Science & Faith

I am certain of three things: I want a meaningful and fulfilling life. I love clinical medicine (amongst other things) and things can’t continue as they have. I’m losing faith.

The beaten path ain’t it.

I wish that I was announcing my retirement from medicine. I’d love nothing more than an easy solution. Unfortunately (fortunately?), I didn’t pick the wrong profession, I don’t hate my job, I don’t want to move to Canada (I hear its lovely) and I’m optimistically suspicious of the private sector. In short: I’m screwed. You’ve heard it before: “the health system is failing” blah blah blah. “there are also good people in health though”. All true. I’ve written (and talked) about it at length (repeatedly) here, here, here and here. Cry me a river right? Am I complaining about employment and my position in the economic top 10%. In South Africa? In 2019? Yes and no. I know I’m luckier then most.

Millennials as a group are typical restless middle children. Wedged between the dutiful (if a little bulldozer-y) Boomers and the contradictory irreverence and energy of Gen Z. We are creating jobs and careers that didn’t exist a decade ago, getting married later (if at all), are steadily decreasing the 2.4 children/person average, own plants instead of homes (home owning being less likely in light of the lovely economy and environmental crisis-es that we inherited from the Boomers and the choke-hold of student debt to name but a few deterrents) all while navigating multiple small and large scale socio-political revolutions. In all of our activism and angst we want more. We are not a particularly content group. We want lives we can be proud of, jobs (that we spend at least a 3rd of our lives at) that we don’t have to endure. We’re simply too aware to be happy with numbly surviving. We want rich emotional, financial and psychological lives. We want freedom and ambition and to break glass ceilings. We’re less likely to tolerate slave labour that’s been cleverly branded as employment. We’re a problem (the good kind) because we’re almost always opposing the agenda. I’m proud of and unapologetic about this. That being said, It’s difficult to not feel like a brat for always wanting more, even when you know it’s right. Which brings me back to my dilemma.

I’m having a crisis of faith (of vocation?). I’ve committed a decade of my natural life, my youthful prime and my entire (short) professional life to something that I love and l constantly joke about it not loving me back. It’s a wonderful profession, truly. I should probably mention that I’m not delusional: I am black African and female so life’s no picnic and there is little to no respite on those fronts. I know there is no utopia. I also know that I cannot continue to work the way I do. Systemically, interpersonally, institutionally. Life is too short to want to escape my day job which has a frequent night and weekend (and much touted lifelong) component. Maybe it’s because I’m at a natural transition: independent practice. I lie awake at night thinking about all the ways things could change. Some are even realistic. “you are not a tree” comes up a lot: change your environment or change yourself. Until recently, I’ve assumed that there were a few set options for doctors.

The aforementioned “path”:
1. Continue: specialise, don’t. Enter the private sector, don’t.
2. Take a slight left turn: leave clinical practice but stay in health. This includes Pathology, Sports Medicine, Aesthetics (which is big money right now though I’m genuinely not sure what’s in a ‘vitamin drip’ that isn’t in the jet fuel I give my intoxicated patients every other Saturday night).
3. Take a slight right turn: leave clinical clinical practice for health associated structures and Academia: aka Public health and research. I assure nobody wants me in a lab.
4. Leave: as in stop or do something else. Even this path is clear. There’s Consulting (I have entire friends who do this and from what I gather it’s proposals, pitches, clients and late nights). The MBA come CEO route. Also included (in the interest of diversity): housewifery and associated structures. I have great difficulty picturing myself in those spaces.

Reality check: What they don’t mention is that once you start working it is hard to stop. Whether it’s Financial responsibility (ranging from fixed assets, debt, bread-winning, black tax and student loans) or lifestyle adjustment, very few of us have the luxury of simply taking a break until we ‘figure it out’. It’s why so many don’t leave. It’s also why wandering off the beaten path gets scarier and less likely as the years (and responsibilities) pile on. Lately I’ve been seeing so many exciting conversations in health spaces offering new ways to leave clinical medicine. For those who need this new path out, I encourage and am happy for you. I also envy you.

