Aoife Abbey: ‘Being a doctor is not like in the movies’

Aoife Abbey’s book, Seven Signs of Life, chronicles the emotional highs and lows of her life as an intensive care doctor. The daughter of a nurse, she grew up in Dublin and graduated from medical school at the University of Warwick in 2011. Now 35, she was until recently the anonymous author of a blog, The Secret Doctor, for the British Medical Association, which was read fortnightly by more than half a million people. She is now working in a hospital in Coventry.

Did you always want to be a doctor?
Yes, although I find it hard to say exactly why. I suppose the most obvious link to my childhood is that my older brother, Aaron [who died last October], was often unwell when we were growing up so I spent a lot of time in hospitals. Being exposed at such a young age to the lives and work of doctors must have had a big influence on me.

What inspired you to start writing?
I’d been qualified just over a year when I had an encounter with a patient, a young girl who was the same age as me, who had a brain tumour. She asked me if it was going to shorten her life and I felt I had to give her an honest answer, which was yes. I was deeply affected by that conversation and couldn’t stop ruminating on it, so I decided to write it all down. I sent what I wrote into the BMA magazine and they published it. Not long after, they asked me if I wanted to take over as The Secret Doctor.

What did you get out of writing?
There were lots of situations – relationships, human encounters – that I was experiencing in my work that required much more from me than purely medical expertise. Writing about them helped me to figure out what they meant and made me feel. Doctors don’t really discuss these things among themselves or with the public in an open way.

Why did you decide to tell the stories in the book through seven emotions: distraction, fear, grief, joy, hope, anger and disgust?
Because juggling these kinds of feelings is an everyday part of being a doctor. As far as the stories I had to tell were concerned, what they had in common was that they all made me feel something very strongly and I realised that the only way I could organise them in a book was according to how they made me feel.

You certainly don’t portray yourself as a saint. You are often angry, crabby, annoyed, indecisive. Was this deliberate?
Absolutely. I wanted to be honest. In a way the book is in direct contrast to some wonderful memoirs by older and wiser doctors like Henry Marsh [Do No Harm] and Paul Kalanithi [When Breath Becomes Air], who are looking back. I was trying to chronicle the real experiences of a doctor at the beginning of her working life. If I don’t look back on it in 10 years’ time and say, actually, I would behave differently now, I know better now, then I probably haven’t done it right. I felt like it was important to get the stories down while they were fresh. I wrote a lot of them the very same day.

Your chapter headings convey more negative than positive emotions. Joy and hope are present but they are outweighed by grief, anger, disgust, fear. Does that balance reflect your feelings about the work?
Being a doctor is not like in the movies. The situations you find yourself in are very complex and give rise to multiple emotions. In the course of an afternoon I might feel raw fear at having to intubate an obese patient who’s had a myocardial infarction [heart attack]; or have to overcome disgust at caring for a convicted rapist; or I could feel exhilarated and sad at the same time when a patient with dementia who’s normally silent confesses to being lonely. So, yes, I have a job where I encounter difficult situations, but the emotions it stirs up are neither positive nor negative, they are just part of being alive, I think. I try to appreciate every situation I find myself in as an opportunity to learn more about what it means to be human.

What’s the best thing about being an intensive care doctor?
You can always make a difference to somebody. It might just be something small, like listening to them. It might be taking into consideration the kind of death that they want, if you can’t save their life.

You quote widely from literature, from WB Yeats and TS Eliot to Raymond Carver. Is reading poetry and fiction a source of solace for you?
Oh yes, absolutely. I have always loved reading, whether it is classics or contemporary novels by Eimear McBride, Sally Rooney, Julian Barnes, Max Porter. When I’m writing I so often think of the way my favourite writers express themselves. There are a lot of beautiful writers out there who can help you explain how you feel.

How else do you wind down?
I take a lot of baths.

Can you see yourself in the job in 10 years’ time?
Yes. I see this as my career for the long term. Burnout is a massive fear, though. There is a growing need for doctors to appreciate that wellness is a construct they have to embrace. We need to find ways to do our job as well as we are able while also being kind to ourselves.

How hard have the austerity years hit you and your colleagues in the NHS?
There are a lot of issues today, all of them related to funding. In critical care there is a huge need for more beds, more nurses and pay and conditions that reflect the hard work nurses and other medical professionals are doing.

What single thing would improve the quality of your life as a doctor?
For about the first 10 years of your career you move around a lot. That can be quite hard. I guess part of me thinks that if I didn’t have to move so much then it would be easier to have relationships that you can keep going. Having more beds for more patients would help, too.

Seven Signs of Life by Aoife Abbey is published by Vintage (£12.99). To order a copy for £11.43 go to guardianbookshop.com or call 0330 333 6846. Free UK p&p over £10, online orders only. Phone orders min p&p of £1.99