Farewell from the Disillusioned Medic

Farewell from the Disillusioned Medic

August 27th 2017

Dear Readers,

This will be my last entry on this blog – for a while, at least, anyway. I guess I’ve said everything I needed to say. I am heart glad and grateful that there is such thing as blogging in this world, because this outlet was a veritable lifeline during what was a very dark time, and your loyal readership and kind words have helped me so much.

I had a lovely conversation this week with Dr Sally Graddon, as ex-doc like me, who found her own happiness as a life coach, and as we spoke, it was funny, poignant and rather moving to find that the our emotional experiences of leaving medicine were practically identical. We talked and laughed about the guilt, the uncertainty, the pain, the loss of identity, the shift in universe and the bitter regret, before both agreeing that it was totally worth it and that we were far happier and more fulfilled now than we were before. Pain is an excellent teacher.

Life for me now is so different, but good different. It isn’t easy – in fact, it’s often frustratingly unpredictable, but mostly I find that exciting. It keeps me on my toes, and suits me far better than the ‘conveyor belt’ feeling I talked about before. They say you make your own luck, and I think to a certain extent that is true. I have been continuously astounded by the opportunities that apparently keep landing in my lap, or the incredible experiences I seem to just fall into, but they happen, I guess, because I put myself in a position that allows them to happen, and don’t shy away from them when they come along. I’m still working things out, but I’ve given up putting a time limit on that – I don’t need to make an overnight success of myself. I don’t need to prove anything. I don’t need to justify my choices to the world and, more particularly, to myself. I can just be proud of being me – even if that ‘me’ is sometimes irrationally romantic!

I used to have lots of regrets about medicine, but I don’t anymore. I have had the extraordinary privilege of working in a profession that gives you a perspective on life and a sets of skills that most people never have access to. There was the good – the strength of the human spirit; the camaraderie of this tribe of beings that share your odd little world; the gentle and unobtrusive wisdom of the older generation; the miraculous victories over the seemingly impossible, like getting a young lad with schizophrenia to finally see that his mum was trying to do what was best for him, rather than trying to kill him.

There was the bad – the long, slow exhaustion; the abuse where there should have been kindness;  the unbearable, fatal cruelty of child abuse, violence, and an uncaring system; of dying mothers and brains riddled by dementia; of yellowing alcoholics despairing of the lives they lost; of good people in the worst situations.

I got to spend time with people from walks of life that someone of my background would never normally have done. I don’t know many people in my conservative, middle-class circle who can say they’ve had a heart-to-heart with a man whose face seemed to be almost crumbling due to his heavy meth consumption. I don’t know anyone else who’s been given origami flowers made out of NHS kitchen roll by a middle-eastern refugee, after sitting with him post night shift to listen to the horrors he had witnessed. And without medicine, I’d never have had a very, very long laugh with a heroin addict, whom I simply could not cannulate in the antecubital fossa because he’d injected so many times that his veins were shot, and who subsequently went on to show me, the doctor, where the best spots on his femorals were!

And I have to say, there’s pretty much nothing that grosses me out anymore. When you’ve had to scrape stinking pus off an STI-riddled foreskin, you end up with a pretty strong stomach.

I won’t say that it changed me entirely for the good, because that wouldn’t be true. There were negative effects on my character as well – for example, medicine makes you good in a crisis (a few nights in A&E will teach you that), but it often left me nerve-wrackingly anxious in general life. It taught me to grow up extremely fast, but it also made me bitter and cynical in many ways, and I started not to like the person I was becoming. It added colours to my box of metaphorical paints, but left me without the energy or the inspiration to use them, so life became rather grey and faded. It brought out the selfless in me, but also the self-neglect.

To paraphrase that song from ‘Wicked’, I couldn’t say if I’ve been changed for the better, but I do know that I’ve been changed for good.

I feel so honoured to have been a doctor. Even the bad stuff was good in its way, and I think of our time together with pride, and with peace. Who knows if our paths will cross again, but even if they don’t, that part of my life will stay with me. It will remind me that there is still so much to learn, and that, while I think I know myself ever so well, there’s probably something waiting right round the corner that will shock me into realising I don’t know myself at all.

The slight irony is that, the thing I loved most about medicine was the interaction with patients, and that was the thing that was most difficult to find the time to do, given the vast pressures we were under. Now, having left medicine, but still having the title of ‘doctor’, I have the time and the ability to listen to sad things without becoming sad myself. People tell me stuff they wouldn’t tell other people. They trust me and ask my advice, but really I think it’s just being heard that does the most healing.

I accept now that it is possible for me to help other people without being a clinician. I think I was always meant to heal through words, rather than operations and prescriptions. My old med school professor was right – I didn’t really belong there.

Funny old thing, life, eh?

 

 

 

 

 

 

 

 

 

 

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Should I quit medical school?

Staring out to sea
Staring out to sea

Through the work I do with Medic Footprints, I’ve met many a medical student who has quietly confessed to me their struggles with their studies, and asked whether I think they should simply quit medical school.

