentrated probably in this area. Not so much in the community, but more here where I’m living.

I know you have been involved in many nonprofit organizations. Can you talk about the ones that you were in when you first retired, and then where you are now?

Well, I went through a period where I didn’t do much. I was closing my practice and doing some part-time work at Marin General Hospital. And then after a little while, I got a little more involved because I found out that I didn’t want to do just part-time medical work. So this is when I got more involved with more volunteering and more nonprofits. I was a member of the William Babcock Memorial Endowment board of directors. And I did that for several years. And then the Marin County Commission on Aging, which I did for a very long time and was chair of that twice. I just went off of that in July.

What does the Commission on Aging do?

It advocates for older adults over the age of 60. It is a federally qualified commission, and that means that it is funded primarily by the Older Americans Act that comes out of Washington. We fund educational and informational programs, and we partially fund the nutritional program. The Whistle Stop delivers home-delivered meals under this program. We are also advocates for senior housing, transportation, and other support services for low-income folks who may not have access to some of these services in the county. So it is a pretty active program that many people do not know about.

And do you feel you were able to accomplish something?

Oh, yes, I think it does a lot of good. I think there is a lot more that could be done, though, but we don’t have money for it.

Were there any particular programs that were close to your heart?

One was the Health Committee, I was chair of that under the Commission on Aging. I was chair of several committees. I just like the whole program. It really takes in the whole county, and things that have to be done identifying needs of older adults.

Are you still involved with other volunteer activities?

I’m president of the board of directors of Senior Access, which is a daycare program for folks with memory loss: that’s a euphemism for dementia. It’s really an interesting program. They have an outing program, which takes some of these people out to interesting places all day, and they have lunch: museums, the Bay Center, all kinds of places. They also have a program in San Rafael where they do artwork and have music, and they do exercises and so forth. These are people that need some assistance with their living arrangements, but they also have caregivers who get worn out. So this is a support program for them, too.

One hears that caregiving is very stressful.

It is! It is a huge and increasing problem in the county.

Any other volunteer activities?

That’s mainly it. I do some activities with the Bioethics Committee at Marin General Hospital, and I just recently resigned from the Biological Safety Committee at the Buck Institute, which was kind of interesting, but I didn’t have enough time for it. I’ve tried to pare down what I’m doing.

We’ve talked about your physical and artistic pursuits, and your volunteering. What about your mental activities in general?

Well, let me tell you, dealing with nonprofit organizations is a challenge. I kept my medical license until May, so I had all of the continuing education requirements for that. And that was because one volunteer activity required that I have an active license, and I was medical director of the Adult Day Healthcare program in Novato, and that also required that I have a license. I was also working here as a consultant and at Kentfield Rehabilitation Hospital as a consultant on a part-time basis. So I kept up the medical part without having to do direct patient care. I worked with physicians and nurses on those programs.

So you have really been extraordinarily active! Do you miss practicing medicine itself?

I miss the patients, but there are a lot of other things I don’t miss about it. I was a solo practitioner, and this was very demanding because you didn’t have too much extra time, although I was able to collaborate with other solo practitioners to take calls. I don’t miss having to be on call at night or on weekends, and I don’t miss the business part of it. I left medicine at about the time things got really complicated, so I was fortunate to be able to quit then.

Do you find that retirement gives you more time for friendships to deepen?

Oh, sure! That’s part of friendship. It takes nurturing, and that means time. The people I’ve met around here are extraordinary, I can tell you. It’s an amazing group that lives here. There are people who have had varied professional and/or personal lives, who are willing to share them. It is a whole new experience.

So it’s a different social group.

Yes, a different social group. When I retired I found that joining a golf club gave me a whole different social group. People I never would have known. And they were interesting, and some of them have remained friends over the years. And some of them, you know, it was golf only. And then when I got on the Commission on Aging, I found that it was an extraordinary group of people, and people I never would have met otherwise. And some of them became friends. So everything that I’ve done has opened up new gates to different groups and different kinds of groups of people.

It sounds like retirement has really allowed you to enter these new worlds.

Oh, yes! Several different new worlds! And they’re all what you make of them. Not too long ago I was at a party with one of my colleagues who was getting ready to retire. And I said, “What are you going to do?” And he said, “Well, I don’t know!” And I said, “You know, you really ought to have some kind of a plan of what you’re interested in doing.” And he just shrugged.

Did you have a plan when you retired?

I did, I had a plan.

And what were the key elements?

Well, the key elements were that I wanted to do some part-time work, which I was able to do, but I also wanted to do a lot of the things that I hadn’t had time for.

Are you happier than when you were practicing medicine?

