Standing leaden faced arms down listening to a crackhead bleat and scream about how I was terrible at my job and everything wrong with them was my fault and about all the fantastical ways they had of getting me fired and ruining my life, I thought, not for the first time, that I am in the wrong line of work.

As I was standing there today, studying the rotting molars of the man on the other side of the desk as he shouted and raged at me, the man screaming at me like he was my social superior, the man that I know for a fact lets strange men rape his mouth for spare change, I felt another little piece of myself slough off and fall to the floor.

I am so sick of patients.

I am sick of being required to care about these incompetent, fragile, ungrateful lumps of flesh.

I am sick of helicopter parents nursing their adult children into early graves.

I am sick of half absent parents rocking up, half dead children in tow and blaming me for it.

I am sick of all the people with that can’t turn up or get out of bed or hold down a job but are perfectly capable of getting drunk and going for a drive.

Or getting pregnant and going for a drink.

I am especially sick of encountering the same 15 or 20 faces 3 to 4 times a week, I am sick of them thinking we have a rapport, that we have a relationship they can use to manipulate me into doing things for them that I am not supposed to.

I’m sick, very, very sick of how much dealing with entitled, stupid, drug addled people, middleclass oxygen thieves and hypochondriacs, lumpen addicts, adult regressives, the professionally mentally ill and the terminally insufferable distracts from actual, useful, patient care.

I am sick of primary care and the flotsom and jetsom that feel free to constantly abuse it.

But I still deal with them.
And I deal with them well.
I am very, very good at my job.
The patients like me.

I am a professional, and professionalism means compassion, means above and beyond, means letting the job eat away at you, means working hard, always, everyday, for people that don’t deserve it, don’t respect it, don’t understand it, don’t notice it.

I am a long service professional.
I have been employed in healthcare in one form or another near constantly for 16 years.

30-80 hours a week, every week, for 16 years.

To be clear, I am not a doctor, or a nurse, I am one of the myriad other functionaries that any complex healthcare system depends on.

At the minute I have found myself back in a patient facing role for the first time in about 5 years, and I’ve suddenly realised I hate people, all over again.
The last time I had to directly interact with patients on the day to day they were all too sick to actually speak.
Covid had its downsides but say what you will, people on ventilators tend to stay where they’re put, and they tend not to snort coke in the bathroom.

I am, quite possibly, more than a little bit bitter.
I am aware that nothing I am writing here will read particularly favourably, and I am also aware that in a few years or months or weeks time I may regret quite a bit of this. But I don’t really care about any of that right now.

I am sick of caring about people.
Because I do care, I care too much.
I know so, so much about people that see me as a faceless interchangeable automaton.
I get angry on their behalf, I go the extra mile for them, I double check everything, I call them and remind them, I chase up all the things they’re supposed to chase themselves, I do everything short of wipe people’s arses for them and if someone asked me to I’d probably do it, I’ve done it in the past.

I have done so many servile, unpleasant, difficult things for so many ungrateful self damning incompetents.

I have the NHS lanyard I was given when I first got a permanent job, still hanging up on a corkboard in a room back home, I’ve got the old uniforms mouldering in boxes somewhere, most of the people I know I met through the hospital, or healthcare, when I talk to my family, all in similar lines of work, we talk about the job, about how shit it is, about how fucked we are.

I have made the profound mistake of letting a profession become part of my identity, and now I hate the profession, and as a result I am now fucked.

It’s not even a good one, there’s barely any money and abolutely no respect, and its a niche that once you’ve grown into its very very hard to leave, healthcare is a sticky field, one you can always find work in but one that’s hard to use to get work outside of.

Proficient in yelling at old people is not a marketable skill in most of the rest of the economy.

The worst part of my current job is that all the patients I actually like and respect are getting worse. For every 10-20 meaningless faces there are 1 or 2 that my heart bleeds for. The 10 year old allergic to everything, the 13 year old grinding forward toward suicide, the one that flinches when any man talks to her, men and women in their 30’s and 40’s dying young, all the nice old people, minds rotting from the inside out, falling away from themselves.

I hate that I am burning out to the point where I don’t have energy for them anymore.

I feel my jaw clench evertime I brush against any little annoyance, I feel myself getting closer and closer to snapping with every patient failure, or time wasting phone call, or broken system I interact with.

Everything is broken now, every system is straining against staff burnout and shortages, equipment failures, aging patients, incompetence, corruption, political stupidity. Everyone I talk to is coming apart at the seams and it just keeps getting worse.

I can’t keep doing this to myself, but I have no idea what else to do.

It’s pointless to care about the work but I do.

I am professionally obligated to deliver compassionate, competent care. I am required to care about people.
While I’m being paid to.
But I can’t stop doing it in my free time, and it’s ruining my life.

Where do you go after you can’t care anymore, when putting food on the table and looking yourself in the eye both require you to?

If you’d asked me 6 years ago if I was proud of the work I did and if I thought I was making a difference I would’ve looked at the floor and looked back at you and probably stuttered out something about being embarrassed to say it, but yes, I was proud of the work I was doing and that I felt I was helping people.

So quietly proud of being good at something that does not matter and has possibly never mattered.

That’s gone now, I’m not proud anymore.

I am a torn up, worn out cunt that’s been stupid enough to let a system use him up to nothing, and too cowardly to quit once he realised that was the case.

Once, about 3 years ago, while driving back from a seminar, my jaw seized up and my vision started to fail. I pulled over to the side of the road and sat there until it passed.
I thought I was having a stroke.
The next morning at lunch someone at work told me that it was probably a panic attack.
I didn’t take a single day off.
I just got on with it.
It’s happened again since, twice, once again in the last month.

Fool, little idiot, little pawn, little foot soldier, cannon fodder.

I am dead inside.
I’m still stupid and I’m still a coward but I’m going to quit, I’m going to desert. I need to stop caring for a while.

And after that what?
I don’t know how to do anything else. I’ll cross that hill when I come to it.