God and the doctor


I love my textbook. It’s not often I say that, so I should explain. The Oxford Handbook of Clinical Medicine is a lifesaver for hundreds – no – thousands of harried medical students in their clinical years. Small enough to fit into a pocket or shoulder bag, it’s just about perfect for slipping out under the desk when the consultant has just asked you about the three main causes of hypercalcaemia. But that’s not why I love it.

I love it because I was expecting to hate it, and then I opened it and was confronted not just by medical text but by poetry. Yes, real actual poetry. Page 14 conjures Macbeth to console the tired junior doctor on call: “Come what come may, time and the hour runs through the roughest day”, while page 389 gives us a taste of Sherlock Holmes: “I see you have been hunting bushbuck in the Eastern Cape again, Mr S–. This eschar is the tell-tale tache noire of typhus.” This is how a textbook should be: bringing hope and inspiration and a good giggle in the most jaded moments.

This dreary Monday morning I really didn’t fancy talking to anyone, let alone patients, but page 14 brought respite (it’s a good page). “Patients are sources of renewal, not just devourers of your energies.” So, with that in mind, I went to see Mrs A.

Mrs A was sitting on the side of her bed in the respiratory ward, a beautiful orange scarf over her long grey hair. She told me about the pain in her chest and the way her heart beats strangely, and how she’s breathless all the time. “My heart isn’t good”, she said. “I think I’ll see Christmas, and then I’ll be done”. “Is there anyone at home?”, I asked. “No”, she replied. “All alone, apart from God and the doctor”.

Mrs A’s story shouldn’t really have brought me renewal, but somehow just the fact of talking to her, knowing that this is the meaning of my day-to-day, brought hope. If God and the doctor are all Mrs A has, well – I have no hope of being God, so I’d better become a damn good doctor.


The events of life

Medical school starts in a month and I’m terrified. Yesterday was my last day at work and now I may never need to work in an office again. All those years of staring glassy eyed at a computer screen wondering what went wrong, why I’m here instead of out in the real world. Wondering if this is just what happens, this is how people get stuck until the end of their working lives; not brave enough to make a change.
Does that make me brave? Dear god, I have so many fears.
To those who say “but you’re following your dream!”, I say I’ve agonised over career choices for so long now that the question ‘what do you really want?’ has become meaningless. The reality was lost months ago in some bizarre mental labyrinth of questioning and meta-questioning. Is this what I want or just what I think I want? Or what I think I think I want? Or what I ought to want? Or what I will want once I’ve found the exit to the bloody maze and just got on with it? I definitely didn’t agonise this much aged 18 – undergraduate decision making got about as complex as sticking a pin in a map and opening the UCAS book at random. Now I’m worried about everything.
I’m worried about where my life will go. I’ve just left a nice, easy job in a lovely organisation in a beautiful town with loads of friends, to spend four years unpaid in an ugly city training in a profession notorious for its lack of work–life balance. I have a home in a town renowned for being full of lovable geeks who are into knitting, riding geriatric bicycles with baskets on the front and making blackberry jam. I just spent the afternoon at a festival in an allotment. An allotment! I love lying in parks while my friends play musical instruments, and dancing in the street at dawn. Will I become subsumed into some frazzled medic mould with no time for anything except regurgitating textbooks, polishing my stethoscope and getting as off my face as possible in an attempt to hide from reality? Not that I have a problem with getting off my face but I’d rather do it whilst dancing crazily in a field to some mad brass ensemble than whilst downing 50p shots in a club.
And aren’t there more important things in life? As much as I love studying and want this challenge, I also want to have children and a family. Preferably before I’m 40. And I want to spend time with them. I sat at this festival today watching a mum playing with her family. She probably wasn’t a doctor but her kids were beautiful and happy and loved. They were all out in the sunshine together dancing to music, not in a nursery or on a hospital ward. Why is it that most doctors tell other people not to do it…and why am I incapable of listening?
So is it possible to have a balance: be a good medical student, a good doctor and still retain your interests and friends and be happy? All the evidence points to “no, you’ll have no time for anything and even if you do you’ll be too tired, you’ll only talk to other medics because no-one else will understand and you’ll be sucked into a cynical system where you’ll be too exhausted to care about anyone.”
But I challenge that, I have to. I need to believe that if I want to have a life I will, however hard it is.
I did my first bit of medical school reading today. Here’s the very first line. “Anatomy is the setting (structure) in which the events (functions) of life occur.” Oh brilliant, I want to start an argument already. There is so much more to life than that.