No, I never was particularly unhappy. I think happiness is enjoying what you’re doing, and I enjoy what I’m doing right now. I may go and do something different six months from now. I don’t know, but I’m open to suggestions! The thing is that I never wanted to have people too interested in how old I was. When you get to a certain age, a lot of people think that you’re not able to do certain things. I come from a very long-lived family. I figure that as long as I’m capable of doing these things, nobody has to know that I’m as old as I am and say, “I don’t know how you do it!” It isn’t how I do it, it’s just me. You make of life what you’re capable of doing.

What would be your advice to physicians who are nearing retirement? How do you think they should prepare for it?

I think it is really important to do it with the right attitude. I did it because I wanted to retire. I think some do it because there is some pressure to have them retire, either health conditions or whatever some of the other issues are. And I think they’re at a disadvantage, I think you really have to want to retire. I look back at my father who was 74 before he retired--he was a small-business man. And he decided at 74 he wanted to retire. He never wanted to retire before that. I think that’s an advantage, whatever your reasons are, that you really want to retire.

Have you had any experience since you were retired that made you say, “Oh, this is what retirement is all about”?

I don’t ruminate very much. I just take life as it comes, and I enjoy it. Some days I don’t know what I’m going to do yet, but I find something to do.

Was there any time where you were particularly happy or ecstatic?

That’s kind of hard to say, looking back, because I’ve never been unhappy; I’ve always been satisfied with what I’m doing. There was a period where I was conservator for a good friend who had been a patient of mine. And I thought, I’m so happy that I can do this for her. And she wanted me to do it, and she was not capable of handling her own affairs. So I did that for a couple of years, and that was very satisfying, really, to be able to do that for someone who wanted me to do it.

Filmore Rodich, MD

Dr. Filmore Rodich, 81, practiced internal medicine full-time in Marin County from 1963 to 2003. He was president of the staff at Marin General Hospital from 1981 until 1983. Born in Minneapolis, he received his MD from the University of Minnesota, followed by an internship at the U.S. Public Health Service Hospital on Staten Island and a residency at the Mayo Clinic in Rochester, Minnesota. He also served two years in the U.S. Air Force at Travis Air Force Base. After retiring, he continued to serve as a medical examiner for the Federal Aviation Administration (FAA) and began working part-time on the medical staff at Villa Marin, an active retirement residential community in San Rafael. Dr. Rodich and his wife, Judith, live in Lucas Valley, where they raised their three children. The following interview was conducted in his Villa Marin office on Jan. 7.

Could you give me a general description of what your job entails? How does it compare to your former practice?

I don’t have to make hospital rounds, so when I come here I make rounds on the personal care unit and the skilled nursing unit. Then I come to my office, and I have an appointment schedule for the rest of the morning. Patients or residents who want to see me about various problems can come down to my office. I have about two or three hours of outpatient visits. There are 210 condos here, so there are about 350 people. They are all seniors, and they do get sick. We provide a fair amount of medical practice for our senior citizens, who are into a phase of life where they require a little more care.

Are the outpatient office visits basically the same as when you were in practice?

Yes, that’s what I love about this job. I practice medicine, see a lot of pathology, and make a lot of diagnoses. I think we help our people.

What about the business aspect? When you had a private practice, I assume you were running it and dealing with the insurance companies and all that.

Yes, we had business meetings and dealings with personnel and many other issues. We don’t have any of that here. I am basically an employee, and so the administration is out of my hands. I am perfectly happy to yield that responsibility to others. I just practice medicine, which is lovely.

You also work part-time as an FAA examiner, which you’ve been doing for 45 years. What does that job entail?

The FAA requires that pilots have periodic medical exams. An airline captain has to have an exam every six months, and the pilots who are not captains but have senior flying positions get a Class II, which lasts for a year. Pilots who are over 40 need a Class III exam every two years. It is up to the pilots to engage an FAA medical examiner.

The FAA certifies me as being a qualified medical examiner, but it’s up to the pilot to make an appointment and pay me for the exam. So it is a private practice, and I have a steady group of pilots who have been coming to me for years and years. It is a very pleasant practice because it is like greeting old friends. It’s a responsible job, but it’s a pleasant job because most of the pilots are pretty healthy and are good people.

You also volunteer for the RotaCare Clinic. How often do you do that?

It is a three-hour stint once a month. Kaiser, to their great credit, donates the third floor of their clinic in downtown San Rafael on Monday and Thursday evenings from six to eight. They donate that time for the clinic physicians to see people who have no insurance, so it’s a free clinic. The Rotary Club provides the medications; the nurses, interpreters, pharmacists, and doctors volunteer their services.

Do you have any trouble recruiting volunteers for the clinic?

They are always looking for more volunteers. They are trying to expand and provide another night, so they need more doctors. When we arrive, that waiting room is full, so we have to take care of quite a few patients. It is a very pleasant clinic--there is camaraderie with the other volunteers, and the patients are very appreciative.

