“I’m done,” were the first words I heard over the phone. He was not done yet. He prevailed for almost a year; part of the next six months spent hobbling around the office with a cane … until that became impossible.

But the message was clear. His recently diagnosed cancer was advanced; he was not going to beat it. He succumbed a few months before his 75^th birthday.

I do not remember that conversation very often. But one of the office workers recently noted that it was soon to be the old boss’s birthday, and it got me thinking. He had been an impressive individual. I never saw someone with such capacity. Well into his 70s he was working twice as hard as me, or anyone else I knew, in the OR and in the office.

He would joke about worrying about what he was going to do when I, 15 years his junior, retired. He seemed to think that he could go on as a practicing neurosurgeon beyond 80.

Of course, he could not and would not. But the hubris was there.

Even before he got sick, there had been hushed quips in the hallways. Little errors and lapses of judgment/execution had been creeping into his practice. Nothing terrible, the sorts of things that happen to anyone. But they seemed to be coming a little too frequently. I knew that at some point I was going to have to have a conversation with him about the future.

How? When? Mother Nature took care of that for me.

A man, born in the 1940s, intelligent, indeed smarter and harder working than almost everyone else, refusing to acknowledge that time takes a toll and that he was not the man he once was. Things seemed OK, until suddenly they were not. Then they fell apart.

It can be a hard pill to swallow if you have lived by the mantra of never give up.

While not as physically demanding as becoming a Navy SEAL, we all know that neurosurgical training is brutal. It is

hard to get into a program and even harder to get through. Most who start will finish. There is no bell to ring when you have had enough; nobody is encouraging you to quit. But there are long hours and sleepless nights. Mix those with the rigors of learning to differentiate normal from abnormal, navigate around delicate anatomy, accomplish structural rearrangements. All while taking care of very sick people. It is very, very tough.

Climbing up the political ladder and winning the big prize in politics must be even tougher. But having successfully run the gauntlet does not mean that you can go on indefinitely.

I tell most of my patients that they can expect a best before date of 80 and an expiry date of 90. They know what I mean. Yes, people are living longer and better. But just as most of us start to notice real declines in our stamina and mobility after age 60, those declines become much more limiting, even in the very healthy, after age 80. Sure, there are 90+ year olds living independently and driving cars. But should they be?

The generation that is starting to hit their best before date, the Baby Boomers, are in denial. Do they think that they can work forever?  Why?

History today concentrates on the turbulence of the 1960s, but it was also an exhilarating time to be coming of age. Men were walking on the moon. Scientific and technological achievements suggested endless possibility. Perhaps, subliminally, the name, Baby Boomer, did the same thing … suggesting eternal youth. Millennials and Gen-Xers do not get the same ring of optimism from their tags.

But the Baby Boomer generation is not alone. None of us like/want to get old. There is little self-realization that frailty is a universal condition with prolonged survival, even among doctors.

Medical Staff by-laws were recently revised in my hospital. I felt that they removed some professional autonomy from the medical staff, and gave the hospital administration too much power. I was surprised that there was so little pushback from my colleagues. But one clause did get a strong reaction … mandatory biannual physical and cognitive assessment for physicians over age 70. The pushback here was surprisingly universal and strong; so much so that the provision was struck.

Average life expectancy, for those that survived childhood, was less than 65 years in 1789. Given current trends in longevity, perhaps it is time for another Constitutional

Amendment. While Article II, Section 1, Clause 5 sets a minimum age for eligibility for the Office of President, there is no maximum.

I do not think that politicians are that different from doctors. Would you let an octogenarian operate on your brain? And should one be running the country? It could happen again, soon. Perhaps, like politicians, we should be looking at age limits. The public deserves better.