“Doctors are measured in how they speak to people because we want to celebrate success, but we also want to make sure that people understand not everyone will be successful with their treatment.“
My original plan was to solely become a paediatric anaesthesia doctor, but I changed completely to also become a sleep medicine doctor, whilst coming across a sleep disorders unit in the ENT hospital I used to work at. So, I’ve split up my job: At the moment I work in both anaesthesia and sleep medicine. Both the fields of work I do are pretty enjoyable as I get to meet a lot of different people from different walks of life. However, the difficulties of doing two jobs are that you are working at 150% of a normal doctor rather than at 100%. So, the challenge is trying to keep on top of everything.
From a mental health perspective, my anaesthesia job is very good as the focus is on one patient. However, it’s also very challenging because when things go wrong, they go wrong very quickly. There is very little room for error. This carries across both my specialities, but it is very profound in anaesthesia because of the way things go wrong. When errors happen, people come down on you like a tonne of bricks. I have had colleagues who have become suicidal because of an error. I had an error in my career which put me in a very bad place for several years. I think despite the fact that they say it’s a no-blame culture, is a complete blame culture. The pointer stops with the consultant no matter what happens and that is mentally taxing.
A major turning point in my anaesthesia career was when a patient died shortly following an operation, so there was obviously an internal investigation. I witnessed the blame culture, the bullying, the harassment that goes on behind the scenes and mostly, the lack of support. The investigation was not impartial, and I was blamed with the view of being a scapegoat. That was the hardest thing to face because when you are against an organisation like that you don’t feel safe and protected to do your job. On top of that, you are dealing with the error itself which is a huge blow to your professional pride as well as the professional duty of care. You feel bad for the error and the patient’s family. You take it personally and you feel that you haven’t done a good job, so you feel like a failure as well. I think it nearly stopped me from continuing in medicine. But I did carry on, thanks to the fact that I already had a different speciality. I could see a future, there was a purpose. If I was only in anaesthesia, I would have stopped pursuing a career in medicine. It is unfortunate that doctors are put under such strain and stress.
One of the things that got me through was a doctor’s helpline. I was feeling really bad, and I phoned it. Helplines are really useful because they give you a renewed perspective. In my case, it was that most careers do more good than harm. Looking from different perspectives can reduce the anxiety and pain following the error. Another thing that helped me was to remove myself completely from where I was. I went on holidays and in the process, I left everything at home: I did not take a laptop or anything and I went to areas where there was no signal and you could not communicate with the world. I had an epiphany – that the world is a bigger place than one thing happening in one place, even if it was a bad thing. You are also equally doing good things. For instance, during my time with the investigation, the patient had a big reaction and I managed to pull them through. So, you need to reflect on the good things too.
I think it’s important to use renewed perspectives to cultivate a mindset that when things go wrong, you will be blamed but you are also going to do a lot of good things and the world is so much more. You are more than just that error. It is very important to have hobbies where you can reflect on this. My reflections whilst on holiday made me realise that unlike prior to my error where medicine was the only job I could do, when I left, I became resilient knowing that I could do any job in the world because I have the skills. Medicine has taught me other skills, not necessarily just medical-related ones. This helps you get through something bad because you know that if it isn’t medicine for whatever reason, you can do something else. You can still provide for your family, be a person in your own right and achieve well. After all, it’s just a job. Whereas we are brought up to think that medicine is the only job you can do once you train in medicine.
That’s one thing I’d like to introduce to medical schools. They must allow medical students to realise that yes, things are going to go wrong, and you have to try your best not to, but this is only a job. You can do something else, you can retrain and do anything, anywhere in the world. I think that helps, maybe not for everyone, but at least for some. Also, it’s very important for healthcare professionals to discuss a lot more about the adverse effects early on in the patient’s treatment, so they feel more protected when things go wrong. If there are some adverse effects, doctors are not going to be so misjudged or judged harshly. A lot of the time we don’t like to scare patients from treatment; However, in this modern age we have to turn it on its head and say that every treatment has its problems, and you have to be prepared that if these occur, there is nothing we can do to remove these problems. I think we need to lead with so much more than just the good things about the treatment.