The loneliness and disillusionment can be crushing, but you may also find the best people in the world.
Medicine can be remarkably lonely. It is so otherworldly that at times it feels completely detached from “real” life.
Our job – doctor – sounds so straightforward. We help people. We treat sickness. We delay death. We ease suffering. Universally the role is understood.
Truthfully, I’m not sure the role is understood at all, until we do it. And then, without people around who equally understand medicine and you, it becomes remarkably lonely.
And the blessing of being surrounded by medical friends is not afforded to everyone. An airtight encapsulated love from people with the same job, the same nightmares, the same sadnesses – when you get it right, it will change your life indescribably. I write endlessly about my medical friends because without them I would be an empty, misunderstood shell of a human. Truly.
When I talk to doctors and medical students who are lonely or bullied, feeling like outsiders in this tough, heartless world of medicine, desperate for medical friendships that nourish mind and body, I reassure them again and again: these friends exist. And they’re worth digging through the medical trenches and waiting for.
Like many or most of you, I started my medical studies young. I was 17 in the first year of the MBBS and started practising medicine at 23. I had had a simple and easy life. I had not seen any meaningful sickness or grieved for anyone. Other than simple viral coughs and colds or teenage dysmenorrhoea, I had no real reason to seek medical care. I didn’t come from a medical family and my high school friends all drifted to non-medical disciplines and different universities. So, I started medicine quite independently and with very minimal insight into what this life actually looks like.
I came to the orientation camp in our first year of medical school proud, excited and confident. My mother had taken me to the university bookshop over the summer to buy the textbooks on the first year reading list. She bought me all of them, even the recommended-not-required. We labelled them together and carefully chose a new backpack to lug them to uni. Something feminine but serious.
After years of mandatory ugly public-school uniforms, my mum had also taken me over the summer to buy new clothes. We carefully picked out cool jeans and grown-up sweaters and everything my heart desired. We went to Myer and David Jones and all of the expensive stores because my mum was so proud to buy these clothes for me.
After all, for a first-generation hard-working immigrant family, raising a child in a foreign land, alone and unsupported, carefully, safely, lovingly to adulthood, for that child to become a doctor means a celebration and a sigh of relief decades in the making.
On the first day of the orientation camp, I wore the outfit that my mum and I had thoughtfully planned: light blue flared jeans and a hot pink zip-up fleece jumper. It was the coolest outfit I had ever worn. I went to the registration desk to announce my arrival, pick up my name badge and orientation package. I didn’t know anyone at the camp but was looking forward to a fresh start.
I was excited, after a summer of dreaming and anticipation, to meet my new peers, the friends with whom I would journey on this grand new adventure. I greeted the student ahead of me in the queue, introducing myself – perhaps this would be my first new university friend! He, I can recall with complete certainty, was wearing an oversized white T-shirt and grey jeans. He didn’t return my greeting. He didn’t smile. He took one look at me and said derisively, “Wow. That jumper is so bright it’s blinding. If I were you, I wouldn’t wear that again.”
It wasn’t said teasingly. It wasn’t said jokingly. It wasn’t said by a neurodivergent man unable to read social cues. It was said cruelly, with full intent.
Days later, I learnt that he was something of a medical nepo baby: the son of two well-known doctors who grew up in a famously expensive house with lifelong private school education. He was nothing like me, and perhaps to him that showed.
Years later, I would finally wear the jumper again, after I matured and understood this was a deeply insecure person who didn’t deserve a minute of my time. I dread to imagine someone trying to talk to me like that today. Honestly, I think I would respond with such disproportionate retaliation that I would end up the bully.
But in the seconds and minutes and hours later, all I learnt was loneliness and heartache. I cried that night. Every expectation I had for medicine had been crushed in that moment. Medicine was not a collection of loving, kind, hardworking people who spent the summers painstakingly picking out cool jumpers with their proud mothers. It was ugly, competitive, unfeeling, overconfident, bullying, insecure, privileged.
