Yes, you've covered a lot of it there, Bengali. The 'heroism/vocation' thing is particularly annoying (seeming, as it does, to coexist with the flipside belief that 'good doctors don't make mistakes'), and really does appear to permeate into the more general consciousness. Two incidents stick in my mind:
The first was during my experience as a House Officer, the one-year rude awakening in which one realises that 90% of what one learned in medical school is of negligible use when faced with the everyday horrors of physical illness (much of which we can, realistically, do almost nothing about) and death. Within the first few weeks, I realised that everything I thought I knew about being a junior doctor was wrong. I knew the hours were long, I knew I'd feel stressed, I knew the system would demand much more than I was able to provide. What I didn't expect was that I'd feel so shit, physically and mentally, about the whole thing. I quickly began to resent the system that literally consumed me, used me as a resource; I resented the many, many stupid, unfair, illogical rituals we've elaborated around physical morbidity (the need to heroically 'save lives' - or be seen to be saving lives - at all costs; the increasing legal need to resuscitate everyone; the expectation that one must give 100% of oneself 100% of the time because to draw boundaries, to insist "it's a job" is to be a Bad Doctor; the absolute inability - on the part of all and sundry - to accept that doctors make mistakes).
Anyway, my every spare evening was spent catching up with sleep; my social life dwindled to nil. Eventually my mother, concerned that I'd been out of contact for several weeks, came to see me at the doctors' residence. I was knackered, my acne had re-erupted, I constantly ran colds (hospital air-conditioning) - and I told her why I hadn't called her. She got a little weepy but smiled and said she was incredibly proud of me, she was proud of my 'heroism', my self-sacrifice.
I'm sure she meant well, but that made me feel angrier than ever, made me feel that she didn't understand at all. It wasn't heroism, it wasn't self-sacrifice; it wasn't anything good or positive. I didn't want to be a hero or a martyr. I wanted sleep, I wanted to be treated like a normal human being. I felt trapped within a stupid, rotten, dishonest system which brutalised people too naive to know any better, consumed our idealism.
My mother couldn't see any of this. She'd swallowed the myths of self-sacrifice; she thought it was a good thing. Her attitude made me aware, more than ever, of the experiential gulf that exists between those who know the medical world from the inside and those who don't.
The second experience occurred later in my medical career, when the Year of Hell was suitably distant, and I'd accepted that, while I still occasionally hated the job, I was now far enough along the path that I was stuck with it. I'd make the best of the situation, enjoy the pleasurable aspects, deal with the shitty ones. Late for my out-patient clinic, I reversed into a parking space and over a woman's toe. I jumped out, apologised profusely and offered to drive her anywhere. To Accident & Emergency? No, she insisted, she was fine; she was certain nothing was broken, she was in a hurry. She scurried off.
Well, at some point, she must've taken my registration number and got my details, because a letter arrived a week or two later, addressing me as 'Doctor' (I can't honestly remember if I told her I was a doctor or if she found it out herself). A few hours after seeing me, her foot had swollen, making walking painful. She'd eventually gone to A&E: nothing was broken, but she'd needed analgesics and a surgical tubi-grip. In her letter, she maintained that I was responsible for her pain/suffering as well as ruining a pair of her shoes, and she wanted £200. Fair enough, I thought, it was my fault - but what pissed me off more was the explicit criticism that, because I was a doctor (albeit a 'head' rather than a 'foot doctor') I should've recognised that she was too anxious to talk to me at the time and insisted that she go, there and then, to A&E. I should've examined her foot myself. The fact that I'd done neither of these things and had "allowed" her to disappear off was somehow particularly surprising/disappointing/negligent because of my job.
That annoyed me, at least partly because it succeeded in making me feel extremely guilty. I wrote her a cheque for £200, worried about it for weeks, and took months of agonising to decide that, just maybe, I was an ordinary member of the public who'd been involved in an ordinary accident, and had behaved in a perfectly ordinary way. The fact that I'm a doctor did not necessarily mean that, morally, I was always obliged to 'go the extra mile'. There were times when I was - and am - off-duty.
These anecdotes are rambling and (still rather) embittered - but demonstrate, I hope, the enduring myth of moral heroism, of sacrifice. I guess there's nothing to say that either my mother or the toe-lady believed the myth specifically as a result of TV medical dramas, but I see those same assumptions running through (almost) every such programme I've ever seen. |
