I moved from the UK to work in an ICU in a large teaching hospital and couldn’t have been more excited about starting work. Until this point I had done all my training in the NHS (National Health Service) and was relieved to no longer be fighting a daily battle in a financially struggling service on its knees.
I didn’t have long to settle in my new adopted country and was straight to work within a week of arriving. The hospital was new, immaculate and had a great coffee shop; I thought that I would be very happy. Sitting in my first handover I earnestly listened and couldn’t help but feel slightly intimidated by the professionalism and slick manner in which my new colleagues spoke. Moving on to the daily business of the ward round, it became apparent that everything was unfamiliar, computers with no login, different units, trade names for drugs…. a sinking feeling crept into the pit of my stomach
“I can’t do this”.
Over the first week my confidence just packed its bags and left me. Still ever the optimist, I told myself it would get better. Next came nights. Now I know everybody hates night shifts except for vampires and exotic dancers so I wasn’t too perturbed by the feeling of dread washing over me as 8pm approached. However, once I got down to work, all the trials of the unfamiliarity of the previous week plus an overwhelming feeling of loneliness turned that feeling of dread into one of blind panic.
“I definitely cannot do this”. I went from hoping to succeed to praying to survive.
With every subsequent week off came the relief of not being in work followed by building anxiety about the next week ahead. I didn’t recognise myself, I couldn’t make decisions, became a jibbering wreck when it came to procedures and felt like I couldn’t speak to anyone more senior without sounding like I’d never set foot in a medical school, let alone an ICU. I made mistakes, which I know happen in medicine, but had few coping mechanisms to deal with them. I become convinced that my colleagues and supervisors thought I was useless and a fraud.
I spent my entire annual leave intermittently panicking about when I would have to return to work. I looked for ways to improve how I felt but then was often entirely de-motivated when it came to doing them. I loathed that I was facing the realisation that I wasn’t cut out for the profession I wanted to do.
I have always considered myself emotionally and physically robust and couldn’t understand why I felt like I was drowning in anxiety. I tried to be honest with myself about whether or not I was depressed, but outside of work I was happy. I was healthy, slept well, ate well, had beautiful children, was married to my best mate, had plenty of hobbies and was developing great new Sydney friendships. One of the lovely residents described me as ‘winning at life’ and I thought ‘If only you knew’, I suppose I was comforted that I at least appeared to be coping, like a swan, calm above water, furiously paddling underneath.
Over time, I learnt how to cope in this alien environment but I was unable to shake the work-based anxiety completely and felt so ungrateful for having this great opportunity yet resenting it. My husband was incredibly supportive but save going to work and doing it for me, he couldn’t actually do anything.
My biggest mistake was not talking to anyone who could actually help me. I think anxiety became my dirty little secret that I let myself wallow in, I needed reassurance and the professional equivalent of a hug. I formed good working relationships with my colleagues and found talking about successes and failures cathartic. However, in hindsight, it was all lip service and I never actually admitted that I was struggling so badly for fear that it would be seen as weakness or an admission that I couldn’t cope. Even when talking about this article I find it hard to say the words “it’s about anxiety at work”. Perhaps this is just me, but I think fears of this nature are endemic in the medical profession.
The culture is changing but it’s slow. There is a sense of duty to ‘keep calm and carry on’ which is what I did, because essentially there is work to be done. There is something to be said for getting on with things, I had less time to worry and the more I accomplished the better I felt and my natural positive mindset started to return. I now feel very lucky that life has equipped me with the tools to help myself on this occasion but should the army of anxious little demons ever return, I wouldn’t hesitate to seek outside help.
I believe this experience, although difficult, has proven invaluable. I have evaluated whether I do want to be a doctor multiple times and always come to the same conclusion that I wouldn’t want to do anything else. I have learnt that I am not immune from mental health issues. The most important lesson for me was that wellbeing is not about how much kale you eat and yoga you do, but about how well you can weather the storm.
‘Part 2 – What to do when you drop the ball‘ will be published Wednesday 22 March 2017