What do we really know about the lives of our doctors? If you’ve read Adam Kay’s memoir, This is Going to Hurt, you might have an idea. But there are hundreds of stories—from GPs and nurses to anaesthetists and surgeons—playing out in hospital halls everyday. The Life After the Letters podcast by Dr. Amile and Dr. Suba is dedicated to shedding light on a few.
The podcast reflects on those difficult experiences—from dealing with personal grief to performance anxiety in a high risk environment—and medical cases, like the Irish abortion referendum, which are shaping the world today. But it also highlights individuals, often within the NHS, that are taking health into their own hands. The resounding message? The lives of doctors can be as rich and varied as the patients they treat.
When they’re not recording their podcast, Dr. Amile and Dr. Suba are on call in Pediatrics and Obs & Gynae respectively. So we decided to turn the tables and ask them a few questions of our own. What’s it actually like working on the Obs and Gynae ward? How do women feel about talking about their vaginas? What are some of the biggest myths about the NHS. And what do they eat for lunch (important question)?
Has doing the podcast changed your outlook on your work at the NHS?
Amile: For sure. We’re both aware that burnout is a reality for many of our colleagues. Doing this podcast has allowed us to explore and examine the way we approach work everyday. It’s also given us a more holistic view of the way we approach and see our patients. They are literally just people with their own experiences trying to get by. It’s our responsibility to set the boundaries for our working life.
Suba: The podcast has functioned as a space for reflection and learning for me, so I would say yes. It helps me process the difficult experiences and builds appreciation for our NHS.
Suba, what’s it like working on the Obs and Gynae ward?
Suba: I love working with women. I’m from a very matriarchal family and went to a girls school which were some of the best years of my life. You have to be able to communicate well in Obs and Gynae as you’re dealing with healthy patients rather than people who are unwell. A lot of women are there to do a normal thing—get a smear, have a baby—so you have to be able to explain what’s happening. Or they’ll be pissed off with you or complain.
Amile: Also in Obs and Gynae you have a lot of cool women leaders. In other surgical specialties it’s a lot of men or women that have had to act in a certain way to stay in their field. A lot of them don’t have families or children and they’ve had to prioritise their careers entirely with no work life balance. For a while, only a certain type of woman would have been able to get to that position.
Amile, what are some of the hardest situations that you have to deal with in Pediatrics and what’s your method for overcoming them?
Amile: In paediatrics, your patients are children. And though every child may not come with a parent or carer, they will all come with an individual set of social circumstances that determines their trajectory. Whilst many will have families that care and do the best by them, there are some standout situations where the safety of children are put in jeopardy. These are the stories that stick with you when you get home.
What are some of the major myths to do with women’s health that you see over and over again in your work?
Suba: A big thing I've noticed is how many women have very heavy or painful periods and haven't seen a medical professional about them. There's an attitude of “just get on with it” even though it's clearly affecting your life beyond your period being a minor inconvenience. Another thing I always hear from women is “I didn't want to waste your time”—no one should feel like health concerns are invalid.
How do you think most women that come into the NHS feel about their vaginas?
Suba: In my experience I have found it varied—from women who are comfortable using the right language such as vulva and vagina (a minority) to women who are overly embarrassed to discuss their vaginal or vulval health (also a minority). I have found the majority fall in the middle, where clearly they're not used to talking about it but are willing to and manage to do so with encouragement and normalisation.
Amile: As women, we’re socialised to be apologetic, cautious and conservative. And in relation to an intimate body part those instincts are heightened.
What are some of the biggest myths about the NHS?
That there are enough doctors and nurses. There aren't—a considerable proportion of our staff come from the EU or overseas and we couldn't manage without them. Staff retention is an issue too, with a lot of people are finding it more attractive to work overseas or in other industries.
That immigrants are crippling the NHS. They aren’t. In fact, immigrants disproportionately contribute to the NHS. They are our nurses, doctors, pharmacists and managers. Furthermore, immigrants access the health service much less than those born in the UK.
What parts of Adam Kay’s book really resonated with you?
Suba: Adam Kay’s book was fantastic and I read it over a year ago whilst in my second year of work. His tales of life as a house officer really spoke to me as that was what I was going through myself. His depictions of night shifts where you're armed with your bleep and your stethoscope and fighting fires all over the hospital really hit home.
Amile: I’m gonna ignore the question, and answer my own. Being Mortal by Atul Gawande has stayed with me more than any other memoir-style book. It gave me a more holistic view of the way clinicians should approach and make plans with their patients. It reminded me that decisions made in “best interests” are subjective. One person might be fulfilled by walking their dog everyday. Another person from watching football and tasting ice cream. Their life goals are literally what you need to work towards. It’s not good enough to prioritise life and safety above happiness.
You’re obviously dealing with physical health, but how much does your work engage with themes around mental health?
Suba: Mental health seeps into absolutely everything. I find in A+E especially, an easy 80% of the issues I see are more to do with mental health than physical. I'm also conscious that we are holistic beings and that all aspects of a person's health need to be in balance, so I do my best to acknowledge that at work.
Amile: Without addressing the way people live their lives and what interventions might serve them best, your success in ‘doctoring’ will inevitably be limited. I remember learning about something called ’the health belief model’ in first year of medical school. Every health problem will have either be caused or impacted by the way the mind works. For better, or worse. It’s our job to take that into consideration when making management plans!
Obviously you guys are in the health sector promoting being healthy, but the lives of doctors are notoriously unhealthy. Do you see that changing?
Suba: Work doesn’t promote a healthy lifestyle at all. We eat chips and beans at the canteen.
Amile: We’re well paid shift workers a lot of the time. Doctors don’t go to the gym very often, they don’t eat well, take care of their physical health. At the canteen you’ve got chips and beans for lunch or a sandwich and you go to M&S to get a microwave meal for dinner.
What do you do to keep your personal health (physical and mental) in check?
Suba: I do my best to listen to my body and intuition and make time to engage in things that bring me peace and joy. With regards to work, reflection is key for me and my practice is constantly transforming. However this also rings true in life—taking a step back and taking stock of how I am and if myself is content and grateful is very important for me. And if I'm not, then considering how I can be.
Amile: Similarly to Suba, intuition and regular reflection is important to me. In addition to that, I like to plan my schedule ahead of time. I book my gym classes ahead of time and use an online calendar to keep track of my work. It allows me to see where I may be lacking time or balance in my week and rectify it at a touch of my keypad. Listening to podcasts, visiting galleries, eating out and reading books are just some of my go-to fillers.