Why I left private practice for the public sector

Some of the greatest psychological stressors are said to include breakups, death, moving house, and starting a new job. Sometimes we choose one or more of these willingly, and hope to hell that the payoff will be worth it.

For two years, I worked in private general practice in Cape Town. The benefits of this kind of employment were sizeable – I made a living on relatively few hours, and had no overnight calls. I got to sleep like a normal person! I had a flexible schedule, and could always increase or decrease my hours as necessitated by my needs.

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The cons, however, were not insignificant. Any leave I took – sick leave, vacation, or for a course/conference – was unpaid. I was paid by the hour (and that has affected my taxes, too). I was often the only doctor at a practice, sometimes one of two. The patient-pressure was immense – I never managed to get a grip on seeing 4-6 patients in an hour. I simply was neither able nor willing to compromise patient care, nor my medico-legal accountability.

On the other hand, I did get to live in Cape Town. Cape Town! Although the city can be scary and inhospitable to newcomers, there is so much to do. I could never tire of it. As Murphy would have it, I made a lot of friends and found communities to slot into during the final few months.

But why did I ultimately decide to pack it all up, and move AGAIN?

Because I was miserable.

I am not going to unpack that misery now (maybe another day), but I soon found myself completely out of love with my work. I missed the sense of a team. I missed being able to discuss cases with colleagues, and having someone with whom to commiserate. I missed the somewhat academic environment of public hospitals. I care a great deal about primary healthcare and public health, but I found that I was swimming against whitewater rapids, and treading water was becoming more difficult by the day. Although I wasn’t working very many hours, I found myself constantly low and tired. Often, I would delay leaving for work until the very last minute, and then arrive late. My career seemed hopeless; I felt heavy and inert. 

In short: I hated my job.

I do not use that term lightly. In previous jobs, I had certainly had days when I hadn’t particularly enjoyed working. This was not that. Hating my job is probably one of the worst things that has ever happened to me, and unless you have experienced it, you cannot begin to imagine it (I certainly could not). I have very clear memories of LOVING being a doctor before, so I know that this had little to do with my profession, and more with the direction I was taking and the environment I was in.

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And now I get to work scrubs to work every day!

So when the call came to offer me a job in anaesthesia, the scales weighed heavily in favour of the new job. There was the matter of the city and the people I would be leaving behind – and I did not make that decision lightly. Ultimately, being unhappy at work was negatively impacting on all spheres of my life. I had to get out, or it would kill me.

And so, I said yes. I packed all my belongings for the fourth time in three years, to move to a small city with significantly fewer resources.

But I think I am happy here. I have completed two months of supervised work, and I am starting to have my own independent theatre slates. It has been extremely high-stress, and my confidence has on numerous occasions hit the very bottom of rock bottom. I often fall asleep on my couch in the early evenings, because my brain feels so fried from all the mental exertion.

But I love my job again.

And I cannot begin to explain what a game-changer that is.

Threatened By The People We Serve

A few weeks ago, the community around one of the hospitals where I work picked up their torches and pitchforks (well, sort of) and protested again. I’ve written before about South Africa’s protest state of mind, and about working during a riot.

As it stands, when this specific community protests, they protest right outside the hospital. No matter the reason for protesting, they block all entrances to the hospital and threaten anybody who tries to circumvent them.

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Police told us to turn around. We called our superiors. They told us to come to work. Continue reading “Threatened By The People We Serve”

You guys! I ran a marathon!

In September 2015, after reading Tom Foreman’s My Year of Running Dangerously, I got it in my head to run the Two Ocean’s Marathon. For some reason I didn’t click that it was actually an ultra at 56km, and that I would need to run a qualifying marathon first. What can I say, sometimes I’m a little inattentive.

ANYWAY. Today I ran my qualifying marathon, the 43rd Buffs Marathon in East London (South Africa) – and my first marathon ever.

What an experience. Continue reading “You guys! I ran a marathon!”

Back to Stutterheim

As interns we are allocated 22 days of leave annually, and we are allowed a maximum of eight days per four months. This ensures that we don’t miss out too much of any of our rotations, but necessitates some fine planning if one wishes to take a break.

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So instead of going very far for a weekend breakaway, we learn to explore the gems spread around the Eastern Cape. Continue reading “Back to Stutterheim”

Throwback: Roadtrip Through History

I wrote this post as a note on Facebook exactly five years ago, 6 July 2010. I’m often ashamed when I read my past writings, but this isn’t one of those times. I’ve left it exactly as is. I’m not sure how much sense it will make to people who are not familiar with South Africa, but I decided to share it here in any case. I’ve hyperlinked some things for comprehension’s sake.

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The extravagant price-increases as brought on by the hosting of the FIFA World Cup recently necessitated a 12-hour road-trip to Cape Town, as opposed to the usual 90-minute flight.

A cold and dark 05:00 morning progressed just as we progressed through the land of memories.

Memories of debating trips – so many debating trips.

Here we debated.

Here we lost.

Here we won.

Here I learnt that the line between conviction and contradiction truly is a fine one. Continue reading “Throwback: Roadtrip Through History”

A Story of a Statue

It’s a pretty bad time to be a statue in South Africa. If you’re not from here, a quick run-through: at the University of Cape Town, students have successfully petitioned (to put it mildly) the University Council to remove a statue of Cecil John Rhodes on their campus. Not long after that, a statue of Paul Kruger was vandalised, as well as a memorial for the animals that served and died in the Second South African War.

Click image for reference.

I haven’t really said much about the saga because I can understand, to some extent, the people on all sides of the argument. I did not attend UCT and I feel no particular loyalty to Rhodes. I don’t feel particular affinity for Kruger, either. And animals are awesome, but the real reason I feel strongly about statues being vandalised is because I believe in history. Continue reading “A Story of a Statue”

Communicating with Patients who don’t Speak Your Language

I’ve been working for just under two months now and one of the most striking differences between my cushy Western Cape training hospital and my current Eastern Cape job is that here, many more patients cannot communicate with me in a language we both understand.

I am bilingual, and in the Western Cape this has meant that I could communicate – either in Afrikaans or English – with probably around 90% of my patients. These days I probably speak an improvised fanagalo 90% of the day; so much so that I sometimes accidentally speak it to my colleagues and family!

That said, in Cape Town I sometimes had refugees as patients who could not understand a word I spoke, so it is not completely new to me. Here are some tips for when you and your patient don’t speak each other’s language, literally.

language Continue reading “Communicating with Patients who don’t Speak Your Language”