Today, you and thousands of others begin as a foundation one doctor. It’s taken you eight years to get here, and your graduation from medical school two weeks ago was a special moment. You became ill during the journey and then instead of being the doctor in training, you became the patient. You are now on hefty drugs for life, yet you have chosen to continue your ambition to be a doctor to care for others.
Eleven years ago I was in your shoes. I’ve long removed the rose-tinted glasses I got from watching television medical dramas that depicted heroic doctors saving lives by placing two defibrillator pads on a chest and shouting “clear”. It doesn’t quite work like that.
You joked on graduation day that so far this had cost you a vital body organ, your hair, money and so much more. Don’t let the job rob you of anything else. I remember not having the time to eat or drink. The choice was lunch or go home somewhere near to 7pm – even though the end of shift was meant to be at 5pm. I lost so much weight my skinny jeans became baggy.
No government is worth you getting ill, especially this one
When I eventually got time to pee, the colour of my urine was darker than my most dehydrated patients. I was so exhausted that disappearing into a toilet cubicle for a few minutes was respite. You repeatedly ask your patients, “Have you eaten or drunk anything today – have you passed urine? But you yourself have not for most of your shift.
Don’t do it that way. We care, so we put others before ourselves, but patients need us to be well to look after them. I should have made time to rest, eat and drink – you should not repeat my mistakes.
A patient becoming unwell in front of you is a terrifying experience. I found it more scary than the war zones I’ve worked in. But help will come when you call for it. You are not expected to deal with this on your own. Be forewarned, there will be challenges. On my first FY1 on-call, I called for help when I couldn’t get a cannular into an elderly patient despite numerous attempts. The stressed registrar shouted down the phone that he would absolutely not be helping me. Thick skin; it’s not personal. It often means they aren’t coping well themselves. We are all under pressure and some of us cope with it better than others.
You will become a patient clerking machine, taking medical histories, asking strangers the most personal questions about their lives. Always treat that with the utmost respect.
The speeches at your graduation said that you are starting your career in an NHS within an unclear future. It is fighting for its own life and the most significant patient you are going to come across is the NHS itself. The wheels are rattling and threatening to fall off. As it pushes forward, shakily, the pressure falls on us to hold it up. Jeremy Hunt and the government sit inside the carriage, cracking the whip to make us work harder and faster. Do your best, fight for your patients but look after yourself. No government is worth getting ill for, especially this one. If you find something else to do along the way that makes you happier – go. There is no shame in that. Life is short – your job teaches that daily. If you choose to stay, find your own way to belong to this incredible but dysfunctional family, this historical and noble profession.
One wise registrar told me when I was unwell and worried about having time off that the hospital won’t grind to a halt without me. You’ll think you are the most essential person there with the pressure of expectations placed on you. But you are not. You are a tiny part of a massive machine.
I did pass, but needed the psychological support of my tutor after that experience. I tell you this not to frighten you, but to warn that these things happen, and help exists even though it can often seem lonely. You have tutors to speak to, as well as the rest of us, your fellow doctors. Don’t suffer in silence. Whatever you are going through, many of us will have experienced similar. The circle of medical life continues because one day you will be the senior, and won’t behave that way to your juniors.
Conversely, mentors who have guided me both officially and unofficially have been phenomenal and outnumber the negative experiences. I have been struck by their sheer humanity and their dedication to ease suffering of their patients. Their commitment to the wellbeing of their team has saved me many times. Nothing compares to being in the presence of these incredible people. I stand in their light hoping some of it will stay with me.
Most rewarding of all is the knowledge that on any particular day you will help another human in the most crucial of ways. Never forget in among all the noise that your patient is the most important person. That moment you ease someone’s pain, suffering or discomfort is a privilege. Eleven years on, that has never dulled. Remember it because there will be times when you want to give up. Look instead for the reasons why you became a doctor, and never let anyone take that away.
My final words for you are buckle up for the ride, take it a day at a time – the fastest two years of your life are about to start. Eat, drink, clerk.
Your big sis,