The voice of junior doctors

THE trials and tribulations of his life as a junior doctor have proved a rich source of inspiration for Dr Max Pemberton.

His behind-the-scenes accounts of life on the wards were first published as a regular column for the Daily Telegraph and won the Royal College of Psychiatrists’ public education award. The stories were then turned into his successful debut novel, Trust Me, I’m a Junior Doctor in which he reveals the desperation of long hours and a massive workload with stories that are terrifying and funny in equal measures.

He followed that up with a candid account of his experiences in FY2 working in a homeless outreach project in his second novel Where Does it Hurt? – What the Junior Doctor Did Next. He again mixed fiction (for example, Max Pemberton is not his real name) with autobiography to describe the harsh realities of frontline patient care.

He has just finished his third book which follows the same characters and is set in a hospital geriatric ward. A TV version of Trust Me… is also on the horizon after Max sold the rights to his debut novel.

Max studied medicine at UCL in central London and also has a first class anthropology degree. He started working as a doctor in 2003 and is currently a specialist registrar in psychiatry, based in London. He continues to write for a variety of publications.

When did you first know you wanted to be a doctor?

When I was very young I wanted to be a marine biologist, but when someone explained that I’d likely end up swimming in raw sewage counting barnacles, I reviewed my options. Around the age of 13 I settled on being a doctor and aged 15 I did work experience at a local hospital for older people and I loved it. An inspirational manager took me under her wing while I was there and showed me how medicine could be a force for good, advocating for the disenfranchised and challenging stigma and inequality as well as meeting and treating fascinating people. I left with a determination to become an old age psychiatrist – not the usual career aspiration for a teenager.

What was the most important lesson you learned as a junior doctor?

Eat. My friends and I lost so much weight in that first year because we simply didn’t find time to eat properly. A well-stocked freezer is a lifeline when you’re too tired to traipse to the shops. It’s so easy to just eat junk food when you’re busy and stressed but it’s important to look after yourself if you’re going to look after other people. Remember: a bag of Monster Munch does not count towards one of your five a day.

What inspired you to choose psychiatry?

Psychiatry was the best career choice I could have made. I love listening to people and hearing their stories and this is precisely what psychiatry is all about. It covers so many different areas there’s something for every taste and it’s an incredibly friendly speciality. It is so intellectually stimulating plus you develop strong, enduring relationships with patients, which makes it extraordinarily rewarding. I particularly enjoy old age psychiatry because so often society throws these people on the scrap heap and – although it sounds a bit corny – you really can make a difference to their lives.

Any advice for those looking to pursue a career in psychiatry?

Psychiatry requires sound medical knowledge combined with excellent communication skills and the ability to empathise. Be enthusiastic, read around the subject and if you’re still at medical school, try and organise your elective or special study modules in psychiatry. See if there’s a psychiatry society set up at your university and go along to their events. If not, ask The Royal College of Psychiatrists about setting one up yourself – you’ll win so many brownie points if you do.

How did you get into writing?

I started work as a journalist while at medical school, so I’ve been writing much longer than I’ve been a doctor. I was working on a consumer health website to fund my way through medical school, but I discovered I loved writing. As I got more experience and made contacts, I started writing for print media and my career grew from there. Just before graduating I approached the Daily Telegraph with an idea for a column detailing my first year of life as a junior doctor and a year later they asked me to continue by commenting on news, culture, ethics and the politics of healthcare, which I’m still doing. After the publication of my first book, I was approached by other magazines and newspapers and I started as a columnist for Reader’s Digest.

How do you balance your medical career with your writing career?

It depends on what writing commitments I have but I tend to write very late at night. At weekends I’ll go out and then come back and write until dawn. When I have a book to finish, I write furiously in the last few weeks before deadline and try not to go out (much). I don’t have a television or children and I do think that not having these two things frees up an amazing amount of time.

What response have you had to your books from doctors?

My readership is quite broad and my writing is predominantly aimed at the lay public rather than doctors. Even so, most of the responses I’ve had from doctors have been very positive. All my colleagues know about my writing and have been tremendously supportive. A lot of medical students and would-be medical students contact me saying that they’ve enjoyed my books and asking advice. I get a very hostile reaction about a lot of my columns from government organisations and senior NHS officials, but as far as I’m concerned, that’s mission accomplished.

How do you preserve patient confidentiality when you’re writing about your job?

There is a process I have to go through to ensure that certain key aspects of patient information are changed to ensure that patients can’t be identified. Most of the characters are composites although I usually start with one patient encounter I’ve had that raises a point or an issue and then layer the character details on top of that. There is a lot of legal input.

Do patients ever recognise you?

Yes, sometimes, and I occasionally hear people talking about it when they see me in A&E and it’s never been a problem. In fact, people seem to quite like it and several of them have asked if they can be a character in one of my books. A lot of members of the public recognise me from my photograph in the paper and stop me when I’m out shopping. They’re usually very kind, but they do often insist on telling me their life stories when sometimes all I want to do is grab a pint of milk and go home.

Any advice for those who want to get into writing?

In many ways breaking into journalism is far harder than getting into medicine. It’s very competitive and a lot of it is down to pure luck and serendipity. Just don’t give up. As a medical student I would spend Friday evenings writing pitches to magazines and newspapers, most of which I never even got a reply to. Also, practice writing and read as much as you can.

Interview by Joanne Curran, associate editor of FYi