The Parental Reaction

I told my parents about my resignation today.

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I cheated. I chose this weekend because on Sunday they’re throwing me an engagement party, and are currently busy with preparations – I was hoping this would be enough to distract them from the magnitude of this revelation, hoping it wouldn’t make headline news. I suppose I also hoped that my engagement would provide something about me for them to be proud of – an oasis in this current desert of my achievement.

I couldn’t do it on my own. I came back to their house in the early afternoon, and several times when my parents asked me how I was, it was on the tip of my tongue, but I was too chicken to say a word. When my fiancé arrived later in the evening, I felt so guilty. My parents were laughing and joking with him, and behaving as one does with someone who is familiar, yet not quite close enough to be treated with the comfortable indifference of family.

They were enjoying a fascinating conversation about the interpretation of Buddhism by different Asian countries when I dropped the bomb. The smile on my mother’s face vanished in an instant, and I couldn’t even look at my father. I felt about an inch high as they expressed concern at my failure to finish FY2 – why couldn’t I stay till April? It’s only a few months away! I could have completed this stage of my training! People change, didn’t I know that? If and when I want to return to medicine, having FY2 would have been so much better. What was I doing leaving without a plan or another job to go to? Not a sensible thing to do. Should have talked to my dad about it first.

Perhaps it was beneath me to resign without consulting them, but genuinely, it was not out of any disrespect for their opinions. I feared telling them – that much is true – but this is a decision I had to make on my own. I can’t keep running to mummy and daddy every time something goes wrong, and then blaming them for giving me advice I don’t like. I am a grown woman and I need to start taking responsibility for my own decisions.

I could tell my dad was deeply affected by the news. He grew very quiet, and that was harder to deal with than spoken disapproval. He asked if I was really not enjoying the job, and when I said I was not, he said it was important that I was happy. He gave me a comforting smile later on, so I knew it was OK.

Still, I felt very emotional. It grieves me to grieve my parents, who have loved me so much and given me everything. While they were setting up the marquee for the party, I ran upstairs and find solace in Jane Austen’s Northanger Abbey for a few minutes. Jane Austen has saved me from many a personal crisis, and if anything she reminds me of the strength of the written word. She will never know how she has saved me, and who knows how many others she has and will continue to save with her wonderful, wonderful books. Though tears were rolling down my nose, I couldn’t help but giggle at her wit and laugh at myself:

“Miss Morland, no one can think more highly of the understanding of women than I do. In my opinion, nature has given them so much that they never find it necessary to use more than half.”

The problem is, I cannot answer any of my parents’ questions. I cannot reassure them at all. I was summoned to see the Dean on Thursday – the doctor in charge of foundation medical education in North East London. I was a bit nervous about seeing her, wondering if she was going to try to persuade me to stay, but she was actually very kind and understanding. She seemed genuinely worried about me, and had the same concerns as my parents. Some of my colleagues and seniors as well do not see this as the wisest move.

There are a lot of well-educated, older, more experienced people around me telling me that what I’m doing is effectively crazy.

Why am I not listening? What the hell is wrong with me?

I don’t know. I really don’t know what I’m doing and I’m not entirely clear on why I’m doing it, but there is a strange freedom in that. It’s almost cathartic to have this aspect of my life fall apart in front of my eyes, like a forest fire burning through the old scrub and making space for the new, green shoots that peep up through the soil when the blaze is over.

Oh dear, maybe I will live to regret this. Or maybe I will realise my true potential. I am good at medicine, but good isn’t enough. Improving my skills just to keep my head above water isn’t satisfying, being bored of learning is deplorable, signing up to tedious projects and audits just for the sake of going on to the next stage is intolerable.

I want to do something I’m brilliant at. I want to be hungry to learn more, I want to stay up till 3 am absorbed so deeply in my work that I don’t realise the time, to speak so passionately about it that I make people think I’m weird. I want to get back to the girl who asked for a French grammar and verb table for her 16th birthday because she was a total geek!

Was that Northanger Abbey quote strangely apt? Have I, for all this time, only been using half of my understanding? Maybe one day I’ll look back at this period of confusion and realise I was simply being ‘clever enough to be unintelligible…’ *

Till then, I live in hope.

