‘You’re bossing it, as a woman in medicine and a woman in sport’.
‘You’re holding down a tough job, a relationship and demanding training at the same time.’
‘You’re a superhero.’
All things that have been said to me reasonably recently, by friends, colleagues and blog readers. On the surface, I’m doing well, but I’ve definitely been pretending to myself and everyone else that everything in the garden is rosy.
Being a young female doctor, and trying to hold down a house, relationship and some kind of training regime, feels overwhelming almost all of the time. The only way I can try to describe it is feeling like I have many, many plates spinning at the same time, and to keep them all spinning takes divided attention and never giving any of them my full focus.
If I focus on one properly, I hear the sound of several others crashing to the floor. In a society that buzzes from being busy, and a workplace culture where long, stressful hours are the norm, it’s taboo to say you’re struggling.
As a doctor, you are the problem solver. You come on shift, and a pager is attached to your person. Whenever it bleeps, you’re obliged to answer, whether it’s the first hour of the shift or your twelfth. Whether you’re free or whether you’re so overwhelmed with jobs to do that you feel like screaming. Now, now, now, everybody’s demands flow in. This discharge note needs writing NOW, the man in Bed 6 needs a new IV line for his 6pm meds NOW, this patient is becoming unwell and needs you NOW, this electronic system needs updating NOW so we don’t fail our audit, come NOW because your alcoholic patient is having a withdrawal seizure. A calm, polite manner is expected at all times as you race from ward to ward to get things done.
Everybody is busy and everybody is overworked, but we do it because we want to care for our patients. We have a brief cry shut in a bathroom or linen cupboard, and then we carry on. We ignore our failing kidneys and aching, hungry stomachs because patients need us. We work past our shift finishing times, because if you’re walking out and a relative needs to speak to a doctor about their loved one, or somebody stops breathing, it’s a vocation not a job, and you can’t just leave. Goodwill oils the wheels of the NHS to keep turning in the face of ever-increasing demand and decreasing funding.
Almost as soon as I started my career last August, it became clear that the Government’s contract reforms were bad news. We took to the streets in our thousands up and down the country to protest against fundamentally unsafe new contracts for doctors. When they didn’t listen, 98% of us voted to take industrial action to make them take note, and next week, the fourth 48 hour doctors strike is set to go ahead. In spite of all this, the Government is imposing these contracts on us anyway. An Equality Impact Assessment was carried out after concerns were raised about the unfair nature of the new contract, and the report this week was released, with repetitive use of an absolutely staggering phrase.
‘In summary, whilst there are features of the new contract that impact disproportionately against women, of which we expect some to be advantageous and others disadvantageous, we do not consider that this would amount to direct discrimination as the impacts can be comfortably justified… Any indirect adverse effect on women is a proportionate means of achieving a legitimate aim.’
That’s right. Because I am female and a doctor, I am viewed as collateral damage to the greater good by the Government in their mission to reform doctors contracts to make us cover more hours for less pay.
Since last August, I have been becoming steadily more disillusioned. I have worked up to 90 hour weeks on occasion, sacrificing sleep, mealtimes and social contact to keep patients safe on grossly understaffed rotas. I have missed family occasions, seeing friends, and keeping myself fit and healthy because I was on an inflexible, unfair rota. I am now at a point where my enthusiasm and goodwill has gone. My motivation to do the extra things required of doctors in their free time, such as keeping a professional portfolio, carrying out audit work and attending courses and seminars has gone. 8 months into this job, and I’m considering leaving, as a direct result of the new contract; I’m already stretched to my limit, and have nothing more to give.
Last night, for the first time, all of this overwhelmed me so much, I sat and cried. Cried for the future career that’s shrouded in uncertainty, the not knowing where I will live or work at the end of this year, or whether I will even be a doctor any more.
At 23, I have dealt with more terrifying, emotionally demanding, horrendous situations than any of the Tory ministers imposing this new contract on me, but that counts for nothing. It counts for nothing to them, because I was unfortunate to be born with a pair of ovaries and not a pair of testicles. Because if I want to be a parent, it’s me that will need to take maternity leave, and God forbid, if I become a single parent, it’s me who will need to look after my child. The light at the end of the tunnel was a stable, financially secure job at the end of medical school and my first couple of years in medicine, and that light is going out, as thousands of doctors make the necessary arrangements to leave England if these contracts come in, me included.
I’m Sarah, I’m 23 and I’m a junior doctor; and I don’t think I can do this any more.