It was just me, in the fluorescent monotony of a hospital room, looking at my fifth patient of the day. She had stomach pain, tired eyes and test results that revealed absolutely nothing wrong. She was scared, frustrated and hurting. And for the first time, I felt nothing: a realisation that landed with the dull thud of inevitability. ‘This is it,’ I thought, ‘this is the day you stop caring.’
One of my mentors had warned me, years ago, when I was a fresh-faced junior doctor just out of medical school: ‘The moment you stop caring is when you know you’re burned out.’ At the time, I laughed it off, buoyed by the unwavering hubris of youth. Not me, I thought. I’m different. I’m built for this.
Do you remember January 2021? Many people choose to forget that month. The Christmas lockdown, hastily ordered from the prosecco-drenched offices of Downing Street, had been largely ignored. People were returning sheepishly to their towns and cities of residence, and those who hadn’t defied Boris Johnson’s half-hearted missive were not-so-silently judging those who had. The surge in COVID cases, passed around dinner tables with supermarket crackers and Brussels sprouts, was beginning to crest into a huge swathe of deaths. It would be the second-deadliest month of the pandemic. There was a strange atmosphere in the country, an unsteady mix of fear and frustration.
By this point, I, like many other healthcare workers, had replaced my initial fear with grim resignation, and a thick resolve to continue battling what was beginning to feel like an endless war against an ever-evolving enemy. My housemates and I – all doctors, all exhausted and dazed – had developed a new routine for dealing with the situation. We would wake, shower, steel ourselves and set off to our different hospitals. We would avoid small talk in the mornings. After work, we would come home, eat, distract ourselves with streaming shows and avoid talking about work at any cost. On the rare occasion that our days off landed at the same time, the three of us would cook together, then drink ourselves to oblivion, ignoring the horror that lay just out of sight.
I had taken to wearing scrubs while driving, to deter a police force that was enjoying exercising its new powers on black people (I was stopped on my way to work on two separate occasions). Once there I would change into my actual scrubs and make myself a coffee. Like many people, I had taken to yoga at some point in the previous year, in an attempt to harness the calming power of the wellness explosion. I would drink my coffee, and practise my breathing, pushing away the rising sensation that had started in my gut in April 2020, and was constantly at risk of boiling over into a full-blown panic attack.
Measures enacted to maintain our sanity were doomed to fail. A somewhat heavy-handed metaphor for this was our ‘wellbeing room’. It was an office in the bowels of the hospital, equipped with an uncomfortable sofa, some dying plants, and a Nintendo Switch chained to the wall. It literally went up in flames after someone left an incense stick burning unattended.
On this particular day, the beeps, shouts, moans and constant humming of the department that day were overlaid with a piercing, relentless fire alarm, courtesy of a distressed patient who had broken the glass in a moment of desperation. The fire brigade was quick to attend, telling us that, as there was no actual fire, they were unable to access the circuit board that would allow them to turn the alarm off and were, understandably, unwilling to let us start a fire so they could end the racket. So, with the alarm ringing in my ears, I started my shift.
At this point in the second wave of the pandemic, we junior doctors were handed the grim task of risk-assessing patients who had been admitted with COVID. There was a checklist of criteria for us to assess whether someone would likely survive in the event of needing a ventilator. For each patient, I followed the same protocol, but it never became easier. I explained to families that their loved ones might not make it out, even as their voices trembled with hope over the phone.
