The Perks of Being a Doctor

A&E

When you grow up in a medical family, you notice how useful it is to know a doctor. Our friends come to my father constantly with their problems; whether it’s for advice, reading a scan or even organising a scan, knowing a brilliant Radiologist like my dad is an exceptional advantage.

My uncle is my dentist. I still feel a bit guilty when we go to his house for dinner and eat dessert in front of him.

Down the road are a married couple. She’s our family’s GP and he’s a paediatrician (and formerly my boss) at the hospital, but they’re old family friends as well. If ever I need advice, both their mobile numbers are on my phone. I don’t feel guilty about his because it means I won’t take up valuable patient slots at the practice. I guess it helps that I’m a doctor myself and tend to know what’s wrong with me already, but it’s just so practical to not have to make an appointment when I know that all I need is a quick chat. That appointment can be left for someone who really needs it.

I remember when I accidentally dropped my brother down the stairs when he was a baby (yes, it was an accident, although my brother now teases me mercilessly about how I did it on purpose, and declares that any mental deficit he suffers from is my fault). After my dad arranged head scan for him, and a paediatrician friend checked him over, they confirmed he was absolutely fine, so I now tell my brother that all his failings are his alone!

It’s not just family and friends. The cleaning lady, the postman, the handy man and even the gardener have all asked for assistance and advice, and my dad has always been very giving of his time to those in need. Cynics call it nepotism, and the GMC has very strict rules about how far you can go as a doctor to treat those you know personally, but I really think society has become so obsessed with this concept of impartiality that they’ve forgotten that it’s human nature to use what you know to help those around you.

Which brings me to what happened last night: over the last week or so, my fiancé has been complaining of a ‘spot’ on the back of his hand. It did just look like a regular spot, but it was hurting him a lot. As the days went by, the area became redder, more swollen and more painful. I treated it with all the over-the-counter things I could think of, but nothing seemed to be working. Last night, when he came home from work, it looked worse than it ever had before, and I was certain it was cellulitis. There was possibly also an abscess, and he needed antibiotics. My fiancé, however, has only just started a new job, and was irritated at the thought of having to take time off work so early. Making an appointment at his GP practice was always difficult, and he had no desire to wait around in a hospital for treatment.

I was at my wits end trying to figure out what to do. My home town was too far away to ask my GP or family for help. If I was still practising, I could so easily solve this problem! Even though you’re not allowed to prescribe for family members, it would have been simple enough to take him along to the hospital and get one of my colleagues to see him. Hell, I could have even lanced the damn abscess myself! As it was, I couldn’t even put a dressing on for him. When I was a doctor, I had access to all this stuff.

I really felt that I was failing him. And yet, I chose this. It’s not my job any more.

Luckily we had a hand from Dr Karen Morton, founder of online GP service Dr Morton’s. She  told my fiancé it was serious and needed immediate treatment. I’m so thankful she called, because I would never have been able to convince him to go to A&E otherwise!

11.30pm. Along we went to Whipps Cross. Funnily enough, we were in and out within an hour. I guess that, with the strike going on, people were staying away from A&E. We were seen by a lovely nurse who made us both laugh. She dressed and cleaned the hand, and gave us the antibiotics and painkillers he needed.

While we were in the waiting room, my fiancé asked me why I was upset. I told him how I felt; that I missed being a clinician. I was so frustrated that I knew exactly what to do and yet couldn’t make it happen. I felt like crying. Medicine was such a huge part of my identity, I didn’t know how to be without it – I didn’t feel like anything without it. I know this sounds melodramatic, but I was tired and frazzled, and seeing my fellow doctors strike earlier had stirred up a lot of emotions.

“Medicine’s not who you are, it’s just something you did for a bit,” my fiancé told me kindly, “You’re more than just a doctor, you know.”

I told him about a doctor I’d met that morning on the picket line of Guys and St Thomas’ hospital. I interviewed him for this blog and he told me about how he used to have anxiety attacks every time he came near the hospital. He pushed through it, however, and is now a paediatric trainee.

I remember that feeling. I remember feeling sick with fear before every shift. I remember having to coax myself out of bed in the morning, just to get up the courage to go to work. I remember the amount of wine I needed to get myself through a run of nightshifts. It wasn’t a healthy place to be, but I felt I had given up too early. Should I have just carried on, hoping one day it would finally be ok? Should I have, as some friends suggested, restarted my antidepressants, just so I could get through my training?

