After putting in many hours of self-reflection, I’ve finally come to a break through about how I’ve come this far.
Firstly, it is greatly connected to my personality type. I am ‘the helper’ and ‘the achiever’. Always empathic, as a child I learnt to put my needs aside to be the carer for my sisters. My family are people who value hard work. I quickly realised that ‘achieving’ brought me love and validation. While mistakes resulted in me being punished or ignored.
Though I know it was all with the best intentions, this led to a very twisted sense of self on my part. I didn’t think well of myself and tried to achieve in everything that I did, sports and academics. I collected medals and certificates. It felt good to be validated and it felt even better to have my family reward me for it.
Extension into adulthood – getting into med school
When I decided to be a doctor I looked for the reactions of those around me. By this stage I didn’t really know how I felt inside, or what I liked doing. The focus was on milestones and goals.
I’d obsess about a particular subject and work to get the marks for it. I had decided to get into med school, so I worked for that.
Getting into med school was exciting for me. It felt good to win. It was addictive and I wanted more. I wanted to win at life.
Also, I liked being of use and feeling helpful. So medicine made sense. As a child I had wanted to be a vet, for a brief period I contemplated being a zoo keeper…but I figured medical school wouldn’t be too different. The consensus from my family was that medical school was a better choice.
On reflection now, I think a few family members were living vicariously through me. My grandmother always said she would have been a great doctor, she was the person that urged me to pursue this path. My family also love telling others that they have a doctor in the family.
I was excited when I first walked into med school. Full of energy, I’d wake up at 5am, get into my outfit I’d laid out the night before and journey the almost two hour commute from home to medical school.
Two end of the line trains later, I’d be at my lectures and eager to learn. The first semester of medical school went well. I made friends, partied and got great exam results. What a dream, right?
Second semester was when things started to unravel. Partying too much, not being selective with the right friends, I got into a bad situation. I was assaulted and then things started to spiral downwards.
I managed to scrape through semester two, and made it onto second year. Marred by a court case over the assault, I wasn’t fully recovering.
Second year was okay, but I was definitely in a bad place mentally. My eagerness for life and learning was not what it was. I began to slip into feelings of depression. For the first time in my life I felt disillusioned with medicine and the world. I started to see that not everyone could be trusted, and not everyone in the world means you well.
The situation was isolating, and I lost many friends over it.
Third year, was one of the hardest years of my life. The court case finally ended that year, I started full time clinical work, and I was in a bad romantic relationship. I lost the court case and found clinical work to be miserable.
I didn’t want to be there, I would cry in my car to and from placement. It was a low point for me. This was when I really started to question everything, especially my life choices. Was medicine even right for me?
Gap year – high point
In third year I decided that I needed to get away from it all, so I deferred fourth year and spent it travelling. My year off was a year of highs. I broke up with my boyfriend at the time, and finally escaped all the negative talk he would aim at me. This year I developed a better sense of confidence, had fun and met amazing people.
It finally felt like I was being myself. I began to paint, do photography and read again. There were no toxic people around me, and I loved every moment of it.
Returning to medical school was a tough decision. I didn’t want to, but I had decided that I didn’t know what else to do. Part of the decision was to finish what I started, I didn’t want to be labelled a university dropout.
I wasn’t raised to be a quitter.
Back to medical school
My final two years of medical school were a lot better than my first three. Part of it was that I was in a different year group, another was that I had matured. I was tougher, and things didn’t get to me as much.
Fourth year was more structured learning too, which helped me. By fifth year, where it was another loose way of learning I was experienced and comfortable enough to do my own thing. I graduated with honours and the university medal.
Yet, despite how things may have seemed on the surface, I was still unsure of my choice of career. I didn’t want to work as a doctor or start internship. I kind of knew how it was going to pan out before it even happened.
So to prolong the inevitable, I took another year off!
I declined my internship place and spent my year after graduating travelling again. I actually lived in a car, and drove around South America with my partner. We showered in truck stops, washed dishes in public, cooked on a borrowed gas stove and slept where we parked the car.
Not for everyone, but honestly it was the time of our lives.
I loved it. But my inner anxiety followed me on my travels. As well as an unopened copy of the textbook On Call, I really thought I’d sit down and study but I never did.
I worried about the money, we had none, hence our living in the car. I worried about what I was going to do when we finished the trip. What would I do? Should I be a doctor? Should I do internship or cut my losses now?
Back to medicine
In the end, I decided to do internship. I wanted to get my general registration, and I felt like doing that milestone would bring me a sense of fulfilment, success, completion and recognition.
You weren’t really seen as a doctor if you didn’t do internship, right?
So I went back! I did internship during the pandemic.
Internship was hard, as I expected, but I didn’t fully know how hard it was going to be. I didn’t expect to hit rock bottom or experience a breakdown. But I did.
It didn’t start off all bad though, my first 12 weeks were actually enjoyable. Maybe because I like experiencing new things. Part of it was also the group of people, the team was amazing, my seniors were so kind and supportive. It was as good as I could have imagined.
After this term, things became more challenging. I was put on a term meant for people more senior and felt a lot more isolated. My senior was rarely on site so there were many unsupported moments. Large male patients would yell at me and I’d feel helpless. Most of the juniors in this department weren’t kind or helpful. Teamwork wasn’t considered a thing. However, the nurses were amazing and they’d make me tea and give me chocolate. They’d check in after a particular hard day and really cared. I’m forever grateful to them.