It might be the stress of the gruelling degree that’s getting to them, or the loss of conviction in their direction. Personal issues and a lack of support might be compounding their distress. Nowadays politics also has a part to play, as recent events have shone a harsh light on NHS working conditions, and medical students haven’t had much of a say in the debate. It’s no wonder they’re disenchanted.

But I find this question really hard to answer. I wish I could write a checklist or questionnaire that helps you decide – but the truth is, there are so many factors, variables and possibilities involved in this dilemma. It’s a deeply personal and sometimes quite horrible place to find yourself, and if you’re reading this, you might well be going through this yourself.

What I can do is tell you about own battle with this question. Over my six years in med school, I asked myself again and again whether I should leave.

Pre-clinical

I was really excited to start my studies at Bristol, but almost from the first semester of the first year, I had suspicions that this degree wasn’t right for me. It was weird – it just didn’t feel right somehow.

However, there were three things that stopped me from taking decisive action at that point:

1. Despite my misgivings, I did actually enjoy some of my classes. It turned out (to my shock) that I was fairly good at biochemistry. My natural nerdiness and curiosity made things like physiology and genetics fascinating, and while nothing about histology sparked even the remotest interest, and the smell of formaldehyde in dissection classes made me feel sick, the ratio of classes I liked to classes I disliked was fairly balanced.

2. Going to university was a huge change in my life – there was a lot going on, and I was gaining independence and evolving as a person. There were so many things I felt confused about and unsure of that medicine was just one thing on a long list.

3. It simply felt way too early to decide. I was always a dedicated student at school, and I didn’t like to give up on things. I had worked so hard to get into med school, and I wanted to give it a chance. I felt I owed it to myself and my family to get through the exams and give clinical a go, and if I’m honest, I felt too young and inexperienced to make those kinds of life decisions.

Nearly dropping out

By the middle of the second year however, things were not going well for me. I was struggling mentally and emotionally, and when I went to see the pastoral care advisor, she helpfully shrugged and suggested that I  just ‘take a year or two off to sort myself out.’ I hear that pastoral care has improved since I left Bristol – I really hope that’s true!

Things got so bad that I got to a point where I couldn’t cope anymore, and fled from Bristol with no real intention of returning. I quite literally packed my bags, left my housemates a goodbye note and got a train home. This is the closest I came to dropping out. I was a total mess, and I couldn’t face the idea of continuing. I did eventually return and go back to my studies – but not without the assistance and support of family, friends, doctors and therapists.

Needless to say, it was a real low point, and it left me feeling quite confused over whether it was medical school that was making me unhappy, or whether I was just really unhappy in general. The two things seemed to merge quite a bit – stress at uni affected my mental state, and my mental state gave me a bit of a negative view of my studies.

In hindsight, I should have done more to take care of myself during this time, but my attitude to life then was very much ‘grit your teeth and get through it.’ Youth and physical fitness got me through a lot – I went on lots of long walks, and danced on the university ballroom and latin team. I also met my now husband in the latter part of that year, and he did a lot to help stabilise my mood.

Unable to put my finger on what was making me miserable, I gave my degree the benefit of the doubt and continued.

The credit crunch

The financial crash had a big impact on my view of things. My friends doing three year degree courses were worried about launching a career in such an uncertain climate, and I had heard horror stories from people who had already graduated and were now struggling to find jobs. People always told me that ‘medicine is a stable career’ (even though it actually isn’t that stable, when you take everything into account) but it felt safer to hide away from the big scary world for a few more years at university.

Still, I knew I needed a break from medicine.

Intercalation in Leeds

Now, in retrospect, it probably wasn’t the best idea to use an intercalation as a ‘break’. Doing a Bachelor’s degree in a year (even if it is intercalated) does not constitute a break! Certainly not for me anyway. And I’m not sure why I chose to study medical imaging. For a person who dislikes maths, doing a degree in what essentially was mostly physics, was a terrible idea. I hated it.

I also made the move for the year to Leeds in order to study it. My reasons for doing this included a vague desire to ‘get away’ from the Bristol scene, and because my best friend was studying there. Actually, the fact that medical imaging was one of the intercalations offered at Leeds, but not at Bristol, was probably why I chose that course. If the course had been offered at Bristol, I might not have been permitted to leave.

When I talk about it now, I see so clearly that I was a just bit lost. My series of sub-optimal decisions was just an attempt to run away from my problems, but at the time, I felt I was being pragmatic and making the best of things.

I left Leeds with an unsatisfactory 2:1 degree, having found the course totally boring and pointless, and with the uneasy feeling that I’d done myself a disservice somehow. I don’t, however, regret the friends I made and the experiences I had that year – I had a lot of fun living up north!

Running off to Paris

Although I briefly went back to Bristol to start my clinical years, I was already planning to leave again. The ERASMUS exchange was on the cards – the very reason I had chosen Bristol University in the first place. They don’t run the exchange anymore, which is a shame, because it was one of the most amazing things I have ever done.

My application to the exchange was successful, and I went away to Paris for six months to study at the Université de Pierre et Marie Curie. It was a bit stressful, because they had a different syllabus (obviously all in French) and I still had to sit the same exams as everyone else when I got back, but it was totally worth it. I had adored French at school, and the chance to actually live in France was a dream come true.

