Dr Charlotte O’Kane has led a quite remarkable life, overcoming huge obstacles to achieve her life dream of becoming a doctor. In this interview she talks about how she managed to do this with CF, as well as how exercise and fitness help to maximise her health.
Martin) You have CF and you went to a school where no one before (or since) had gone on to medical school. Hardly a typical background for an aspiring doctor! With so many factors going against you, what made you think you could qualify from med school and were your family supportive or apprehensive about you taking on such a big challenge?
Charlotte) I think anyone with CF knows how much time you spend in hospital as a child and being around medicine so much really inspired me to first start thinking about medicine as a career at an early age. I really liked the thought of helping people as much as I had been helped.
I surprised everyone by passing my 11-Plus, but when the local grammar school wouldn’t let me in because they said I would “be too sick and pull their grades down” my local school took me in and really nurtured me. I did go through a teenage phase of thinking about other careers but, for me, the love of medicine and biology, the flexibility in career paths and the sense of achievement I would gain from this career really swung it for me. I think a contributing factor was the amount of people telling me I couldn’t do it, which spurred me on to prove them wrong!
I was lucky during my A levels and degree that I kept fairly well. I am a realist and stayed at home during university to get as much support as I could, although I’m not saying I didn’t enjoy the occasional (!) night out. My parents were both very supportive of my decision and are still very proud of me. My school were always so supportive of me and even invite me back to speak to the students every year.
M) Once you were in medical school, how did you manage to fit in the long hours of studying with your healthcare commitments? Did you manage to fit in any of the socialising that students – especially medical students! – are famous for?
C) I have really been studying non-stop since the age of 16 when I committed to trying to get into medical school and it really doesn’t stop once you get there. Studying through medicine, competing to get your top spot for a job as a junior doctor and then recently studying for GP training examinations – I’m a dab hand at revision and trying to have a life as well. It isn’t easy and by no means am I the best at it.
I always tried to make the relevant people know about my CF (tutors, occupational health, equality advisors) and they really are a great resource. I was able to get a grant from my university to help me with software and other equipment to make studying easier and luckily all my lectures were online if I couldn’t make it in. I always made a revision timetable (I’m a bit of a perfectionist) and scheduled in breaks. I also found surrounding myself with a constant supply of snacks helped as well!
As I mentioned, I did stay at home as I was in a London university so I didn’t party as much as some others, but I did have my fair share of groggy hungover mornings curled up in the corner of a lecture hall…those were the days!
M) The hard work doesn’t stop when you’re out of med school, if anything the hours get even longer when you begin work as a junior doctor. How have you managed to balance your own healthcare with the demanding workload?
C) I’ll admit now that I am not very good at putting my own health first and I had a period of neglecting myself quite a lot, ending up in hospital with MRSA in my first year of work and feeling pretty rubbish. It has taken me a while to listen to what my body is telling me and give myself time. I do however find it incredibly hard to call in sick as I always feel so guilty!
I went part time from my second year of work, after some prompting from my CF team and family. I currently work 80% with gives me some breathing space and time to catch up on things. This is still quite a busy rota even at 80% and I’ve been able to negotiate with occupational health to be exempt from night shifts, as I find it impossible to fit everything in when working nights. I have the option of dropping down to 60% if I need to but I’m trying to complete my training as soon as possible so that I have more control of work life when I’m fully qualified as a GP.
I try to prepare as much as I can in advance (like making up a month’s worth of morning medication at a time) and my partner is really great at trying to get my nebulisers washed for me so that I can fit those in too. I also have endless to do lists to make sure I put in my prescriptions, get port flushes and put in notice to work early for appointments. It can get exhausting!
M) Many people with CF are discouraged from pursuing a medical career due to the increased chance of picking up an infection from the sick people you are surrounded by. Does this ever concern you and if so, how do you try to minimize the risk?
C) I would say the older I get, the more I worry about this as there definitely is more of a risk in a hospital setting. This is one of the main reasons I have decided to go into general practice as it is easier to screen the patients that you see. However, you will always come across someone that you are not sure whether you should come into contact with.
Firstly, as I mentioned before, I try to let supervisors and consultants know about my background. If I hear the words “Pseudomonas”, “Bronchiectasis”, “face mask” or “MRSA” I speak up and just ask if I can stay outside. I also avoided the oncology paediatric patients on my paediatric rotation – it helped that the consultant in charge used to be my paediatrician and was always looking out for me!
