A personal essay from a writer who was once a doctor.
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.
That fifth patient of the day required less of me. A simple stomach pain with no emergency cause. All I needed to do was offer her some kindness, some gentle reassurance that nothing was urgently wrong, and refer her back to her GP for further testing. But as I sat there and felt nothing, that old mentor’s words joined the ringing of the fire alarm in my ears: ‘The moment you stop caring is when you know you’re burned out.’
Burnout doesn’t happen overnight in some Hollywood-esque crescendo of exhaustion. At first, it’s forgetting to eat lunch. Then it’s not bothering to call your mum back. Then it’s your fifth shift in a row where you don’t have the energy to ask a colleague how they’re doing, because you know they’ll ask you the same, and God help you if you have to put that into words. Burnout is a gradual erosion of everything you used to recognise as yourself. By the time that patient sat in front of me with their vague stomach pain and their quiet desperation, I had nothing left to give. I had become someone I never thought I could be: detached, numb, going through the motions like a robot on its last factory charge.
It wasn’t just me. The system itself – the NHS – was falling apart in a way that mirrored my own slow collapse. On the surface, it looked fine enough. For those on the inside, the underlying rot was impossible to ignore. There were 24-hour waiting times, nurses relying on food banks, and patients stuck in hospital for weeks. Corridors were turned into makeshift wards, filled with ‘beds’ that were actually chairs. First-year doctors were earning barely more than the London living wage. Some people think the NHS’s problems started with the pandemic, but that’s a comforting lie. The pandemic didn’t break the system; it just exposed what was already broken. And the same goes for those of us who work within it.
I used to pride myself on my empathy. My ability to connect with people; to offer kindness even on the worst days. But empathy, it turns out, is a finite resource. And when it runs out, it’s gone – at least for a while. So I tried the yoga, and the deep breathing exercises, even buying one of those guided meditation apps that promises inner peace for five minutes a day. None of it worked. The anxiety and the crushing weight of responsibility all followed me home like a toxic shadow.
Leaving medicine wasn’t just a professional decision. It was an existential one. Giving up my licence to practise felt like surrendering a piece of myself, like admitting I couldn’t hack it. I’d built my whole identity around being a doctor, and walking away felt like an act of betrayal – not just to my colleagues or patients, but to the version of me that had worked so hard to get there. But what choice did I have? Medicine had taken everything from me: my energy, my empathy, my ability to feel joy.
There’s a kind of unspoken martyrdom in medicine. The idea that you should sacrifice your health, your relationships, your entire sense of self for the sake of the job. That’s the culture we’ve created, and it’s killing us – quietly, slowly, until one day it isn’t quiet anymore.
In the months since leaving, I’ve started to rebuild. It hasn’t been easy. For a while I felt unmoored, as if I’d cut myself adrift from everything I knew. But slowly, I’ve begun to rediscover parts of myself that I thought were gone for ever. I’ve started writing again, something I hadn’t done in years. I’ve learned to sit with my feelings instead of running from them. I’ve even rediscovered my empathy – not as some superhuman ability, but as a quiet, fragile thing that needs protecting.
Most importantly, I’ve realized that leaving medicine doesn’t make me a failure. It doesn’t erase the years I spent helping people or the lives I touched. It just means that I recognised my limits.
For those people still working in healthcare: I admire you. And I hope, more than anything, that you remember to take care of yourself. For those thinking about leaving: you’re not a failure. You’re human. Sometimes, the bravest thing you can do is walk away.
