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Wilkommen to my blog - my name is Karin Purshouse, and I'm a doctor in the UK. If you're looking for ramblings on life as a junior doctor, my attempts to dual-moonlight as a scientist and balancing all that madness with a life, you've come to the right place. I'm currently a doctor/research trainee in oncology after spending a year doing research in the USA. All original content is licensed under a Creative Commons Attribution 4.0 International License.

Wednesday, 18 February 2015

Identity Crisis, doctor style

My sister and I often reflect on how strange it is that activities we were forced to participate in as children, such as weekend walks in the countryside, are now activities that we proactively seek out with fervour and enthusiasm.  It is true that as an adult, I definitely find both energy and solace in mountains and by the sea.  As such, I left a few pieces of myself in the Sierra Nevada, and in the Pacific Ocean on the Californian coast for safe keeping before heading back to the frozen East Coast.  

Ocean Beach, SF
Because did you know that emigrating causes one to have something of an identity crisis?  

Since I was 14 years old, all I wanted to do was become a doctor.  And then I became a doctor, and loved it, and didn't mind the long hours, being scared witless, the crying-in-broom-cupboard moments and my frustrations when my knowledge hit a wall.  I count myself incredibly lucky to never have regretted my choice of career, with the occasional traumatic on-call exception.  
Not the worst sight to wake up to...
Camp stove dinner triumph
But moving to America has been a bit like being on life heroin - you suddenly think about what life is really about, and what the possibilities are.  Of course I still want to be a doctor, and a scientist.  But it has been the first opportunity I've had to reflect on the various little side projects I've done along the way - this blog for one thing, but also other writing projects for other blogs and journals, medical politics work with the BMA, integrating global health aspects into both clinical and research work, teaching anyone from primary school tots and teenagers to medical students and other junior doctors, travelling with my trusty (and now verging on falling apart) rucksack... I mean, cool, but it kind of makes my head hurt just thinking about how I squeezed it all in.  And now that, lucky bum that I am, I have got my dream job back in Oxford (plus/minus international research element) for a few years, I feel compelled to take the chance to chill the hell out and give life a little time to happen with some of the aforementioned projects and just in general.  The question is - what does that even mean?

A few thousand feet up and 12 miles later
The lovely fellow Fulbrighter with whom I hiked and camped around Yosemite National Park recently and I were discussing this balance of knowing what you CAN do with what you WANT to or SHOULD do.  Mainly because we're conscious that, as Fulbrighters, we're seen as these super career-hungry go-getters with endless focus and drive.  Well, true that I don't like to be bored (or boring), but speaking for the two of us, we're just massive nerds who love what we do.  Go-getting, me?!  That just sounds hilarious.  I've come to realise that I'm getting to a stage in my as-yet fledgeling career where I'm going to have to start making decisions about what I want the rest of my life to look like and what activities will be involved.  This is borne out of loving clinical medicine and *all-the-other-stuff-I-listed-above*, but that there are only so many hours in the day.  Plus it's just awesome to give life itself a chance to happen in all its randomness and unexpectedness.  I believe doing a job like clinical medicine also lends itself well to a bit of mix and matching if you want it to be.  For example, I did a trial run of doing a proper bit of writing while I was in California (those train rides are long...) and it was wonderful (experientially, that is. The quality of the content... tbc...).  

Managed to turn my back on that view long enough to smile at a camera...
Don't get me wrong, these are very first world problems.  I am lucky to do a job I could do anywhere and prefer to embrace the uncertainties ahead. But I also know all too well that life is short and beautiful, as my time in Cali reminded me.  In the interim, I also wish I could be gifted my appetite and the ability to sleep back, which, despite the glorious physical exhaustion of the last few days seem to have both temporarily left me.  A bit of solid reflection on the kindness shown to me by new and old friends in Cali, the East Coast and UK (even if not all are UK based at the moment) already helps.  I was thinking as I headed back to Connecticut from California how crazy it is that I came here just five short months ago, not really knowing a soul, and how lucky I am for the multi-national friends I have made, in addition to the wonderful old friends from various life adventures who continue to add sparkle to my life.  People are so GOOD!  The next four months will whizz by.  For some reason, that reminds me of a passage I read during the summer which gives me a big smile whenever I think of it.
'And now these three remain: faith, hope and love. But the greatest of these is love.' (1 Cor 13.13)
After all, an identity crisis is not so bad as long as you have some lovely folks by your side.

