Dr Lianne Leung – food for thought (and other basic physiological needs)

Dr Lianne Leung
Intern

A few weeks into our internship, we had a horrendously busy day. None of us juniors on the team had a chance to eat lunch that day. At some point, I remember starting to feel a bit woozy, but I told myself I would get some food after this next job. And then the next job.

And suddenly, it was 6pm and all I had had all day was two coffees. My brain was no longer working straight and, defeated and somewhat dizzy, I slumped into a chair in the clinical workroom, wondering aloud what my BSL might be.

Then, as if on cue, a fellow teammate came into the office, looking faint. She told us she was just found to have a BSL of 2.6, had been given a carbotest, and was feeling somewhat better now. We still had to insist that she go home and we would help cover the rest of her jobs for her.

Our Fellow came to the office expecting us gathered and ready for an evening paper round, instead finding us splayed across the room.
“What happened here?” He asked aghast, taking in the carnage.
Between the teammates remaining, we somehow managed a garbled response that the day had been chaotic.
“Guys, you need to eat. I don’t care what happens during the day, but you need to eat, okay?”
We deliriously nodded in response.
“No, I’m serious. You have to eat.”


I’m glad I had this experience early in my internship. On reflection, it’s saddening that not one junior on the team had felt they could take a break through the day. Worse, even after she required medical treatment for hypoglycaemia, we still had to insist and reassure our teammate that she could go home as she was still thinking about work.

Despite food being a basic human need, we juniors still did not give ourselves permission to prioritise our own wellbeing. Where did we learn that this was what it meant to be ‘hardworking’ and to be ‘a good doctor’? When did we learn it was acceptable for doctors to miss lunch/have horrendously delayed meals? I remember the JMOs telling us as medical students: “You should always have time for lunch as a medical student.” I didn’t question it too much at the time, as it fit my understanding of what it meant to be a doctor, and had been congruent with our first few weeks working as well: a patient has been waiting hours? Yes, I will see them before I eat. A nurse wanting to confirm a medication? Yes, I will go through it with them before I go for food. A phone call? Hello, Lianne here, intern; how can I help? This is hardly a unique experience and I’m sure many (if not every) reader would be able to share a similar story.

Yet, while you certainly should always eat lunch as a medical student, why should that be different to just one year later, when you are employed for your clinical judgement and there are greater medico-legal consequences of errors, but suddenly it’s not as high a priority to fuel your brain and your body anymore? Of course, everyone’s body is different and has different nutritional needs, but when did food go from being a necessity to a luxury, or even a weakness?

I don’t know how to change “I didn’t get lunch ‘til x o’clock” from being perceived as some glorified expression of how busy and dedicated we are to being a sign of a failed medical system or a twisted inherited culture, but I do know I am grateful for those that champion self-care and help dismantle these ingrained beliefs. Additionally, even if there are posters and public campaigns* raising awareness about doctor welfare, it made all the difference to have a senior on the team who knew us and whom we trusted giving us permission to eat lunch, and who role-modelled that behaviour themselves.

Similar could be said about drinking enough water, getting enough sleep, or any number of other physiological needs for us to stay physically and mentally healthy. Logically, it makes sense that if you take care of yourselves and take care of your teammates, you can take better care of your patients...but logic does not drive all decisions. It was years of role modelling from seniors passively absorbed during medical school that led to these beliefs, and it will take role modelling from other seniors to unlearn this, in addition to time and conscious effort on my/our own part to build new habits.

For now, I pride myself on keeping a well-stocked ward snack drawer, welcome to all, in the interest of improving patient outcomes.
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*For example, I LOVE this campaign from the UK.
https://ep.bmj.com/content/104/4/200

Dr Lianne Leung is an intern at Fiona Stanley Hospital, having graduated from the UWA Medical School in 2020. She has interests in mental health, care of the elderly and doctors’ welfare.