Being a tick in the box (part 1 of 3)

Ticking the boxes

(First published on doc2doc on 28/01/2014: http://doc2doc.bmj.com/blogs/doctorsblog/_being-tick-box )

Do you remember the day when you found out you passed your finals? You are looking at the list of all those in your class who made it. You see your name. Yes, you’ve made it! There is that initial moment of disbelief and you flick your gaze back to see your name on the list again. And again. Then once more. Congratulations! You are a newly qualified doctor. All those sleepless nights of revision and hours of frantic essay-writing have paid off. You are ready – and now qualified – to save the world! Amongst congratulations from your relatives and friends you may even add a humble status on Facebook “… is a doctor”.

I used to be fascinated whenever I heard of some Registrar who left Medicine. “What?! Why would anyone do something crazy like that?” I pitied them for missing out on what felt like the Journey of a lifetime. I was one of many who would arrive to the ward to prepare the patients’ list well before the ward round. I loved drawing boxes next to the hundreds of tasks and then ticking them off when a task was complete. More often than not I would choose to tick off extra boxes on my list of jobs instead of a ten minute “natural” break. I would then still say on the Hours Monitoring Exercise that I had had my half an hour of rest. Does this sound familiar to anyone? I would turn up to work ill because my conscientiousness would not let me call in sick. I would stay till nine or ten in the evening sorting out endless paperwork in the full knowing that I would be called disorganised if I was to declare the extra hours during the Monitoring Exercise. I told the guy who I liked very much that I had to take care of my career and did not have time for a relationship. I was moving towards that better future and a comforting thought stayed with me: “It’ll get better”. It felt worth it.

I had my highs and lows, just like any other doctor. I felt grateful to my patients who taught me so many lessons about me and about the world around me. I felt grateful for the opportunities to meet amazing mentors, to go to fantastic conferences and events, and to make my small difference in other peoples’ lives. Over time I also learnt that thinking outside the box within the NHS is punished. So I kept silent, only ever venting my frustrations in The Mess with other junior doctors. The years went by and I was still ticking off boxes on the list of jobs instead of “natural breaks”. It started to feel less natural.

“Is this all my life will ever be?” Whenever this thought popped into my head, I would feel guilty. I felt like I am betraying my patients, my colleagues, and even the society that invested in my medical training. I had always been “a high achiever” who had passed all professional exams with flying colours. Tick. My multisource feedback forms were complimentary. Tick. I had made it through all medical interviews first time round. Tick.

Like a thief in the night, I would sheepishly type “alternative careers for doctors” into Google. It really did feel like a crime. I could not share it with anyone. What is wrong with me? Am I the only one? What happened to the joy I had the day I saw my name on the list of newly registered doctors? What happened to my creativity, my enthusiasm, my passion?

I had ticked off all the goals in my professional life yet it felt like there is really more to life than ticking boxes. There was more to life than staying in the box. I was a registrar in the highly sought-after specialty, yet it wasn’t feeding my soul. In my hands was my fantastic CV with all the achievements that got me the dream job yet I could no longer ignore the nagging feeling that something was missing in my life. The story I heard few years previously about a senior registrar who left Medicine somehow no longer felt all that outrageous.  I had a job that I had once been told “thousands would die for” but I was not ready to kill myself over it.

After many months of soul-searching and reflecting, I had my epiphany moment.  One Friday evening I stayed behind after a clinic to do my paperwork. I walked into the Registrar’s office to collect my bag. What I saw was like a wake-up call, and I never thought it would be that simple. My senior colleague was still in her theatre scrubs crossed-legged on the chair staring into the computer screen. She was surrounded by multiple patients’ notes and numerous papers. She was doing an audit. Her partner was on the phone and I could work out from their conversation that he really missed her. It was 8pm on a Friday evening. She kept telling him she had to do the audit but would try to come back home soon. Eight o’clock on a Friday evening. That insight into my future in the NHS gave me the answer. I had to break free. My world was about to change…

(This was part 1 of 3 of my story of transition. Continue reading what happened next.)

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