Rexit: Corridor Consults and Quiet Goodbyes

Anyone who knows me well saw this one coming. This one's a little raw — so it deserves another f**king disclaimer.

This isn’t a blame piece. It’s a reflection.On what happens when the system isn’t enough.On corridors that become endings.On why I left renal medicine — and what I learned in the wreckage.

There are no references or links here, for a reason. This is my side. My version of events, however flawed or partial.

And if you’re one of the people involved — or think you were — know this:

This isn’t a blog about you.

It’s about me — my experience, my fallout, my healing.

I’ve tried to be fair. If it makes you uncomfortable, that’s not because I’ve attacked you. It’s because truth has a sharp edge when it’s held up to the light.

On why I left renal medicine — and what I learned in the wreckage.

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Some exits are ceremonial. Speeches. Handshakes. Cake.

And some — well, some happen in a corridor, in a whisper loud enough to echo for years.

I didn’t have a firm plan to leave Renal. Not really.

I had a sort of Crisis meeting with my Training Programme Director (TPD) — the man who’d once been both, back before everything fractured — and my new "bequeathed" replacement Educational Supervisor (ES). I’d prepared a document. Not a resignation letter, but something that felt close. It laid out my reasoning, my timeline, what I felt I needed and the quietly desperate plea not to be relocated.

See, in my deanery, a city move was tradition. Aberdeen to Inverness — a gorgeous but isolating 120-mile shift which I'd done once already when I was kidless - and much less broken (read on, it wasn't the kids that broke me... then at least).

But by then, I’d had my second son. My first, a premature boy, still needed more than most two-year-olds. I was still carrying the grief of losing my father to pancreatic cancer with just two weeks’ notice. Still struggling to climb out of a breakdown that had put me under acute psychiatric care for hallucinations and depression.

I asked not to move. I gave them the letter — the one I’d spent too long writing, too long worrying over.

They didn’t say no. They just... didn’t say yes.

And then, later, the conversation ended — not in that room, but in the corridor.

The Corridor Exit

He caught me in passing. The TPD/Former ES. Still someone I couldn’t look in the eye but spoke to me perpendicular in a terse, busy, bluntness to his voice of a man needing a quick answer to get on with his day:

“Are you staying in Renal or not? I need an answer now because I have to reply to this letter you sent.”

That was it.

No private room. No reflection. No acknowledgement of everything I’d put in the document. Not even eye contact. Just: Are you in, or are you out?

I said no.

He said okay.

And walked away.

The Good Men in the Machine

My TPD wasn’t a villain. Neither was my second ES. They were decent men working in a department ravaged by consultant departures, internal politics, upheaval and scandal.

The whole system was wobbling under the surface. This was 2018 — before COVID — but winter pressures were already biting deep. People were stretched, brittle. The support structures weren't just strained — they were gone.

And while I came with my quiet binder of evidence, my emotionally driven attempts to explain and reflect and plan a return — what I met was silence. Exhaustion. A blankness from men who no longer had the bandwidth to absorb one more broken registrar trying to find a reason to stay.

My first ES, my TPD, was paternalistic. He often told me how intelligent I was in passing — perhaps too often. And like most compliments from pseudo-father figures, it became a pressure. I think I craved his approval in a way I never really unpacked until years later. And when I lost that approval, it hit hard. He didn’t shout. He just… switched off. And I absorbed that as failure.

My second ES — older, philosophical — has none of these qualms and burdens. He was the first to say it plainly:

“You’re too smart not to leave and do something else.”

He gave me permission to leave.

Not that I needed it; by that point - I knew where I stood.

Hopeless

By this point though I already knew I'd lost the consultant cohort in it's entirety. Their written feedback was scathing;

"I do not do renal on calls so can not comment directly but my feeling is that David often needs a lot of reassurance"

"David has difficulties with prioritization and partly because of wanting to cope with things and not ask too many questions/ ask for help"

"David talks a lot but I am never convinced he has really got a grasp of the pertinent issues"

— probably unaware (or unbothered) that I could read it myself. A few tried to soften it after the fact. Quiet corridor sit-downs. Pep talks disguised as post-mortems. But each one felt like another dressing down. Another weight on the chest of someone already suffocating in shame.  

I'd naiively asked for these feedback forms to get a handle on where I was, where I should start to rebuild. My TPD/ES was exaseperated I'd done it at all - probably knowing where it was all headed but too concerned of my fragility, or too overwhelmed with the complexity, to put it to me himself. It was a no-win scenario - knowing was as dangerous and toxic as ignorance.

