An ache I can’t medicate

I was allocated [a deanery in the Midlands] for my foundation training just when – after the death of my mother and finally finishing medical school – I was beginning to re-experience familiarity in my sense of self. In London, the city where I was born and feel most connection, aliveness and comfort. Reluctantly and after an unsuccessful application to remain in London, I surrendered to the [Midlands].

When I find the time to reflect on it, macrocosmically, being a doctor is a privilege. During this first year of working, I’ve come into close contact with so many different lives. I’ve broken bad news – ‘I think they’re sick enough to die’. Shared hopeful biochemistry – ‘things are moving in the right direction’. Synthesised the complex into succinct summaries. I’ve taken an interest in when strangers’ bowels are moving, and even more interest when they’re not. I’ve bargained, negotiated and resolved conflicts.

There are tears I’ve comforted and tears I couldn’t. Tears of gratitude, tears for still having lots to live for. I’ve listened to hopes of seeing bulbs optimistically planted bloom in spring. Hopes of holidays to Skegness and home before Christmas. I’ve witnessed birthdays on the ward and dying wishes. I’ve touched warm bodies – and I’ve touched cold ones, very carefully. This job is as exhilarating as it is exhausting.

But there are days I come home from work and can’t feel anything. I move through handovers and ward rounds, listen to patients, offer care and yet I return to my flat and feel an emptiness I don’t know how to name. Somewhere between adrift, rootless, and disenfranchised. Our training teaches us how to be competent, to be efficient. But it rarely, if ever, fosters space to fall apart. To say: I am not coping. I don’t like where I live. I am lonely. I want more from my life. It is entrenched into us that we should carry on – while carrying grief, guilt or weariness in secret. There are days I feel I am performing care, meanwhile longing to be cared for myself.

Often, I feel that what’s meaningful to me in medical practice is at odds with the wider system. Mundane moments. Sharing TicTacs with a patient as I took her for a chest x-ray – there were no porters, and it needed to be done. Wheeling another out for a cigarette in the sun, which seems sacrilege on a respiratory rotation (and I’m glad the consultant didn’t see). But she was palliative and who am I to judge?

One unseasonably warm [spring] day, I was shifted from my base ward to cover another, due to inconsistent staffing levels, as is frequently the case. That day, I was looking after a young woman admitted from a psychiatric hospital, isolated in a side room. Not only being worked up for probable TB, but also living with bipolar disorder. In many ways, our encounter brought my shadowy emotional undercurrent to light. Neither of us were where we wanted to be.When she asked me if I would want my mother to come and visit me, I could have assumed the role of detached doctor. But instead, I told the truth and responded as a daughter who has lost hers. That encounter deserved a poem; not because I always have the energy to write – but because meaning found me. The personal and the professional collapsed into one another – and I needed to honour that. Writing has remained my anchor in times of loss and longing, as well in moments of awe, joy and optimism.

Although I’ve found community [in this new city] through poetry, I still feel untethered. Still exhausted. But every so often there are interactions with patients that provide meaning. And I try to meet them not as a doctor, but with presence and attention – as a person wearing scrubs.

Coincidentally, I was moved again to that ward on the patient’s day of discharge four weeks later, which allowed some rare continuity in the hospital environment. After I’d finished my jobs, around four o’clock, I went and caught up with her for an hour. She was going back to university and told me her mum did come to visit after all. She’d been asking after me. I told her that I’d written a poem about the days we shared four weeks earlier.