Trouble in Paradise: the Type A personality effect

I feel very rested. I’ve just come back from a wonderful skiing holiday in the French Alps, and aside from the terror of voluntarily throwing myself down a frozen mountain, it was a chance for me to relax and reset.

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I did a bit of soul searching while I was away. There’s something about fresh air, white snow and beautiful views that opens your mind to a new perspective, and I’ve been pondering over the fact that I’ve become increasingly stressed over the last few weeks. To make things worse, I’ve been increasing my stress by getting annoyed with myself for being stressed – which is very counterproductive. I was getting snappy with my closest friends and family, and I felt like I was tearing my hair out most of the time. It’s a vicious circle that I find myself in more often than I like – I feel that I should be able to handle everything, and that struggling is a sign of weakness. Now even more than ever, I feel I should be able to handle everything. After all, I’ve just left one of the most intense professions there is, so everything that follows it should be a breeze, right? Right…?

Apparently it’s not that simple. While we were away, conversations with my fiancé and new skiing crew gave me a reality check: I’ve just left my career under distressing circumstances and started working at Dr Morton’s in an industry that is completely new to me without any training. I’m trying to finish this novel that means so much to me, while also trying to work with my brilliant mentor Gyles to help other doctors who are struggling with Medicine. If this wasn’t enough, I’m doing an online course in marketing which demands at least 7 hours a week, and to top it all, I’m trying to plan my wedding. To say I’ve bitten off more than I can chew would be an understatement.

When I left Medicine, people shook their heads and told me that finding a less stressful job elsewhere would be impossible, because every job is stressful in its own way. I never believed that, because to me, the stress that came with Medicine seemed to be on a different level. There aren’t many jobs in which taking your eye off the ball for just a moment could actually kill another human being. I really don’t know how Air Traffic Controllers do it.

But I have to admit that, in a way, it is true. Every job is stressful, but the crucial part of this concept is that every job is stressful for me. Somehow my attitude towards my old job has seeped into my new life. I continue to set high expectations for myself and am constantly seeking approval. I allow myself to feel overwhelmed by the workload, even when my colleagues are telling me I’m doing fine. It’s left me questioning where this outlook on life came from, and how to change it.

Wikipedia defines Types A personalities thus: “ambitious, rigidly organized, highly status-conscious, sensitive, impatient, take on more than they can handle, want other people to get to the point, anxious, proactive, and concerned with time management… high-achieving “workaholics”, push themselves with deadlines, and hate both delays and ambivalence.” Reading this definition made me feel a bit depressed because it pretty much describes me to the letter.

It makes me think back to being an A-level student. All of my peers who got into medical school were, to some degree or another, ‘high-achieving workaholics’. It was inevitable – medical school places are hard to come by. Bristol told us they offered just 250 places per year for 30 000 applicants. To be chosen you had to fight hard. You had to be obsessively hard-working to get the grades and work experience necessary, organised enough to have several different hobbies and ambitious enough to be good at all of them.

I’ve read that who you are and how you think depend very much on the people you surround yourself with. You direct circle of peers unconsciously set your boundaries, so personal, professional and financial success tend to be an average of those who have the greatest influence over you. In medicine, this can be a good thing, because it can mean that standards are held high, but I think it can be fundamentally damaging as well. As doctors I can’t help feeling that we tend to drown a little in our shared intensity, with over-ambition in one feeding the overwhelm of another.

I remember sitting our fourth year exams at Bristol. It was an intense year because it was the year we studied all the sub-specialities. I recall the sheer panic I used to feel, gazing at the huge pile of books before me and wondering where the hell to start. A helpful revision tip from one of our professors was simply to ‘learn everything’.

So there we sat trying to cram the enormity of medicine into our addled brains. What was odd, however, was that it was an incredibly lonely experience. My dad had told me stories of how he as a medical student in Newcastle used to have study groups with his friends and how they used to help each other out. I had assumed that I too would experience this nurturing, communal atmosphere, but the reality was a bit of a shock to me. It felt more like a competition, to be honest. The medical school made it worse by making some of the exam pass marks variable – the grade boundaries were set depending on the standard that year. This was an incredibly unkind thing to do, because it set the students directly against each other. You’d always be hoping that someone else got a lower grade than you so you could have a greater chance of passing.

The only way to be certain you were studying the right things was to do past papers. Everyone gets used to this practice at school because teachers do their level best to get hold of paper for you – however at medical school, past questions were a closely guarded secret, mainly because the board of examiners couldn’t be bothered to go through the rigmarole of writing different questions each year.

