Yesterday I did not cross a picket line. I don’t yet know the figures for how many junior doctors did choose to work, aside from those who were unable to strike, but I would not blame anyone who chose to. I almost did.
I woke up at 5am and my heart was racing with moral indecision. This ultimate question of where my ethical and public service role as a doctor lies; with the individuals today, or the systems of the future, has had me on edge for days.
After the deliberation that went into my blog “should I strike” I realised yesterday morning that the question I was really battling was, “Do I need to answer this question for every junior doctor, or just for me, in my own context?”
By this I mean, if I am reassured that my local department has made contingency plans that, bar an outlier event, can manage a normal Tuesday in paediatrics, then do I need to worry about other parts of the system not coping? Where does my moral responsibility lie? To every patient coming through one specialty? One directorate? A hospital? Or in the whole country?
And if I do only need to focus on my own department, then once I have resolved that the contract is a bad idea in practice, (alongside, not just because of, the BMA protestations) then striking is ok.
And that is why, walking to the hospital yesterday, unsure if I was heading for the picket line or paediatrics, I chose to strike. Because I had had reassurance from my colleagues that my consultant colleagues had brushed up on their “junior doctor skills” in preparation; I knew paediatric consultants are all very hands on usually; and therefore, the consultants could be “every doc” for the day.
And in balance to that, I hoped that all my colleagues in other specialities and other hospitals (all of whom I spoken to in paediatrics were) could also say the same about their own departments.
And so I took a stand, withdrew my labour, and was reassured by consultant colleagues at lunchtime that all was so far ok.
And this is the moral line I have drawn for myself. Others will have drawn theirs in a different place they are comfortable with. It is still possible to have an ethical debate, but for now I have my answer.
So where does it goes from here?
That’s the next question that’s exhausting to even write about.
The current contract is definitely out, the shortage of staff and low morale will not be solved by August, or even in five years. The debate about what junior doctors should do, and for how much money will continue to be mixed up in all the other problems and grievances the overstretched, but wonderful, NHS is facing.
That is reality, that is politics, that is the murky public system we entered. Idealism is being requested to take a holiday. But for now, I am still a “tragically naïve”, hopefully maturing, banner holder for it.
Lizzie Wortley is a paediatric registrar working in Northwest London who is interested in quality improvement, acute care, and particularly enjoys debating the psychology of doctors and patients.
Competing interests: None declared.