“What are you talking about?” said my fiancé, “You did something you hated for 8 years and now you think you didn’t give it enough of a chance? I never got to see you when you were a doctor. You were constantly tired, and always ill. We never knew where you were going to be from one year to the next, and we couldn’t plan anything in advance because you never knew your rota. You were grumpy and miserable, and you just weren’t you. It’s different, now you’ve stopped; I actually get to spend time with you.”

It was the first time my fiancé had ever told me honestly what it was really like for him when I was working. It dawned on me that maybe my inability to treat his cellulitis didn’t fail him as much as my former lifestyle had.

We walked out of Whipps Cross together, after a free appointment, with two boxes of free medication in our hands. The NHS really is amazing. I definitely took what I did as a doctor for granted – it was my job, after all – but it was incredible, and that’s why it’s so hard to walk away. But looking at the striking doctors from a distance, I can see things in a way that I couldn’t before: even after everything the NHS puts them through, doctors still continue to fight for it, and when you put it like that, their struggle is more poignant than ever.

 

Click here for an exclusive interview with a junior doctor on the picket line.

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So… what do you do?

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December is the prime time for this question, or versions thereof. With everyone getting together for Christmas and New Year, I knew I would be catching up with friends and relatives and meeting new people, so small talk would be abundant for a good two or three weeks. I have to admit, I was dreading it. I was afraid of their judgement and remarks. I suppose I was also afraid of how I would react to their reactions. I could hardly justify my situation to myself, so how could I justify it to others?

I have always taken it for granted that I could give people a satisfactory progress report. “I’m in year 13” turned into “I’m in year X at medical school,” which turned into “I’m working at such-and-such hospital.” The only variation to contend with was the inevitable follow up question: “Have you chosen your speciality yet?”

Traditionally, the responses I have given to these queries have depended largely on how I feel about the person asking them. With kindred spirits – the people I feel will really listen and might understand my point of view – I am honest, but mostly I’ve just been busy hiding my true feelings about it all these years, even from the people closest to me.

As Christmas loomed, everything seemed so complicated. What was I supposed to say when people asked me what I was doing now?

“I had a quarter-life crisis and quit my job with no plan B, so I’m now officially unemployed and relying on my savings and my fiancé to get by. I have no current certainty or prospects, and not much of an idea about what to do, except a vague plan to write a novel that I’m unjustifiably optimistic about.”

It sounded terrible. I almost wanted to avoid the festive parties altogether to save myself from this humiliating admission. I also felt bad for my parents – when people asked them how I was getting on, they would be having exactly the same problem.

Then, two things happened to me.

The first was deciding to locum after my little visit to the job centre. That gave me something solidly medical to say, and was a relief. “I’m locuming at the moment” is a brilliant answer for those you don’t really want to talk to, and who are just asking you for the sake of saying something. It’s satisfying for both parties and the perfect precursor for a swift exit line.

The other was this: at the start of December, in between dancing for joy and plunging into the depths of despair, I started job hunting on the Guardian website. I found an ad I was interested in for a managerial role in a charity, but being inexperienced with this sort of thing, I was doubtful. I worried that I didn’t meet the criteria in many of the job specifications, because a lot of them stated the necessity for formal qualifications or specific experience. But, as my fiancé told me, job specs are not hard and fast rules. They represent the ‘ideal’, and most companies would rather hire the closest match than wait for the perfect candidate. My career coach has also been helping me to realise the value of the skills and experiences I already have.

So I shot off my CV, not really believing anything would come of it. Then two weeks later, I got a call. The charity had said my application was certainly unusual, but they had loved it. They offered me a telephone interview, and after that, they offered me a formal interview. I’m going in for it next week. Whether or not I get the job in the end, it’s been such a boost for me just getting to interview.

It’s also nice to sing my own praises. It’s not something I got to do much in medicine – it was more about people assessing me. ARCPs are tick-boxing exercises and applying for clinical jobs requires more form-filling and exam-taking than knowledge of your true strengths, skills and weaknesses. It’s just the nature of the medical profession that everybody is presumed to have all the necessary skills for their level. As a result, the thought of doing a non-medical interview is scary. No longer can I rest on my laurels; I actually have to prove myself. It’s made me sit down and think about what I’m really good at, what suits me and what I really want – perhaps for the first time in my entire life.

