As a mature-onset junior doctor – which is how I sometimes describe myself – fellow medics judge with a casual glance that I’m 20 years older than most of my fellow new starters. They’d be right. Occasionally, someone asks, “What did you do before medicine?” “I was in the Diplomatic Service,” I reply. There’s a stare and an awkward pause, and the questioner says, “Why on earth did you leave?”
Wanting a new life
In 2011, I returned from a posting to India. I called my friend Bianca, who I studied with at Oxford back in the day, and who is now a GP, having graduated with an English degree and worked as an acupuncturist and yoga teacher.
“I want to become a doctor,” I told her.
“Are you crazy?” she said.
“Why would you want to take your brilliant career in the Foreign Office and swap it for medicine? I love my job, but are you sure you want to start again at 40? Think of all those nights and weekends, and the compassion fatigue…”
She had a point.
I had loved the Foreign Office
I had once loved my work in the Foreign Office – an organisation I still feel somewhat attached to, a prodigal daughter who will not return. I spent two years in Kosovo, talking over coffee and cigarettes with former Kosovo Liberation Army soldiers and politicians fighting for Kosovo’s independence from Serbia. In January 2004, I travelled to Iraq, shortly after the US occupation. As a young diplomat representing Blair’s Britain, I felt a sense of duty: We’d got ourselves into this mess and I had a small role in helping us get out of it. As the spokeswoman for the UK Special Representative and the British Embassy in Baghdad, my job was to explain to the Iraqi people and – more importantly from Number 10’s perspective – the Western press, how we would make the phoenix of democracy rise from the ashes of Saddam Hussein’s regime, and bring development, clean water, food and jobs to a country torn apart by brutality and conflict.
The reality of the Foreign Office
The reality was, of course, different. I remember General Kimmett, the US Army spokesman, rebutting an Iraqi journalist who complained about the terrifying roar of Coalition helicopters patrolling over Baghdad: “The sound of those helicopters? That is the sound of freedom”. The echoing cool darkness of the green marble inside the lofty circular atrium of Saddam’s palace was a retreat from the glare, heat, chaos and dust outside. The nightly mortar attacks would send me tumbling out of bed, onto the floor, wriggling into body armour until a fresh-faced young soldier from 2 Para came to escort me out of the fragile portacabin I slept in to a safer building with a concrete roof. I travelled to Abu Ghraib, the US detention camp where 10,000 Iraqi insurgents were imprisoned. I saw Saddam Hussein, shackled and broken, led to his trial. I watched US Spectre gunships fire missiles at Mahdi Army rebels outside the Green Zone.
Working on hostage negotiations
In October of that year, Margaret Hassan, a British-Irish humanitarian worker, was kidnapped by armed men on her way to work. Within hours, a specialist hostage negotiation team from the Metropolitan police flew to Iraq. I met them in Kuwait, on my way home from a week’s leave, and we took the British RAF Hercules transport plane into Baghdad. As the Embassy’s press officer, I participated in planning meetings about how to handle the kidnap, including COBRA, the emergency meetings with London, and worked closely with the police negotiators.
Amidst the drama and suspense, Margaret’s husband, Tahseen, came to the Embassy on a daily basis. The kidnappers were calling his home, demanding not money but release of “political prisoners”, a demand to which the British Government would not acquiesce and over which Tahseen had no control. It was an appalling burden for him to bear. Tahseen talked about his life with Margaret and how much he wanted her to come home; I listened to him every day. I supported him through the crisis, through the terrible day when we were sent a video that showed Margaret being murdered.
When I discovered the missing piece
In May 2005, I was posted to the US. I must have had post-traumatic stress disorder, as I remember being terrified of fireworks and at one point believing there were masked men in black who were about to mount an assault on my Dupont street apartment in Washington D.C. After a year in Bush’s State Department, I got a scholarship to Princeton to study for a Master’s degree in international relations. At a course on negotiation skills, I began to understand what was missing from my experience of foreign policy. I cared passionately about the people whose lives I was involved in, but I had not been allowed to feel for them.
A visit to India
I moved to India and started my next job, focused on India’s relationship with Pakistan and the conflict over Kashmir. Dressed in shalwar kameez and headscarf, I travelled to downtown Srinagar to talk with politicians and local activists, the light of idealism shining in their eyes. My police security detail hovered obtrusively nearby. An English teacher from the University of Kashmir invited me for dinner. She told me her husband was in prison and her eight-year-old son had become disturbed and aggressive. The policy papers I wrote for the British Government were not going to help this family.
My husband and I travelled to London in April 2011. By this time, we had a small daughter, and our lives were busy and demanding. On the daily commute to and from work, in between the morass of emails, I thought about where I was headed.
Realising what I wanted for my children
I was 38 and I wanted to be a good mother to my children, in the sense described by the psychoanalyst Winnicott – present, nurturing, providing love and security. I was not sure if I could do this while living overseas, out most evenings, schmoozing politicians and business people, “dining for Britain” as we jokingly used to call it. I wanted my children to play with their cousins and know their grandparents. I had no desire to send my children to boarding school. I did not wish to fall victim to the three “D’s” of expat life (as a former boss used to call them) – drink, debt and divorce. I wanted a life connected to family and friends. How could we manage this while moving to a different country every three years?
