
et me just spit it out without too much preamble, and in the hope that your kind and forgiving selves won't hold it against me. At least, not forever.
I'm a doctor. In fact, I'm a doctor who is currently training to be a psychiatrist.
There. That wasn't so hard, was it?*
I haven't been completely opaque about my profession, and I know that some of you who trouble to read these sometimes incoherent ramblings more closely than others may have already figured it out. Nor do I bother to shout it from the blogtops. I have my reasons, and yes, you bet I'll list them for you.
For one thing, I believe in absolute patient privacy. I try not to talk about work with my own husband even, and he's a doctor too. (The 'normal' kind you'll be glad to know. We're not a pair of married head-shrinkers, although I have met some of those, and generally it ain't pretty.) If I've been to see a doctor, and it was awkward and intensely personal, and maybe more than a little weird, I wouldn't like it very much if they then used that encounter as material to generate amusing anecdotes at my expense. (Although, it might be OK if it generated profound, moving and illuminating observations on the meaning of life and the human condition, but I seem to be short on the talent required to produce those, so I leave the patient tales well out of it.) Also, you can, and indeed you must, develop a rather macabre sense of humour when pain, sorrow, suffering, madness and death are the bread-and-butter of your daily work**, and I have found that sharing this can deeply disturb the uninitiated. (That humour I
do share with my husband. It is how we survive.)
I also firmly and absolutely believe in my own privacy. I am
rubbish at maintaining anonymity. I want to share things about myself and my life, and the more I do that, the more identifiable I become. It may be an odd balance of power in the doctor-patient relationship - me knowing all about them in intimate detail, them knowing nothing about me - but that is how it safely works. If a patient ever found this place and came to know all my innermost thoughts, neuroses and turmoils...? Well, that's a chance I take in keeping this blog, but I bet it would make for one hell of an awkward encounter.***
Last, but by no means least, I fear the wrath of my professional regulatory body. They do nasty things to doctors who bring the profession into disrepute, even in their personal lives, which is why I try to keep it all a bit... sanitised. I like my work, and I'd very much like to be able to keep on doing it for the forseeable future.
But work issues have been bugging me lately. Bugging me to the point of distraction. And so I feel compelled to raise something that I feel ultimately affects us all, even if indirectly. (Here in the UK at least.) That something is the misery of the NHS, and in particular the misery of its junior doctors.****
This miserable junior doctor in actual fact.
I choose medicine, believe it or not, so that I could help people. Do something tangibly good with my life. Never feel guilty about a single penny earned, or spent, because it had literally been paid for by blood, sweat and tears. (Mine, as much as anyone else's.) To me this attitude does not fit comfortably with sharp business acumen. I am embarrassingly apathetic politically, but when it comes to healthcare I strongly believe that equal access to a high standard of it is a basic human right, and should, for the most part, be unaffected by one's individual ability to pay. Once healthcare is privatised, doctors become self-employed businesspeople, and no matter how altruistic you may have been to begin with, the need to feed, clothe and shelter yourself and your family introduces an enormous conflict of interest. How can you be certain that you are acting in your patients' best interests, if in the act of treating them you are also directly taking care of your own? For me, it just doesn't add up. (Please note, I am in no way trying to comment on the healthcare debate raging across the pond. It is my personal dilemma of which I write.*****)
Which is where the NHS-induced misery comes in. This is not the appropriate forum for a tirade about how shitty the conditions of my employment are, and how unsupported and under-resourced one of the most highly stressed and vulnerable groups of professionals are, and how frankly unsafe this can make things for the rest of us. But increasingly, I have had to think that long-term, maybe the NHS is not for me. Maybe I will be forced to cut and run to sunnier climes, maybe I will have to go private, for the sake of my own health and sanity. I'm not the only one - others like me are leaving in droves - but still I hate myself for even thinking of it. Especially for thinking of private practice. How could I live with that conflict between providing for others' needs while making sure I can meet my own? But then, how can I remain in the NHS, as jaded, cynical and disillusioned as I have already become? I don't know the answers to those questions, but I'm beginning to think that therein lies the secret to my future career happiness.
So there you have it. A bit more (possibly ill-advised) self-disclosure. A bit of a rant, a weight off my chest. And the only thing I can really ask you to take away from this post? Please be kind to your doctors when next you see them, as silly as that may sound. Believe me when I say that it's harder for them than you may think.
*Was it?
**Although mainly, it's tedium. With some moments of unbelievable joy and awesome inspiration at the immensity of the human spirit as well.
***And I won't even mention my fear of being stalked. Nope, not mentioning it...
****Read on dear friends, I am miserable because I feel the NHS isn't working as it should, not because I don't think that it is A Very Good Thing. It is.
*****Although, yes, privatised healthcare is a rubbish idea. Shoot me for having a political opinion.
AND Have you seen Nurse Jackie? It may be the best medical TV show I've seen yet. And that female British doctor with the fabulously ridiculous shoes? I want to be her.