There were rumours on several occasions that past exam questions were circulating around some of the students, but no one ever spoke of them directly. If you had them, why would you share them? There was no incentive for student collaboration, and every reason to be secretive. People would lie about how hard they were working, or pretend that they’d ‘done no revision at all’ when you knew they had spent the last week burning the midnight oil face down in a copy of Kumar and Clark.

Not all doctors are the same, of course. I had a Greek SHO colleague in my orthopaedic job called Georgios. He was an incredible person to work with, because nothing ever seemed to frazzle him. No matter how many patients came through the door, or how full the theatre list was, or even how useless the system seemed, he still found time to discuss Greek philosophy with me over a hot drink. His motto, which I still repeat often in my head, was:

“Relax. Have a coffee.”

The Greek accent made it sound all the better!

The stress I feel now is definitely of a different kind. I do want to perform and be successful, but I know that there’s little chance of me doing anything truly catastrophic in my new job. It’s funny because, if I hadn’t been a doctor first, I might have had a very different view of things. I could see how, in a parallel universe, someone as highly strung as I am could easily crumble in the start-up environment. It’s demanding and uncertain, and because I like my bosses, I really want this to work for them. There’s a lot riding on a new business – reputation, money, relationships and sanity – and for the many that fail, it’s a terrible blow.

But having been a doctor, the silver lining is right before me – I just have to remind myself it’s there. The fact is, no one’s going to die if I make a mistake. No family’s life will be destroyed if I have a bad day. I won’t be hauled up in front of the GMC or struck off if I’m too tired to do the job properly. In exchange for that, I have given up the profound wonder of healing and curing the sick, but I honestly feel rather glad of that. I’ve come to see how damaged I am in my approach to life, and am in need of a little self-healing. Life is stressful and demanding enough; adding one’s own unremitting self-criticism and cruelty is really quite unnecessary.

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Officially Unemployed

When I talked to my dad about my resignation, it was difficult to bear the disappointment in his voice when he said:

“So, what, you’re officially unemployed now are you?”

I hit all kinds of low when I took myself along to the Job Centre before Christmas to register as unemployed. It was my fiancé’s idea – he did it when he graduated until he found his first job, and didn’t see any shame in it.

“You might as well try it,” he said, “You might not get the allowance anyway because you left voluntarily, but it will be a new experience for you.”

So I went along with some reluctance. It was so strange. As I went through the doors, narrowly escaping a dubious-looking guy at the front door who was attempting to sign people up for something, I felt an extreme sense of shame. It’s hard for me to write about it now, in fact. All my hard work and good grades had come to this.

I took a seat inside and waited to be called. They were running late by quite some time, so I had a good opportunity to look around at my fellow claimants. I live in a fairly run-down part of London, so I wasn’t surprised that many of them looked unkempt and down-trodden. We all kept our heads down and avoided eye-contact. This wasn’t a situation that encouraged chit-chat. A loud argument broke out between a claimant and an irate employee nearby. It seemed he hadn’t brought any paperwork at all with him and expected her to simply believe he was who he said he was.

My name was finally called. My assessor was a Muslim lady who did a double take when she looked at my application. She was (quite rightly) astounded that I was a qualified doctor. Why on earth was I here?

“What happened?” she cried.

I began to speak, and as I did, I think I was more honest than I have been with anyone for a long time. I told her how I simply couldn’t face going in anymore. I told her about my illness and how it knocked me. I told her about the anxiety I felt about working as a doctor. As I spoke, the reality of how little I valued myself began to sink in. I felt completely pathetic – a broken woman – crawling along, a shell of her former self. Without Medicine I felt totally worthless.

Her eyes softened as she listened to my story. She then talked me through my options, and told me about the process of claiming the benefit. She said we would need to meet at least once or twice a week, and that I would need to keep a log book, and how I would need to prove that I was trying to get work by signing on to a specific forum and spending 35 hours a week actively looking for work. It felt very demeaning and paternalistic, like I was a prisoner on parole.

At the end of our meeting, she noticed it was my birthday the next day, and asked me if I was doing anything nice. I told her I didn’t really feel like there was much to celebrate this year.

“Oh, don’t say that,” she said, kindly, “Sometimes when thing like this happen, it works out for the better in the end.”

She told me about how she had trained and worked as a dental hygienist many years ago, but something happened that made it impossible for her to practice.

“At the time I thought it was a disaster, but now I realise it worked out for the best. My nephew is quite seriously unwell and is often admitted to hospital, but my brother doesn’t have the time to look after him because he’s a GP. There’s no one else but me who can be there to pick him up from school when he’s ill, or sit with him for hours in A&E. Some of my family still say it would be better for me to go back to my old job, because it’s a better career, but sometimes you just have to look at the bigger picture.”

