Behind the drapes: the reality of life as a doctor

dt_141231_doctor_depressed_sad_stress_800x600.jpg

My longest day at work?

I was a registrar and we were doing a big cancer operation. I got to work and did a ward round at around 7am. We started operating at 8am on the Thursday and the operation finished at around 3:30am on Friday. With the patient back in the Intensive Care Unit, I raced home for a shower and a change of clothes. I was in the car on the way back to the hospital at 5am; it wasn’t good news. There was a problem for this patient. We observed her for a couple of hours but we were back with her in the operating theatre at 10am. I finally went home at 5pm on Friday, so delirious I couldn’t even direct my mum out of the hospital and back to my house.

-

I’ve heard the jokes about doctors. Wednesday is golf day, we all drive a Mercedes and live in mansions that over look the beach. We swan onto the ward, just like on TV, look at some charts and then swan out again. It’s shiny, pompous and lucrative. Except that this could not be further from the truth.

Today the 7th of June is Crazy Socks for Docs day where doctors and anyone who wants to lend some support are encouraged to wear your craziest, mismatching socks as a marker of the very real and very prevalent issues of depression, anxiety, suicide and burnout amongst doctors. Research from BeyondBlue showed that doctors, particularly medical students and female doctors, had a much higher rate of mental illness than the general population and a frighteningly high rate of suicidal thoughts.

The troubles facing doctors have reached a fever pitch and with good reason. Doctors are struggling and the worst part about this is that it puts two groups at risk; the doctors and the patients they are there to take care of. The reasons that doctors are at risk are myriad. Medicine can be inherently stressful; it has struck me on more than one occasion how much pain and suffering I’ve seen over my career and that is something that other professionals aren’t necessarily exposed to. The stress of being responsible for another person is enormous without doubt. In addition to this, doctors can be exposed to long working hours, on-calls, bullying and pressures from administration.

Many doctors are suffering in silence, afraid to ask for help for risk of being seen as weak by their colleagues, risking important and difficult to come by training positions or for fear or reprimand by the Medical Board which could result in the suspension of their licence. Currently in Australia, only WA has an exemption to mandatory reporting laws that stipulate any doctor who treats another doctor for mental illness must report them to the medical board or risk their own licence.

As I said, the time has come to do the right thing by doctors for their sakes and for the sakes of our patients. There are some stressors in medicine that aren’t ever going to go away; the life and death of some of our days, emergencies will always happen in the middle of the night, shift work, training and so on. It’s entirely reasonable to help us develop skills that allow us to cope with those times and to be resilient.

The other side of this equation are the things we can do something about. These are things like bullying or safe rostering. I recently saw on Twitter a redacted letter to doctors working night shift that they were ‘not being paid to sleep’ so for them to catch a ten minute nap to refresh was being outlawed. That kind of fare is not appropriate, not safe and not at all humane. Likewise with mandatory reporting laws; they serve no purpose other than to isolate those who need help even further and they should be repealed without delay.

Being a doctor is the greatest profession and I am obviously biased but it is a great privilege and a fulfilling job. However, we need to take better care of our carers and today I hope that everyone who can make a doctors day better or worse does so.

To learn more, visit Crazy Socks for Docs