Reflections Before Takeoff: Starting My First Overseas Job in the UK
The day had arrived when I was about to leave the safe bounds of the Bagayam campus of the psychiatry department of CMC Vellore, where I trained as a psychiatrist. I lived in the junior doctor quarter closest to the department. I preferred to walk from home to the department while on call. Cycling in the middle of the night was a thrilling experience but also had its downsides. You might find yourself pushing your bike with flat tyres after it rolled over a thorny bush. A short distance meant you had less distance to walk with your bike.
Amongst several things I have learned in the past few years, one of the most important lessons was to ‘have a good enough rapport with the patient’ before you delve into the clinical details. Building trust is essential in fostering open communication, allowing the patient to express his or her feelings without fear of judgment. However, doing this effectively is easier if the doctor can relate to the context of the patient. This was initially difficult as I grew up in Kolkata (then referred to as Calcutta) in eastern India. I relocated more than 1700 km to complete my postgraduate training in psychiatry at Vellore in Southern India. It took me more than a year to learn the local Tamil language and understand the finer nuances of the locally used idioms of emotional distress. By the time I became reasonably confident about the language, the time had come for me to leave for another country even farther away.
As I was to start my first medical job in Scotland in a couple of weeks, a specific thought dawned on me while I sat in my aisle seat on a British Airways flight to London. How would my last patient feel if they had a doctor from Scotland interview them in rural Tamil Nadu? This doctor would not know that Pongal was a festival next month; the same word can also refer to a rice dish you had for breakfast. He will not know about the rituals of ‘aadi masam’ in Tamil Nadu. But more importantly, he will not know how to say ‘vannakam’ when he starts the interview or thank the patient by saying ‘nandri’ after concluding the interview. All this mattered greatly if you wanted the patient to follow your instructions and come to you for a review in a few weeks. What if the doctor was Scottish and did not have the opportunity to learn all this? While thinking all this, I dozed off to sleep.
On arriving in Scotland on 31st December, expecting to join for work on 1st or 2nd Jan, I first realised that most of the offices, including the hospital’s human resources department, remained closed pretty much till 5th of Jan of any new year. The cold winter winds and the snow told me every moment that this was far away from home. I did not feel homesick. I was too excited to start a new life in a new country with only one doubt: “How will I establish rapport with the patient?” The first few days of my job were spent on completing induction training. Then I realised that patients in the United Kingdom were very familiar with the idea of being looked after by doctors from the Indian subcontinent. They even said that they loved Indian food. Patients sought someone who would listen and genuinely care. Over time, my patients in Scotland taught me many important lessons that have stayed with me till today.