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Retirement from colon and rectal surgery is usually a personal decision. The details of when, why, and how are individually specific and are shaped by our life experience, desires, personal and family commitments, and financial considerations. The reflections of two respected senior colon and rectal surgeons are presented to delineate some of these aspects. KEYWORDS: Retirement, practice limitationsObjectives: Upon completion of this article, the reader should be familiar with the nonfinancial aspects of retirement from colon and rectal surgery.Harry T. Papaconstantinou, M.D. For many young physicians, retirement goals are limited to financial planning and retirement accounts (e.g., 401K, 403b). As the years pass, we become consumed with our careers and assume that retirement is far in the future and will take care of itself. This cannot be farther from the truth. There are numerous resources from which we can get information on the financial aspects of retirement; however, the questions of when, why, and how are more individual specific and are shaped by our life experience, desires, personal and family commitments, and financial considerations. This article is intended not to be a reference for how to plan your retirement but rather a few narrative experiences of some of our more respected colleagues who have faced or are facing retirement. How, when, and why you choose to retire constitute a personal and individual event. It is our hope that the experiences presented in this article will help the reader begin to think about a comprehensive retirement plan that meets his or her goals that are beyond financial considerations. This should start early in one's career and should be reevaluated on a regular basis.Ernestine Hambrick, M.D. To explain why I did what I did about ''retirement'' back in January 1998, it is necessary for me to take you back to 1992. That was the year my older, only brother died of metastatic sigmoid cancer. When he was diagnosed, 60% of his liver was already replaced. He appropriately, I believe, declined futile 5-fluorouracil (5FU) chemotherapy, which was all we had to offer back then.After recovering from surgery, he was amazingly well for 15 months. During this time, he got his family and affairs in order. He was even able to make three cross-country trips in his beloved 18-wheeler to say goodbye to the scores of friends he had made over his many years as a professional truck driver. During the final 3 months of his life, he faced his rapidly deteriorating physical condition and obviously imminent death

Upper gastrointestinal manifestations of collagen vascular diseases have been well described. Recently our attention has been focused on the colonic complications: fibrosis and stricture resulting in obstruction, severe obstipation and recurrent fecal impactions secondary to pseudo-obstruction, progressive colonic dilatation resulting in gangrene of the colon, and sigmoid volvulus and diverticulitis in the presence of both wide- and narrow-mouth pseudodiverticula. Patients with these colonic manifestations of collagen vascular disease are disabled, if not severely ill. Recognition of the problem enables the surgeon to plan definitive surgical intervention ranging from segmental resection to total colectomy and ileoproctostomy to restore satisfactory large bowel function.

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