I also desperately wanted to include my love of languages and words in my new medical lifestyle. French and German had been my favourite subjects at school, and I couldn’t bear the idea of losing my fluency. The exchange gave me the chance to see if the two were compatible. You can never really know these things until you try them, I guess, and I was optimistic (perhaps naïvely so) that I could balance my outside interests with my medical career.

Finishing the clinical years

With four years out of the six done by this point, the idea of my quitting medical school seemed rather silly. I had come this far – only two more years to go – I might as well finish. Again, I was grappling with the dilemma that, although I didn’t really like being in hospitals, I wasn’t sure whether I didn’t like it because I was ‘just a medical student’. Everyone seemed to say that being a student was a bit rubbish, but it all got better after you qualified.

How could I possibly know, therefore, whether I would like being a doctor?

When I qualified, I realised that it was true – being a doctor was better than being a medical student in lots of different ways. I really enjoyed parts of my F1 year, and had my character been otherwise, I might have been one of those doctors who loves the job but hates the system.

Of course, that turned out not to be the case, but I could not possibly have predicted that as a student. I did not know myself well enough then to make that call – it was only at SHO level that I began to understand what I needed.

I really didn’t want to leave uni with an unfinished degree either. I couldn’t imagine what I would do or where I would go. The last four years had been solely dedicated to becoming medically qualified. What on earth would I do with my life if I left now?

When the last year came round, I was feeling pretty good. The marathon was nearly done. By April, I had my passed my finals, got the SJT out of the way, secured a place at my desired Deanery, and was about to jet off for an amazing elective in Sri Lanka and India. It was the end of an era – I had done it! I felt more relieved than happy, but it was a nice feeling to finally be able to put Dr in front of my name, and swearing the Bristol Oath on graduation day was an exciting and proud moment.

How do I feel about it now?

I can honestly say now that I am really glad I completed medical school. I feel incredibly privileged to have had an insight into the worst and best moments of human life, and even though I left the profession in the end, the fact that I am a doctor has benefited me enormously in my new career. Doctors seem to have no idea of their value in the non-medical world, and how many transferable skills they have. My medical education has opened doors to me that would never have even been visible otherwise.

That’s not to say I don’t have regrets about how I reached that point – I do wish I had taken better care of myself, been kinder to myself and allowed myself a little more breathing space. Medical school is a weird, highly-pressured environment, and this does hugely impact your decision-making. What I discovered is that it isn’t really possible to completely disentangle personal and professional/educational issues. They are intertwined, and as soon as I gave myself the chance to properly reflect, I was able to start tackling both.

It’s not just you

I hope that sharing my story helps people to feel less alone. I used to think that everyone else was doing so well, and often wondered why I couldn’t cope as the others seemed to. I was constantly intimidated by the intellect of my peers, and a little jealous of those who were always going out, and aced exams even though they said they’d ‘hardly done any revision’. When I look back now, I am proud of having passed every exam, including the ones after the ERASMUS exchange, but while I was actually in Bristol, I felt woefully mediocre.

With so much pressure, and an examination structure that pitted us directly against each other, I suppose it’s no wonder that it all got a bit competitive, and some people played up to this more than others. I heard stories of med students sabotaging each other, or hiding resources from other people – I can’t say for certain if those stories were true, but I can see how stress and desperation might drive such practices.

I was never the best – I never got a distinction or really excelled in any modules. By the end, it was my aim simply to pass! But it didn’t matter a jot once med school was over, and it certainly doesn’t matter now. I know I was a damn good doctor, and I know I have got to where I am now because of medicine. I just wish I had known that it’s OK to have doubts, that it’s right to give precedence to your health and happiness, and that it’s possible to leave if it doesn’t work out.

 

 

If you need further information on this subject, there are lots of resources out there, including Medic Footprints, Other Options for Doctors and More Than a Dr

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

New job and new start

I have some news… I have a new job!

I’ve been interviewing with Aspirant, a global management consultancy, since December, and I found out in January that I had the job in their European operation. I’ll still be working in marketing, but this time there won’t necessarily be a medical aspect to it. I’ve been working my notice period since then, and last Friday was my last day at Dr Morton’s.

My colleagues gave me the sweetest card and some incredibly thoughtful parting gifts: a bottle of Sekt, a little bottle of prosecco that I said I liked the look of months ago, and an anthology of Jane Austen novels (they know me too well!)

It made me even sadder to leave them. I’m excited about the prospect of working with Aspirant, and I know that career-wise, this is the right move for me, as I had reached a plateau in my old position, and wasn’t really progressing, but I did feel a little heartbroken to leave behind such colleagues. For all that I worked ‘in a team’ as a doctor, I never felt true team spirit until I met them. Sure, I worked with great people with whom I got on well, and it was always very diverse and multidisciplinary, but I think it is a very rare thing to work with a bunch of highly intelligent people, with vastly different skill sets and backgrounds, who complement each other perfectly, bring out the best in each other, encourage creative thinking within one another, support each other and build strong friendships outside work. I don’t think it’s just a medical thing – it’s difficult to have such a serendipitous combination of factors in any industry, I believe. I feel truly lucky and humbled to have tasted it, even for  short time. They made work fun.

