What You Lose to Medicine

When I was in Medical school, we still had old fashioned hardwood desks in the lecture theatre with decades of graffiti carved, written, chipped into them. Asides from the confusing “Haroon has no teeth” or the disturbing “The vagina is a lie”, there was one that stands out thinking about this topic:

“Where’d my life go - this is nothing like Scrubs”

There’s a strange, almost cultish optimism that gets sewn into you at the start of your medical career. It’s the kind of giddy zeal that comes from watching too much TV doctors and not yet having met your first death certificate.

You hear all about what you’ll gain. Skills. Security. Status, Sex if you’re lucky.

If you’re luckier, Purpose, if you’re not completely dead inside.

But what no one talks about — not properly, not honestly — is what medicine will take.

Because it does take. Slowly, quietly, and often with your full permission. Until one day, you wake up in a slightly-too-firm NHS bed, eating a cereal bar with surgical gloves because the mess ran out of spoons, and you realise: you're not sure what version of yourself is left.

This is a blog about that.

It’s not to scare you off. It’s not a warning. It’s a record.

Of loss. And what it teaches.

Loss of Time

It’s the big one, and it starts small.

• “Sorry I missed birthday drinks.”

• “I can’t come, I’m on call.”

• “Can we reschedule the Christening?”

You blink and it's five years later, and someone’s toddler is now a teenager. Your own toddler, maybe.

When my wife's Gran died I was working 120 miles away - I had to negotiate why it was so important to miss a shift, and whether she was close enough to count. I went in the end but paid for it thereafter. Horrendous shift after a 24 hour stay and a 7 hour round trip.

The job never once told me it was sorry.

You give time freely at first — because it feels noble. Then later, resentfully — because you realise how little you’re getting back. Eventually, it’s not even a transaction. It’s a leak.

There’s no chances to really stem the flow - boundaries in medicine are scheduled in the rotation so non-negotiable. And pushing too hard can tag you as a troublemaker - and when that vibe is put about, well, no-one will swap with a troublemaker.

Loss of Confidence

You start medicine cocky. You have to. Otherwise, you'd never walk into a room and tell a stranger you’re about to stick a finger up their arse.

Unless that’s your thing, I’m not here to kink-shame.

But medicine strips that confidence away with precision.

I failed exams. Four times - twice, both under- and post-graduate. That number still clings to my ribcage like a scar. And every time I got back up, a little less sure of myself, a little more brittle.

You learn to smile. You learn to mask. You learn that confidence in medicine often means pretending you’re not breaking. Then that gets hit.

Rinse. Repeat. Resent. Reaffirm. Respect.

There’s this paradox in clinical training: you’re told to be humble and reflective — and also to lead resus when someone’s heart stops. Good luck reconciling those without losing a piece of yourself.

Loss of Hobbies, and the Bits That Make You You

I used to act. Properly. Plays, theatre, writing stuff. Until someone — a consultant, a mentor, someone who probably meant well — told me to “pick a lane.”

So I did. I chose medicine. I stopped doing drama.

And something in me atrophied.

It took stand-up — angry, tired, chaotic stand-up — to bring that part of me back. Because I needed a space where I wasn’t just Dr. Wandless. Where I could be me. Or at least pretend to be.

I had to wait till someone couldn’t tell me no, and even then it was in a sterile box. It needed the be possible to cauterise if it ever became malignant. But it was possible - so I did it.

That’s the thing they don’t tell you: medicine eats identity. And if you don’t fight to reclaim it, it’ll swallow you whole.

Loss of Connection

I got a WhatsApp from a mate the other day — photo of his new baby. I hadn’t even known they were pregnant. That’s how out of the loop I was.

You don’t lose friends to fights. You lose them to rotas. To exhaustion. To 10pm texts that never get answered because you fell asleep halfway through typing “haha that’s mad”.

The friends that survive? They're the ones who understand silence. Who get that love doesn’t always come with a reply.

But it still hurts. The shrinking of your social circle. The quiet disappearance of people who used to know everything about you — now they just know your job title.

Even catching up can feel like learning someone new, all with a depleted social battery, a babysitter to rescue from your kids, and a lifetimes worth of traumatic nonsense to hide.

There’s joy in nostalgia - and that’s worth it’s weight in gold, but it’s always a little sad when it devolves into that. History.

Loss of Well-being

There’s a story I tell sometimes because it’s funny, but also not.

I was trying to have a shit. Middle of a shift. Got bleeped four times (even answered one, grunting). Three people were waiting outside the door. Couldn’t do it. Couldn't poo under pressure even in an IBS-pressed state with eight tons of Phenylalanine acting like Napalm on my Gut flora.

I had to find a secret toilet just to be left alone.

That’s medicine. No privacy. No pause. No moment to exhale. Even your bowels get performance anxiety.

And in the long run?

• You stop exercising.

• You eat crisps for dinner and cold pizza for breakfast.

• You stop checking in with yourself because you’re too busy checking in on everyone else.

I gained more than 6 stone and got Gastroenteritis from last nights poorly microwaved food like once a month - honestly, my gut microbiome must have been a barren wasteland.

Then one day, you break. Quietly and elegantly in a midlife crisis way. And nobody notices until it’s too late — because you’ve been too good at hiding it.

Or, if you're like me - in one, massive horrifying shitstorm.

It’s not an if, it’s a when. Ask any doctor and they’ll pinpoint it for you. That moment when they fell down.

Loss of Perspective

Spend long enough in the chaos, and your calibration goes to shit.

You get spat on in A&E, and your first thought isn’t “that’s unacceptable.” It’s “please don’t let this turn into a complaint.”

You hear about someone’s trauma and your brain instantly sorts it by severity like some disgusting leikert scale.

“Not bad. Worse. Seen worse. That’s horrific.”

You start grading people’s pain because you have to — otherwise, you’d drown in it. And you start slipping. Not because you don’t care, but because you’ve stopped feeling it.

You harden as a shell, protective and solid. Compassion fatigue isn’t burnout. It’s anaesthesia.

And it’s how good doctors turn cold.

The Reckoning

So why do it?

Because in the middle of the loss, you find strange little things worth keeping.

The friendship forged in the middle of an arrest buzzer. The patient who thanks you even when you’ve given them bad news. The moment you realize someone trusts you with their chaos.

And you realize that not all loss is damage.

• Some of it is amputation. Cutting off what's toxic and painful to save the rest of you.

• Some of it is cautery. Burning the edges to keep yourself from bleeding.

• Some of it is refining. Some of it is clearing the weeds so you can see what matters.

For me? That’s my wife. My kids. My core group of idiot mates who send me memes and keep me semi-sane. That’s what I’d burn it all down for.

Final Word

You will lose things to medicine.

It’s not personal. It’s structural. And it’s survivable — but only if you know what you’re willing to give up.

If the answer is “nothing,” then this job will eat you alive.

But if you can make peace with some loss — if you can fight to keep the parts of you that matter — you’ll make it.

Not unscathed. But real. Human. Maybe even kind.

And that? That’s a doctor worth being.

Stay Missing

—DW