Dr Ali Brookes / Obstetrics and Gynaecology Registrar / London
You may remember Ali Brookes as the calm and cheerful junior doctor on Bear Grylls’ reality survival series ‘The Island’ in 2018. Now back in O&G training in London, Ali tells us about the highs and lows of island life, from jungle critters to dehydration, epic thunderstorms and intense friendships. Surviving five weeks on The Island formed the spring board to an amazing adventure-fuelled year, from to trekking the 1300km Te Araroa trail in New Zealand, to travelling around South America and Canada. In her article, Ali discusses burnout, negotiating time out of training, the joys of freedom and navigating the return to work.
Taking time out of training is always a difficult decision. When is the best time to do it? Will they approve my application? Will I be able to afford to take the time out? Will it be detrimental to my training? Will I make an arse out of myself and commit career suicide by going on reality TV?! These were all questions that I asked myself at some point during this process.
I was an Obstetrics and Gynaecology ST2 when these thoughts starting ruminating around my head. I had recently got married and, faced with the increasingly daunting prospect of ‘grown-up’ life, I had incredibly itchy feet. I felt that I desperately needed time to tick a few things off my ever-growing bucket list.
I knew it wasn’t a good time to take an Out of Programme Career break (OOPC, or ‘Oopsie’ as it’s more often known). The progression to ST3 in most specialities is a difficult one and O&G is no exception. However, I weighed up all my personal circumstances (no kids, no mortgage, patient and understanding new husband) and decided that this was the time for me.
I was also experiencing burnout, something I’m sure other junior doctors have felt too. I had lost touch with almost all my extra-curricular passions, resented going to work, felt lost in an increasingly stretched system and needed a break from it all to figure out what my priorities were. Many of my friends from medicine had relocated to Australia and New Zealand and with the quality of life over there, I didn’t blame them. Others had left medicine all together, in pursuit of alternative careers less demanding on their time and emotions and more beneficial for their bank balance. I really wanted to find a way to reinvigorate my passion for medicine and allow me to continue working in an NHS that I am incredibly proud of.
Having made the decision in February 2017, I submitted my application for an OOPC well before the deadline with the required signatures from my Educational Supervisor, Training Programme Director and Head of School. Whilst these were rather intimidating conversations to have, everyone was very understanding. They were also remarkably interested in the fairly unorthodox provisional plans I had made. ‘Send me a postcard’ were the last words from Mr Ward, the London Head of School of Obstetrics and Gynaecology, as I skipped out of the door. (I actually feel bad that I never did send one!) With approval granted and formalised in writing the next day (never before have I experienced such efficiency within the NHS), I set about planning my year. I wanted adventure, I wanted extreme and I wanted to fit in as much of it as possible within the year.
I had always been a big fan of ‘The Island with Bear Grylls’, and was sitting in the pub with some fellow O&G trainees one evening when a friend piped up “Have you seen this advert Ali? It sounds like it would be right up your street.” For those who don’t know, it’s a reality TV show where Bear Grylls puts 16 people on a desert island for five weeks with just the clothes on their backs and a few basic tools. You have to survive by finding water, catching and killing your food and building shelter until he comes back to collect you. The crew live alongside you under the same conditions and there are definitely no hidden luxuries.
Sure enough, a few beers down, I wrote my application for ‘The Island’ on the bus on my way home. Not thinking much more about it, I continued to plan the main event of my year: the Te Araroa trail. This is a 1300km hike down the length of New Zealand’s South Island which I was planning to do with a friend.
A few days later I received a phone call from the television company and had a phone interview. I was then asked to go in for a face-to-face, filmed interview. It all started to get a bit real.
I was about to go to work on my final night shift in October when I received the call. “Ali? Are you sitting down? We want you to come on The Island with Bear Grylls!”
Sworn to secrecy by the television company, I went to my night shift jittering with excitement about where I might be spending the night in a few weeks’ time. The preparations for the show then began in earnest. Medical assessments, camera training, psychological reviews, meetings with the production company, sorting out kit and filming at home and work. It was amazing to have an insight into a completely different industry. We flew out to the filming location in late October. We had a few days of survival training where we were taught how to make fire by rubbing sticks together, build shelters that might protect us from the monsoon season (they didn’t, it turns out), humanely kill crocodiles and snakes, filter and boil murky ground water to enable us to drink without getting gastroenteritis and to identify which scorpions were poisonous and which ones would just really, really hurt. We were isolated from the other Islanders so I had no concept of who I would be spending the next five weeks with.
As an Obstetrics and Gynaecology trainee, I was more than a little nervous about the potential medical emergencies that I may be presented with on the island. There were the obvious contenders: diarrhoea, dehydration, sunstroke, infected bites, machete wounds. But would there be more difficult challenges? Snake bites, shark attacks, falls from cliffs (as had happened in the previous season), rip tides… All a little different to managing the labour ward in London! And would I be able to cope trying to help others whilst surviving on the bare minimum of food and sleep myself? Little did I know that there were two other doctors (both GPs) and a nurse who were also going onto The Island. Between us we managed to keep everyone in a state of relative health for the duration.