I must also thank my bosses as well. I’ll never forget that they gave me – a lost and very confused doctor – a chance to do something else with her life. This job gave me the space to learn and grow, and figure out what I like and what I am good at.

My new job is going to be quite a different working experience, as it’s all remote working. I’m not sure how I feel about working from home full time… (Will I get bored? Am I going to go stir crazy? How do I keep myself motivated?)

It certainly hasn’t been an easy year – there have been significant challenges, and not just professionally, but I have learnt something from every experience, positive or negative. This year has been as much about a change of attitude and personality as it has anything else. When I left medicine, I was completely oblivious to the paucity of my skill set. I didn’t know how much I didn’t know. Things I thought I knew about myself were suddenly challenged – abilities I thought I had suddenly failed me when they were tested in a different way. We medics live in a somewhat sheltered world, where things work in a certain way, and we don’t need to develop certain skills because we simply don’t need them. Unless you make the effort to step out of the bubble, you may never realise that. It’s not a criticism – there’s nothing wrong with absorbing yourself in your vocation, particularly if it makes you happy. It’s more a comment on me really – I was poorly prepared for the ‘real’ world.

I think the hardest knowledge-gap to overcome was that of myself. At 28 years of age, I’m only just beginning to learn my likes, dislikes, strengths, weaknesses, motivations and aversions. I honestly thought I knew this stuff, until this year forced me to defend myself on all those counts, and I found my resources sadly lacking. I remember doing an Emotional IQ test a while ago, and being puzzled by my bizarre score – I was really good at reading other people, responding to their needs and imagining what they might be going through, but totally hopeless when it came to myself. As my best friend once put it, I was ‘seeing the world through the prism of my own experiences’. It makes me wonder how many more epiphanies are coming my way and whether I’m ready to cope with them!

It’s been messy and emotional, but I was chatting to a couple the other day – friends of mine who are at a different stage of life, with some of their kids almost grown up and others still little, and long careers behind them. They are at a turning point in their lives, partially by choice, but a large part of it is that circumstances have made change a necessity. They joked that it was good that I’d had my ‘quarter-life crisis’ now, before kids came into the equation and made it all more complicated!

So Aspirant is my next adventure. I can’t deny I feel extremely nervous about starting, but it was surprising how much a kind little message from a future colleague-to-be really reassured me that things are going to be OK.

There’s just one more thing I’d like to say in this post, and that is how I got this job:

I know I keep banging on about it, but medics out there need to know the power of networking. I was at the Giant Health Event just after we came back from our honeymoon – I had free entry thanks to a Press pass from Medic Footprints (read the article here if you like). I was listening to a panel discussion about health tech start-ups, and one of the panellists was Chris Hafner, the President of Aspirant.

He said something I really liked: he basically had a mini-rant about how frustrating it was when HR firms focussed so resolutely on hiring people who looked good on paper. He lamented how often brilliant people without much experience, but plenty of brain and potential, were overlooked. He believed that bringing fresh eyes to a problem sometimes provoked the creative thinking required to solve it, whilst someone with decades of industry experience, while sometimes useful, had a danger of falling into complacency. He even went as far as to say that a little naivety regarding the history of your company or industry was beneficial (in small doses), as it means that you are not stunted by the weight of known limitations, or put off even starting by knowledge of the complexities ahead.

I felt a certain kinship to this message, having recently been said clueless but enthusiastic person, so I did something that former-me would never, ever have done: I sought him out after the discussion, told him why I liked what he said, gave him my card and took his. We had an interesting but brief chat at the conference, and at a later date met for a more lengthy discussion, when he went into detail about Aspirant’s ethos and his own dreams for the company. I got the ‘kindred spirit’ feeling from him, as we seemed to think in a similar way, and I admired what he was trying to achieve.

The suggestion of a job came out of that, and after several interviews with other team members, I accepted the offer. It really was as simple as a quick conversation about a genuine shared opinion.

I start next Monday!

Crippled before the race begins: how the med students are feeling

Hello all, I wrote this yesterday after I went to Birmingham medical school for the day to represent Medic Footprints at a national conference hosted by BAMSoc (Birmingham Academic Medicine Society). As well as academic presentations and poster displays, there was also a focus on career development and mentoring. One of their committee members, Lauren Quinn, was telling me how they were inspired by the Medic Footprints ACW (Alternative Careers and Wellbeing for doctors) conference last October, and wanted to bring something of it to their own university. It was pretty interesting to hear what current med students have to say about their medical careers…

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bmasoc-logo

I’m sitting on a train on my way back to London from Birmingham New Street, and thinking about the experiences I’ve just had at the BAMSoc conference.

I was there with fellow Medic Footprints team member Dr Jogisha Kukadia, an orthopaedic registrar who’s taking a break from the classical training path and locuming while she does other things and tries to figure out what she wants to do – such a common story now. I was unsurprised to see the recent government statistics confirming that only half of FY2s continue into speciality/GP training – there seem to be more reasons to leave than to stay these days.

