I’ve been reaching for the words for a while now, but somehow it has been really difficult to formulate them into coherent sentences.
Driving to work this morning and hearing yet more news about the state of the NHS, the tears actually started to fall. There have been months of debates and strikes and plenty of opinions on both sides. This may just be another voice in the crowd, but I’d like to share my experience.
21 years ago I was in South Africa, naively thinking I was going to change the world. I was about to start at medical school – it was an incredible exciting time. I’d wanted to be a doctor from a young age – however clichéd it might sound. It was from a genuine desire to help people. There was no particular ‘light-bulb’ moment, but the passion was there. I knew the journey would be full of challenges. Even in my interview, I had been asked how I would deal with working 100-hour weeks – they still happened back then. At 19, thoughts of having my own family were light-years away and I was ready to dedicate my time and energies to learning.
Six years later and I was ready to hit the wards. As with many others, my first day at Central Middlesex Hospital left me wondering what on earth I’d learned. None of it seemed to help when I was wildly trying to insert lines, catheters and various other devices into people. In my first week working in orthopaedics, we had a young chap that had been involved in a hit and run and had broken numerous bones and damaged his spleen. He was in theatre for about 10 hours overnight with both the surgical and orthopaedic teams and I was scrubbed in throughout. As a team we all went for breakfast afterwards and there was such a sense of support and camaraderie. That week I worked over 100 hours.
General Practice beckoned early on. I married my medical school man and family life wasn’t really compatible with A&E shift patterns. GP training was flexible and my trainer was ‘old school’ and inspirational. He taught me so much, not just the medical stuff, but the more intangible – recognising triggers, picking up on cues, being there for families during their saddest moments, and all the other challenges that General Practice brings.
And then things slowly changed.
Appointments increased – we went from seeing 14 patients in a morning, to over 25.
Paperwork increased. More and more government targets, that often took us away from proper patient care. (Should you really ask about someone’s smoking status, when you’re seeing them following a bereavement?)
Requests for home visits increased, with larger patient numbers. There were the ones with genuine need, but demands from 18-year-olds with a cold could be frustrating.
And then the more insidious threat of litigation. I know many colleagues who have been sued and it has often marked the end of their careers. The unseen anxiety that most clinicians have – I’ve been told on several occasions by patients that I have to refer them or else they will sue me. Not a comfortable situation and one that makes our role as gate-keepers ever more difficult.
My own mental health felt compromised.
I’d wake at 2am worrying about the work-load the following day, worrying about making a mistake, worrying about being a rubbish mother and a rubbish doctor. Only my closest friends know about my last few months as a salaried NHS GP and the toll it took.
It’s taken over 2 years to regain most of my confidence and happiness, and it’s been a long hard journey.
There are still ‘blue’ days. I felt I had totally let myself down. I always assumed that I’d be a successful GP partner one day, and that was now never going to happen. As with most medics, I probably over-analysed and picked myself apart until there was very little left. I know I wasn’t alone – my husband was asked in his last appraisal whether he felt suicidal. When he looked a little surprised at the question, the reply was that the previous doctor had actually killed himself.
A profession of caring, hardworking people have been crushed by their working conditions to absolute breaking point. And, if we as doctors are breaking, we simply cannot provide safe care for our patients. We all need to look after each other and find a little compassion. Out of my medical school intake I only know of two GPs that are still working full-time in the UK. The rest have either emigrated, resigned, work very part-time or are struggling with their own health issues.
So the tears fell this morning for many reasons. For the privilege of helping those through some dark times. For my amazing friends and colleagues who continue to fight on in a broken system. For the doctor that I never felt I quite became. But mainly for the profession as a whole who are grieving for an NHS that has changed beyond all recognition in a mere generation.
And for me, what now?
Time to open new doors and see what lies beyond…..
Clare will be writing a follow-up to this post soon. I hope that this will illustrate that it is possible to follow what interests you and be successful. You don’t have to find a career that fits neatly into a box. We all have so many transferable skills.
If you have any thoughts or questions, or even a thank you to Clare for sharing her story, please do comment below. (You will need to sign in here to do so if you don’t already have a WordPress account).