The trouble with being a superhero

As a young GP, I took four weeks annual leave, my total allowance for the year, in which to have my first baby. I didn’t claim maternity leave as a matter of principle.

It was 1980, and I was in rural practice with one partner who had taken me on knowing that I was female, married, 28 and as yet childless. I loved the job. My partner was near retirement – the best doctor that I’d ever met, and generous with his experience – it was a partnership made in heaven!  

I was very grateful to him, it was impossible to get locums and I was reluctant for my pregnancy to disadvantage him in any way or for my behaviour to impact negatively on other women wanting to be partners in general practice.  I was probably misguided, but these were different times. 

The patients were more practical and mindful of my pregnancy – night calls dropped to an all-time low. The wife of a very hypochondriacal man rang one night when I was about 38 weeks and still on the 1:2 rota. 

Recognising my voice, and having seen me recently, from vehemently demanding a visit, she said: ‘Is that you, Doctor? You go back to sleep – he can wait til morning!’

I finished work at 7pm on the Friday, and went into labour the following Monday lunchtime while decorating our bedroom (my first experience of the effect of the nesting hormone!) 

I had had my daughter in time for tea and was back at my desk four weeks later. I noticed that my partner’s relationship with me had cooled in the last weeks of my pregnancy – he’d look at me oddly but I was very well and although I got fearfully hungry, dashing to the chip shop after morning surgery, I felt that I was pulling my weight.

When I came home with the baby, I was bundled off to bed as my own GP, my senior partner and my husband opened a bottle of champagne and congratulated each-other downstairs. Sipping my own meagre glass, they weren’t oblivious to my part in the production, I noticed as I listened to their excited chatter.

It was obvious that as well as the effects of alcohol, there was a high level of relief from all of them. The senior partner and his wife now behaved like proud grandparents, and I realised that the imagined coldness had been anxiety about my health and guilt about me working so hard. 

Two years later, I had my second child, and this time cut myself some slack and planned to stop work at 38 weeks and have a rest. But I went into labour the very next day. I had four weeks off completely, and then eased myself back into work with two weeks part-time. We claimed maternity pay for my six weeks and I didn’t take any other holiday that year – the practice income had never been so high!

The advantage in having so little time off is that you return to work when you still have the vestiges of that amazing surge of energy that childbirth produces.

It enables you to fight off any threat to your newborn. My friend was able to take her own discharge and walk home with a haemoglobin of 8g/dl the day after a C-section, because she missed her other children!

The disadvantage is that although many of us like the notion of being a superhero, it tends not to be sustainable – and I found that the hard way. 

Two years after my second child was born, I got the flu, probably not all that badly but badly enough for me to realise just how little I had in reserve. It felled me so much that thought I might die. 

When I recovered, I thought: ‘this is all post-viral’ – I’ll give myself a month and then decide. A month later, I gave my partner my notice. My husband, also a doctor, was applying for SR jobs, so I knew we would soon be on the move and could justify resigning to myself.

I continued to do a couple of sessions each week in the practice, and my replacement was easily recruited – it was not too devastating a burn out, but silly and unnecessary. Having unreasonable expectations may seem commendable, but it’s setting yourself up to fail and that’s very damaging to your personality. 

When one of my daughters was in a similar situation, in her mid 30s and keen to start a family, times were different, and by then she had less to prove. I was pleased that she felt able not to commit herself to a demanding partnership.

Beware of living up to your income – I’ve seen that in so many colleagues who are then trapped and unable to cut back their commitments despite struggling. Feeling that you have no options makes the struggle so much worse.

At every stage, one should ask, is this level of work sustainable, and do I have an exit strategy if it’s not?

Having a job that you love is a great privilege, and medicine can be the best job in the world. It has the advantage of being sufficiently well paid and, nowadays, flexible enough for a sustainable balance to be struck, whatever your gender or family situation. 

I fear that many young doctors fail to achieve this. First, you have to realise that you don’t have super-powers and be aware that the ambition, pride and drive that we were all selected for can be your downfall.

Dr Diana Ashworth was a GP for 35 years in mid Wales, and now writes – her new book You don’t have to be a genius…, a memoir of medical school and beyond, is published by Clinical Press