Anyway, it was a very interesting day. I used to wonder whether it was ‘too soon’ to be discussing alternative careers with medical students – after all, they haven’t even started yet – but then we’ve had a few medical students come to events over the years, and indeed many of the doctors in our network started their journey while at medical school. As Jogisha said, it’s never too early to set an example and ‘sow the seeds’, as it were.

The general feeling from many of the medical students we spoke to is that they are really feeling the strain of what’s going on in the NHS, and questioning the future of their careers. Already they’re planning F3 years and thinking about leaving, and a couple of them were even thinking about quitting medical school before finishing. I felt keenly for one student who came up to me and told me how a friend ‘couldn’t bear the thought of doing the clinical years, but felt she couldn’t speak to anyone about it ’. And there was another who found medical school was eating into every aspect of life, and becoming so stressful, that hobbies and interests were no longer fun. I remember feeling these things at medical school. I thought I was alone, but in reality I think that a lot of people probably felt that way – we all just hid it very well.

A really lovely moment today was when three final year students came to us and told us how ‘refreshing’ our talk was. It was actually brilliant to meet them, because they seemed so impressed with the ethos of Medic Footprints, and so amazed that this whole world of possibilities existed. I’ve got used to it now, but I mustn’t forget that, just a short time ago, I too was ignorant of any path but the well trodden one of continuous, relentless training until consultancy. We spoke for a long time about various things – dealing with the guilt of leaving, having little to no access to alternative careers information at medical school, the tendency of medicine to make everyone conform to one ideal, like robots rather than thinking, feeling , individual human beings.

We told them numerous stories about doctors were know who have done things differently, like Gyles Morrisson, Evgenia Galinskaya, Stephanie Eltz, Sandeep Bansal and many more. They seemed so shocked – the expression on their faces must have been exactly as mine was the first time I went to the ACW.

They told us how they felt they were losing who they really were. On their first day at medical school, they were told by a lecturer that ‘half of them would be GPs’. This is, of course, the government target that the med schools are clearly pushing, but it made the students feel as if they had no autonomy over their careers and were just there to do as they were told. They told us about the Situational Judgement Test, and how even the exam itself was designed to imply that, though work-life balance was important, work was the ultimate priority.

When did medicine become like this? It’s a vocation, to be sure, but that doesn’t mean it should come at the price of your happiness and enjoyment of life. We are breeding a generation of miserable doctors, shuffling onto the wards to do their duty rather than loving their job. What good is that? Who does that benefit? Certainly not the patient, for whichever way you put it, an unhappy doctor is never going to be as effective a clinician as a well-rested, emotionally supported doctor who is happy with their life.

It was also absolutely fascinating to hear a talk by Peter Minnis, who is training to be a doctor in the Royal Navy. Jogisha and I looked at each other in astonishment when he told us how much they earn. Not only are school fees paid for, but they are also salaried while they are at medical school! Think of that! To be paid for studying! It seemed unreal. And then the fact that, as a naval FY2, you could earn £56k! Madness! That’s more than double the normal FY2 salary! And just when Jogisha and I were thinking it was probably a man’s world, he told us that about 50% of naval doctors were female! Apologies for the overuse of exclamation marks, but my mouth literally dropped open during this talk.

Peter then went on to describe the other benefits of being a navy, army or RAF doctor: the camaraderie, the great social life, the sense of belonging, the problem solving, the autonomy, the hands-on approach in which skills like wound closure, intubation and other aspects of advanced trauma life support were taught routinely – all of these things were exactly what I imagined life would be like when I applied for medical school, and I was so disappointed when it was not. Junior doctors nowadays are massively deskilled because their exposure to all this practical stuff is so minimised. I couldn’t believe this way of doctoring still existed in the armed forces! Clearly, the medical students didn’t know either, as some of them sounded annoyed that they had never been given this option before.

In the navy, you are also, by default, obliged to step out of medicine every so often, as you are a naval officer first and a doctor second. You are expected to muck in and assist with the other jobs to be done on the ship, and you travel the world while you do it, so the very nature of the job protects you from that dangerously unhealthy state in which medicine becomes omnipresent and all-encompassing. Of course, there is a risk involved – you may pay for it all with your own life, and I don’t pretend that doing such a job easy, with the long missions away from home and the ethical implications of the job. But you could argue the NHS has its own risks – the rates of physician suicide are that much higher than the average person, and both mental and physical health problems are growing increasingly common. I would die a thousand deaths before going back to being the mundane, bitter shell of a person I became as a doctor.

Someone asked me if I would still recommend medicine as a career. That’s a tricky one. I recently turned down an opportunity to speak at an event that was aimed at helping college students to get into medicine. I couldn’t do it – given my background, I couldn’t reconcile myself to the cause. Having said that, a medical degree is a valuable one, and medicine itself is a wonderful profession if you remove all the inane obligations thrown at you by the system.