It has never been a problem and in fact most of the time, my consultants will say to me “Don’t worry about seeing this one Charlotte – I don’t want you getting ill”. I was working in Kings before and was concerned about having to see CF patients on my on calls (at night you are the only on call doctor for the wards). The CF team were great at letting me know if there were any outliers I should avoid and the hospital at night team saw all the patients that I couldn’t see. It sounds like it has been easy but it is difficult, and in an emergency or if I haven’t been given all the past medical history I’m sure that I’ve seen patients that I would have normally tried to avoid. I guess for me that is a risk that I have to try and manage as well as I can.
M) What advice would you give to the support network (friends/family/colleagues) of someone with CF who is training to be or working as a doctor? What can they do to help?
C) I would try and make sure that this is definitely the career that they want to go into. I couldn’t imagine doing anything else but there have been times that I question whether I made the right decision (usually when I’m running to a crash call at 3am feeling exhausted or working long hours when my friends are enjoying themselves). But if they have made up their mind then I would say just be there for them. They will rant at you!
But if you can be there with a sandwich after a long on call or make them a lunch when they don’t think they will get a break – that would make the world of difference. I would also encourage them to take advantage of flexible training as it really helps, you can change the level of training you do and isn’t looked down upon by colleagues in the slightest.
M) On to your running – you completed a half marathon in 2010 and are now training for a Tough Mudder run this September to raise money for CF. Was being active something instilled in you as a child or was it something you got into later in life?
C) I was always really active at school and loved PE. I used to run cross country, be part of the athletics team, mainly running the 800 metres, and took up dance as a GCSE. It’s just something I enjoyed. My mum was always ferrying me about from one event to the next and my school always seemed to come up with another team I could join. It was non-stop at one point.
When I started studying hard, exercise kind of went on the backburner unfortunately and I just didn’t have the time to exercise. My lung function started to get worse so I decided to set myself a goal to complete a half marathon with the aim of raising money for the CF unit at Kings, whilst also improving my health at the same time. I think being so active when I was younger made this easier and I set myself goals for each week of how much I could run and built this up gradually. I think my sister (who doesn’t have CF) and I raised about £2000 and I managed to get round in a respectable 2 and half hours. I recently got the same antsy feeling and in a moment of madness signed up to Tough Mudder. Again I want to improve my fitness and lung function through training and gradually building up my tolerance and I also really want the t shirt at the end to walk around the gym in!
M) What training do you do to maintain your fitness and get into shape to run a half marathon or Tough Mudder?
C) When I was training for the half marathon, I would mainly go out pounding the streets trying to build up time. I will start doing that soon for Tough Mudder – I like setting myself small goals as I’m running such as making it to the next tree before stopping. I don’t really enjoy treadmills but do go to the gym.
I’m lucky that my boyfriend is a personal trainer and has completely changed my work out. I now do a lot more weight training and so focus a lot more on building muscle in my back, arms and legs. Again I’ve started off with small weights and built up as I’ve got a bit stronger. I try and keep the tempo up as I do this so it gets the heart and lungs pumping at the same time. I find this useful if I’m unwell as can scale it back to how much I can manage (decreasing cycles/ reps or just going for a slow walk on treadmill). Since I’ve been doing this, I’ve not had any admissions into hospital whereas before I’d have felt down every few months and end up admitted. I try and go 2-3 times a week but I don’t always have the time to go so I’ve just purchased a fitbit and try and hit 10,000 steps a day. It’s really great and you can keep a track of your heart rate too.
M) Does diet play an important role in keeping you healthy? What types of food do you try to eat and what do you try to avoid? And how do you balance eating healthy with the need for calories?
C) I don’t really try to avoid anything as I really have to make a conscious effort to maintain my weight which means nothing is off limits although the majority of my meals will contain a lot of vegetables and protein. I will eat calorie dense snacks that I enjoy in order to maintain my weight.
I have an unhealthy addiction to Fresubins too!
M) Finally, do you have any other tips for people with CF looking to fulfill their goals?
C) I would say, above everything, do not believe someone telling you that you cannot do something if you want it. It may be harder and you may have to take a different path to get to your end goal, but it will make it so much more worthwhile. I would say set small goals, reaching that next tree, getting a good grade on that next paper or making it to the end of a long stretch of on call. I would also say, look after your health – nothing is more important. I have learnt that the wrong way and if I could go back, I would have been more mindful of this. Apart from this, enjoy yourself as much as you can and as much as your CF allows. Go on holidays, see your friends, enjoy your family and loved ones – these are the times that you will treasure and make the rest of it so worthwhile.
A huge thank you to Charlotte for taking the time to share her wisdom!
*ALWAYS ENSURE YOU SPEAK WITH YOUR MEDICAL TEAM BEFORE MAKING ANY HEALTH RELATED CHANGES TO YOUR LIFESTYLE*