Over the course of my late-life medical degree, I coined the snazzy phrase, “First do no harm begins with self-care”.

It was a play on the Hippocratic oath, designed to empower some of the other, much younger students to look after themselves throughout a high-pressure degree. 

Despite regularly advocating for healthy personal and professional boundaries, I wrapped up that degree surprisingly unwell.

Powering on

By final year, my energy levels had declined and I’d noticed a raft of changes in my body. 

Being a mature-aged student (I was 40 at the time), I told myself I was just getting old. But as we approached graduation, that thought struck a vein of terror. If the perils of age were troubling me this much at medical school, how was I going to survive internship?

Midway through our final exams, I got home from a comedy gig I was performing at and had a funny turn (so to speak). My health deteriorated sharply after that but I powered on.

I applied for special consideration for the exams but didn’t have a diagnosis to share at that point, just the vagaries of being very unwell and a medical certificate from a local pharmacist in lieu of my fully booked GP.

In the dark as much as I was, the medical school rejected my application.

Despite this, I passed my exams but then ended up in hospital, pale and exhausted, where we finally got to the bottom of things. A benign but nasty tumour had been lurking at the base of my brain and wreaking health havoc for the preceding year or two.

It turned out that funny turn was the tumour bleeding into my skull.

Roland Bull lies back against a pillow in a hospital bed. He looks pale and unwell.

I made it through exams but wound up in hospital where they found the cause of my “funny turn” and subsequent health issues. (Supplied: Roland Bull)

“You deserve the university medal for getting through exams with all this going on,” said one of my new specialists a few weeks later.

I wore the statement like a badge of honour for months. 

I felt preternaturally resilient: if I could get through medical school in the midst of a health crisis then surely, I could do anything.

All those thoughts of being less energetic and capable than my younger peers morphed into pride at being able to handle so much more than the average person.

Nonetheless, I postponed my internship for three months to get back on my feet. 

The reprieve wasn’t all smooth sailing as I packed up my house in Canberra, moved in with family in Queensland, got settled and then braced for Cyclone Alfred. But I was itching to commence life as a junior doctor so ignored my sub-optimal recovery and launched into work in April this year.

Human after all

I lasted two shifts then totally crashed, physically and mentally.

Tail between my legs, I had to admit I was human after all. 

In fact, valuing resilience over adequate self-care had been a trap that set me back a few steps on the path to recovery.

While completing medical school that unwell was a notable achievement, it was also incredibly stupid. I’d navigated a dangerous health event in survival mode, but I couldn’t live the rest of my life that way.

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Of course, that didn’t stop me from feeling like an absolute failure for having to pause internship again so soon. 

Happily, the extra time off gave room for some quiet contemplation. I can’t help but think that, while it takes a lot of resilience to navigate a personal crisis, it takes even more to safeguard your health in a society that values testing your limits in pursuit of productivity.

Clearly, I still view self-care as indulgence, even though I bang on about it at every opportunity. But taking the time to be healthy and well before delving into something stressful is invaluable. I wish I’d done that rather than rushing into work before I was ready.

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Giving yourself permission to step back and breathe or to tread a different timeline to the people around you can prompt all kinds of apprehension, embarrassment and shame. I still feel each of those things from time to time as I carve out the necessary space to balance work and health.

I’m also still itching to progress my medical career, just as long as I’m well enough and have a plan in place to stay that way.

Being cognisant of my own wellbeing will make me a better doctor and make things safer for my patients.

Because first do no harm begins with self-care and all that.

Roland Bull is a freelance writer, comedian and doctor.

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