The day we got dropped off (or should I say thrown out of a boat into the rough sea 300m from shore) was such a mixture of nerves, excitement and apprehension. I was conscious that we would only be given 24 hours’ worth of water when we arrived, so I had drunk a lot of water in the morning. When the main man Bear Grylls arrived to take us out on his speed boat I ended up having to be lowered off the back of his boat to pee…twice! Not a good start.
My time on The Island was an absolute rollercoaster. Nothing can prepare you for the intensity of the experience. We spent the first night on the jungle floor, soaking wet after our swim to land, freezing cold and being eaten to death by jungle critters. We didn’t find any food other than coconuts (which unfortunately are a personal nemesis of mine) for eight days. The water we drank was from a muddy puddle. This would refill with each deluge of rain that occurred almost nightly for the first three weeks. It was impossible to sleep for more than half an hour at a time before being woken by the next thunderclap or downpour. I had one particular moment of desperation near the end of the experience when I was curled up on the beach at night and the heavens opened again! It was pitch black, our camp had flooded, the fire was at risk of going out, we hadn’t eaten anything more than a morsel of yucca for days, and I was wondering around in the dark trying to find dry firewood in the middle of a monsoon. “What the hell am I doing?”, I thought to myself. “No one forced you to be here. You are here by choice.” But even in those darkest moments, quitting never crossed my mind. Not only would I have felt like the ultimate failure, but after all my ‘tough girl’ talk to my friends and family back home, I never would have lived it down.
Whilst there were incredibly dark moments on The Island, I also had some of the best days of my life. Living on a beach on an uninhabited island in the middle of the Pacific Ocean, where we could watch the sunset every evening in total stillness, was a true privilege. Eating crackling off a freshly killed wild boar (which evaded our capture for longer than I would like to remember) roasting over an open fire; the pure elation at finding yucca for the first time; the sweetness of fresh pineapple after a month of no sugar; the relief when the rain came when our muddy puddle got empty. I made amazing friends. Living through that kind of trauma (and it was a trauma, albeit a self-inflicted one) means you get to know people very intensely and very quickly. Without the other Islanders keeping a smile on my face it would have been miserable. We told stories around the fire, sang songs, played rounders, had a talent show and held the first ever Island wedding. And we survived for 35 long days.
The night before Bear Grylls came to collect us at the end felt like all the Christmases I had ever experienced rolled into one. I couldn’t sleep, I was so excited. I cannot put into words the pure joy at seeing his boat pull up to collect us. We had done it. We survived. Yes, I stank. Yes, my hair looked like a bird’s nest. Yes, I only weighed 43kgs. Yes, I was beyond exhausted. But we had done it. It was a truly unique, once in a lifetime, money can’t buy adventure that I am so hugely grateful and honoured that I got to be a part of.
I flew home a few weeks before Christmas and spent time fattening up again with my family. It was the first year since I qualified as a doctor that I didn’t have to work any bank holidays around Christmas and I thoroughly enjoyed it!
Then came part two of my year of adventure. My good friend Liv and I walked the length of New Zealand’s South Island from Ship Cove to Bluff: 1300kms of trail through the mountains. We were completely self-sufficient, carrying our own food, tent and clothes and did not see civilisation for weeks at a time. I somewhat underestimated the physical toll that starving on a desert island would take and found the first few hundred kilometres (!) really tough. However, we soon found our hiking legs and went on to complete the walk in 68 days. Another truly wonderful experience.
For the final few months of my year off I went travelling around South America and Canada with my incredibly patient and oft neglected husband, Oli. He had also managed to take a three-month sabbatical. I came back to the UK in September feeling incredibly lucky to have had such an exciting, jam packed year with numerous points crossed off my (ever-growing) bucket list.
As October loomed and the end of my year drew to a close, I was very anxious about returning to work. Would I remember how to do a caesarean section? Could I still interpret a CTG? Would I remember my ePortfolio password?! Thankfully, doing a caesarean really is like riding a bike. I have been incredibly well supported during my return back to work and have had no negative feedback from consultants or junior colleagues for taking time out. Quite the opposite in fact.
Taking a career break is a big decision and there is a lot to consider when making that choice. But, in my opinion, it is a wonderful opportunity to see the world, do that challenge you have always wanted to do, go on reality TV if you so wish, and have your job waiting for you at the end of it. I was lucky enough to have a year filled with excitement, starvation, elation, desperation and great adventure. As a result, I feel much readier to come back into training and settle down to that ‘grown-up’ life people keep talking about.
Contact / You can follow Ali on Instagram @ali_wandering