One of the most important jobs we can do is to tell the truth well,in a way a person can live with.Niki Fisher/illustrationroom.com.au
I used to live another life,right here in the pages ofThe Sydney Morning Herald andThe Age. When I started as a trainee journalist 20 years ago,it was a time when we still learnt shorthand,and reader feedback was as likely to arrive in a hand-addressed envelope as an email. It was a thrill to find a job with so many opportunities to talk to people and go places. Stepping on board a US Navy ship in Sydney harbour for a press conference,flying to Africa for a travel story. Over the years that followed,writing newspaper articles and books and columns just like this,I sent hundreds of thousands of published words out into the world,words which will be forever adrift on the internet,too many words to ever be reeled in and recovered.
But at some point in this journey,something changed for me. Three months after having my first baby,I found myself in the emergency department of Sydney’s St Vincent’s Hospital on New Year’s Eve,2009. The reasons were journalistic rather than medical. I was writing a book about illicit drugs,and arranged to spend the night among the health staff and party casualties for research. Around me surged so much life and activity,nurses and doctors working with speed and dexterity,applying professional expertise and street smarts in equal measure.
There was no glamour to be found among the fluorescent lighting and linoleum,but I loved it. I loved it so much I started to get ideas. Could I become a doctor?
In a burst of postnatal optimism,at a time when I was younger and everything felt possible,I decided it wouldn’t hurt to try. Between feeds and naps,I studied for the medical school entrance exam. I hedged my emotional bets by figuring if I didn’t get in,or got in and failed,the study would not be wasted. Because learning is never wasted if you are a journalist. In the end it was not wasted time in any sense,because I got in and kept going. And here I am,11 years after starting medical school,nearly seven years since qualifying as a doctor,in my sixth year working as a psychiatry registrar,still going.
I have learnt to listen without speaking,to think without having to write.
I kept up writing for a long time. Then I stopped. In the past couple of years,I’ve been working on silence. I have learnt to listen without speaking,to think without having to write. The similarity between journalism and psychiatry is that you are always meeting people and learning from them. In journalism you then share that information;in psychiatry confidentiality is all.
This silence might also be about the loss of certainty,about what to say and how. For all the talk of doctors and egos,if anything medicine has worn down my ego. It’s made me quiet and watchful. It has made me more measured,as I tread the most painful stretches of the Dunning-Kruger curve,where a person learns enough to realise how little they know. I have adopted medicine’s circumspect language:“not unreasonable”,“may be consistent with”,“I wonder if … ” .
Ultimately,though,the reason I stopped writing is because I stopped hedging my bets. There’s a trap a career-changer can fall into,which only becomes apparent with time. They may find themselves tiring of the new career,and the one after,and the one after,moving from field to field unsatisfied,always finding fault.
This hasn’t been the case for me. I’m pleased with my day job,and writing has fallen away. Enough time has passed to know I made the right decision,not because my current profession is better than the last,but because it’s the right one for me now. There are days I feel like I might have helped someone. And that’s enough for me now,which might be as much about the modest aspirations of middle age,if anything. These days it’s enough for me to have something useful to do,a brisk walk,a sunny spot to sit.
Of course what I’m saying is undone as I write it. Here I am claiming to be silent,in a stream of published words. So let me explain that. More recently,I’ve been reflecting how psychiatry done well requires more than silence:it requires considered speech. One of the most important jobs we can do is to tell the truth well,in a way a person can live with.
This might come in the form of explaining a diagnosis or formulation,or simply in asking the right question. Psychiatry also requires advocacy,and that means speaking beyond the hospital ward or clinic room. The conclusion I am moving towards is that I will try to say less,but say it well.
Lisa Pryor will discuss her career change with Amy Coopes and Norman Swan at the on September 11.
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