Is there an option 5? What about people like me Who want to “stay”? Who understand that the non-choice (see option 1) comes with the following T&Cs: you will have to put your head down and endure. You may never thrive. It might cost you your sanity and internal well being. Once you decide, it will be said that “you chose this life” knowingly (and it will be true). That to live out your purpose (a job that is meaningful, often stimulating and of service) you have to drink the Koolaid and accept that toxicity is never far behind will forever be your bedfellow. Would you do it? Or can we do something?

This is where YOU come in. This is a cry for help though not a very traditional one because I’m not at the end of my rope (yet), I’m not in any danger and I know I’m not alone.
To my health professional colleagues, I’d love to start a dialogue here or at least encourage you to start some of your own. A real, raw and safe one: What have we identified that would make hopeful juniors and brilliant seniors alike want to run for the hills from a profession that they once loved (still do?). What can we do about it? #WhatShouldWeDo?
I know it’s been health-heavy but I’d love input from my friends and readers in other professions who have faced a similar crisis of faith. Solutions, suggestions, success stories. Did you get out? Did you change your environment? Did you find a mentor? Did focusing on the patients make the difference? Did you take a break? How did you do it? Who do you know that tried? Did they fail? Was it worth it? I’m genuinely looking for answers.

Help. Please.

I’ll leave you with my favorite poem’s favorite poem: If by Rudyard Kipling.

Fun fact : The Script is still my favorite band despite decidedly peaking with their first two albums.

Next: the Sequel An Education

10 thoughts on “Science & Faith

  1. Interesting I should read this this particular week when I’m experiencing a mild bout of career induced existential crisis. The idea of hanging my stretch for a bit to go somewhere out in the world to fetch my life has been causing me a little bit of a headache. It’s brilliant that you pointed out that it’s not as easy, particularly for the middle class black girl who’s bank account is only now getting comfortable with a steady flow of cash – how do you fetch your life somewhere else when there are bags to secure and your salary is your most realistic chance at it? In my case my crisis is exacerbated by the limitations of the public health system. Solution? Dunno, dreaming, trying things out, making plans, weighing up options, staying open minded and like you say, there’s no utopia – medicine is not what I thought it would be, nothing else probably will be.

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    1. Thank you Lerato, I couldn’t have said it better, you phrased it so well. I’m glad this resonated with you. As for me I’ve accepted a few truths: I have a very aggressive separate savings account that debits monthly with the plan to cover my fixed expenses for a few months if taking a break becomes inevitable. I’m also starting to accept the possibility that I’ll have to carve an entirely new path because the existing one doesn’t serve me.
      I’ve also been heartened by the responses, I’ll share a few of the wonderful insights shared in my stories. I hope you keep the conversation going on your personal and professional spaces.

      I’m still holding out for suggestions on how we can start fixing the system in general but everyone seems stumped on that front. For now.

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  2. Having had such a breezy year this year for my Comm serve I’ve had a lot of time to actually reflect on this feeling and soul search on a more less burnt out spirit. Coming fresh from internship i faced this impending gut feeling of “is this really it?” At the start of the year. I was no longer excited about some things and very depressed being isolated from the rest of the world in Kuvukiland. I felt very restless and uneasy about “making my next career move” because I actually didn’t feel as excited as one ought to be when building towards a dream.

    The months went by and I decided to actually just chill and allow myself to properly relax this year. No crazy hours doing calls and having more personal R&R time definitely did a number on me. I was able to think on a more clear mind not fueled by regret and anger from a shit call/ busy week in a ward. I was able to listen to myself again, pay attention to the little nuances and messages the universe gave me while I’m at work or even when off work.
    I guess what I mean is we ALL need Atleast a month or few for down time to re-evaluate our jobs because to be honest you’re no longer a building on the dreams of a teenager. You are now an adult with an adult mind and adult feelings and the world we work in has immensely shaped how you look at your life. I think more than anything is that we need to have more conversations about this “coming of age” as Doctors as you have highlighted we are not alone in this feeling. In the interim more realistic avenues should be available like going to talks or expos surrounded on alternative job opportunities for us as I firmly believe the mere fact of engaging on such shifting opportunities in itself forces you to go back to square one and address the “WHY” so you know where you actually want to go forward. In the future ? Perhaps a paid 2 months of leave, I don’t know but it definitely plays a part in mental health and I am blessed to have had an opportunity to be on the side lines a bit this year and actually think hard and deep about this.

