@@CHAP@@ Introduction
In 2010, after six years of training and a further six years slugging it out on the hospital wards, I quit my job as a doctor. My parents still haven’t forgiven me.
Sorry for the spoiler, by the way, but you knew the iceberg was coming in Titanic, and you watched that all the same.
When my diaries were first published in the UK, I thought I’d written a very particular, parochial book about the life of a doctor in the National Health Service. But I was—not for the first time in my life—quite extravagantly wrong. It has now been translated into thirty-seven separate languages, amounting to nearly three million copies, and I get regular e-mails from doctors in Belarus and Bogotá, in Barcelona and Bangkok, telling me, “This could have been set in my hospital.” Not to mention from countless doctors in the States who’ve read imported or (ahem) bootlegged copies and say exactly the same. However a health-care system might be set up or funded, the experience of being a doctor is utterly universal. The same heartbreak, the same hilarity, the same damaging work schedule, and, of course, the same baffling array of objects getting constantly inserted into orifices.
I should still give you a very quick primer about our health-care system; unlike an intern’s first day on the wards, I won’t drop you in the deep end, breeze off, and expect you to know exactly what’s going on. The NHS was founded on the principle that it’s free at the point of delivery and you’re treated according to clinical need, not ability to pay—whether you live in Windsor Castle or on a bench outside Windsor Station. Other systems around the world might be more efficient, but I’d drag myself out of a coma to argue that none of them is fairer.
Universal health care is obviously a bit of a political hot potato on your side of the pond, but—much like ant-egg soup or a night of bukkake—don’t knock it till you’ve tried it. Here in the UK, you don’t have to check your bank-account balance after booking an appointment or delay treatment until your finances allow it, and (ahem, again) no one ever faces bankruptcy because of medical bills.
Like the health system’s other 1.4 million employees, I will always feel tremendously proud to say I worked for the NHS. It’s unlike any other national asset; no one speaks fondly about the Bank of England or the London Underground. The NHS fixed our broken arms on field day, gave our grandmas chemotherapy, treated the chlamydia we brought back from spring break, started us on inhalers—and all this wizardry was free and right when we needed it.
So you’ll forgive me for feeling sentimental when, a few years ago, the GMC (General Medical Council—the bastards who regulate doctors in the UK) wrote to say they were taking my name off the medical register. It wasn’t a massive shock, as I hadn’t practiced medicine in half a decade, but it was still a huge emotional wrench to permanently close that chapter of my life.
It was, however, excellent news for my spare room, as I cleared out box upon box of old paperwork, shredding files faster than Willie Nelson’s accountant. I couldn’t quite let all of it go, rescuing from the jaws of death my training portfolio, where doctors log their clinical experiences. On flicking through its curling pages for the first time in years, I remembered shuffling up to my hospital on-call room between crises and scrawling down anything remotely interesting that had happened that day like a blood-spattered, epically tired Samuel Pepys.
Reading back over it, I was reminded of the brutal hours and the colossal impact being a junior doctor had on my life. It now seemed extreme and unreasonable in terms of what was expected of me, but at the time, I’d just accepted it as part of the job. The extra mile was the normal distance. I wouldn’t have flinched if an entry read swam to Iceland for prenatal clinic or had to eat a helicopter today. I truly believe that anyone who ever has or ever will encounter a doctor should better understand what it’s like to be on the other side of the scalpel, should get to peek behind the scrubs, the gloves, and the calm demeanor. So here they are, the diaries I kept during my time as a doctor, genital warts and all. What it was really like on the front line, how my personal life became a hobby I never had time for, and how, one terrible day, it all became too much for me and I finally hit the iceberg.