As the Yuletide approached, I started to see my situation is a different light. Yes, there are things in my current situation that I don’t like, but there is also plenty of potential. This is a really exciting time for me, and I really need to give myself a break. It sounds cliché to ‘have faith in yourself’ and to ‘stay positive’ but these little things can be incredibly difficult to do. I still struggle sometimes, but I’m working my way towards another cliché where I see my glass as half full.

So now, when people ask ‘what are you doing now?’ I have an answer I’m proud of:

“Well, I’m planning to locum while transitioning into a new career. I’ve got an interview with a charity soon for a management role. In the meantime, I’m volunteering for Medic Footprints to help other doctors in their careers – a role that I got because the directors were impressed by an article about their conference on my personal blog. I’m also researching the British colonization of Asia to give historical accuracy to the novel I am currently writing.”

There. Sounds much better doesn’t it? And the best things are: it’s all true, and I can say it to everyone.

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Image from Malla.

Malla is a small business coach and expert at answering this question!

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.

 

Hitting Rock Bottom – apparently you bounce

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It’s been two weeks since I stopped working. Two weeks sober. What a fortnight I have had…

When I woke up the next day at 8am instead of 6am and had nowhere to be, it felt delicious. The hours of the day stretched out before me, with waves of potential, and to be honest, all I really wanted was to have a break for a bit. I knew I would need time to process leaving Medicine. I didn’t quite anticipate the size of the grief reaction that was about to hit me.

The following Friday, I took myself down to Russell Square where the Professional Support Unit is based. I called them before I left my last job on the advice of the Dean and I really can’t recommend them enough for any doctor in training (foundation or speciality) who is in trouble. They provide all sort of help, from confidential mental health support to career coaching. When I called I had a really interesting conversation with a lady who turned out to be herself a creative – she is a freelance screenwriter who also works on a freelance basis for the Professional Support Unit. They allocated her to be my mentor, I suppose because of our common interest in writing.

We sat down together in a little room with the sunlight streaming in, and we talked. She asked me about my strengths, my likes, my dislikes and my values. And do you know, I found it so hard to articulate those things. After all that communications training, and despite my own quadrilingual tongue, I could not think of a word to say for myself. I panicked internally; how the hell was I going to perform in future interviews if the answer to “what are your strengths?” was silence?

I can’t really say I’ve ever thought much about any of those things. My strength was always my ability to pass exams or ARCPs, my values were insignificant because I was already doing something of such great value, and as for my likes and dislikes, that conversation mainly revolved around the choice between doing medicine or surgery, or between being a hospital doctor or a GP.

My mentor (I will call her ‘Jane’ for the purposes of this) then tried a different tack. She asked me to describe different experiences in my life. She got me to talk about the time I did some voluntary work in West Nepal, and suddenly, talking became a whole lot easier. I could actually appreciate the fact that turning up in the middle of nowhere in an unknown country was pretty brave. I could see that, after being told I was going to be an English teacher but then when I got there, they needed me to be an Art teacher for deaf young people and Dance teacher for street kids, I needed a great deal of adaptability and quick thinking to provide that.

“You’re a storyteller,” Jane told me, “You find it easier to talk about yourself through the medium of stories.”

Deep down, I’ve always known this. I novelise everything because it makes it easier for me to understand and therefore easier to cope with the difficult things in life. I didn’t realise this was a good interview technique.

She gave me some homework to do and I left feeling pretty positive. I realised that now was the perfect time to get to know myself a little better – not with a view to becoming self-centred, but more with the aim to appreciate what’s there already and what isn’t, and to have confidence in my strengths while appreciating my weaknesses. I started to look at my CV, which is very medic-orientated, and tried to see how I could change it to make sense to non-clinical people.

Then the doubt set in.

One day last week, my dad called me up with the express desire to talk about my career. What am I doing now? I’m just lying around at home? Officially unemployed. After all that work, I’m unemployed. So how am I managing financially? Oh, I’m using my savings? Well that’s not very sensible, is it? Am I just going to be a housewife now? Am I going to rely on my fiancé for everything now?

It was so distressing that I couldn’t carry on with the conversation. The idea that no longer being a doctor meant I could only ever be a housewife was ringing in my ears, and I was crying. I tried to rally myself: ‘I will find a job. It might even be a well-paid one, who knows? I will earn my own money and be a useful member of society.’ But it was no use, because when you’re faced with people around you who are baffled by your choices:

“I just don’t understand why you didn’t finish F2! Even if you didn’t want to continue being a doctor in the future, why didn’t you finish F2? It’s bad not to complete things. When you start something, you should finish it. You only had 4 months to go! What are your reasons? What’s your plan?”

