13 December 2023

Working over the holidays | joy, privilege, guilt, challenge

As we approach the final days of 2023, the weather is bleak, wet and cold. I’m feeling reflective about a busy 12 months: this was the year that many doctors finally spoke out – or perhaps more accurately, people finally took notice – about the bullying and misogyny faced by too many in medicine. There is a lot of work to do, and while words alone don’t mean action, it does feel like the beginning of something. Thank you to everyone who has shared their experience.

This was also the year that a Clean Air Bill was passed in Wales – the Environment (Air Quality and Soundscapes) (Wales) Bill – and the UK government set out plans to introduce legislation to prohibit children born on or after 1 January 2009 from legally buying cigarettes.

I have been in post as vice president for almost six months now. I am determined that the RCP in Wales really values and listens to all physicians. But of course, the college voice is only as strong as its members, so please propose your colleagues to become fellows in 2024, particularly newer consultants and specialty and associate specialist (SAS) doctors.

The most wonderful time of year

Who doesn’t open the Christmas and New Year rota with trepidation? Whichever way it falls, someone has to cover the festive period and those in-between days when the rest of the world seems to be lying on the sofa. There is no doubt that working while others celebrate is tough, but it’s also a feat of endurance to navigate a never-ending post-holidays ward round, and I find talking to people about tricky scan results even harder knowing that it should be a happy family time.

I am privileged to come from a line of female doctors. My 90-year-old aunt tells me that she was required to work over Christmas as soon as she reached the clinical stage of medical school. The professor of medicine carved the turkey and medical students were expected to help serve the food – clearly there was no option if you wanted to graduate!

My ideal New Year’s Eve would be spent on top of a mountain, but as a new doctor in Edinburgh, I worked as a senior house officer in the ‘Old Royal’, and as the newbie, I ended up on-call for CCU on my first Hogmanay. Happily, however, it turned out that the hospital roof was a prime position for the traditional firework display at the castle (with a rapid exit planned back through the window if the arrest bleep went off).

Christmas on-call

What about balancing our commitment to our patients with our desire to spend time with our families? I discussed this with some of my colleagues. Dr Sam Rice, regional adviser for south-west Wales was on call five years in a row when his children were very small. His teenage boys still ask every year whether he is going to be home. Sam used to start his ward round at 4:30am on Christmas morning to try and get home in time to open presents (but only succeeded twice). 

One trainee described the guilt of missing family celebrations balanced with the recognition that patients admitted at Christmas are often very sick. It’s hard not to feel a pang of regret about your life choices when all of your friends are out partying and you’re just happy that the vending machine is working at 2am!

And what about the other side of the coin? The paramedics, GPs, nurses, care workers and emergency responders who also care for our loved ones over the holidays – I am so grateful to these teams for everything they do for us. We are all in this profession because we care; we want to support and guide our teams through the privilege and challenge of working during the festivities. I know at Velindre Cancer Centre many of our international colleagues have offered to cover Christmas over the years – and whether or not you celebrate Christmas traditions, whether your family is around the corner or scattered all over the world – I really hope you can find some time to relax, time to reflect on your challenges, successes and experiences, and time to appreciate the commitment we have all made to support our patients and our colleagues this past year.  

So whether you’re working or not this festive season, stay safe, and have a very merry Christmas! (And I’m really hoping that nobody has their Christmas lunch from a vending machine!)

Dr Hilary Williams
RCP vice president for Wales
Consultant medical oncologist