    As you can tell I don’t have the answer yet but you are starting the journey of self re-discovery that I took months ago and trust me it’ll heal and align things for you just as long as you continue exploring this topic endlessly. Also don’t measure your outcome, for me being able to actually have a mood board with “aspiration and dream jobs” on it was an achievement cos I haven’t done that in YEARS. A part of me died and they slowly coming back. I hope that for you too, cos I know being a goal orientated person and then going through this rut of “just living by” is really confusing 😂Take it one step at a time and try by all means to not over think it.

    Liked by 1 person

    1. Thank you Melusi. What you’re saying echos a lot of similar sentiments that we need to be gentler with and listen to ourselves. Take a step back. I’m glad you found the space because this goal-oriented thing is hard to shake 😂 keep the light alive Prof (no pressure)!

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  3. Funny! This right here is me! Exactly what I feel my life has come too!
    A crossroad of some I stay or should I go? Move forward? Or take that right or left you speak about!
    We all love medicine and to an extent we have a common reason as to why. Personally I don’t think it was for the money (ha! I wish we were paid more for what we endure). But my love for people, the body and in a sense paying it forward because of the doctor who once treated me as a kid when I was Hospitalized with bad pneumonia.

    Being a doctor is a dream I’m so blessed to have fulfilled BUT I wish I had known how mentally taxing it would be, how unkind it is to the very people who are suppose to heal our communities.
    We laugh a lot about how rough/lit it is but even after the passing of many doctors due to mental health and Or car accidents from pure exhaustion – we are STILL not doing enough to support each other. We are but replaceable right?!

    As for me being a victim of a car accident post a trauma call with subsequent MDD, I must say I have seen it all! The unkindness of those very people we laugh about the “litness” of this profession. All of a sudden being an inconvenience for not being at work. Yes I get it of course, one doctor short means more work for those present…but we are human too! We get sick, we burn out etc.

    I’ve stayed and for a few years now I’ve continued to stay, to push and just maaaaybe I’ll be okay. Just maaaaaybe with gaining more skill and being more senior I will feel better but it hasn’t!
    I’m leaving!
    Not forever because my heart is with medicine, but like what Melu said – you need to stop, pause and reevaluate!
    It’s almost taboo to do that in this profession because OMG you are wasting time etc but at the same time is it worth you peace? Will a few months do that much harm in the long run? For mental health?
    I don’t think so!

    Do I know how I’m going to pay for things or what next year has in store for me? Noooope! But I do know that sitting down for a bit will restore my mental health again! And right now, that’s top priority to me!

    My skills, and my knowledge won’t die! What is meant for me will always be mine. I have faith in that! But I will not loose my life over being a doctor!

    Liked by 1 person

    1. ❤️ If I may: I remember the aftermath of your accident, things were never the same. I also remember how worried I was when you were talking about leaving, how radical and taboo it felt. How it felt so stupid that we almost lost you because of a call and all the casual near-miss car accident stories people started to share in response. I also remember how much of a difference the small acts of a kindness your seniors and juniors alike made in your life when you tentatively returned. Issalot. Choosing ourselves shouldn’t feel radical at all. I’m stressed by how many have expressed the choosing of self in life/death terms, as if staying is a moral threat. I applaud you for being brave and choosing you. Medicine isn’t going anywhere but there will never be another you Zak ❤️

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  4. This post is basically my current dilemma.
    Having gone through a somewhat challenging internship, I had hoped that comm serve would be kinder. But 2019 has shown me that the grass is not greener in the Cape and that Bara is not the worst thing that can happen. And to be honest, the more time spent in the clinical side of the public health system the more frustrating it is to realize that policies don’t change in our tea rooms and the systems at play are so intricate. So essentially at the end of it all you’re left burnt out not only from the workload but from the overwhelming realization that your clinical skills are the tail end of the solution.