These are reasonable questions to ask, and I know the people ask them are just worried about me and wan the best for me, but I find it hard to reveal my real reasons because I fear they won’t be taken seriously. I left because my heart was telling me to, and my only definite plan at the moment is to finish my novel while somehow finding my way into the right career. Such delicate and vague ideas are too easily quashed before they blossom, so I protect them from the storm around me by keeping them to myself.

People tell me that I’m just too romantic. I’m just a dreamer. A friend of mine told me all the people she knew who had tried to do something different and had ended up crawling back to their original profession with tails between legs, but she also told me that even if I manage to get another job, it will never make up for the fact that I didn’t finish my F2, because this is the biggest mistake of my life and I will regret it.

It makes me feel panicky just recalling these conversations. I feel like a small child who had done something very bad and was now being scolded, but it was worse, because I didn’t have the protection of being a small child. I am an adult, supposed to be successful, supposed to be self-sufficient, but all I am is one great big failure.

There it was. That word. Failure.

It’s surprisingly easy to go from niggling doubts at the back of your mind to full-blown depression. It’s a well-trodden path for me, so I know the way down pretty well, and down I went. I felt completely and utterly worthless. The weight of my mistakes and my decisions weighed heavily upon me, and I just couldn’t see how I was of any use or benefit to anyone in this world. I was only a burden on my parents, on my fiancé and all my friends. I was so low and so anxious that I couldn’t even bear the thought of locuming! What was the point of continuing? What the hell was the point of me?

Thankfully, the way back up is also a well-trodden path for me, and what I have found is, when you feel that way, you internalise everything. Paradoxically, you do become self-centred, caught in a loop of negative feedback with you in the middle of it. You break that when you connect with other people, and specifically when you help other people.

On my birthday last Friday, I went to look after my friend, who recently was admitted to hospital, and was coming home to an empty house, as her husband was away in Sri Lanka. I made her lunch and did some jobs for her, and helping her made me feel like a good person again, and she helped me by listening to me and comforting me.

I had just come back from running some errands for her when I noticed some books on her bookshelf. They were her husband’s books about the history of Sri Lanka, written during the 1800s. I could hardly believe my luck! My novel is historically based on the British colonisation of Sri Lanka and here in front of me were books documenting that very period! I asked her if I could borrow them.

I am now sitting on my sofa at home, exactly where I was a week ago, when I was so paralysed by fear and doubt that I felt unequal to everything, but now I have a book in my hand. I’m reading two others at the same time. Researching this topic is exciting! It’s actually fascinating to get a glimpse of what happened and how people lived in those days. My hand alternates between pens and highlighters and I’m brainstorming about how to include all this history in my story. The time passes quickly and I am in my element.

Things aren’t completely OK yet, but this enthusiasm is infinitely better than the despair I felt last week. I still feel really concerned that people will think I’m just bumming around and sapping resources, but I’m beginning to see that worrying myself into a frenzy is just about the perfect way of becoming the very thing I’m afraid of. I am not a failure. As for being accused of being a ‘romantic’ – that’s absolutely correct. Count me with the dreamers, and watch me make a career out of it.

 

The Dangers of Ego: how medicine became my self-esteem

ohne arbeit

The other day, I was on my way to the Royal London Hospital to discuss my resignation with the Dean of my Foundation School, when a man going past on a bicycle stopped next to me.

“Are you lost?” he asked, with an accent that I recognised to be Sri Lankan. I turned away from the map and looked at him, and his features confirmed our common heritage.

I explained I was looking for the hospital, and he pointed me in the right direction, but before I could get very far, he began to tell me all about the amazing pastor at his church, who apparently had died, visited hell and heaven, had a chat with Jesus, and come back to earth again. I suppressed a smile as he asked me if I had time to chat, and said I was in a hurry. He then asked me why I was going to the hospital. I obviously didn’t go into my real reasons, but the moment I said the words ‘I’m a doctor’, he looked at me with such awe, as if I were the one taking return journeys in and out of the afterlife.

It’s not an uncommon reaction. Although the medical profession is much less revered now than it was twenty years ago, people are generally still impressed when you tell them you’re a doctor. “Wow! That’s incredible! You must be clever,” they say, or “I couldn’t do what you do.” As for my Asian relatives, particularly the older generation, I represent the ultimate achievement.

