I hate when people ask me "do you like being a doctor?" - because the honest answer I have to give is "no" and this is obviously followed up with them inevitably asking "why?" - and its almost impossible to give a concise reply. It's like when someone asks you what happened in the 1000+ page book you just read, or the three hour film you just watched. Without giving details of characters, their relationships, events leading up to events - you would never be able to do the story justice, therefore you aren't sure whether to bore them for half an hour with the actual detail, or just give a short societally acceptable response that doesn't really answer their question or give them any insight. Only this isn't a 3 hour film, or a 1000 page book, it's a 7 year nightmare. I think this is why the majority of medics surround themselves with other medics. It's much easier to talk about a complex film with someone who has also seen it... To answer a none medics question of "Why don't you like your job?" and give them the information they are asking for, is never going to be a linear story, it's like picking litter up from a field after a busy festival, there is no obvious, sensible route to take, and no linear direction that will get the job done quickly. There's shit everywhere, and sifting through it is going to be a tiresome, long task. I feel I have 1000 sentences, that all want to escape at once. 100's of awful situations I have been in, anecdotes that regular people would remember for a life time and have the story rehearsed to perfection, ready to share at any social gathering to the "ooohs" and "aaaahs" of the crowd. Stories that I struggle to recall because I've forced them so far to the back of my consciousness. Stories that I have never really sat down and thought "shit, that actually happened", usually because 10 other shit situations happened in succession right after. To give just a few examples... Being woken from a power nap at 4am by the shrieking of your emergency bleep going off, then within 10 minutes, eyes barely adjusted to the light, being thrust into a operating theatre, warm blood splashed down one leg, elbow deep into a terrified woman's abdomen, extracting the blue stillborn baby.. Ten minutes wasn't fast enough. I could talk about many similar devastating, traumatic experiences I encountered while on obs and gynae for hours. You haven't felt fear until you've seen litres of blood gushing from a pale, clammy young woman's vagina as she clutches her bump in pain, begging you to help her... Then there's the Christmas Day medical on calls. Waking up at 6am on Christmas Day and seeing the lights turned on in other people's houses, excitement flooding their homes for the day ahead. There's no tree or decorations up in my house because I haven't had time, and what's the point, I'm not getting any time to celebrate or see my family because I'm working 8am-8pm (which roughly translates as 7.30am - 9.30pm). Then I'm working the same shift Boxing Day and then New Year's Day too. "Oh well, never liked Christmas anyway" - I lie to myself. I get to work and just as we're about to hand over, the crash bleep goes off, (this usually translates as someone's heart has just stopped and you need to be there, 5 minutes ago..) the night SHO sprints through the hospital with me. We arrive first, a nurse is doing chest compressions and a little old man (the patients husband I assume) is sobbing and shaking in the corner. I shove him to the back of my mind as I collect information while simultaneously acquiring an airway to breathe for this lady and instructing another nurse to attach the defib pads to asses the heart rhythm... It's VF, a rhythm that can be shocked, we charge the defibrillator, clear everyone away from the table "administering shock....Now back on the chest" and the compressions continue. The night SHO is bent over trying to get a cannula into the ladies vein, she's clearly way too tired to still be here given she will be back for another shift this evening, but when duty calls... The rest of the team arrive and I relay what has happened. We continue resuscitating for what feels like seconds (but was actually 30 minutes), and eventually all agree to stop. The patient dies on Christmas morning. The majority of the crash team quickly disappear at this point, like cockroaches scuttling away as a light is turned on, back to whatever they were doing before the crash alarm went out. The registrar is sat writing in the notes while i notice a nurse consoling the elderly gentleman by his dead wife's bed. They'd been married 50 years. I go over and explain what had just happened as no one had spoken to him since he arrived on the ward early in his best suit, to spend Christmas morning with his love. He held my hand, looked deep into my eyes and thanked me sincerely for everything i had done, then told me how much he was going to miss his best friend and how Christmas would never be the same again. My heart broke for him. But there's still a good 11 hours of this shift to go. Must move on. Must forget. I wipe a tear from my cheek, take a deep breathe and answer my bleep. "Someone is vomiting blood, lots of blood, and their blood pressure is falling, we need you to come quick"... As soon as I hang up I get another bleep, a nervous nurse telling me she thinks someone is having an allergic reaction to some antibiotics, then suddenly they're struggling to breathe... They look blue... I tell her to put a crash call out immediately. The reg and I set off running. It's not even an hour into my shift. Then there's the much loved night shifts. My 'favourite' being the weekend nights, or the nights before a bank holiday. Getting into your car at 7pm after a failed days sleep, the sun still glistening in the sky, listening to the radio DJs enthusiastically ask what everyone's plans are for the evening, as they play feel good tunes to get everyone in the mood. Driving passed beer gardens, the smell of BBQ in the air. Kids laughing and playing in the street... Sitting in handover, eyes already heavy, stifled yawns escaping as I try to pay attention to the endless list of sick patients being handed over... Sleeping in the day has never been my strong point and now I will pay the price. I glug down my third coffee as I look for change to buy a bottle of coke from the vending machine, I need caffeine and I need it now. I've received 5 bleeps in the half an hour that we were sat in hand over, and two more on the way to the vending machine, I should really answer them.. Off I go to find a phone to receive the inevitable burden of the potentially traumatic situations at the other end of the line. "Once the doctor has been told, it's their responsibility". I start making a list as the endless jobs pile in, my pen runs out, so I dig it into the paper making a sort of reverse brail, hoping I can decipher it later. First job on my list, steal another