*Jane Austen again, of course.

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Why don’t you just finish…? Life on a conveyor belt.

conveyor belt
From youtube.com

You’re 15 years old. It’s careers days at school and various people are giving you talks, presentations and hand-outs about their jobs, and your careers advisor is telling you which GCSEs you’ll need to do. You’re suddenly faced with the enormity of the decision: what do I do with my life?

Medicine was always the path mapped out for me: my father is a brilliant doctor who loves his job, my uncles and aunts are doctors and dentists, and I come from an immigrant Sri Lankan community in which it often feels the only respectable vocational fields are medicine, dentistry or law. Well, sometimes accountancy and engineering are ok, but only if you didn’t get into Medicine or Law – I am only half joking here.

When you see how deeply this idea is engrained into Asian culture, you can understand why it’s so hard for me to tell my family that I’m leaving (a job which I have yet to do…), but I don’t think it’s just an Asian thing. Everybody knows that medicine is a noble profession, and when you tell people you’re a doctor, many of them still look at you with a sense of awe and respect, and in today’s society, achieving your ambitions no matter the consequences is seen as a good thing. I suppose I fell in love with the idea of being doctor, of being like my dad: a life saver, a game changer, an inspiration.

Somebody once told me that becoming a doctor is a high price to pay for being good at science. I was good at science at school, but then I was good at everything – a straight A student – which meant I never learned the connection between being passionate about what you do and being good at it. Passion breeds genius, and I couldn’t see my genius: in science I was fine, but I was outstanding when it came to languages.

Picture from www.intherooms.com
Picture from http://www.intherooms.com

I remember so clearly the day I tentatively told my parents that I wanted to read modern foreign languages at university. They were worried that there were no job options for language graduates unless you wanted to be a teacher. I guess it was just a lack of knowledge on their part about how the job market works, having only ever been exposed to a very limited variety of professions, but I was only 17 at the time so I believed them. My own ignorance about the working world frightened me, and I thought it best to follow the advice of my elders. They actually recommended dentistry at first, but I was not taken with the idea of looking into people’s mouths (I admire my dentist uncle for being able to stomach it!)

So medicine it was. I applied enthusiastically, and a few months later, got offers from Bristol Medical School and Leeds Medical School. Cambridge turned me down, to everyone’s dismay but mine. I had secretly sabotaged my Cambridge application by opting for one of the colleges with the fewest places available for medicine in the hope that I wouldn’t get in. I didn’t want to go to Cambridge – I had only applied to Cambridge in the first place because my teachers thought I should, such was my need for approval.

I have to state here that I do not blame my parents or teachers for advising me as they did. The told me what they knew and helped me to the best of their ability. It was just unfortunate that it didn’t work out.

The first two years at Bristol were what we knew as ‘Pre-clinical’, as they were devoted to pure science. There was a small amount of clinical teaching thrown in, but it was mostly hard core lectures on Anatomy, Biochemistry, Physiology, Epidemiology, Embryology and other subjects I slept through.

As time went by, I began to miss feeling academically brilliant. When you go to medical school, you make the unpleasant transition from the top of your class at school, to feeling like a very small fish in an incredibly intelligent pond. Oh yes, I had been good at science at school, but here were people with eidetic memories, with natural mathematical flair, with research skills I could only dream of. I felt very mediocre. I never failed an exam, but I always got a ‘Pass’, and never a ‘Distinction’ like the brightest students in my year. I worked very hard, and envied those lucky few who seemed to go out clubbing every other night and still did better than me! I began to doubt my intelligence.

I had a very difficult patch in second year, when I felt so unhappy that I went back home to my parents, determined to give my studies up altogether. I am actually very glad they turned me round and sent me back again, because at this point it was the stress of exams that was getting to me, rather than a desire to change careers. Going back and getting the pass mark helped me to appreciate how resilient I was.

I was also reassured by the people around who said ‘you don’t need to be academically brilliant to be a great doctor.’ My dad was always telling me medicine was more of an art than a science, and he is right in many ways.