My old dream, not my new one
I grew up in Grimsby, a working-class girl from a proud, dysfunctional and not financially fortunate family. Going to Oxford and working for the Foreign Office had once fulfilled a dream: I could travel around the world, doing something I believed in. But now I felt trapped, no longer independent, far away from the people I’d imagined I would help. In India, I spent much of my time meeting political contacts at smart restaurants while some of the world’s poorest women and children begged for food outside.
I looked into the future and saw myself becoming a different person than the one I had intended. Although I loved advocating for climate change and fighting the good fight on human rights, the thought of selling security exports or promoting Brexit for UK Plc stuck in my throat. What happened to the idealistic young woman who’d once sat on a roof at an anti-road protest and stated emphatically on my Civil Service application “I do not wish to work for the Ministry of Defence as I am a pacifist”? I felt compromised and disillusioned. I no longer enjoyed my work: the politics and endless striving made me miserable.
How I started again
I started volunteering for a charity, Single Homeless Project, cooking a weekly meal with young men and women who had lived on the streets. I did a course on psychoanalytic theory at the Institute of Psychoanalysis. When I said I wanted to become a doctor, my tutor took me seriously – “all metamorphoses happen slowly”. I bought some A-level science books and studied biology and chemistry while my baby son napped. In the evenings, when both children were fast asleep and the washing up was done, I researched how to get into medicine. One evening, I took a deep breath and applied to university; the experience of filling in that UCAS form again, 20 years after I’d done it the first time, was excruciating.
How do you fund a brand new life?
The next problem was how to finance this endeavour – and how to bring around my long-suffering husband to this plan. He was opposed, and I didn’t blame him. He married me when I was a British diplomat and part of him looked forward to gin and tonics on the lawn as the Ambassador’s husband at some point in the future. Instead he found himself supporting our little family and doing much of the childcare, a bit like an Emperor penguin balancing two eggs on its feet, while I studied to become a doctor — a path he feared would lead us to penniless ruin.
I told my boss that I was thinking of leaving the FCO to become a doctor. He gave me a searching look.
“Sometimes it’s the things we don’t do in life that we regret the most,” he said.
I put in my application for voluntary redundancy. I looked back at the seventeen years I had spent mostly happily in the FCO and wondered if I was doing the right thing. On the day I signed the exit agreement, I stood on King Charles Street and cried.
Go to medical school in midlife
Medical school was a culture shock – the worst culture shock I had experienced since travelling to India for the first time as a teenager. The soft sell to graduate students was that we would be “respected for our previous experience” and could use this to further science and improve bedside manner. Once on the wards, this quickly fell by the wayside and the rigid, military-style hierarchy of medicine kicked in.
As a medical student, I was the lowest of the low. I knew nothing and had no skills other than getting in the way of doctors who did know what they were doing. I could not even take blood, let alone resuscitate a patient, prescribe a complex drug regime or perform surgery. So much for being able to lead international negotiations or lead an organization: I could barely keep up with a ward round.
Humiliation…and understanding
It was a humiliating and humbling experience that often reduced me to a blubbering wreck. But slowly, I realised there were things I did know. I knew how to listen. I knew how to read a situation, to find my way around an organisation, to see the patient’s perspective. I still had a brain, and I loved to study. Patients liked me; they felt I understood them. As I worked my way through a hospital ward, I found there were some advantages to being an older student. I could empathise; I had “life-experience”; I was familiar with adversity, had experienced marriage, childbirth and physical illness. I knew where patients were coming from, unlike the vast majority of medical students, straight out of school and with zero qualifications in the University of Life.
Nonetheless, medical school was a struggle. Juggling assignments and exams with childcare was brutally hard work – I stayed up late into the night and left early for the commute to south London, reading medical textbooks on the Northern Line. I continued my therapy, with a wonderful, kind and insightful psychoanalyst. My FCO golden handshake could not cover all my costs, so I worked part-time as a science tutor. It was exhausting. Back on the wards, I watched the ease with which young doctors clerked a patient, reached a differential diagnosis, stayed up all night, sat more exams, took orders and barked some of their own, and wondered if I would ever make it.
Finally becoming a doctor
Four years later, along with a crowd of now-close compatriots, I sat my Finals. In the middle of my exams, my father died, swiftly and agonizingly, from acute myeloid leukaemia. Trying to do OSCEs – medical role play exams – in the middle of a tidal wave of grief and loss was difficult. To give St George’s medical school their credit, they helped me cope. Somehow I got through it, and finally became Dr Whitford, OBE – something I know would have made my father proud. A few months later, the first coronavirus cases appeared in the UK, and I became one of the first generation of foundation doctors to start work in a global pandemic.
My new life in medicine
In my first year as a medic, I have looked after patients on high-flow oxygen, cared for intubated patients during long nights on ICU, held the hands of patients who are dying from Covid, broken the news to families. I’ve helped in operations, administered life-saving treatment, made mistakes. It’s been a rollercoaster. I’ve often been moved, sometimes overwhelmed, never bored. It’s not been easy – my social life and status have been decimated, my children say they don’t see me enough, my salary has been cut in half. But I can honestly say that becoming a doctor has been the most rewarding thing I’ve ever done, right up there with getting married and having children. When I think about the gorgeous residence in Myanmar that I’m never going to live in, I remind myself that working with MedGlobal in the Moria refugee camp on Lesbos would be a million times better. I think about what I do, and I feel happy.
– Dr Victoria Whitford OBE
