Can you believe it?  I’m finally out of things to say.  After publishing in excess of 2000 articles, I’ve reached the point where either I have covered all the aspects of medical care or I have a real writer’s block.  I’ve been struggling for weeks trying to come up with informative, entertaining and uplifting articles.  Last night, I asked myself the age-old question, “When is it time to quit?”

In my experience, most humans don’t know when to quit.  One of my most difficult tasks, as a family physician, was taking a patient’s license to drive away.  Men and women, alike, put up a fight.  Often, my patients would become verbally abusive; and, on occasion, they actually became physically threatening.   Many times, they would leave my practice.  Their families were afraid to confront them; and many times, they allowed their loved one to drive against my advice.  On occasion, the results were catastrophic.  I vividly remember one patient’s story.

Mr. V’s memory was bad.  As long as he did not vary from his daily routine, he functioned fairly well but once his routine broke down, he was in trouble.  One summer day I received a call from the Indiana State Police:

Officer – “Dr Segal, do you know Mr. V?”

Dr. Segal – “I certainly do.  He’s been my patient for 20 years.  Is he ok?”

Officer – “He’s fine.  He stopped at the fire station and asked them how to get to your office.  He showed them your card and stated he had a 10 am appointment with you.  It’s 4 pm here.  He’s on the southside of Indianapolis and doesn’t know how he got here.”

When Mr.V’s family told me that he refused to quit driving, I told them to take his keys away and sell the car.  They stated they could not do that to him.  Instead, they had to drive down to Indianapolis to pick him up (and they were the lucky ones).  They were lucky he didn’t die in the middle of a corn field or cause a major accident. They were lucky they didn’t have to go to a morgue to identify his body.

When is it time to quit driving? Work? Sky diving? Climbing ladders? Operating machine tools? There is probably a time when we should quit doing everything, even sex.

So how do we know when it’s time?  Certainly, when loved ones tell us it’s time to quit, we should, at the very least, listen to their advice.  We should weigh the risk of continuing to do what we want to do vs. the benefits of it.  We should assess our impact on others.  Perhaps, we should also discuss our thoughts and decisions with our physician and/or clergy. We should review all of our alternatives carefully.

Ultimately, when to quit whatever is a personal decision as long as it doesn’t adversely affect others’ health and safety. When the health and safety of others are at risk, family and friends have to step up and help their loved one find a way to gracefully and safely quit.  

When I started in practice, taking away someone’s driver’s license was crippling as he/she became isolated and dependent.  In today’s world, Uber can be at your doorsteps in minutes and can take you anywhere.  Finding alternatives to help our aging loved ones as their skill sets diminish and they need to quit is paramount to helping them age gracefully and safely.

So, if someone you love is too old to safely ________(fill in the blank), help them find a way to quit while maintaining their dignity and safety.  If you need to quit ________, don’t be stubborn or prideful.  Don’t refuse help, embrace it.

And by the way, have a sense of humor.  When it’s time for me to quit driving, I’m buying Lisa a chauffer’s hat and vest and sitting in the backseat.  I’ll be the world’s best backseat driver!

Here’s your music.  Kenny Rogers, “Gambler,” sums it up nicely.  “You’ve got to know when to hold them, know when to fold them.” Here’s your joke for today:

 A bus load of Senior citizens was traveling to a casino. Halfway into the trip, a little old lady walked up to the front of the bus and told the driver they had a pervert on the bus.

The driver told her he would check it out at the Casino. So she went back to her seat and sat down. Five minutes later a second little old lady walked to the front of the bus and told the driver they had a pervert on the bus … Since this was the second complaint in five minutes, he thought he had better check it out. He pulled the bus to the side of the road and walked to the back of the bus.

There he found a little baldheaded old man crawling around on his hands and knees. The driver asked, “What the hell are you doing down there?”
The baldheaded man looked up and said, “I lost my toupee and I’m trying to find it. I thought I had it twice, but mine is parted on the side.”

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