Starting a new job fresh out of uni is always rough: Will the boss like me? Is this measly starting salary enough to combat the thousands of pounds of student debt I’ve racked up? What if I fuck up on the first day?For a junior doctor, it’s no different. Well, no different apart from the fact their student debt can be up to £90,000 due to the sheer length of their studies, the pay is around £14 an hour and fucking up on your first day can involve a patient’s life in your hands. The first Wednesday in August – dubbed “Black Wednesday” by medics – is the date in which freshly qualified doctors are thrown into the NHS workforce at the deep end. It also precedes the week in which death rates rise six to eight percent compared to July.
No matter how much time (and money) is spent on med school, little can be done to prepare junior doctors for the physical and mental shock of entering an underfunded health service. No amount of late night studying for exams can prepare you for your first night shift dealing with a cardiac arrest on your own. The hours are exhausting, the intensity of the work is incomparable, and people’s lives depend on you – but at least the pay’s decent… right? Wrong. Many junior doctors now earn less than staff at Pret A Manger, after their recent pay rise.Since 2008, NHS junior doctors have taken a 26.1 percent pay cut, according to recent calculations from the British Medical Association. That’s why the measly two percent pay increase offered by the government this year is being protested with a three-day junior doctor strike until the 16th of March. We spoke to four junior doctors about their experience on the frontlines of the toughest work industry in the UK.‘Two guys in balaclavas burst into the room carrying their blood-soaked friend in their arms and shouting for help’
“It was a relatively quiet night. The wait time was around four to five hours, which is crazy to be considered quiet, really, but often it’s a nine to 11 hour wait at night. Suddenly, two guys in balaclavas burst into the room carrying their blood-soaked friend in their arms shouting: ‘Please help, please help. My friend has been stabbed.’ First we tell the guys in balaclavas to leave, then we pick up his mate, throw him onto the bed and strip him to find exactly where he’d been stabbed and stop him from bleeding out.I put out a trauma call, which sends for an overnight anaesthetist, orthopaedic surgeon and general surgeon. I’d basically describe these guys as the Avengers of the hospital – it doesn’t matter if they’re sleeping or tending to another patient, they have to attend to this call. Despite being a relatively junior member of the team, I had to lead the entire operation: There aren’t enough doctors to deal with all the emergencies at night. We managed to eventually get the bleeding under control and make sure he didn’t go into shock, but it was an incredibly intense hour. When I told my boss I could’ve done with more support, they simply said, ‘I’m sorry but in the bed next to you a young 21-year-old actually went into cardiac arrest because they snorted the wrong kind of cocaine at a party.’ I found that really difficult to register – there’s so much going on, you can’t predict the number of emergencies that’ll come through.
The sad thing is, a few days later the guy who’d been stabbed came in and accused us of stealing his watch. I could only think, ‘Wow.’ If only he knew how worried we were about his life. I try my best to put aside my emotions, but it’s emotions that make you a doctor and not a machine. It’s frustrating to go home and think, ‘I did the best I could, but there’s more that could be done for this individual.’ And I don’t mean by one person, but by the system, by the government.” – Mike, 30, East London‘On my first ever nightshift I was the only doctor looking after 450 patients by myself, and I had to save four critically unwell patients at the same time’“It was about 2AM on my first ever night shift, aged 25, when my bleep [i.e. bleeper] went off with four severely unwell patients at the same time. One patient was having a heart attack, another a severe asthma attack, the other a diabetic emergency and I can’t even remember the fourth. It was almost impossible to think because I was so stressed and so overworked – I couldn’t really process what was going on with them or what I needed to do. I was the only doctor covering all 15 of the wards, with about 30 patients each, and I felt very out of my depth, very alone and very scared, really. My hourly rate was only around £15 at this point, too. After that, I just went into the corridor and cried for a long time. I seriously debated quitting medicine for a while, but never followed through because you just kind of get sucked in.” – Becky, 28, Croydon
‘His wife was screaming as he lay there with a fountain of blood spurting out his penis’“My first on-call shift after med school was very much a baptism of fire – well, blood. I got a fast bleep a couple of hours in, which basically signals an emergency, and I turn up to hear hear a woman screaming, who turned out to be the patient’s wife. When I put my head round the curtain, the man was lying there with a fountain of blood spurting out the end of his penis – it was literally hitting the other side of the room. I remember standing there, staring at it, just trying to rack my brains to work out what the hell I do in this situation. No one taught me this at medical school and there’s added pressure when everyone’s shouting and screaming at you. My mind went completely blank. Eventually gut instinct kicked in and I launched myself at his dick and clamped it with my hand to stop the bleeding somehow. The wife is screaming; he’s screaming; I’m basically screaming while I just hold this man’s dick and wait for help. I laugh about it now but at the time it was very traumatising because I had no senior support whatsoever.” – Orla, 29, Kent‘During the pandemic, I had to tell families their relative was dying multiple times a day’“To this day I still have a small level of PTSD from COVID-19. I had to call families and tell them their relative was dying, then hold the phone to their ear so they could say goodbye. On average, I had to do this two or three times per day – I look back and can’t even believe that happened. Afterwards, no one came to check if we were okay, no one suggested we might need help coping, I had to go and find therapy myself and I’m still paying for it. The resources are there but the wait to get allocated takes months and months.” – Anisha, 30, Hull
‘I had to make a split decision and decide which patient to save – no one tells you you’re going to play God’“My first night shift was one of the worst nights of my life, I broke down crying at least three times. The hospital was short on staff so it was only me and one other doctor covering the whole hospital – that’s 600 beds.One patient was having a really severe asthma attack when a fast bleep came through, so I got a nurse answer the bleep for me because I was busy trying to save this patient’s life. She came back and said there was a patient on the other side of the hospital whose oxygen level had dropped to a really life-threatening level. Under normal circumstances, you’d get another doctor to see them while you attend the patient you’re with, but there was no other doctor. In that moment I had to make a split decision and choose which patient I’m choosing to save. No one tells you that you’re going to play God at some point: You don’t get support, nobody follows up and checks in on you. At a talk from one of the defence unions, I actually posed that question to them: Where do I stand legally if I have two dying patients and I have to pick one? Their response was, ‘It’s on you. You’re not protected. If you’re the only doctor, it’s on you to make that decision.’ I felt so disheartened hearing that, it really scared me. You can’t avoid having sick and unwell patients, but you can avoid having staff shortages and no support.” – Orla, 29, Kent@izzy_copestake