By the near end, it was all even less subtle and became obviously impossible. I've toyed with the idea of adding the gory details of it here in multiple iterations, but frankly what was or wasn't said matters little to the narrative and even misrepresents the people, personally at least, involved. I don't hold that feeling for them now, and even I'm not that petty (citation needed).

Losing the Backroom

When it was clear I'd lost the other registrars, the Nurses, the Ward HCSWs; that was what made the end feel inevitable. Not the leadership — the team.

I really don't blame them - I was erratic at the best of times. I didn’t cover shifts. I couldn’t swap. To them, I was the reason they were working more. They were told, You’re covering Dave’s shifts (citation needed).

And they resented me for it. Fairly.

Some ignored me. Others whispered. Some openly rolled their eyes. A couple even flat out called me a dickhead. None of them trusted me anymore. And I don’t blame them.

You can’t train in a team that doesn’t want you there. That doesn’t joke with you at 3am. That doesn’t ask how you’re holding up. That stops seeing you as one of them.

The Golem effect was in full swing. They expected me to flounder — and I did.

The Teaching Role That Wasn’t

I tried to reset. Took a Clinical Teaching Fellow role. Half-in, half-out. Supposed to be supernumerary. Give me some space to breathe, reset, get back on it.

It wasn’t supernumery. Naturally.

Department pressures, staffing gaps, the need to keep my banding for financial reasons — all of it meant I was still doing the job I’d tried to step back from, only now with less protection, more scrutiny, and divided loyalties. The resentment grew. Mine. Theirs. Everyone’s.

The whole thing became untenable.

I broke - again - in a bigger way this time.

Not Fragile. Just Kintsugi.

The last thing my TPD ever said to me — in writing, at least — was in a leaving card. A short note about grabbing a beer one day, debriefing the whole mess. It was kind. And maybe it was genuine. Maybe he really wanted to understand.

But I’ve never taken him up on it. Because I still don’t know if it would help. Because I’m still not sure I could look him in the eye. Because, even now, part of me feels like I let him down.

Maybe it was the paternalism. Maybe it was the dynamic that felt uncomfortably close to my fractured relationship with my late dad (I know how weird that sounds, but trust me - it's weirder coming to that conclusion in therapy...)

Maybe it was the guilt. Or the shame. Or the grief. Or the cocktail of all three, stirred by sleep deprivation and a brain that needed help long before it asked for it.

But I walked away.

I walked away, I didn’t plan to ever go back.

Could I do it now?

No. I’ve changed. I have the diagnosis. The tools. The meds. The support. I can work as a GP; I can function in that particular chaos.

Am I better for it? Probably. Humility and Impostor syndrome aside I feel like I've rebuilt more than the sum of the parts.

But Renal? No.

I liked nights more than days. I liked the take more than the nephrology. I liked the patients more than the system around them. I like the procedures more than the pathology.

I had thought I belonged there. I was wrong.

So Why Write This Now?

Part of the catharsis of reflection is to eventually drill down for the gooey oil of self-actualisation.

I've known this story all along, but often when people ask me why I left, usually after a few attempts at not asking for decorum's sake, I'd give them a sarcastic answer:

“Let’s just say — no matter what you’ve heard — I definitely didn’t sleep with anyone important’s sister.”

(And for the record, I didn’t sleep with anyone in Renal. Familial or otherwise.)

I've even held off for so long knowing that, maybe even now, people who were part of it are still working there; still protentially have strong feelings about it themselves, or even not and haven't given me a spare thought since 2018. I honestly don't know but I hope, in a way, this wasn't aimed at them.

Saying I had ill feelings about them/it now would be like being furious at water for aquaplaning into a car-crash, and deciding I'm never bathing again - it's not the stink I need, nor will it stop me being immersed in this world either way.

I suppose I write most of these reflections for the same reason - because there are probably others like me.

Who didn’t leave because they weren’t good enough.

Who didn’t leave because they didn’t care.

Who didn't leave because they couldn't hack it.

Who left because, when it all went awry, the system failed to supply what they needed — in silence, in corridors, in resentment dressed as feedback and burnout dressed as failed "resilience."

Because sometimes, what they needed, for whatever reason, wasn't there.

And maybe you’re one of these people. And maybe no one ever said it:

You didn’t fail. The fit failed. The support failed. The silence failed.

But you, didn’t.

Stay Tall

--DW