I think I would still recommend it, I just don’t think it’s right that medicine should be done full time. When I say full time, I mean it in a junior doctor’s terms, where every hour of every day is spent either working clinically, working at home on projects, papers or portfolios, or worrying about work. I think cultivating interests outside of medicine should be encouraged and applauded, because it is simply unhealthy and unwise to do this kind of work without respite and relief.

What struck me most today was not so much that these students were already disillusioned before even beginning their careers. It was that they were so disempowered. So often we heard from those who were unable to share their fears for fear of censure, ignorant of the many forms a medical career can take, and pressured to ‘complete’ their training as fast as possible. These are the reasons why medicine can feel like a prison. Without a way to address these issues, what happened to me will happen to them – they will get to a point where they just can’t do it anymore and quit. I hope that we can make a difference by intervening sooner, and showing them that you truly can achieve a balance between medicine and life. I hope we can also show them that it’s OK to ask questions and have doubts, and that their wonderful, high-functioning individuality is their greatest asset, not something that should be stamped out of them.

 

 

 

12 months older, I must admit…

rain

So here it is, New Year’s Eve, and 2016 is coming to an end. It’s been a bit of a disastrous year for the world in many respects, but for me, I can truly say this has been the best year of my life. As well as getting married, this was the year that took me away from my life as a doctor and threw me onto a less comfortable, but much happier path.

“I can picture myself sitting exactly where I am now, one year ago, my mind racked with anxiety and guilt, my confidence shaken and my direction lost.”

When I think about myself this time last year, I wish I had a Tardis – or some such other time travelling contraption – because I can picture myself sitting exactly where I am now, one year ago, my mind racked with anxiety and guilt, my confidence shaken and my direction lost. I sat here crying, in the wake of my resignation, terrified of what I’d just done but too repulsed at the idea of going back to even consider locuming. It was also around the time that the new junior doctor contract stuff was kicking off, and I couldn’t imagine returning to the ever increasing frustration and uncertainty.

I was traumatised, I think – not only from my experiences as a doctor, but also from the illness that gave me a seriously big reality check earlier that year. I was still recovering from it in body and mind, and I didn’t feel equal to coping with the changes in my life, even though I had been the source of them.

The last pay cheque had been spent on Christmas and rent, and I was living off my savings and what seemed like borrowed time. I felt like a failure. I felt that I had let everyone down – a burden to my fiancé, a disappointment to my parents, and worst of all, a disappointment to myself. I listened to the same songs over and over again – holding onto my reasons for leaving (Gotta Go My Own Way), trying unsuccessfully to convince myself I would succeed against the odds (Hall of Fame) and waiting desperately for some distant day when I could look back and say I survived (Survivor/I Will Survive).

I was sitting here thinking that I was ‘nothing more than a doctor’, with no other skills or abilities, not realising just how many superhuman capabilities one has to develop as a doctor. I was wondering who on earth would employ, what on earth a failure like me had to offer. My mind was toxic and I just wanted to withdraw from the world, too ashamed to raise my head again. It may sound melodramatic to me now, but those feelings were real at that time. I was in a dark place.

And yet , despite being so down, there was something inside me that was determined to fight. I almost can’t believe it still – I walked into another job with a good salary and a senior position. I picked up my new skills from scratch and did my job well l. I remembered that I had other talents. I grew as a person. I healed. I felt special, unique, proud. I had the time and space to be there for my best friend as she got married, and to plan my own dream wedding. And I learned – my goodness, did I learn! It was an educational kaleidoscope. I discovered a world of things I had no idea existed, and finally jumped out of the box I had been sitting in for so long.

I once again attended the Medic Footprints ‘Alternative Careers and Wellbeing  for doctors’ event that I went to last October. It was just before my wedding, but I was determined to go, because last time I was there as a frightened and unsure delegate, and this time I went as a mentor and team member, with a spring in my step and the desire to give some inspiration back, after having received so much.

My husband and friends tell me now that they’ve ‘got me back.’ I am sad to think that I ever let my career take away any aspects of my personality, and I think that if I had my time in the NHS again, I would do things differently. But it’s so easily done – when you’re in that bubble, it’s hard and sometimes too exhausting to change things.

I think there’s part of me that will always miss being a doctor. It was such a fundamental part of my life, and I can’t deny that I still sometimes wish that I could have made it work. But I have no intention of going back. I see now that I just didn’t belong there – it didn’t suit me – and that’s OK. It’s not for everyone. You can’t change who you are, you just have to embrace it. Of course, things aren’t all plain sailing and rosy at the moment, but I am happy notwithstanding. I feel more in control and that things are more as they ought to be. I went into medicine because I wanted to help people, but this year has taught me that there’s more than one way to make the lives of others better, and I am finally using the gifts I have been given to do just that. If nothing else, this blog has helped other doctors, and for that I am profoundly grateful and humbled.

