By Dr Jacques Conradie — Neurosurgeon
A cold evening. Hospital corridors stretch out ahead of me as I move from one ward to the next, finishing rounds and checking that patients are settled for the night. Before pushing through the next set of doors, I glance at my phone. The family WhatsApp group is alive with photographs: a long weekend, everyone together, making food and laughing. For a moment, I feel an ache I rarely allow myself to acknowledge. I am caught between the privilege of the work in front of me and the simple wish to be home.
No one hands you a syllabus for the hardest part of becoming a doctor. We are taught anatomy, physiology and pharmacology. We learn procedures, protocols and clinical decision-making. What we are rarely taught is how to carry the emotional weight that comes with it all: the long shifts, missed family gatherings, difficult decisions and patients whose stories stay with us long after we leave the hospital.
Early in my training, I believed exhaustion was a badge of honour. Many of us did. Medicine has long operated on an unwritten curriculum: that endurance equals competence, that asking for help signals weakness, and that good doctors simply cope. Yet the reality is that South African doctors work in an environment of immense pressure. Staff shortages, resource constraints and overwhelming patient loads place extraordinary demands on healthcare workers, particularly those early in their careers.
The consequences are becoming increasingly difficult to ignore. Research from South Africa has shown high rates of burnout, depression and psychological distress among junior doctors. These are the very professionals we rely on to keep our hospitals functioning, often working long hours under challenging circumstances. Acknowledging this reality is not a sign of weakness. It is the first step towards change.
Encouragingly, the profession is beginning to respond. In 2020, the South African Medical Association, together with psychiatric and psychological professional bodies and the South African Depression and Anxiety Group, established the Healthcare Workers Care Network. Through a confidential 24-hour service, healthcare professionals can access counselling and emotional support when they need it.
Support like this simply did not exist for many of us when we started training. But formal support systems are only part of the solution. The culture of medicine must continue to evolve. We need to normalise conversations about mental health, encourage help-seeking behaviour and recognise that wellbeing is not separate from professional performance.
The fundamentals matter. Sleep matters. Exercise matters. Time with family and friends matters. Therapy matters. Checking in on a colleague who seems withdrawn matters. Most importantly, senior doctors must model these behaviours openly. Junior clinicians learn far more from what we do than from what we say.
Looking after ourselves does not make us less resilient. It makes us better doctors. A clinician who is rested, supported and psychologically well is safer, more compassionate and better equipped to care for patients. The most reassuring lesson I have learned is this: the profession that taught us to care for everyone else is finally beginning to care for its own.
If this article achieves one thing, let it be permission: permission to seek help when you need it, permission to prioritise your wellbeing, and permission to care for yourself with the same commitment you bring to your patients every day.