Iatrogenic. The word rang out across the lecture theatre and I quickly wrote it down. I was a few weeks into my medical degree. I was amazed I’d never heard that word before, as it describes a condition or disease that has resulted from medical treatment and/or the actions of healthcare professionals. It was this very phenomenon that prompted me to apply to medical school in the first place.
In 2017, I underwent a spinal operation for a herniated disc. During the procedure, the surgeon accidentally operated on the wrong part of my back. After some months of excruciating pain and panicked insecurity, the problem was uncovered. But it didn’t end there.
Corrective surgery, post-surgical complications, more pain and stress saw me finally give up on my plan to move back to my beloved Berlin, where I had spent the preceding years enjoying a life of underemployed debauchery.
Instead, I moved in with my father in Alice Springs to recover.
I couldn’t quite shake the feeling that medicine had upset my health again, just in a different way than I was used to
I spent the next few years getting back on my feet, reflecting and reinventing myself. I started studying again, then applied for medical school. Ultimately, there were many reasons for my career pivot. Chief among them was a hope that, in helping others heal, I might be able to make up for what had happened to me in some way.
As luck would have it, I began classes and the world promptly ended.
It was 2020 and, as COVID swept across the globe, we junior medical students were sent home to study. That was when I truly discovered the perils of a sedentary lifestyle for people whose spinal columns have been remodelled to resemble a precarious, bony game of Jenga.
COVID restrictions meant no more gym or swimming and limited physio and family support. Combine that with countless hours cramped in front of a webcam, and you end up with multiple trips to the emergency department, new symptoms and failing function. By the end of 2021, when I woke up one morning with a paralysed foot secondary to a prolonged period of nerve-root compression, I knew it was time for a breather.
I couldn’t quite shake the feeling that medicine had upset my health again, just in a different way than I was used to. I knew I needed some time to recover. Happily, at 39 years old, I’m ancient as far as university students go, and was able to pick up paid work quickly, take a year off medical school and focus on self-care.
Nonetheless, over the course of my studies, my spinal woes have progressed from injury to impairment, and don’t show any signs of abating. The condition is now central to my life, with plans and decisions all carefully curated to avoid a flare-up. My goal is to kick the surgery can down the road for as long as possible – at least until I graduate – then see if I can stabilise those wayward vertebrae with a spinal fusion or disc replacement. Both daunting prospects that represent a trade-off between reduced pain and reduced mobility.
Medicine is notoriously unforgiving of its practitioners … put[ting] a lot of pressure on doctors to sacrifice their self-care, health and well-being in favour of their careers
Unfortunately, the condition has already wreaked some havoc on an otherwise rewarding return to study, with my first clinical placement disrupted by an unexpected, debilitating exacerbation. The situation presents another choice I’d hoped to avoid as long as possible, as I try to navigate the space between self-care and academic commitment.
Medicine is notoriously unforgiving of its practitioners, I’ve observed (unless, of course, they happen to operate on the wrong part of your back). What it does do, though, is put a lot of pressure on doctors to sacrifice their self-care, health and well-being in favour of their careers. It’s counterintuitive because, in a vocation that aims to promote and guide the health of others, people often find it very difficult to practise what they preach.
We see the impacts of this dynamic playing out in the workforce, with reports of junior doctors contemplating a career change due to overwork, exhaustion, toxic work environments and a health care system at breaking point. Clearly, the culture of success through self-sacrifice is unsustainable.
It begs the question: Why shouldn’t our doctors be healthy and happy? Why should medicine make anyone – including its practitioners – unwell?
The upside is, the work itself can be phenomenal. I’ve barely started my clinical years and I’m already struck by the extraordinary privilege of having relative strangers come to you for care, to work with them to improve their health and to engage and encourage the people around them to do the same.
Why shouldn’t our doctors be healthy and happy? Why should medicine make anyone – including its practitioners – unwell?
It helps that I’ve lucked out with fantastic clinical supervisors who are encouraging and inclusive, and don’t mind the impromptu physiotherapeutic routines I create between patients to keep my back pain at bay.
It may be that medical practitioners who benefit from a positive work environment don’t need that much encouragement to stick around and do a good job. But deep down, I think all doctors should be encouraged, from the start of their studies, to keep work-life balance front of mind. To reflect on what will make us happy, healthy, well-rounded medical professionals, and ensure we take some time for ourselves to be well.
Perhaps that will end up being the silver lining of my spinal condition: a forced pacing of study and work as my physical circumstances prohibit me from overdoing it. I have learnt the hard way to work within my limits or risk spending a week or two hobbling between bed, the GP, radiographer and physiotherapist.
In more sympathetic moments, I imagine my former surgeon to have suffered some ill-health from the pressures of his chosen career. Perhaps that contributed to the mistakes he made that day. I’ll never know if medicine upset his health as well, but – having gone down the first few years of this career path – it wouldn’t surprise me.
Roland Bull is a medical student, writer and comedian with an interest in sexual health and LGBTQIA+ issues. You can follow him at Instagram .