“It’s all very well being a bookworm, but when it comes to patients, you need people skills, compassion, detective work, communication.”

I still believe this to be absolutely true, but I miss being an academic geek.

‘Just get through pre-clinical,’ he said. ‘The clinical years will be better because you’ll actually be on the wards.’

I took a year out, as many medical students do, to do a BSc in Medical Imaging at Leeds University. I’m still a little vague on my reasons for doing this – I think I was stalling, trying to run away. I hated it. The complex mathematics and physics involved baffled me, and I came out of it with a disappointing 2:2. I felt some success when I presented my dissertation at a national conference, but the mind-numbing boredom I went through to collect the data for that project made it seem hardly worth the effort.

Then it was back to Bristol, to complete the long awaited clinical years. People were right – they were better than pre-clinical. I got to be in a hospital and see how things worked, and I got to speak to patients and their families which I genuinely enjoyed. While following the doctors around, I felt (as most medical students do) that I was getting in their way a lot of the time, but I was glad to get the chance to see what medicine was all about.

I knew however, in my heart of hearts, that I didn’t really belong in this world. There was something about it that I just couldn’t get on with, but it was difficult to express that to my tutors. ‘Just finish the clinical years,’ they said. ‘It’ll be better once you’re working.’

The clinical years went by. I was lucky enough to be at Bristol Medical School at a time when they ran an Erasmus exchange for medical students, and got to spend six months at the Université Pierre et Marie Curie in Paris. My professors warned me that my exam marks would most likely drop when I got back due to the fact that I was going to a different country, with a different language, different medical school, different curriculum and completely different way of doing things – but I didn’t care. I just wanted to speak French. That should have been a massive warning sign right there, but I didn’t see it.

‘Just do your Finals,” I told myself in the mirror, “Then at least you’ll be qualified.’

I still held onto the hope that actually being a doctor would wash away all my doubts, that somehow things would be different, and I would be different. And with the recession biting, I was glad to have a secure job waiting for me at the other end of university.

I sat Finals. I qualified. I got my first choice of job in East London. I still didn’t feel complete.

‘Just finish FY1, at least then you’ll have a full registration.’

I started my FY2 year. Things were getting worse. I was becoming deeply unhappy. I wanted to leave.

‘No don’t leave now,” said my supervisor, “Just get into a specialty training programme. Do your exams, finish your training and become a GP. It’s only three years. Then you’ll be a completely qualified GP and stand in much better stead.’

Three years of misery would stand me in better stead for what exactly?

I know my family, friends, tutors and colleagues have meant well with their ‘just finish’ advice. They want me to be in a good position and credibility in life, and I do too. The ‘Just Finish’ mantra has come as much from my own voice as it has from others, and I have learned much from my experiences. I wish I hadn’t done a BSc that was so wildly at odds with my entire personality, but I am glad I finished my medical degree. It was tough, but it was an achievement, and a great degree to have.

However, there comes a point when it has to stop. I have jumped through hoop after hoop, hoping there will be something good on the other side, convincing myself it will be worth it, but each time all I can see are more hoops and more exams, and each time I become more exhausted and disheartened. It is easy to stay on the conveyor belt in medicine – to keep going for the sake of keeping going, to do the next thing simply because it’s the next thing to do, and not because you really want to. I don’t want to look back one day and wonder how I got there, having been so obsessed with the destination that I forgot to enjoy the journey. I don’t want to ask myself one day why I spent my youth doing something for everyone else but me.

I was planning to finish my FY2, but then I got sick, very sick. As I was lying in hospital contemplating my attitude towards the future, I realised I had subconsciously assumed that I would have plenty of time to do the things I wanted to do, and that the people around me had reinforced that idea in my head by saying things like, ‘you can study your languages when you’re pregnant and have nothing else to do’ or ‘you can write your novel when you’re retired.’

My illness made me face the idea that I may not have a tomorrow. It sounds melodramatic, but it’s true. I began to think about the things I wished I’d done, and finishing my novel was one of the things that stuck out so strongly in my mind. Was I going to slip out of this world with that story untold, those precious words unspoken? Time was suddenly precious, and unbearably limited.

