I’m a woman & the Government thinks I’m collateral damage

‘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.

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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.

13 thoughts on “I’m a woman & the Government thinks I’m collateral damage

  1. Lizzie

    You have my utmost sympathy over the incredibly long hours you are having to work. It is so good to read a doctor’s (so) personal side of the story. It’s bit like the Leave/Remain debate – so many people don’t know which side to take. But reading your side of the story, and that of other doctors too, which I have done on Facebook, really makes me think I’m on your side. It is scary thinking about what the NHS is coming to. And I admire your guts in saying publicly that maybe you just can’t do it any more.

    Having said that, I don’t really understand what you are trying to say in the male/female debate. Maybe you could expand on it sometime.

    Here’s my thoughts –

    “Because if I want to be a parent, it’s me that will need to take maternity leave” – this seems obvious, seeing as how it’s you that will have the baby! One parent has to take the leave, or get the baby looked after by someone else very soon after the birth (in which case breastfeeding, best for the baby as I’m sure as a doctor you’d agree, would be out of the question ) which to me begs the question – why have a baby then? As a doctor would you not would agree that the mother is the most obvious, natural person to look after her own baby?

    I think that as women there is nothing wrong with accepting our limitations (both sexes have them) and EMBRACING our uniqueness instead of constantly trying to be the same as men. I think that a lot of women, of not all, might be a lot happier if only they would do this instead of fighting against what nature, and I believe God, intended. I firmly believe that when men and women accept their different roles and abilities in life then they are a lot happier.

    I have often wondered when reading your blog just how on earth you manage to be a doctor, be someone’s partner, and do all the training that you do. It just isn’t possible to do it all in my opinion. I sincerely hope that you manage to make the right decisions for you. Please don’t explode with anger if you disagree with my opinions – I express them here not to anger you but just to encourage you to perhaps be a bit kinder to yourself.

    Reply
    1. Sarah Marsden Post author

      Firstly, thank you for taking the time to read my post and think about the junior doctors’ side of the story.

      I think what I’m trying to say is that I feel like the new contract will make it a case of have a family life OR have a successful career in medicine for female doctors, and I think that will be a massive shame for the profession. As it stands, the opportunity to work less than full time either to pursue academia or family life has made specialties like surgery that were previously very male-dominated more female friendly and helped to level the playing field. The new contract stands to return these specialties to a very male-dominated workforce again. I don’t think I’m pursuing a fight to be the same as men, but I expect in a career where women bring a lot to the table, that we will be treated in a way that doesn’t disadvantage us for being able to reproduce, much less describe it as a ‘fair and proportionate means of achieving a legitimate aim’.

      In terms of breastfeeding, that’s not a can of worms I really want to open, as I firmly believe what works for one baby and mother might not work for another, and whilst breast milk might have a lot going in its favour, it’s often not logistically possible or possible for the mum, and I don’t think it should be a decision that mothers are guilt-tripped over.

      I would never explode with anger at all- after all, these are only opinions, and anyone taking the time to think about the junior doctors’ contract from both sides is welcome as far as I’m concerned to voice them. Duly noted re being kind to myself- it’s an ongoing project!

      Reply
  2. Susanna

    Lizzie,

    I’m sure you mean well, but I cannot tell you how depressing it is to read views like yours on gender equality in 2016. Unnecessary dig at Mothers who choose not to breastfeed as well.

    Sarah, I am so saddened to read this. My social media timelines are full of burnt out healthcare professionals at the moment and I don’t know what to do to help. It all feels so hopeless.

    Reply
    1. Sarah Marsden Post author

      Susanna, thank you for taking the time to read and comment. I mentioned to you on Twitter my views on breastfeeding but I won’t reiterate them here.

      I don’t know where the answer lies either sadly. I feel utterly dejected by the whole thing, and I get the distinct feeling we’re nowhere near the end of this fight- I think the Government are going to play increasingly dirty, and I feel like we can only go so far to counter it before the public turn on us. It’s like there are 54000 canaries in the mine singing loudly and clearly but nobody is listening.

      Reply
  3. D

    Hi Sarah,

    I’m a junior doctor and a runner and I’ve read your blog for a while. I did many of the same rotations as you as an FY1 in Jimmies in 2007/8.