What else are you doing in retirement? Do you play any sports or travel?

My wife likes to travel, so we do a little traveling. I am not a golfer, and I don’t own a boat. We don’t have a gardener, so I take care of our place in Lucas Valley. I do the minor repairs and all the gardening, so that takes up some of my time. My wife and I are attending adult classes sponsored by Dominican University and the Osher Lifelong Learning Institute. I am enjoying this phase of my life a lot because I have some free time and yet I am still involved with practicing medicine.

I was raised by my widowed mother, and she taught me that life is not a game: it’s not golf or play, it’s work! So over the years, I have enjoyed the structure of having to show up for work and having a schedule, and I like doing what I’m doing. I’m blessed to have been able to become a doctor because it has been a very enjoyable career, and I still like doing it. To me, it is not a chore, it’s not work. I am not one of the doctors who was dreaming about retirement over the years and just couldn’t wait to get out of the office. I liked my practice and my colleagues in medicine. Practicing medicine is a privilege, and it’s wonderful.

And you are still able to do the work that you enjoy.

Yes! People ask me how long I’m going to continue practicing, and I say truthfully--as long as I keep making sense, I want to keep working. The older doctors were trained in a different time, when we didn’t have the wonderful tools available today, like CT scans and MRIs. We are more comfortable just taking care of people with a stethoscope and our hands-on experience. Here at Villa Marin, we are able to get labs and x-rays, but CT scans and MRI exams are available at outside labs.

Has your attitude toward life changed at all since you retired?

When I was in practice, I was always crusading for something, and we faced all kinds of issues. Mostly, I feel blessed that we practiced medicine at a time when it was really fun to practice, but we had our problems too. There was a time in the 1970s when all of the malpractice insurance companies left California. One of my partners had an RV, and he took a group of us up to Sacramento to join others who were petitioning for a cap on compensation for pain and suffering, which was achieved and brought down the cost of malpractice insurance in California. When I was an officer of the staff, I often found myself in the midst of battles. Even though I am interested in politics, I am less combative than I used to be. I’m mellowing a little bit.

Are there any other changes you have noticed?

No, I’m resisting all these changes. I don’t want to be a grumpy old guy! You know, the computer came along, and with a young family I decided to get familiar with the new technology. The FAA now requires me to do my reporting online. I’m not an expert on it, but I’m adequate on the computer, and I love my iPhone.

I see you holding it right there. That’s a pretty recent model.

I used to have an old, complicated program for obtaining medical information. I dumped all that, and I go to Google. Google knows everything. If I have a question about a medicine that has a generic name that I don’t recognize, Google tells me what it is, and gives me the information immediately.

So you are pretty current on all the technology?

Well, I am not an expert, but I love it. I am trying to do more and more, and I find it extremely helpful, especially with drug interactions. If I’m dealing with 80 or 100 drugs that I use and try to see what the interactions are, I get 10,000 combinations, and it’s impossible! Google knows interactions that a human can’t know. We know some of the famous ones, but we can’t know them all.

What would your advice be to physicians nearing retirement?

I actually gave a colleague some advice one time, and it worked. His office was located across the hall from mine. He called me in to tell me he was retiring and was moving to Scottsdale. So I said, “Why the hell do you want to do that? If you are in Marin County, you will always be Dr. X. If you go to the store, or to a restaurant, or you’re on the street and you meet your old patients, you’re Dr. X. If you go to Scottsdale, you’re just another old guy with gray hair, and you’re going to get lost there. And you don’t want to do that.” He thought about it, took my advice, and didn’t move! He has been very active and very grateful that he stayed in the community.

My advice to myself was that if I did something terrible and my name and picture got on the front page of the IJ, I would move to Scottsdale. But as long as that doesn’t happen, I will stay here, and when I go to Costco, where I often see my former patients, we will hug each other and reminisce. So my advice is not to move but to stay right here. Marin County is a great place.

I think it’s wise for retirees not to be too far from a medical center. Having UCSF across the bridge is critical. Your local hospital can do most things, but when you need something special, you need a medical center like UCSF that can do everything. The technological advancements that are available in modern medicine are so unbelievable that if you get to the right place you can be cured.

Do you have any other thoughts that you would like to share with our readers?

There are doctors who discourage people from going into medicine. I have never done that. I think medicine is a privilege and that it will survive the hassles it is now confronting. This is not the end of medicine. Good medicine will always have value, and people will find a way to get good medicine. I don’t know what medicine will look like in the future--it won’t be like it is now--but doctors will be rewarded for their skills. Your life without your health is not worth much.

Mr. Osborn edits Marin Medicine.