I am aware that finishing my FY2 would make it easier for me if I come to regret my decision to leave, and eventually come back to medicine. My supervisors are going to say that when I come crawling back to medicine, my current deviance will make it harder to find a training post, look bad on my CV, maybe even prevent me from practising again without some sort of retraining. They will berate me for having no plan B. Is this bravery or madness? Who knows.

It’s also going to be really hard to tell my parents.

Once upon a time, these arguments scared me, but not now. Frankly, I do not believe I will ever come back. Medicine is a wonderful and noble career, but it’s not for me. I’ll be scribbling stories, dabbling in poetry, brushing up on German grammar, grappling with Sinhalese vocabulary and maybe discovering Spanish, Italian and Hindi.

And one day I will be back in Paris, gloriously unfinished, and speaking French.

My best friend and I in Paris.
My best friend and I in Paris.

Alternative Careers and Wellbeing for Doctors: a Medic Footprints affair…

AwI came across Medic Footprints in a manner perhaps apt for my generation: Facebook. I can’t help being suspicious. In this Big Brother world we now live in, did social media know I’d been desperately googling ‘alternative careers for doctors’ over the last few months? I wouldn’t be surprised if they did.

In any case, I was glad of it. It was an advert for ‘Alternative Careers and Wellbeing for Doctors’, an event which promised inspirational talks by ex-doctors, exhibitions on other career options, career coaching, seminars, workshops, mentorship, advice on health and well-being and plenty of networking opportunities. I jumped at the chance. I didn’t care about the expense of the ticket – it felt like a necessary investment in my future.

Now, since I’ve already resigned, I was a bit worried about going to the event today. I was nervous that it would make me regret my decision. The first talk was to be ‘Do I Really Want to Leave Medicine?’ What if the answer was no? What if someone there presented an opportunity within medicine that I hadn’t considered and wished I had?

Still, I went along with mixed expectations. I soon realised, as is common with me, I had been worrying about nothing…

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The first talk was by Dr Evgenia Galinskaya, founder of Other Options for Doctors.

Other Options for Doctors

Cambridge-educated and clinically excellent, Dr Galinskaya beat off fierce competition to land a registrar post in dermatology. Despite having worked so hard to get there, and outstanding feedback from her colleagues, she found herself missing something in her life, and made the difficult decision to leave medicine to pursue a new life in career coaching.

“Two years later, I don’t make as much money as I did in the NHS, but I have found an inner peace… You have to do what makes you happy.” Dr Galinskaya

She spoke about her emotions at the time she left, and they resonated so strongly with me: guilt about quitting, fear of leaving a steady salary and job security for an uncertain future, a sense of wasting her medical training… It was as if she were taking my current sentiments right out of my mind and giving them a voice. It was hard, she said, to convince those around her that leaving was the right option for her. ‘Once a doctor, always a doctor’ they said.

She even said that she had tried to leave before, but had been persuaded to stay. Her expression of her feelings had been rejected by her peers and mentors. Have I not been through exactly the same thing? When I dared to mention my thoughts about leaving to my educational supervisor earlier this year, I was met with an immediate warning not to waste my education or make rash decisions. She didn’t ask why I wanted to leave, or even consider that it was an incredibly difficult and agonising decision which I have taken literally years to make. Instead she dismissed me with advice that ophthalmology was a good career for a woman.

Anyway, I digress…

In short, Dr Galinskaya was funny, frank, open and inspiring. I knew immediately that I had made the right decision, and my relieved heart opened up to the rest of the day.

There was so much going on. I wished I could have been in two places at once at times, as I wanted to absorb as much as I could.

The Doctors’ Mental Health in the Workplace session turned into a hilarious argument between the controversial and sharp-tongued Psychiatrist Dr Raj Persaud and Dr Andy Heeps, a Fitness to Practice panelist from the GMC. Dr Persaud made some extraordinarily blunt comments about the NHS today – how it stifles creativity and ‘crushes’ innovation while the GMC seek to persecute doctors in the most distressing way possible. He claimed that there was a fundamental difference between those who see being a doctor as just something they ‘do’ as an employee, and those who see it as something they ‘are’. The latter see medicine as their vocation and their calling, and in Persaud’s words, ‘actually give a shit.’ If you’re willing to tow the line and bow down to the rules and regulations put in place by the management, then you’ll be fine in the NHS. However, if being a doctor is something you ‘are’, Persaud claims that your fundamental loyalty lies in providing the best patient care and in pure science – the two things that lie at the bottom of the list of priorities in the NHS. This causes extreme stress in doctors who care.