I have also been learning a particularly hard skill – not to be too hard on myself. The side effect of being driven and diligent is that there is a strong tendency to become complacent about one’s achievements and dismiss little progressions and successes as unimportant. The ‘good’ things don’t count as much as the failures, and this leads to the deeply dissatifying feeling that you’re never quite good enough. Self-praise is hard for people like me, but I’m going to do it now: while I was learning my new trade, I didn’t have the brain space to work on my novel. But now that I know what I’m doing at work, I’ve smashed out another 20 000 words or so. It might never get published, but it’s a project that is important to me and that is taking a lot of work to produce, therefore it’s something to take pride in.

If only I could go back to my last year self and give her a glimpse of the things to come. If only she could see that the outlook is not so very bleak, that she will harness all her resources and that the risk will pay off. I won’t say that I’ve ‘made it’ – my high ideals and expectations of myself continue to push my ambitions in a different but equally demanding direction – but it doesn’t matter. I’m doing things my own way and learning to trust my intuition.

And perhaps more importantly – I’m not just surviving. I’m living too.

Tying knots and unravelling tangles

Dear Readers, I can only apologise for my radio silence for the last couple of months. I do have a very good excuse, however… I got married three weeks ago and my new husband and I have just got back from our honeymoon! We had a perfectly elegant wedding day in Essex, and a splendiferous time in Sri Lanka and Thailand. I must publicly thank my excellent parents for pulling off such a wonderful occasion, and at present I am so happy that I have a mind above career troubles.

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That’s not to say I wasn’t able to make some interesting job-related observations in the process of getting married. I think I may have said before how lucky I was, not only to be free of on call rotas and late shifts, but to be working only part time in the lead up to the wedding. I feel even luckier now thinking about it afterwards, and I can’t imagine how doctor couples manage to plan this sort of thing while working full time (especially Asian weddings, with their huge guest lists and numerous functions!) Some of my married doctor friends have told me they were obliged to rely heavily on friends, family or paid assistance to pull off their big day, and many ended up doing things last minute. Of course, we too relied on my family and did things last minute, but I felt I could be mentally more involved with the process than I could have been before.

One of the biggest gripes about working as an NHS, for me and I think many others, was the ‘life event’ factor. How many of us have missed the weddings, funerals and other important moments in the lives of loved ones, because we couldn’t swap our shift, or because we had an exam or an assessment coming up, or even just because we were too exhausted to go?

I was once shocked when a former colleague of mine told me how the management at her hospital demanded that she work the evening before her wedding! I guess, looking at it completely dispassionate way, there was no reason she couldn’t work that shift, but from a human point of view – how cold, how unfeeling it was! To deny her those sweet hours of anticipation and delight, to prevent her from making any final arrangements and preparing herself for this symbolic and serious moment in her life… It is easy to understand how doctors feel dehumanised and undervalued when their personal quality of life is so apathetically ignored.

I feel truly thankful that my current employers not only gave me a generous amount of leave, but were also kind enough to give me a card and present. Such kindnesses from the management can perhaps only be found in small companies, but they mean a lot.

It is true that not everything about my situation was ideal – my drop in income wasn’t particularly helpful in the lead up to one of the most expensive periods of modern life! But personally, it meant a lot to me to have the time. We got to spend lots of time with my mum and other family members and friends, planning and making a lot of things ourselves. For example, I spent six or seven hours scoring, chopping, hand-painting and hand-writing 300-odd place cards, and looking back, I am so glad that I did that. It was important for us to feel that our wedding had a personal touch, and it did. It was truly special.

Also, as weird as it sounds, since working in marketing, I’ve developed a bizarre need for ‘consistency of branding’, and I confess a secret satisfaction that we had standardised themes, colours, fonts and styles running across all our wedding stationary and decorations. Laugh if you will!

During the wedding there wasn’t much time to think or talk about my current occupational quandaries, but one thing that made me feel quite emotional was my dad’s speech. He mentioned how proud he and my mum were about my educational achievements at school, getting into medical school and eventually becoming a doctor. I know how much it means to them that I joined a profession that they both value so highly, and I felt a pang of sorrow and guilt that I couldn’t continue to make them proud in the same way.

I was expecting far worse, however, during the party in Sri Lanka. We went out there for what Sri Lankans call ‘the homecoming’. Traditionally it is the ceremony that takes place after the honeymoon, in which the bride is welcomed in the groom’s family home – but nowadays it’s more an excuse to have another big party post-wedding, and it was ideal for us because it meant all my family and friends living in Sri Lanka could be part of the celebrations.

My only concern was that it would be difficult to talk about leaving medicine with people there. It’s hard enough to discuss it with some of our Sri Lankan connections in the UK, and I convinced myself, perhaps irrationally, that I would see looks of shock and dismay on the faces of my relatives. The thought of the concerned questions and maybe the shaking heads of disapproval, made me feel faintly sick.

However, circumstance cut me some unexpected slack in this regard… As we went round the tables meeting and greeting everyone, I discovered that the fact that I was now a wife gave me the perfect cover. People seemed to think it quite understandable that I was no longer working as a doctor – I am a wife now, after all. Time to step back in my career, look after my husband and have children. It made me laugh inside to think that, having been such an earnest believer in feminism as a young woman, such a high-achieving, determined career-girl, I would now find refuge in these old-fashioned notions!

I was grateful, however, that I was let off so easily. It meant I enjoyed the party a lot more than I imagined I would!