Tuesday, 10 February 2015

What they don't tell you about science (and medicine)

When I turned five, my birthday present was my first bike.  It was pale forget-me-not blue, and I was so excited to ride it on the thin concrete patio that linked the house to our back garden.  Living in the West of Scotland, despite having a birthday in June, it was still fortunate to have nice enough weather to do a trial run on the day itself.  That was a great bike.
I want to ride my bicycle...
So it was rather a treat to get to ride an almost identical bike several thousand miles away, 21-and-a-half years on.  Riding through Sacramento's sunny streets on a 'winter' (read: 18 degrees celsius) afternoon is just one of the many heartwarming, life-loving moments of recent days after an incredibly stressful couple of weeks (/months!).  

Napa Valley
I've listed this posting as 'What they don't tell you about science (and medicine)' - but perhaps I should call it 'How to pick a job which is nothing like what people think it is'.  People often say to me 'what a solid career choice you've made' or 'it's a job for life' - and about my time in the US as a researcher at Yale as 'you're sorted' and ''you'll always get a job in science'.  I've never believed any of these, but these last couple of months prove, rightly, that nothing is certain.  I applied for a job to return to almost as soon as I arrived in the USA, along with thousands of junior doctors across the UK.  I was lucky enough to get consecutive job interviews, first in December and again in January; but that involved two trips back to the UK.  There's nothing like the cost of a plane ticket to put on the pressure. And justifying your salt as a doctor is stressful both in the context of having done it for the last 2 years, and in my case taking some time out to do research - you feel that you have a lot to justify.  By no means is it seen as a positive thing by all people that I've taken myself off Stateside for the year.

Macarons! Yum yum yum.
The route to becoming a total wine snob...
What's joyous is that I get to do this all over again in 2-3 years' time.  And then another few years after that.  And that's just the clinical bit, where at least there are usually jobs around.  Depending on how much I wish to make science an integral part of my career, I'll be joining the 'publish or perish' world which brings a whole other dimension of uncertainty.  Scientists are revered as being brainiacs trying to save the world - but they are poorly remunerated with very little job security for the privilege.  So before you think that the road is lined with gold for doctors and scientists alike - the exact opposite is true, particularly for the latter.  

Alongside all of that, obviously the job you are doing at the time must also continue, and science does not always play the game.  My 'science' has been working ... variably.  It is somewhat disheartening when an experiment you have been working on for six weeks appears to not be working.  The number of failed experiments that go into one scientific paper - I think it's probably a 1 in 10 ratio of success to failure.  But when those successes come - oh boy!  So exciting!

State Capitol of California
So having traversed all of that, I am now falling in love with life and the world again having taken myself off to California to continue my 'cultural exchange' and give my little brain a rest.  And boy, the love is flowing; the kindness shown to me by a series of relative strangers is blowing my mind.  My senses are kind of overwhelmed with all the sights, smells and tastes that California is offering me - having meandered through the beautiful Napa Valley, exploring the historic corners of Sacramento and creeping through Big Trees (aka Giant Sequoias) Park, I'm probably going to have go on some sort of diet after sampling buttery Chardonnays and fruity Pinot Noirs, sticky Macarons (the salted caramel - WOW), full-flavoured cheeses, delicious lamb dishes, and even a genuinely good portion of fish and chips... and all under the guidance of incredibly kind new friends.  All good stuff for the soul, and good for reminding you about all the things that are great in the world.  After all, a job is necessary but it is just a job.  The kindness of people is of far greater value and one that I am feeling the full force of at the moment.  
I'll leave you with this: we had a chinese lunch yesterday and this was the contents of my fortune cookie.  I'm not sure I have enough of worth to write a whole book yet - but I am not at all short on ideas!