Aesop was a Greek who lived around 600 BC. He liked to tell stories that often involved anthropomorphised animals such as the tortoise and the hare, or the fox and the grapes. The stories were often used to educate children in moral principles. I make no such claim for this version. Neither Aesop, nor Hans Christian Anderson is thought to have authored the tale of The Three Little Pigs, which has been in print since 1840 and has been shown both in cartoon and as part of a blockbusting film franchise ('Shrek').
Once upon a time there were three little pigs. They came from a good sty and had a caring and well-off Mum and Dad who made sure they had a good education. They worked hard and came out clutching nothing but A*s. They all thought medicine was a good choice of career.
The first little pig wanted to know everything about one topic. He decided to work in a hospital, where he could provide life-saving care for the people who really needed it. He worked well in a team and thrived in an adrenaline-fuelled environment.
The second little pig had always considered the bigger picture. He wanted to make decisions that would affect the health of thousands of people. He strongly believed that given the right education and living conditions, people could take responsibility for their own health - with benevolent oversight and management in crises. He went into public health.
The third little pig really liked people. He really wanted to get to know the people he looked after and become part of their lives. See their families grow and have families of their own. He was good at dealing with uncertainty and so, he became a GP. They all went out into the world to make their way.
The first little pig worked very hard; his patients did very well and appreciated his care. At the end of 10 years, he was exhausted but was fairly confident he had done a good job.
The second little pig thought hard about how best to improve the health of the population he was responsible for. He collected lots of data and used it effectively. At the end of 10 years, he was exhausted but was fairly confident he had done a good job.
The third little pig put his patients first, was an effective gatekeeper to secondary care and listened when his patients needed to talk. At the end of 10 years, he was exhausted but was fairly confident he had done a good job.
Along came a big, bad wolf. (The wolf was probably misunderstood rather than truly bad and really only wanted to make things better, but unfortunately he had a habit of upsetting people.) First he visited the hospital. He found the patients had long waits to be seen and didn't get better as quickly as those from the hospital in the next town. The wolf brought in a special team to help the hospital improve their performance. The first little pig blamed himself for the hospital's failings, left his job and went to see the second little pig.
The second little pig gave scant comfort. Unfortunately the wolf had already visited his department. Having decided that he should no longer be part of the healthcare system, the little pig now depended on the agreement of local government for his projects. He had lost funding to collect his data and no longer felt he could make a positive impact on the local population's health. He blamed himself for not making a stronger case for the importance of his work, apologised to his colleagues and left.
They both went to talk things through with the third little pig. He was still exhausted - his working day started at 7.30 am and finished at 8 pm (if there were no meetings to attend and he was up-to-date with his admin) - and he had just been told he would also need to work nights and weekends. He wasn't sure where the extra energy would come from - he was getting older too.
After a long chat over no more than three standard measures of alcohol, they bought three one-way tickets to New Zealand. They never came back.
And what of the wolf? Well, he (probably) had a successful career and retired on a good pension, certain in the knowledge that he had done a good job.
You may believe this tale does have a moral - but medicine is still widely thought to be a good career choice, safe alcohol limits are unlikely to change and we can't all move to the other side of the world.
Not all of us have the confidence to be sure we're doing a good job, like the wolf, but we keep trying. As you gaze on your personal 2014 mountain to climb, just remember the people you care for. We do not find out how they fared at the end of this story, but we can all make a difference to them, if only on a small scale. To assist you in your work, here are our latest content updates.
Happy New Year!