I can’t deny that the idea of ‘relying on my husband’ is uncomfortable for me. My father has always impressed on me the importance of being independent.

My husband has a different view – he sees our marriage as a partnership, where the burden of support is about more than just finances, and fluctuates according to the situation. One day, the tables may turn, and he may rely on me – there’s no telling what may happen in the future. Unwavering and unconditionally does he look after me now, and I must find a way to make peace with this and be happy until I can regain my independence.

As much as I tell myself this vocational hiatus won’t last forever, it is difficult for me to think that I left medicine almost a year ago, and I still have not found a suitable replacement. It is hard, after following a path and a plan for the last twelve years, to suddenly feel adrift. At a time when patience, faith and belief in oneself are paramount, and I have discovered that I, despite all my attempts at courage, am grievously lacking in all these areas.

Having just been in Sri Lanka and Thailand, both majority Buddhist countries, I have reconnected with my religion somewhat over the last three weeks, and I have been reminded of the importance of the Buddhist belief in appreciating the present moment. We spend so much time regretting and reliving the past, and planning for or worrying about the future, that we forget that we live in the present – that everything we do happens in the present.

There was a moment on my wedding day when my favourite Bollywood song came on, and I grabbed my cousins and spun them round on the dance floor. Before I knew it, there was a whole contingency of (mostly female!) guests around me, including my mum, copying my Indian dance moves and making me feel like we really were in a  choreographed Bollywood dance scene! For a moment, I stopped worrying about the caterers and the plan and whether things were running to time. The only thing I was thinking about was the next dance move, and for a few minutes, it was blissful and joyous fun.

It’s time to employ a new attitude. I can’t spend my time worrying about how to replace medicine. I just need to live, and maybe one day I’ll look within and discover that the hole it left has finally been filled.

 

 

So… what do you do? Part 2

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I’m having a bit of a nightmare navigating the delicate social quagmire of speaking to another doctor when you’re a patient who also happens to be an ex-doctor.

It’s always a bit strange being treated and cared for when your job is to treat and care for others, but now that I’m no longer working clinically, it feels even stranger. I was hoping that you, my loyal readers, could give me your opinion.

A few months ago, I wrote a post about the pitfalls of answering the “So what do you do?” question when you’ve just had a massive career change. Now I’m starting to get used to telling my weird I-used-to-be-a-doctor-but-I-left-and-went-into-content-marketing story. Sometimes I even miss out the doctor bit for the sake of ease, but what I’m still finding difficult and slightly bizarre is talking to medical professionals as a patient.

Just after I left medicine, I had to take my fiancé to our local hospital for a minor operation. I remember waiting in A+E, contemplating the mess that was my life, and then we were called into the triage room to be seen by a very nice orthopaedic SHO. I let him explain what was happening, even though I knew perfectly well what my fiancé’s diagnosis was, and exactly what would happen next. Somehow or other, during the conversation I let slip that I was a doctor myself, and the SHO looked surprised and slightly embarrassed as he said:

“Oh! You should have told me before! I wouldn’t have dumbed it down so much.”

I also felt a little embarrassed, but to be fair, my fiancé was the patient, so it was good that he understood what was going on.

But the other day, I went to see a consultant dermatologist. My mum accompanied me, but I was the patient this time. We shook hands and sat down, and he began to tell me about the layers of the skin – first dermatology lesson at medical school stuff -and after debating in my head for a few seconds as to whether I should say something, I remembered the orthopaedic SHO and ventured to interrupt him in what I thought was the politest way possible.

“I’m so sorry to stop you, but I thought I should just let you know – I’m a doctor too.”

Later, however, my mother told me that I’d been rather rude and she’d never been so ashamed of me in her life!

The consultant looked as embarrassed as the orthopaedic SHO, and took a hasty second look at the medical form I had filled in when I had arrived at the clinic. I had written ‘marketing manager’ as my occupation – no wonder he was confused! He then looked at my title – ‘Dr.’ of course. He hadn’t noticed that before. He apologised profusely, but I assured him that I wasn’t at all offended – he hadn’t known, after all.

I felt awful, because he was a nice man and I didn’t mean to make him feel that way. I wondered, as my ears grew hotter and hotter, whether I should have put ‘doctor’ as my occupation on the form instead. It wouldn’t have been strictly true, because I no longer work as a doctor, but to avoid major awkwardness perhaps a little white lie would have been somewhat justified.

I have thought about it many times since. Was my mother right? Was it so very rude to save him wasting time explaining things I already knew ? What if said time wastage had resulted in the consultation ending without my having the chance to ask more complex questions that I really did want to know the answers to? And if I had been inpatient, could I not be forgiven for wanting desperately to get to the point and discuss my treatment options?

I’m going to have to find a solution for this, because there are going to be other times in life when I’ll be a patient. I want to have kids in the next few years, and after the things I’ve seen, there’s no way I’d have them anywhere but a hospital.

So what do I do? Your help would be greatly appreciated as I try to figure out how on earth I, Dr Perera, former junior doctor, am going to explain myself.