She told me to go out with my friends for my birthday and have a good time. Despite my desperate state, she saw someone deserving of a celebration, and I will never forget that. The kindness of a stranger can be incredibly touching, and for a moment I had a weird feeling that I was meant to meet this good lady, that there was a reason it was she who saw me that day.

As I walked out of that building, once again dodging the guy with the clipboard, I knew I would not be coming back. I realised that behaving like the pathetic and helpless person I felt I was only propagated the idea, and I was better than this! In some bizarre way, I was living up to the new expectations that were placed upon me: weak, dependant and needy. Other people had given up on me, so now I had too.

I decided I wasn’t going to do this anymore. From now on, I was going to define myself by what I knew to be true. Regardless of whether I would be approved for unemployment benefit or not, I resolved to withdraw my application, and not to take a penny. (Just as well, really, because I was not approved!)

When I got home, I sent off my paperwork to the locum agency. Previously I’d felt incredibly anxious and scared about walking into a hospital again, so I kept putting off applying for locum work. I guess I still feel a bit anxious, but I no longer feel crippled by it. My fiancé laughed when I told him about my change of heart.

“Haha! It’s because I’ve shown you the alternative!” he said, referring to the process of claiming benefits.

I stuck my tongue out at him, and denied it, but he was right. By making me do this, he has shown me a very alternative way of thinking. An alternative where, instead of thinking about what I can’t do, I think about what I can.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A New Year letter from my better self to me:

Dear Me,

This year, for the first time in perhaps your whole life, you have opened your eyes to who you really are.

Your history of anxiety, self-loathing and doubt have left you feeling scared in the face of this discovery. “Is it too late to change?” you say. “I should have done things differently.”

As much as you are enjoying your new freedom and renewed vision, your negativity is holding you back from embracing it.

So I challenge you in this year ahead to change your attitude. Do not see the past as a waste, but as the path that led you here. Do not regret your former actions because without them you wouldn’t see the value of what you are now. This is your opportunity to do something you really want to do; your investment in yourself now is you saying “I am WORTH investing in!”

The months ahead are not going to be easy. The road you’ve chosen is a difficult one, and you will encounter disappointment. You will fail. You will perhaps wonder why you left the safety and security you had before. So let me write the reasons down here so you can remind yourself:

You left because you have a gift that no one else has. You have a goal that no one else can do but you. You have an inexplicable, unshakeable faith in something that inspires you, and so will inspire other people.

Whatever happens, do not give up the fight. Do not regard the opinions of those who confuse the easy path with the right one. You are clever enough and savvy enough to know how far you should go.

Peach, you have remembered who you are. Mad romantic, dreamer, visionary, optimist. Do not ever forget it again.

 

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The first day of the rest of my life…

I am an ex-junior doctor.

I worked in the NHS for just over two years. I went to medical school for six years. But in 2015, at the age of 26, I resigned from my job. I wrote the post below shortly after I handed in my resignation, and I have been using this blog ever since to document my career journey, and the emotional process of leaving something that had become such a huge part of my identity.

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16th October 2015

I’ve quit my job as a doctor. I can hardly believe I’ve done it, but I have.

Despite all the political turmoil surrounding junior doctor contracts at the moment, and the threat of worsening working conditions, this government’s idiocy is not the only reason I’m leaving.

This has been a long time coming. I never really wanted to be a doctor, but when you’re 15 years old and choosing your GCSEs at school, it’s very difficult not to be influenced by the adults around you who tell you that you’re good at science, and therefore you should do medicine.

I have tried. I really have. I passed every exam at medical school, I got a good job in London, I got very good feedback from my peers, my mentors and my patients – but there was always something missing, and that something ate away at me inside for months on end, killing my passion, fading my colours away.

I don’t know what I’m going to do. I have no plan as such, only a dream to get back into my true loves: creative writing and modern foreign languages. I have no new job lined up for when I finish on December 4th. It is perhaps a little mad to do things this way, with no plan B, but quitting will hopefully give me the impetus to do now what I have been putting off for a very long time.

I want to use this blog to document my journey, and also talk about my experiences as a doctor: the good, the bad, and the terrible. I can now be brutally honest about what it’s really like to work for the NHS – since I’m leaving anyway, I won’t have to worry about losing my job for speaking out!

The NHS can be a brutal and frankly unsafe place to work, and I realised that, without the desire to give up my entire life for his profession, staying in it would be simply too hard. If it isn’t your passion, the huge sacrifices involved in being a doctor just don’t feel worth it.

I have no regrets about my medical career; it was a fantastic experience and has made me who I am today, but it does not define me. The day I leave will be the first day of the rest of my life, and I cannot wait to get started.