pen. Being tired while oncall is quite possibly the most terrifying experience ever. Knowing that with every sick patient, you could be missing something hugely important, through exhaustion you might have started the wrong treatment... then you start thinking about the patient you saw three hours ago and can't remember if you actually prescribed those antibiotics or not... So off you run, back to that previous ward to check, praying the patient is still ok. You haven't felt fear until you get into bed at 11am, finally ready to relax after a horrendous night shift full of death and destruction, then suddenly out of nowhere, you remember those abnormal blood results that you saw at 4am, the ones that needed urgently acting on, but on your way to see that patient the crash bleep went off and your mind was taken elsewhere... The bloods that no one but you will have looked at, and now that patient could be seriously sick... Sheepishly calling the oncall team in the middle of the night to ask them to follow up something you missed / forgot / are worried about, is not an unusual occurrence. Waking up in the middle of the night and remembering that you never looked at the result of the urgent scan you ordered, nobody else knew about it and the patient may need urgent surgery depending on the result... Or remembering that you never went back to speak to those worried relatives of the man who is dying. Now they will think that I'm an obnoxious doctor who couldn't care less about their worries. Most nights are plagued with something. A good way to describe a medical on call is if you took the saddest part of a heartbreaking film, then the scariest part of a sweat-inducing thriller, added in some gory blood filled scenes from a horror film, put a few boring sections in there, just to build suspense (because even at quiet points, you're on the edge of your seat in anticipation of the awfulness that is inevitably about to occur.) add a heart pumping action scene and then maybe a few more sad scenes, then repeat this maybe 6 times. This could potentially be close to a single medical on call. The rollercoaster of emotions isn't safe for any human to go through. To have to push death, heartbreak and constant anxiety to the back of our minds in order to carry on is not healthy. I don't know of one doctor who can honestly say that they like their job, not one. Surely this is rare, for not one person to enjoy a career which they have put so much time and energy in to. And here falls another reason I hate my job - it traps you, you realise there's nothing else you can really do, not do well anyway. Having spent years working to get in to medical school, then 5 years at university, medics work ridiculous hours compared to most other courses. We see things as students, that most people won't see in their lifetime. We have responsibility as 23 year olds that most people won't ever experience. We've put so much time, emotion, stress and money into getting this job. For the last 10+ years I have been so tunnel visioned on getting to where I am now, that any previous hobbies or interests I may have had, were lost miles back down the track. So if the day to day work I've described, the emotional turmoil, the sacrifice of Christmas days, bank holiday evenings, the fact that a medical degree gives you the qualifications to be a doctor, but if you don't like that job? Then you're a bit stuck. If all this still sounds fun to you, what about if you had to miss your best friends wedding because nobody would cover your on call weekend, or that two week family holiday everyone is going on, you can't go because lord knows two weeks off in a row is completely unheard of. I've heard stories of people cancelling their honeymoon because they couldn't swop their on calls, fathers missing the birth of their child because they couldn't leave the hospital when their wife went in to labour. None medical friends are quickly lost because they don't believe the reason you constantly miss their get togethers is because your shift didn't finish while 8pm, then you had to stay while 9.30pm to sort out a sick patient and hand over. Knowing you're back again for more fun the next morning, you surprisingly don't feel that boozy bender everyone else is so excited about. Trying to explain to family that you just can't get two weeks off to join their holiday, you can see in their eyes they think you're just making excuses not to go. I sometimes even feel my family don't like me, a wedge drawn between us by this career I've undertaken. They love me of course, but like, like is a different thing. Despite their best efforts they don't really understand what I do, and seem to have gotten to a stage where they don't even ask. They make comments like "well most people have stress at work", "lots of people work weekends"... the general idea being: "you have a good job, just get on with it". We make so many sacrifices, we lose friends, miss birthdays, push people away, push our own health to the back of our minds, and for what? Despite popular belief, we aren't paid ridiculous amounts of money. My brother earns nearly as much as I do, yet he relaxed, carefree for the majority of his childhood, yet has randomly fallen into a trade, a trade he needed no qualifications to get in to. We aren't thanked by many, it's a rare rare occurrence that always produces tears, I'm not used to receiving positivity at work. My Fort Knox style guard is always so far up in order to take the endless abuse from patients, other staff, senior doctors. I was once handed a cup of tea by a nurse who said "take this, you need a sit down, love" - this slight let down of my guard resulted in a mini break down, tears rolling down my face, so overwhelmed by this minor act of kindness. It's ridiculous thinking about it now. So there you have it, my not so concise explanation of why I hate my job. To summarise, a job I have spent around 10 years working towards, a job I regularly sacrifice my friends, family, free time and happiness for. A job where I have to tell a mother her baby is dead, watch elderly peoples lives fall apart as their soul mate dies, juggle multiple sick people at once, if I slip up for just a second, someone could die. Being covered in human blood/piss/shit/spit is not an unusual occurrence. A job that pays me around Ā£11 an hour, but then requires me to spend Ā£100's of my money on exams, indemnity insurance, GMC fees (the list goes on). A job that has taken a massive toll on my mental health, I've experienced depression and anxiety, yet through them I continue, because to stop will mean teams aren't covered, patients aren't seen and consequently people suffer. The current issue with the new junior doctor contract was just the nail in the coffin for me. As my blog shows, I've hated this shit long before hating it became popular. I genuinely 100% hate my job, and for this reason I will be quitting.