    I am not sure I will be giving much of a solution but I think as Melusi and Zak mentioned I have come to realize that it’s actually ok to take a step back to process all of this before deciding which direction to go. I mean, it takes forever to formulate your understanding of your experiences as training and junior doctors, so it only makes sense that the answers may need some time as well. And stepping back may just mean not doing overtime or completely stepping away from clinical medicine or just taking a month off. Either way it is something we should probably start normalizing in medicine.

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  5. Ntoetse’s takeaways
    1. I’ve been ‘preaching’ #humansfirst to the wrong people: colleagues and friends, we are people first. The public can think what they think. For now. What’s clear to me is that we need to look after the humans in Healthcare and the rest will follow.

    2. Ideas don’t change culture actions do (a gem from Masego Madonsela). Be a micro influencer (ideally we want cultures that don’t need us to be physically present to enforce them). Play the long game: kindness, compassion, leave room for the humanity of others. We need to nurture those that come after us. It’s a relay this thing.

    3. Take care of yourselves. Listen, reconnect and look after the human that is you. All of the basics: exercise, good food, space, therapy, prayer, diet, hobbies, passions (ansidenhisykendegree in something unrelated that you love) all of it. Look after you. You’re human first.

    4. A break in various forms keeps coming up. People who left come back ready to rumble having gained distance, perspective and the tools to survive the hostile environment safe in the knowledge that they’re back voluntarily and are not hostages (see: the NonScience of a Breakup post). Other people take breaks and never return having found purpose, solace and another way. Take a breather: whether it’s a hiatus, a non clinical detour, locum, the luck of chilled community service placement, temporarily foregoing calls and overtime. Nobody prepared us for this. A break is good find out which one you are.

    5. Everybody hates their job sometimes. No job is a 100% wonderful (if yours is: how does it feel to be God’s favourite?). If you become a successful singer you might have to tour with stage fright, navigate industry politics and deal with the realities of fame. So basically, find a way to reconcile this. You shouldn’t be miserable at work where your spend most of your waking (and in our case sleeping) hours though.

    6. We are largely powerless to make big changes that count. Room to be compassionate needs accompanying policy: staffing (HR, management) so that I don’t have to 3 peoples jobs when my colleague is sick, staffing so that we don’t have to risk our lives (and those of our patients) working inhuman hours. Healthcare funding is shockingly Mismanaged (see also: corruption) because from a national budget standpoint, we’re not underspending (relatively speaking). Anyway, It’s above me.

    7. Bravery and honesty with a splash of discipline. Rumbi, my badass entrepreneur postgraduate-pursuing friend said this: almost anything is within your grasp if you’re brave enough to risk it and disciplined enough to work for it. Have the tough conversation with yourself what do you want, what can you do, is your current situation a reflection of that. I’m warning you as someone who is currently having that conversation: it’s not fun. It is necessary. Good luck!

    There’s a story circle on my Instagram with the other responses to this post. Check it out when you have a minute. The conversation is ongoing and you’re always welcome to hit me up.

    Lastly, if you’re still reading (champ!) I’ve found these lyrics helpful right now:
    Understand the truth ’bout that question in your soul
    Look up, don’t look down, then watch the answers unfold
    Life is your birthright, they hid that in the fine print
    Uh, take the pen and rewrite it
    Step out your estimate
    Step in your essence and know that you’re excellent
    Rise (rise), the spirit is teachin’
    Oh, I’m not just preachin’, I’m takin’ my own advice
    Let mama let you know (let you know)
    Mama’s just tryin’, I can’t get no days off
    I don’t get no days off
    Truly, I’m feelin’ it, I had to say that thing twice
    Tryin’ to be a good wife
    Still really hard, I can’t lie
    But I promised you I will fight, so I fight
    If you feelin’ frustrated and (oh)
    You’re sinkin’, I’m jumpin’ in (oh)
    Forgiveness is key because we’re fightin’ something way bigger
    You’ll never lose, we are winners
    I’ll be the roots, you be the tree
    Pass on the fruit that was given to me
    Legacy, ah, we’re part of something way bigger
    -Beyoncé Knowles-Carter, Bigger

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