Hanging up the stethoscope


What do the former Foreign Secretary David Owen, the poet John Keats, the comedian Harry Hill and I have in common? Although this sounds like the start of a bad joke, it is a serious question. No, we are not all poets, nor comedians, nor politicians, but we have all studied and practised medicine only to move on to another profession.

Students choose to study medicine for different reasons. Once qualified, some of us, for equally different reasons, will choose to hang up our stethoscopes in favour of another calling. But why did we give up medicine—why does any doctor? This is often a source of bemusement to those outside medicine who view the profession as an escalator that, once mounted, is ridden virtually to the pearly gates. Medicine, we are quietly reminded, is a calling that it would be impolite to ignore. All that time and study, and of course money, that has been spent must be justified by a fulfilling lifelong career.

It is a simple truth that medicine offers those who practise it the chance to change lives, and to change them for the better. That desire is what takes most of into medicine in the first place, but once there some of us may discover that there are other routes to the same goal.

Some leave because they are forced to choose—compelled by circumstances to give up their chosen profession such as ill health. Others may find they are forced to choose between two different callings. Lord David Owen, the former Foreign Secretary, was a junior doctor in London preparing to sit his MRCP examination when he was elected to parliament. Suddenly, a decision had to be made and a life in politics won out over medicine. But, his choice was not between helping to change lives or not—it was between two means of achieving the same end. While politics might not seem an obvious choice for a doctor there are others who have given up medicine for an altogether more revolutionary practice. For example, the Argentinian Che Guevara wore a white coat before he wore that beret.

Some doctors leave medicine because they are simply much better at something else, and find that they can change lives in other perhaps less obvious ways. The English romantic poet John Keats studied medicine and surgery for longer than he was a poet. For over six years he was either apprenticed or studying at Guy’s Hospital. Despite being well regarded as a junior surgeon, Keats turned out to be an even better poet. However, one life may have informed the other, for there are critics who see strong medical influences in Keats’ poetry. Other physicians who have picked up the pen have also found inspiration in their former careers. Anton Chekhov, the dramatist and master short story teller, has doctors appear in 83 of his short stories. Arthur Conan Doyle drew upon his knowledge of lecturer Dr Joseph Bell as the model for his most famous creation, Sherlock Holmes, and in Michael Crichton’s breakthrough novel, The Andromeda Strain, he told a tale of microbiology long before he dabbled with dinosaurs.

Some of course leave because they discover that although they wish to change lives, the practice of medicine is not for them. Many doctors, like all professionals, become disillusioned at one point or another in their careers, but most soldier on and come out the other side, stronger and wiser. But a few feel it is best to move on. The comedian Harry Hill was a junior doctor in London when he felt like this. Medicine’s loss was, however, stand-up’s gain. While he recalls that there was a kind of gallows humour in medicine, his own whimsical comedy turned into something quite the opposite, perhaps as a reaction. Others who have swapped medicine for comedy may have had the same strategy. There is little that can be attributed to medicine in the work of Graham Chapman of Monty Python fame, nor of Graeme Garden of the Goodies. These two comedians studied medicine, but, for both, the lure of comedy scriptwriting was a greater attraction.

And, what about me? I was not offered a parliamentary seat. Nor did I discover I was the greatest poet of my generation. I did not even feel compelled to find a role that was the antithesis of being a doctor. Medicine and I simply grew apart. The world into which I graduated had changed so radically that my job was now unrecognisable and at the same time my interests were starting to drift away from medicine. I still wanted to change lives for the better, and on good days maybe even change the world, but I wondered one day whether I could do that in another way. And, importantly, I had a Plan B.

Doctors are generally very smart people and smart people are versatile. But even smart people get frightened or bored or frustrated, or simply change their minds. Doctors can choose to leave the job they trained for just as many other professionals do, finding new challenges in a myriad of other roles. As working lives are becoming ever longer, there should be no need to struggle on in a job we find unfulfilling. And there should be no need for the talented to confine their activities to a single career.

Incidentally, if you are looking for a major career change you might consider two doctors who found high office in the church. The 13th century Pope, John XXI was a doctor before he stepped into the shoes of the fisherman. If your aspirations are even loftier, why not emulate St. Luke the Evangelist, and go all out for canonisation. Aim high.

© Allan Gaw 2015

This article has recently been published in FYi, the MDDUS magazine for foundation year doctors. You can view the issue here: http://www.mddus.com/media/1778/fyi14_feb15.pdf

My books available on kindle:

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The Accidental Delete


There are many safeguards built into our lives, and when it comes to typing on a computer it’s no different. I am used to being asked by successive pop up windows, ‘Are you sure you want to do this?’ Followed by, ‘Are you really sure?’ and even, ‘Now, let’s think about this for a moment or two, have you thought through the full consequences of this action, because delete really means delete, you know.’

Well, that’s the way it seems even if the reality is a little less forceful. But, occasionally, the safeguards fail. Occasionally, there is no computer voice of warning or alarm bells, there is just silence and a blank screen, where there used to be words…recently typed words…my recently typed words. Here’s what happened.

I had highlighted text, I had planned to move it and somehow—I’m still not exactly sure how—it was deleted. I was typing on an iPad using a new writing program—one with which I was not fully familiar—and before I was able to discover how to undo what I had just done, I had done several other things, including throwing the iPad on the floor.

I had been writing for a couple of hours, and while the text was neither very lengthy nor very startling, it was still two hours’ worth. My immediate reaction was a classic five-stage grief response: denial, anger, bargaining, depression and acceptance.

My initial denial was complete: this simply could not have happened, not in these days of auto-recovery and iClouds, but it did.

The next stage, anger, followed very quickly and included the throwing of the iPad, previously mentioned. I am not sure I could have mustered any more wrath, had I been watching the burning of the Great Library of Alexandria and the only extant copies of some of Aristotle’s greatest works going up in smoke. My two hours’ worth of typing was hardly in the same league, but their destruction was just as final.

The transition to stage 3, bargaining, was seamless. What if I played around and pressed buttons in different orders? What if I checked the online help? What if I prayed to the god of IT? Surely, there was some penance that I could offer in return for my lost text.

My depression and stage 4 consisted of a slow sinking feeling. The anger had passed almost as quickly as it had begun, and the bargaining was just as quickly recognised for what it was—useless. Now, I was bereft; left as empty as the screen.

Fortunately, we have a fifth stage that lifts us out of grief and the depression that is inevitable with loss. We have bouncebackability. I picked myself up, dusted myself down and started all over again. Or, in other less lyrical words, I accepted what had happened and got on with it. And, I did so in a hurry, in the belief that if I wrote quickly, I, or at least the muscle memory in my typing fingers, might remember what they had written only two hours before.

Time heals, they tell you when someone dies, and it’s true. It’s also true when you lose your work, and in my case the roller coaster of grief I have just described took all of ten minutes.

Mantras of stoicism might help: ‘Keep calm and carry on’ we are counselled in those red and white posters that seem to be everywhere, or perhaps the Scottish version, which I prefer, ‘Stop whining and get oan wi’ it.’ Whatever your strategy, there is much to be said for getting through the first four stages of grief as quickly and efficiently as possible, so you can devote those energies you have left to the practicalities in hand.

© Allan Gaw 2015

My books available on kindle:

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