Perhaps this is a slightly harsh view of the NHS, but it certainly struck a chord with a lot of us who are frustrated with the system’s almost authoritarian demand for obedience and its indifference about what’s best for patients.

Next up was Dr David Perl on his incredibly varied career as a physician, and how psychotherapy transformed him from an arrogant narcissist into a leadership guru. He had some great quotes on his slides:

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The talk about Occupational Medicine by Dr Richard Peters was interesting, as he seemed to suggest that it was possible to find lucrative work as an in-house occupational health practitioner for large private companies without having done any work in occupational medicine within the NHS. I don’t really want to go into the field, but it did make a very interesting point about the difference between the public and the private health world. Dr Peters has built up an excellent reputation, worked for a variety of companies and has a very diverse experience, yet he would never be able to get a job in the NHS as a consultant as he hadn’t gone down the ‘normal’ route. He would have to go back to the beginning, take a pay cut and go through the whole rigmarole of applying to specialty training.

After lunch, Dr Charlie Easmon took us through his story of business success, then failure, and then success again. We met a panel of doctor entrepreneurs who were still working for the NHS and somehow finding the time to develop their businesses. Then Dr Na’eem Ahmed made us all feel humbled with his incredibly moving and impressive presentation about his philanthropic work with his charity ‘Selfless’.

In the breaks I met everyone from medical students considering their first steps, to foundation trainees taking ‘F3’ gap years and registrars contemplating a specialty change. I also met Dr Gyles Morrison, who made a huge impression on me. He had a different take on the guilt many of us felt about ‘wasting’ our medical education:

“Who here did a geography GCSE?” (Several hands go up) “Well why aren’t you all weathermen then?”

It’s true. My friend who did a history degree isn’t an historian, and she doesn’t feel bad about it.

Gyles, a covert artist and musician in his spare time, was a profound reminder that medics are often multi-talented all-rounders with hidden talents. The fact that he left medicine to work in IT and is now an expert in user experience technologies was inspiring enough, but Gyles himself is filled with so much passion and so much energy that it’s truly infectious. He questioned me with a genuine interest about my writing – what’s my novel called? What’s it about? I answered almost with embarrassment, as I currently lack any kind of confidence in my literary exploits. It was the first time I’d really talked about my book with a stranger, and I was touched and reassured by Gyles’ belief in me and his conviction that my plot was a good one.

Speaking of writing, there were two presentations by doctors who wrote poetry and stories in their spare time. It got me thinking, why can’t I do that? Why haven’t I sent of any poems to magazines, applied for any competitions or signed up for open mic nights? It’s because I’ve never considered that I could be good enough to do any of those things, so I’ve never bothered to even try, but in front of me today was living proof that I could be good enough, and people will want to hear my voice.

Other exhibitions and talks I didn’t make it to included army careers, management consultancy, working overseas, medico-legal careers, aesthetic practice, CV management, pharmaceutical work, medical volunteering at festivals, mindfulness, acupunture, yoga… There was something for everyone, and all the delegates I spoke to felt the inspiration and positive energy that infused the Grand Connaught Rooms today.

Afterwards, I spent some time with the founders of Medic Footprints: Dr Abeyna Jones and and Sara Sabin. They had been up since 5.30 am preparing for the event and were understandably exhausted! But I can’t thank them enough for this experience.

Walking away from Medicine was never going to be easy, but the actions of people like Abeyna and Sara make it just a little bit more bearable. Today’s event has given me reassurance that I know what is best for me, faith that I have enough transferable skills to be successful elsewhere, and the belief that maybe, just maybe, I can follow the dream of becoming a published author.

After all, I’m sitting here writing this blog right now.