We always strive to do the best for our patients, to provide the best possible care – why do we not do the same for our colleagues?
The junior doctor
A few years ago, I found myself in A&E.
I had never felt so ill. I was mentally and physically broken. So fractured, in fact, that I hadn’t eaten properly or slept well, or even changed my expression, for months. My hands shook. My eyes swam with too much seeing, and I sat in a cubicle, behind paper-thin curtains, listening to the rest of the hospital happen around me. It was the effort of not crying that stole the most energy. It felt as though the frame of my existence – the fragile scaffolding that held me together – was beginning to snap and splinter, and if no one reached out to help, if no one noticed, the very sense of who I was would soon be spilled from me and lost forever. I knew I was an inch away from defeat, from the acceptance of a failure I assumed would be inevitable, but equally, I knew I had to carry on. I had to somehow walk through it.
Because I wasn’t the patient. I was the doctor.
Each time we visit a hospital, we see them. An army of scrubs and stethoscopes, travelling the corridors with a quiet confidence. We imagine, strangely, that they are invincible. That understanding the mechanism of a disease somehow prevents a person from contracting it. You will never find a cardiologist with angina, a respiratory physician cannot suffer with asthma, and a psychiatrist can never truly understand what it’s like to live with depression. Fallacies. All of them. But perhaps necessary fallacies because they help us to hold on to the belief that a doctor has the power to save us – and if doctors are unable to save themselves, what hope can be offered to anyone else?
For some, though, a stethoscope is less of a protective talisman, and more of a risk factor, because it carries with it an unimaginable burden. The burden of what it means to be a doctor – the internal and external pressure of a definition we have shaped and polished since childhood. A definition moulded by films and television shows, by books and soap operas and magazines. Doctors are objective, calm, knowledgeable. Doctors protect and heal and mend. Doctors fix things. You spend five years at medical school, learning how to fix things, only to arrive on the wards and discover very quickly that there are many, many things you will never be able to fix. During those five years, you sit in front of endless exam papers – exam papers with empty white boxes waiting to be filled with the answers to what you would do in imaginary scenarios – only to find that in many real-life situations, the very best thing you can do is absolutely nothing at all. As the textbooks transform into living, breathing people and the imaginary scenarios become a reality, you will eventually learn that being a good doctor really has nothing whatsoever to do with fixing people. You will also learn that a failure to mend doesn’t make you a failure, and you will learn that an empty white box is sometimes the correct answer after all. But you will only learn these things after walking hundreds of miles of hospital corridors, navigating a landscape so alien and so challenging, you wonder why you ever chose to walk through it in the first place.
But you will learn. Eventually. As long as the landscape doesn’t break you first.
Each time I read that another doctor has vanished from their life, that someone else has felt the need to disappear from this landscape, it takes my breath away for a moment, because it could have been any one of us. It most definitely could have been me, as I sat there in an A&E cubicle trying to work out how a job I had been so determined to do, and so desperate to be good at, had turned itself into my nemesis. I thought back to medical school, to all the past moments that had tied and knotted together and had led me to this one. I thought even further back, to my medical school interview, when I spoke with such passion about a profession I wanted so badly to be a part of. This was my dream, my ultimate goal, and yet it had turned into a nightmare so vivid and so brutal that I could hardly bear to look any more.
On that day, in the middle of a busy emergency department, as I tried to claw my way back from the edge of a cliff, if you had shown me a door marked ‘escape’, I would have gladly walked through it.