For the first time in my happy protected life, I had met people who were so deeply dislikeable and cruel that I wondered how the hell could they be doctors.
For some time, I flailed, searching for the connection to sustain me in this new life. For whatever reason, I didn’t immediately find it in medical school. We moved hospitals every six months then every three months then every six weeks. We were flung from one end of the city to another and then out of the city to some rural town. I didn’t know myself well enough, I didn’t yet have the confidence to be my most authentic self. I tempered down my clothes, the colours, into the sad grey existence that medicine felt like.
It was hard to find a moment of deep, devoted friendship with another med student, and the other 19-year-old friends studying arts and law didn’t really understand my life anymore.
How do you explain that you’re stressed because you still need CPR checked off on a log book? That meant pounding someone’s chest after they died to try and resuscitate them and to try and get that done by the next tutorial since nearly all of the PBL group had already had the fortune of being around dying people and the universe had given them the privilege of doing CPR several times already.
And definitely nobody understands when you eventually do CPR for the first time how emotionally wrecked you feel when a non-medic asks what you did that day. What do you say? Got my logbook checked off, I guess. It just feels lonely.
And it stays like that until you meet the right people. But then, when you do, it is so worth the wait. I finally met my friends, my great loves, after I graduated and started work.
My best friend gives me so much love and care it bowls me over. We met as residents on a paediatric term, and we have grown and greyed with each other, day after day. Now he is a paediatrician at the local referring hospital for our GP clinic and our names are on the paperwork of each other’s patients.
He calls me on the drive home to ask about the sick patient that I worried about all through dinner yesterday. What happened to that lady? he’ll ask. He’s not really worried for the patient, he’s worried for me. He texts on the long days to ask if I’ve eaten and I say no, not today, had a sick patient, and he will say yeah, same but look after yourself. Try to eat.
My other friends were my co-interns, bosom friends from day one.
There was no derisive comment about my navy dress, also carefully picked out on a shopping trip with my mother. Instead, on meeting, their first demand was that I eat dinner with them.
Now they’re brilliantly advanced in their surgical and anaesthetic careers, shining beacons for me, and when I apologise for being late to a catch-up (still stuck at clinic sorry had a walk-in pt w STEMI and VF arrest in the Rx room), they reply in the group chat (Far out, good job, I’m so proud of you/ What a nightmare! Are you OK?/ Do you need help? Do you want me to call?) because immediately they understand what it must have been like to have a patient with a STEMI (a STEMI) present to and then arrest at a general practice.
And if I cancel on dinner plans because I’ve done nothing but break bad news all day and I’m in a foul mood and just want to sleep, I come home to restaurant take-away silently waiting on my porch. Wordlessly, my medical friends understand. Wordlessly, they carry out these acts of love.
So, to the young medical students and doctors who feel friendless and alone, please, please wait for the medical friends who hold you as carefully as mine do.
And then, god, it’s indescribable. It is the furthest thing from lonely you will ever feel. It will make you love medicine so much more. It will make you a better doctor. It feels like everything, everything, every bit of you can be seen and explained and understood by the right medical friends.
I gave a keynote address recently and wore a hot pink suit, chosen at a designer boutique with, still, my mother, now 20 years older and 20 years prouder, the suit so bright that it’s blinding – and my medical friends know. They know how hard I work, and how big a day this is for me, and equally think this is The. Coolest. Outfit.
There is no competition, there is no cruelty. There is no unsolicited advice to tone down my clothes, my voice, my personality. There is only a deep, deep love and understanding. When they see the suit, my friends, they see me. They greet me, smile at me, and say “You look beautiful”.
Dr Pallavi Prathivadi is a Melbourne GP, member of the Eastern Melbourne PHN Clinical and Practice Council, and GP Lead of the RACGP Academic Post cohort support and education program. She holds a PhD in safe opioid prescribing and was a Fulbright Scholar at the Stanford University School of Medicine. She is studying creative writing at Harvard University’s Division of Continuing Education.
