Fortune teller


Every now and again we come to a time where we make Big Choices. A career, get married or don’t get married, have kids or don’t get kids, dedicate your life to becoming an astronaut. For a lot of people this happens in a nice linear fashion, go to high school, university, get a job, progress through job, maybe get married, maybe have kids.

It’s come time for me to choose a career path within medicine, except that it’s medicine which at times feels pretty much synonymous with ‘cult’ in terms of how much it takes over your life. Less helpful is the platitudes of ‘you should choose x, it’s good for women’, where x is something like general practice, or psychiatry. Such a loaded statement! ‘Good for women’ automatically implies that you are the primary carer, that it is your responsibility to choose a career, not in something that you’re in interested in, but that is appropriate for your station. Meanwhile it feels like all the guys are becoming surgeons because they feel no such pressure. Never mind the rest of us who really loved their surgical rotations and could really do that job for life, and be good at it.

It’s not the ‘good for women’ part that puts you off in the end though.

Imagine getting up at 5.30am for a 7am start every day. Now imagine that while you’re at work, you’re not allowed to sit down. You have to stand or walk every minute, all day. You might get a sit down for ten minutes at lunch before getting back up again. Now imagine your boss expects you to manage all your clients externally, and attend all the meetings and keep them happy without their input, that your performance is based on this. When you do see your boss for your internal client meetings, he stands over you and questions your detailed knowledge on everything, and consistently points out what you’re doing wrong for the hours that you are together, still standing by the way. Praise is rarely, if ever, delivered.

This picking and testing happens every day, for at least 12 hours a day, along with the standing. After your meeting with your boss, you go and check on your other clients, your patients, where you learn that one tiny mistake in theatre, one moment of exhausted distraction has resulted in someone suffering a surgical complication. Maybe you had an off moment, maybe you didn’t want to be at work that day, that you wished you could chuck a sickie – except that if you did that, everyone else’s day would then blow out to 24 hours and people who’d been waiting months for surgery would get delayed again. Whatever your moment, you’re painfully reminded that there is no margin for error, no room for an off day. And by the way, you’re on call this weekend, for it’s entire forty eight hours, where yes, you will be required to stand, and yes, you will get called in 5pm Friday and not get home until midnight Sunday where your regular working week will start anew. And you have a lazy intern who hasn’t done anyone’s paperwork so as well as checking forty inpatients (think forty client meetings in one day) you have to write a bunch of discharge letters, and get into theatre with your boss where he will lean over you, test your knowledge relentlessly and tell you everything you’re doing wrong. Until 2am.

So maybe you love surgery, would be a great surgeon, but would you put yourself through that for the next 6 years of your life? Forget your future kids, would you want that for yourself? In medicine, things like prestige and money fall away for most of us in the face of what we want from our lives. What we want from our day. We are always told ‘look at the life your boss has’ when choosing, and decide if you want that. Then you have to fit relationships, kids, and friends and anything else that’s important into that.

I read an article a while ago written by a pediatric heart surgeon who said that while it was nice they were so well celebrated and had achieved so much, that in the end it wasn’t worth it. They’d missed out on friendships, relationships, and woken up with all a whole lot of prestige and not a lot of anything else.

These lessons can be applied to any career, not just medicine. I’m still in the process of choosing, of working it out. I have an idea of the direction, but it’s the details, it’s the cult of medicine that gets me. Who knows if it will work it out?

Sometimes you just have to pick something, give it a red hot go, cross your fingers and hope the rest of your life fits in. The universe will always conspire to help the dreamer.

Time Out

I have three days off. This is a momentous occasion for me because I might have laughed at the prospect last year or instantly written an impossible List of Everything That Must Be Done, done none of it due to exhaustion, then felt WORSE at the end of those days.

Since it feels like such a long time since I had a break, I made only one rule, and that’s not to place any expectations on myself. Of course I made a list of everything I want to do, but only on the proviso that it was perfectly okay not to do any of it.

The sun is out, my house is a mess and instead of cleaning I’m clocking up serious couch time. I bought basil and hot cross buns, ate strawberries and walked in the sun earlier. Now I’m on my couch, my dear old Ikea couch that I’ve had for nearly ten years but can’t bear to get rid of it’s it’s so comfortable (I even had it recovered I love it so much), and I’m reading The Happiness Project.

So much of it is resonating, that moment where she realises she doesn’t read any law stuff outside of work, that what she does with her free time is pretty much what I do with my free time – it’s a sense of catharsis I’ve not felt from reading a book in a very long time.

Which naturally brings me back to, what the hell do I do with my life?

Do I become a GP and smell the roses, show up to work and enjoy my stacks of free time? Do I become a physician, do I dedicate my life to this job? And my free time? Do I escape to public health and work for the government? Or do I leave medicine all together? It’s not the washing machine it’s sold to be. I don’t want to be that person that gets their sense of self-worth from their specialty title. I also don’t want to be bored.

I did medicine because I cared about people and wanted to help. The ugly truth for me was that the system doesn’t give you the time to care, only treat, and most of the patients I see suffer from self-inflicted conditions that they have no real interest in rectifying, they just want a tablet. (There are also lovely lovely patients out there who didn’t ask to get sick who I would cure in a heartbeat if I could, but they seem to be increasingly few).

The Happiness Project has really got me thinking about who I am and what I want. Simple-sounding but doing this and filtering out all your external influences – friends, family, media, is hard. I’ll keep you posted.