Patients Don’t Want Exhausted Doctors


Before you read what I have to say, you should read Dr Nikki Stamp’s post: How tired is too tired?

One day, I’d like to have a study to prove the post title. But for now, we’ll have to settle for another anecdote:

tired doctor

Late last year, while I was on the surgical service, I had a small chat with a family member of a deceased patient.

During our ward rounds, relatives of patients recently demised would come in, requesting a death certificate to be filled. It’s a long process but it has to be done. Sometimes I would console the distraught relatives. Sometimes I would need to answer questions that had no real answers. Other times, as in this case, the atmosphere would be one of quiet acquiescence: the patient had been old, and suffering; her body had become her torture chamber.

As I was filling the death certificate, the relative noted my scrubs (at our hospital we generally only wear scrubs when we are on call, and many patients have picked up on that).

He said, “Oh, you’re on call today.”

And I smiled, confirming.

He asked, “When do you go home?”

I wasn’t sure if I should say, but I guess it’s not secret. “Tomorrow afternoon by noon, hopefully.”

He was still blissfully ignorant at this point. “So you have to sleep in the doctor’s quarters tonight?”

And I said, “There usually isn’t much sleeping going on while on call.”

The realisation was now starting to dawn on him.

“But you don’t touch patients in the middle of the night, right? I’m sure you have someone fresh to help you.”

And because I was on a roll of truth-telling, I had to deny his assumption.

No. I do touch patients. I do more than touch patients. I compress their chests. I run life-saving fluids into their veins. I call grumpy consultants from obscure sub-specialties to inform them that their expertise is needed.

“Sir,” I said. “If you were in a car accident at 03h00 tomorrow morning, I would be part of the team that saved your life.”

And he wasn’t happy. Because how could a tired doctor (team of tired doctors) have to save his life – or, God forbid, his children’s?

Could he refuse, he asked. Could he demand a more awake doctor; if the hypothetical accident occurred?

Well, I guess he could. Whether his request would be granted, or even possible, was another story.

Suddenly, the plight of exhausted doctors all over the country had become personal to him. He understood.

And, not surprisingly, he was horrified.

Dear Medical Student: Med School Is Not Worth Your Self-Harm



A while ago this secret appeared on PostSecret:


“Medical School made me self harm. It better be worth it.”


It made me sad then, as it does now, but I deferred writing about it because… I don’t know why.

An event at my alma mater this past weekend – that I don’t really feel like talking about right now – made me think of it again.

I wish I could say I don’t know what this student was feeling when they wrote their secret. But oh, I do.

I know how unwelcoming the world of medicine can be.

How traumatic.

And how uncaring those who are meant to be your mentors can be.

Medicine is a dog-eat-dog world. We eat our young, and we starve them to such hunger that they start to tear into one another.

Dear Medical Student: medical school is worth a lot of things. I can tell you that because I went from hating medical school to loving being a doctor (well, on most days).

But it’s not worth that.

Medical School is not worthy of your self-destruction.

Nothing will ever be – not art and not science and certainly not the practice of healing.

I’m sorry. I am sorry because that realisation in itself can be earth-shattering.

When you start working as a doctor, you may find that you love it. You may find that the long hours of studying were worth it. That missing parties was worth it. That having shorter holidays was worth it.

But self-harm? Self-harm will not be worth it. Not in this profession, and not in any other.

If medicine – or whatever you are pursuing – is driving you to self-harm, something is wrong. It may be a number of things, but whatever it is, it needs to be addressed. Resolving it is the biggest gift you can give yourself.

Dear Student (ANY student): You are far too valuable for this. 

I Can’t Treat You Like A Private Patient


Dear Patient-at-Public-Hospital

Let me start by saying, I’m sorry you had to come to hospital. While hospitals are never a good place to be, coming to a State hospital in South Africa provides a unique set of challenges – to your doctors and nurses, but also to you.

dear public patient

There are things that private patients get that I wish you could have too: fluffy duvets, enough pillows, air-conditioning, smaller wards, speedier test results…

I wish all my patients could have a “private patient” experience; but I need you to know that there are certain things I will not do. Continue reading

The Passion Deception: It’s Not About The Money, Money, Money


With a seventeen-year-old in the house (my talented younger brother), the atmosphere alternates between hopeful idealism and gloom and doom for the future. It is hard to be on the cusp of making decisions about your life when you have the greatest desire to do something beautiful for the world, and no real experience with finances.

not about the money

The common refrain in our house (and others, I’m sure) has become, “But work isn’t just about money!” I remember saying those same words as I was planning my future; and I recognise them as true. Or at least, partially true.

But you see: work is about money. Continue reading

What I See In Your Photos With “Poor African Children”


1. I see someone who was lucky enough to travel to a magnificent continent

And we welcome you. We welcome you to feel in your bones the wealth of our loam soil. Listen to the stories whispered by our winds. Immerse yourself in our skies. We welcome you to open your heart – and your eyes – to see that our narrative is more than one of suffering.

not tourist attraction

Base image by Stephen and Melanie Murdoch, click for their Flickr Photostream.

Continue reading

The Passion Deception: Beyond What You “Like”


Last week, I wrote about how the idea of “passion” can overwhelm us into unrealistic future prospects. I actually got some good feedback from readers, which leads me to believe that I am certainly not the only one with this experience.

But if you’re a high school student – or otherwise at the threshold of choosing a career – you might wonder, WHERE DOES THAT LEAVE ME? If you have been told your whole life that you need simply to do what you love (and you’ll “never work a day in your life”, yada yada yada), you might not know HOW else to choose a path forward.

My suggestion? Ye ole’ trusty mindmap.

Many of ours (mine included) may have looked something like this:


When in reality, it probably should have looked something like this: Continue reading