When I think about how hard I’m finding it to leave medicine, I can’t help but admit that part of it is losing that massive ego boost. The moment you qualify, you are seen almost universally as intelligent, selfless, noble, caring and respectable. Another bonus is the fact that people have a basic understanding of what it is you actually do – as opposed to the non-vocational folk like my fiancé, whose job description of ‘business consultant in macroeconomics and econometrics’ is vague at best, and downright confusing at worst. I don’t have to justify myself as a good person because my occupation automatically confirms that. I save lives. I help people. I took an oath to devote my life to healing the sick. What kind of person breaks that promise?

The “Bristol Promise”

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When I think of how amazing and necessary the work of a doctor really is, it’s hard to validate my existence without it. If I am ever one day shipwrecked on a desert island, I’d have gone from being someone you’d definitely want to keep alive to someone who can be eaten without any great consequence.

The funny thing is, when I step back and look at it objectively, I can see quite clearly that Medicine is not the only ‘noble’ thing to do in the world. Our intricately connected society relies on the collective effort of many, and we all can influence the world around us for the better in our own way. The problem is, these things are not always recognised  in the same way that being a doctor is. In this world where money and fame is more celebrated than anything else, medicine is still holding on to respect and value by the tips of its fingers, whilst the actions of good teachers, parents, farmers, legal aid lawyers, emergency service personnel and countless others fall by the wayside.

I used to dream about working as a doctor in Africa or Asia with Médecins Sans Frontières, providing healthcare for the poorest and most vulnerable. When I started to become unhappy in Medicine, this dream was the only thing that kept me going, but I realise now that my desire to be of service had become tainted with selfishness. I wanted to make a point, to show that I am a good person, but there’s something paradoxical in the truth about this: if you do something you hate for the sake of being good, resentment will poison any happiness you gain until you can’t do it any more. But if you use something you love to do something good, the happiness you gain will motivate you to keep doing it, and the good you do will be tenfold. The line between selfishness and selflessness suddenly doesn’t seem so clear.

These next few months are not going to be easy, I know. I have already experiences the sneers and sometimes just plain disbelief that I would ever dream of giving up Medicine, and I’ve barely told anyone in my family about it yet. I dread my next trip to Sri Lanka, as there the judgement will be even more severe.

However, I am coming round the idea that my self worth isn’t quite so dependent on Medicine as previously thought. As my best friend once said, “I don’t love you because you’re a doctor – I love you because you’re loyal and kind, and always there for me.”

I am still determined to help people, but perhaps being obsessed with a goal in actually more of a hindrance than a help. After all, my literary inspiration, Jane Austen, didn’t write her books with a view to helping me, but she has. Her books have been my joy and comfort in many a dark moment – one of many unexpected echoes of her quiet, modest life that she will never know. I’m sure if she were alive today, she would tell me to chill out and take myself less seriously.

Perhaps she’d tell even me to listen to Bertrand Russell, who I believe once said:

“One of the symptoms of an approaching nervous breakdown is the belief that one’s work is terribly important.”

My Last Day…s

On Tuesday 1st December 2015, we all thought it was the last day. Every four months, foundation doctors rotate round into their next specialty, meaning a new team, new patients, new rules and sometimes even a new hospital or town. Tuesday was to be that day, but then the unprecedented industrial action was called over the junior doctor contract row. The first strike was planned to take place on our rotation day, and with the government being so continuously unreasonable, the strike seemed imminent. We all said our goodbyes on Monday – to our favourite patients, the nurses, the ward clerks and our senior doctors, knowing how our day to day closeness would fade into brief smiles in the corridors and occasional chats in the coffee shop queue.

For me, there was another goodbye to make: to medicine. It was a very busy day and we were short-staffed, but for once I was grateful for this. It was a distraction from the enormity of what I was about to do: walk out on my profession and my security, into the unknown. My colleagues reassured me with reminders that I can always come back if I change my mind in the future. I know they’re right and I appreciate them trying to make me feel better, but right at this moment, I do not think I will ever come back. Unless financially I am forced to locum to support myself, I think this is it for me.

With this in mind, I found myself becoming very emotional as the day went by. “Is this last time I will write a drug chart? Is this the last time I will order an x-ray?” I even felt sad doing a discharge summary! Grappling with hopeless IT systems and pointless tick boxes has been the bane of my life for the last 3 years, and yet I seem to have become strangely attached to it.