    What I’d say is it gets better. Choose a specialty you like and one that fits into your life. Think about what it will be like as a consultant as this is what you will spend most of your life doing. Governments come and go and contracts change. When I started work I was doing 56 hours a week for the same pay you’re on now. It was hard work but it made me a better doctor and I look back on that time fondly. Maybe one day you will too.

    I know it’s not fashionable to say right now but I love my job and if you choose the right specialty so will you. Don’t give up.

    Reply
    1. Sarah Marsden Post author

      Hi David,

      Thanks for taking the time to read and comment. It’s encouraging to hear from someone who’s been where I am and come out of the other side that things to get better. I have no doubt that a Jimmies first year makes stronger doctors, but it can be hard to see it at the time!

      Specialty applications are the dream that’s keeping me going a the moment. Trying to stay positive and arrange taster days and experience, and find that excitement for medicine again. Fingers crossed!

      Reply
  4. Marie

    Hi Sarah,

    I’ve been following your blog for a long time and I hate to see you so disillusioned. I too am a junior doctor. I’m currently working as an intern in Ireland. Here, moral is at an all time low. Approximately 50% of us interns will emigrate to Australia in July, myself included. While I hope to return to Ireland some day it will be difficult and I will do so purely for family reasons. I always saw the NHS as a viable alternative to working in Ireland, however this I no longer see this as an option. We still work longer hours here. 24 hour shifts are not yet a thing of the past, some SHOs and regs still do 36hrs and 7 night shifts in a row has recently been introduced to the roster.

    In short, I understand. There’s nothing like being overworked and under-appreciated to crush idealism and innovation in our healthcare systems. All I can stay is keep your chin up and look after yourself and your patients. I admire how doctors in the nhs have come out to protest and I wish you every success as unattainable as it seems. Here in Ireland we have mostly protested with our feet and left the country. I don’t believe we have the same support at consultant level for junior doctors that you do. Some believe we have it too easy and that surgical training is suffering as we struggle for more reasonable working conditions. We were never entitled to the same maternity benefits previously given in the NHS so I guess I came into this with my eyes open and an expectation that having a family will impact my training in some way.

    Good luck, you CAN do this. I’m sure I will meet some of your colleagues down under. Coming from a country with a huge tradition of emigration, leaving doesn’t seem like a big deal, however I can appreciate that others can’t make such a decision lightly.

    Marie

    Reply
    1. Sarah Marsden Post author

      Thanks for taking the time to read and comment Marie.

      It’s heartbreaking to hear that things are even worse for you guys in Ireland, and that the NHS was going to be an escape route that is perhaps losing viability as an option. It disheartens me to hear that the protesting against the contract wouldn’t have been an option in Ireland by the sounds of it- I’m so surprised and grateful for the level of support we’re receiving from our consultants.

      Thankyou for your kind words and wishes, and I might see you down under if all ends how the Government wants!

      Reply
    2. Anais

      Damn, it’s competitive enough for Australian junior doctors to find suitable jobs as it is…I hope all you guys will be working rural.

      Reply
  5. Chloe

    Sarah I know I have said this before but it will get better.

    I could have written your post 15 years ago except I was too much of a gibbering wreck. It didn’t seem at the time it could get worse for the most junior doctors, but it has. This attack on women is going to be the last straw for a lot of us.

    If there is anything I can do to help you know where to find me.

    MY top tip is to get yourself a cheapo calendar you can put a big black cross through every day so you can see the shitty FY1 job passing.

    Good luck.

    Reply
  6. Naomi

    Sarah this is so heartbreaking to read – as someone very much NOT in-the-know about the ins and outs of the new junior contract, it’s so horribly obvious that this government (still) believes women are inferior. Women like you – who, as others have said – are absolutely kicking ass, bending over backwards and quite literally running themselves into the ground for the rest of us.

    Please know how much I, and so many others, appreciate what you and your colleagues are doing every single day. Like D has said above – governments come and go, contracts do change and this too shall pass. X

    Reply
    1. Sarah Marsden Post author

      Thanks for taking the time to read and comment Naomi. It’s heartwarming to have public support at such a difficult time. That and seeing the patients we help every day is our sole motivation at the moment to keep kicking the Government now until they give in x

      Reply

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