The job of a junior doctor isn’t what you thought it would be. The patients don’t get better.
You are losing weight. You didn’t have time to eat lunch, because for every task you cross off your to-do list, three are added on. You cannot make it to the canteen, because if you leave the ward you are called on your bleep for urgent discharge letters, cannulas and patient reviews. You stay late, then when you are finally home you can’t see through the tears to cook and you don’t have the energy to leave the house to shop.
Or maybe you are gaining weight. You are eating the sweets and doughnuts at the nursing station, eating the chocolate and sugary drinks from the vending machine, grabbing the chips in the canteen and picking up a takeaway on your way home. You know you need fuelling but you don’t have the emotional capacity to plan your meals and take care of yourself.
You can’t sleep. You lie in bed and wonder how the sick patient is doing. At 3am you remember the jobs you haven’t done, the tasks you didn’t hand over. You phone the doctor who is on call, or the nurses on the night shift, to check and double-check. You wonder if you are caring too much. You can’t switch off; this does not feel sustainable.
You dread the cannula failing on the patient in bed three, because you can’t face the 30-minute hunt for another vein. The patient is so nice, but when he reassures you with “don’t worry, you’ve got to learn”, you wonder who is caring for who.
You wanted to be a doctor so that you could help people, yet you’ve spent these first few months asking people to help you. Which blood bottle do I use? What dose of warfarin should I prescribe? How do I order a CTPA on the computer? What is a CTPA? Who do I call if I think they’ve dislocated their hip? What if I’m wrong?
You feel that you are slowing everyone down, they’d be better without you there, and that you’re not cut out to be a doctor.
Every doctor has felt like this. Every doctor has pretended not to feel like this.
Over time we have learned to eat when we can, and to look after ourselves first. The routine tasks become easier, and we improve at time management and prioritisation. We learn to hand over to the next team, another person, or the next day.
We have slowly accepted that being a doctor is not about helping people, but caring for them. It can be exhausting to care, and caring doesn’t always give people the help they’d wanted. No one wants to be told to stop smoking, no one wants another blood test, no one wants a nasogastric tube. The rewards are not gratification, and the satisfaction has to come from within.
Our heart still sinks when we are on call and the phone rings, or someone unexpected interrupts our day to ask for our advice. What if we don’t know the answer? What if this task is about to consume our day? How can we keep on caring?
There will always be too many days that end with the sense you haven’t done everything you should, and with a list of jobs that is longer than it was when you started.
Occasionally we feel fortunate enough to be a part of a great team of people and processes that assist people in their recovery from an accident, to reach a diagnosis, survive an infection or operation. Sometimes we have the honour of guiding patients and families through significant life events, or to keep them comfortable as they die.
Occasionally a patient will thank you for the part you played, but to accept their thanks feels fraudulent, as you know your role was small. You know that your care has caused them discomfort and distress. You worry that someone else might have done it better, or maybe even you should have done it better. But you must learn to feel satisfied, as they have noticed that you cared.
You will find it gets easier, and you will get through it because you have insight. You are asking for support and you are talking to your friends and family. You are doing just fine. You will rotate on, you will find a job that excites and inspires, and scares you a little less.
The greatest thing about a medical degree is there is a specialty for everyone, and you will find the job that suits you.
Meanwhile, please keep on caring.
If you would like to contribute to our Blood, sweat and tears series about experiences in healthcare, read our guidelines and get in touch by emailing sarah.johnson@theguardian.com