It is a fact universally acknowledged that in comparison to a large proportion of the general population, doctors are paid relatively well.
If the perspective of someone working in this field is anything to go by, there are some days when you realise that you are not paid nearly enough for the work that you are expected to do.
Being a doctor is hard.
And being a good doctor? That's even harder.
The job is time intensive, labour intensive, stress filled, all consuming, unhealthy and often thankless.
People have asked me, what's it like being a new doctor?
I smile and say, it's fantastic, and on most days, this is true.
But then there are days when what I really want to say is this:
It's like going to work in the morning, finding out that one of your patients has unexpectedly died overnight and wondering... What exactly happened? How could this have happened? Was it something I've done? Was it something I didn't do? How do I fix this?
But you can't.
It's like finishing a 36-hour shift (or an 8-hour shift or a 14-hour shift), making your way back home and not being able to shake the feeling that you've forgotten something... And you hope and you pray that whatever you've missed wasn't something big. And you lay at bed at night thinking... Have I done something today that might have adverse effects on someone's quality of life? Have I done something wrong that can't be fixed?
But your head is cloudy from fatigue and the day is all a blur and you remember next to nothing, as hard as you might try.
And after a while, you are overwhelmed by the futility in wondering and you pass out from exhaustion.
Or... You stay awake in bed. Which is worse.
You stay awake in bed, fully aware that in a short couple of hours, you will be expected to be on the wards once again. And the longer it takes to get to sleep, the less sleep you will get, the more of a zombie you will be in the morning and the more mistakes you will make.
If you're lucky, the anxiety and adrenaline eventually wears off and you find yourself asleep. Until, that is... You find yourself waking up in the middle of the night, every hour, wondering... Is it time for work yet? Should I be getting up now? Am I late for work? Where's that ward list that I needed to update?
What is it like being a new doctor?
It's like feeling exhausted after a long shift and wanting nothing more than to drive home and get into bed but knowing that driving after being awake for as long as you have is extremely unsafe. In fact, it's like you've got a blood alcohol that's above the legal limit.
So here's the question... If you're not allowed to drive in that state, how on Earth would it ever make sense that you'd be allowed to prescribe lethal drugs or make life and death decisions? How could you ever be expected to be sharp enough not to miss anything?
But you are.
As a doctor, you're expected to function at 100%, 100% of the time.
Your days consist of answering questions. Questions from patients, families, senior staff, junior staff, students, other members of the healthcare team... All of which you will be expected to know how to answer. You are expected to know everything about everything at all times.
As a doctor, your job is to care for other people, regardless of how you're feeling. If you show up to work and you're sick/tired/depressed/run down, well, suck it up, princess. There's only room for one sick person in a consulting room, and you're not it.
There are days when you think, I would give an arm and a leg for just one more hour of sleep, and those are the days when the money isn't worth it.
You lay in bed, unable to move, and you think, can't I just pay them to let me stay in bed? If I have a mental break down, will they finally leave me alone?
At that stage, the prospects of becoming criminally insane (or trading your stethoscope for a desk job, depending on your temperament) are excruciatingly tempting, believe me.
And then... There are the cover shifts. An untamed monster of stress and anxiety of demonic proportions. On-call days are mildly better in terms of stress levels, but only mildly.
In GP-Land, your days are filled with patients, one after another, and there's not much time in between to think. Just like working in ED, everyone that comes through your door is there for a different reason and although there's no way to anticipate what that reason might be, you've got to be prepared for it all regardless.
If you've forgotten something, or if something has slipped your mind during a consultation, you'll be lucky if you ever remember it because as soon as one patient leaves, another one comes in. And always, the most important patient is the one sitting in front of you. It's them who is entitled to your full attention, not the one that you've just seen, and you need to get it right every time.
If, like me, you're lucky enough to get awesome supervisors who love to teach and are good at doing it, there's also an element of stress that comes into play where you don't want to disappoint them. You want to do your best, be the best, and always be one step ahead of the learning experience. And often that internal pressure and stress is just as bad as the external ones that you have to deal with.
Being a doctor is hard.
So why so we do it?
Different doctors do it for different reasons. For me, and for most of my doctor friends (or colleagues, as those grown-ups say), we do it because there is nothing else that we'd rather do when we wake up in the morning (and sometimes late in the night) than exercise the privilege of helping our patients.
I suspect that the 'I want to help people' line is getting a little old these days at medical school interviews and thus probably isn't very likely to secure you an admission. However, I've found in my recent experience that, as cliched as it may seem, it's only cliched because nothing explains it better.
I watch myself and my friends go through so much hardship for this job, it's incredible. Day and night, week after week, we put aside our wants and our needs, push through our comfort zones, time and time again, for the sole reason that it is expected of us. The world expects it of us, and we expect it of ourselves. We do not question it, we do not settle for mediocrity.
Except for the occasional lazy intern, and believe me, there are unfortunately plenty of those going around making a nuisance of themselves. The rest of us though, are fairly hard workers.
And what makes it good, is when we get to the bedside of Mrs Jones or Mr Smith and we get to tell them in all honesty that we are doing the best we can to make things better for them. There is no joy in the world that's quite like the one you get when you gain someone's trust, and feeling like you want to do right by them. It is seriously empowering, and it gets you through all the rough days, every time.
And that is why I do it. That's my reason for waking up in the morning.
The way I see it, nobody likes being sick. But if my patients have to be sick, the least I could do is make the experience a little better for them, not just through medical intervention, but also through my interaction with them.
After all, in my short years through life and medicine, I've learnt that a little smile, a little laughter, and a little bit of humanity goes a very, very long way.
And, without a doubt, it is not only healing for the patient - it heals the physician as well.
We simply would not survive without it.