Then my psychiatry term was another tipping point. I’m not cut out for acute psychiatry, it was scary, confronting and at times dangerous. I was physically attacked, verbally abused and it was hard trying to do work with people hitting the walls in front of you. The isolation rooms with nothing but a padded mattress were distressing and my manager publicly humiliated me after a particularly hard day.
I found myself sobbing in front of the nurses and patients, even our long stayer (who had one-to-one nursing 24/7) asked if I was okay.
After this point I just began to slowly break down. The overtime, constant after hour shifts covering the hospital, abuse, unsupportive seniors and witnessing severe illness got to me.
I couldn’t leave work at work.
Then I was involved in a negative patient outcome. I wasn’t directly to blame, it was a system error, with multiple health care professionals involved. Yet this event shook me to my core. I spent weeks crying over it and obsessing over what I could have done differently.
I couldn’t sleep and I really looked like a shell of myself.
It was so hard to just continue to work, with no break in between. I asked for help and time off, saying I wasn’t coping, but my call for help fell on deaf ears. There were no resources to support me, the answer was to keep working.
My rotation at the time was very difficult, my registrar was a hard boss and we were constantly understaffed. They made me come in an hour early to pre-round (unpaid overtime), operate with them all day and evening (even though I dislike surgery and there was no ward cover besides me), and still gave me purely negative feedback. It was a constant mad rush to do all my jobs, try keep people alive medically, cover the teams that didn’t have doctors and assist her in surgery. Between cases I would run up and down the hospital to answer the nursing calls, one day I was completely torn apart by the nursing unit manager for not being on the ward, even though it was out of my control.
One example of my boss’s behaviour was when I had rounded on all the patients before she arrived at 6.30am. I handed her the list of patients and her response was, “you should have stapled this”. No hello, no how are you. Just that. Then she proceeded to say that I shouldn’t have left ‘on time’ the day before because it’s not acceptable. Despite all the work being done and the fact that I had actually left late. This was my snapping moment. I had had enough, I’d been trying to meet all the requirements (because these people are in charge of our ultimate assessment) but now I didn’t care.
We had an argument, where I pointed out the fact that I’d spent the last few days pulling 12 hour days helping her in surgery plus meeting the ward jobs and coveri
ng other teams. Was that not good enough for her? No. So I told her she had unrealistic expectations. Her response was to ask me what I was going to do about it. I said I’d escalate to the manager and education supervisor and she said she “didn’t know how this term would go” for me if I acted this way.
I threatened to quit
Well I spoke to my managers and said that I was going to quit, and not finish internship. I had had enough. My supervisor called me and I basically said that I was on the edge. Turns out this senior had a history of juniors having issues with her, it wasn’t just me, and in the end things were ‘straightened out’.
I no longer had to come in early, my senior suddenly treated me a lot better, and I didn’t end up quitting.
I felt proud of myself for standing up. Though I know this isn’t accessible for all juniors, especially those that need to keep quiet to get accepted onto a training program. I figured that I had nothing to lose, but not everyone has that luxury.
Residency and not taking everything so personally
So I passed internship. It was one of the hardest things I’ve ever done. It took an emotional toll on me, and I really needed a break. But I wanted to finish and I did. What to do next?
I considered leaving medicine, but soon found out that most jobs, even locum, required at least two years working experience.
Not just internship.
After all that I felt that I had to stay to be relevant. So I did. It was a tough decision, and I questioned it a lot, but I completed residency. It wasn’t as rocky as internship. Experience helps as well as learning to draw boundaries and learning that most things are not all about you. For example, when someone was yelling at me, I started to realise it wasn’t anger at me, it was because they were hurting. I began to stop taking everything so personally.
Also, as a naturally sensitive person, I learnt to stop feeling so much. There’s a reason why doctors seem detached at times, it isn’t sustainable to take on everyone’s emotional load.
Where I am now
I figured after residency I’d be free to decide what I wanted to do. I’d completed what I needed to. But now the goal posts have moved.
My tendency to finish what I started is urging me to continue on the path of medicine. I’ve come this far. Shouldn’t I specialise?
Now my thought of ‘you’re not a doctor til you finish internship’ has changed to ‘you’re not a doctor til you specialise’.
The narrative I hear regularly is that ‘your life opens up after fellowship’. Is that true? I don’t know. I saw a lot of sad fellows in my time. In fact, I don’t have a role model of any fellow that really loves what they’re doing.
I’m a bit skeptical about this whole specialising thing, but part of me is drawing me to finish what I’ve started.
Yet another part is telling me to leave now, while you can.
What’s holding me back is a whole other story that I’ve already written about. Fear of failure, fear of how others will view me, fear of disappointing my family, fear of regret. All fear. I guess I’ll write about that next time too!
Why I’m opening up
I’m writing openly and honestly, because I believe being vulnerable and raw is beautiful. I believe we should be honest with ourselves and those around us. We can’t deny who we are forever. I also hope whoever reads this knows they’re not alone in whatever struggles they have. I’m not painting myself as a victim, because I’m not. This blog is dark at times because I was in a dark place. I don’t want to sugar coat it or make it seem polished and perfect, because I wasn’t.
I was hurting. Rock bottom looks ugly. But when we hit our lowest point, we are open to the greatest change (Aang The Legend of Korra).
Self-reflection is a powerful tool, looking at who we are and what shaped us is key to understanding ourselves. We all have traumas and our own battles. I’m sharing mine to accept myself for who I am, flaws and all. To also show that you’re not alone. With self awareness, we can make the right changes and grow into who we are meant to be.