The hardest reality to face was that of blood taking… I remember how nervous I used to feel when I first started doing bloods and cannulas on real people back in medical school. I remember the venepuncture failures when I first started working, and sidling up to my seniors, looking sheepish, to ask for help after two unsuccessful attempts. Then I did a Geriatric job – thin, faded arms with sagging skin and veins as thin as paper, which collapsed into bruises at the touch of a needle. My Paediatric job was the most challenging of all – tiny, premature, newborn hands with miniature vessels made visible only by a transilluminator, and the harsh, yet irrepressible guilt as their innocent screams ring through your ears at 3 in the morning while you stab at the skin they have owned for barely ten minutes.

Thanks to these experiences, I am now rather good at taking blood, and over the last four months, patients have told me often that my technique is painless. It is a skill that I can’t really take elsewhere with me, and it does feel like a waste. I cried after cannulating a patient yesterday.

As I walked around the hospital doing various jobs, I got a sense of how privileged I have been to have occupied this world for a time. I scoop up a set of back-breakingly heavy patient notes, and the unattached bits of paper inside all slide out unpityingly onto the floor. As I sigh and pick them up, I realise I am looking at someone’s cancer records. If I wanted to, I could log into the system and look at their bloods, or pull up their scans and see the tumour myself. I could read their clinic letter and find out what their prognosis was. I am privy to some of the darkest moments of people’s lives every day. How odd to lose that suddenly.

I wander over to theatres to find a consultant, and peer into the operating room to see if he’s nearly finished. There’s an anaesthetised patient on the table, half naked with a long bloody slash down one leg. Hip replacement. Isn’t it weird that I get to see this? It’s so normalised for me now that I don’t even think about it, but other people – non-medical people – would find it overwhelming. Inspiring. Fascinating. Gross.

As the day came to an end, I said my goodbyes, took a deep breath and went home. I didn’t have time to be emotional, as my mind was pre-occupied by the plans I had that evening with some colleagues: we were planning to go into central London in our scrubs and stethoscopes to talk to the public about the junior contract row – a ‘meet the doctors’ initiative. I thought it fitting that the last thing I would do as a junior doctor would be standing up for the profession.

Just as my train pulled into Liverpool Street, however, the news came through that the strike had been called off! And agreement had been reached at the eleventh hour! I messaged my colleagues and there was a lot of confusion over why this had happened and what it meant for us, so our meet the doctors plan sort of disintegrated. I had to laugh because I’d just spent the whole day mourning the loss of my daily grind, and here I was going in the very next day to do it all again!

It did feel very strange that this political storm was going on during my notice period. I’ve been vigorously defending my fellow junior doctors whilst knowing that I’m going to be jumping ship very soon. It does feel like I’m abandoning them, but then perhaps they can use me to their advantage and tell the newspapers that Jeremy Hunt’s schemes forced me to quit!

My actual last day was again very busy, as several patients were unwell. Two patients had post-op bleeding and needed blood transfusions. One developed an awful looking wound infection and another was found to have cellulitis. One was paralysed from the waist down, but had the attitude of an angel and the patience of a saint, while another walked cheerfully around the ward for most of the day, but then would crawl back into bed whenever the doctors came in, complaining of ‘unbearable’ pain and not being able to move at all. I had referrals to make, letters to other hospitals to send, rehab units to call, discharge summaries to do, drug charts to re-write, bloods, x-rays, cannulas, and of course, a tour of the hospital and a patient hand-over to do for the person taking over my job. At about 4pm, I sat down to have lunch. Then one of my patients developed signs and symptoms of a heart attack! Nightmare day! I sorted everything out for him and was just about to leave when the emergency buzzer went off in one of the side rooms. I smiled at my colleague as we ran over – it seemed as if Fate did not want me to leave! Luckily it was just a false alarm.

I finally left the hospital at about 6.30 pm. I expected to feel upset, relieved, overcome by the significance of the moment, but I did not. This long, drawn out goodbye has only left me feeling incredibly anxious, and when I got home, I cried for nearly an hour. My worries about locuming, the future and financial stability got the better of me, and I suddenly felt very scared and alone.

What am I going to do now? How am I going to employ my time? How do I make a living? I try to believe I can do anything I want to, but it’s hard to do that at the moment. My nails are bitten to pieces with the stress of it all, and I can’t shut my worrying brain off. Deep down, I know that resigning was the right thing to do, but right now, it feels awful. This is the culmination of my ‘break-up’ analogy. Divorce papers signed, possessions split, paths diverged – bring on the wine and the ice-cream, because I just need to feel my way through this.

goodbye