Thanks: It’s nice to be nice (but don’t count on it)

Thanks aren’t part of the job description.

They’re not in the GMC Good Medical Practice, they’re not in the NHS contract, and they’re definitely not in the fucking rota. But they matter. Oh god, they matter.

Not because they boost your ego — although, let’s not lie, they do — but because they’re tiny, fragile proof that you’re not just a ghost in the system. That you haven’t completely lost your humanity somewhere between eConsult #300 and the seventh existential conversation of the day.

The Board

I’ve got a board in my office.

It’s not full. It never will be. But it’s pinned with the little thank you cards and scraps of paper that remind me — on the days when I’m staring into the abyss of another complaint — that I’ve made a difference. That someone noticed.

It’s pathetic, really. I keep them up like trophies. Not because I need the world to see them — though I do hope the occasional patient clocks it and thinks, “Hey, maybe this guy’s not a complete dick” — but because I need to see them.

Because there are days in this job where it feels like you need to bail out the water and you’re sprinting into the sea with a teaspoon.

And the tide’s laughing at you.

So a card that says, “Thanks, you listened” — that’s currency. That’s gold bullion. That’s better than an MBE some days.

What Thanks Actually Means

Here’s the thing: we’re not trained to expect it. If anything, we’re told not to.

“Don’t do it for the gratitude,” they say. “You’re paid to help people.” And that’s true. But no one tells pilots not to appreciate applause when they land in a storm.

Thanks is weird in healthcare. It’s unreliable. It’s often not proportionate to what you put in. You can pull out all the stops, advocate like Erin Brockovich in scrubs, call sixteen departments, dodge six landmines, and still get a complaint because the parking machine outside ate a fiver.

And yet you can say, “Sorry, it’s viral, no antibiotics,” and get a handmade card and a Toblerone.

It’s madness.

The Mentorship Loop

Look — I’m a praise seeker.

Have been since childhood. I like the dopamine hit. I like knowing I’ve made someone’s day slightly less shit.

So sue me.

But it’s also a trap. Because once you rely on it — once you start chasing it — you’re not helping people anymore. You’re performing.

And there’s nothing more irritating in a clinical environment than the human version of a labrador with a clipboard.

I learned that the hard way.

I once had a consultant who loathed me for it. Gave everyone else glowing praise in ward round feedback, and gave me the kind of ‘constructive coaching’ that might as well have come with a sock and a brick.

So yeah. Thanks is nice. But don’t need it. Don’t beg for it.

And for the love of everything, don’t expect it.

Who Thanks You?

Not the ones you save. Oddly.

Not the family whose cardiac-arrested relative you brought back in resus.

Not the ones you advocate for with letters so scathing you get CC’d on HR policy updates.

Not the ones you spend three hours coordinating care for across six departments on a Friday at 4:45pm.

No. It’s usually the ones who came in panicked, and you listened. The ones who felt heard. The ones you couldn’t fix, but at least you tried.

It’s, more of often than not, not the ones you go above and beyond for.

Because the more they get, the more they think they should have gotten. And when it inevitably falls short of perfection — because, spoiler, you’re human — the fall feels further.

Cards > Clicks

PALS feedback might eventually reach you (emphasis on “eventually”). Like a bottle thrown into the ocean hoping to reach your inbox six months later.

And don’t even start me on patient satisfaction surveys. I’ve had whole clinics where the only person who filled it out was the one who thought I was “dismissive” because I didn’t order an MRI for their sore knee from 2013.

But a card? A little note? A “Thanks for today, it meant something”? That’s real. That sticks. That goes on the board.

That reminds you that not everyone is out for blood or benzodiazepines.

If You’re a Patient Reading This

Here’s the advice: if you had a good experience, tell someone. Doesn’t need to be an essay. Just a few words.

“Thank you, you listened.”

“Thanks for calling me back.”

“Thanks for not making me feel stupid.”

Stick it in an email. Hand it to reception. Send it to the surgery. Name the doctor, nurse, receptionist, or paramedic that did something right.

Because we remember those. And on the worst days, they’re why we stay.

Final Thoughts

I don’t expect thanks.

But I collect it.

Not because I want validation (okay, I already admitted I do), but because in a job that often feels like you’re failing by default, thanks is a tiny rebellion.

It’s a reminder that sometimes, just sometimes, the job works.

So yeah — don’t expect thanks. But if you give one, know that it’ll probably end up on someone’s board.

And that it might just be the thing that stops them quitting.

Stay Thankful

—DW