By Theresa Rézeau

Dedicated to my brother, Doctor Camille Tchuinkam Sipze, whose strength and resilience I witnessed as he pursued his Master of Public Health during the COVID-19 pandemic. And to all healthcare professionals who continue to care for others while carrying burdens of their own.

There is something profoundly unsettling about placing your life in another person’s hands. We do it every day, often without considering what we are asking of them. We enter a hospital with pain, fear or uncertainty, and expect the person wearing a white coat to understand what is happening inside a body they have never inhabited.

We expect knowledge, competence and reassurance. Above all, we expect answers.

But what happens when the doctor has none?

In 1891, the British painter Sir Samuel Luke Fildes (1843-1927) presented The Doctor, a remarkable painting of a physician attending to a gravely ill child. There is no operating theatre, no sophisticated machinery and no display of medical achievement. Instead, we find ourselves inside a modest family home, where a child’s life hangs in the balance.

The child lies on a makeshift bed, formed from two chairs pushed together. Beside the bed sits the physician, leaning forward, his chin resting upon his hand. His attention is fixed upon the little patient. In the shadows behind him, the child’s mother has lowered her head in distress, while the father places a hand upon her shoulder. His eyes remain directed towards the doctor.

Three adults are gathered around one small life, yet each occupies a different emotional world.

The mother is overwhelmed. The father attempts to remain composed. The doctor is expected to do both, while assuming responsibility for the child.

Fildes gives us no indication of what the physician is thinking. His face is serious, his posture attentive. We cannot know whether he is hopeful or afraid. What we do know is that he has remained beside the child.

A lamp illuminates the physician’s face while the first light of dawn enters through the window. He has spent the night watching over his patient. Fildes associated the rising sun with the beginning of the child’s recovery. We are permitted to see that promise in the light, even as the physician’s attention remains fixed upon the child before him.

The painting has long been celebrated as an image of medical devotion, but we are drawn to another question.

Who is looking after the doctor?

The origins of this painting make that question particularly poignant. Years before he painted it, Fildes and his wife lost their young son Philip in 1877. The devotion shown by the physician who attended their child, Dr Gustavus Murray, made a lasting impression upon the family. That experience of personal loss and professional compassion has long been associated with the painting’s conception.

Fildes understood the position of the parent. He had lived through the anguish of watching a child die. Yet he chose to place the physician at the visual centre of his composition.

The painting recognises something that medical progress has never entirely removed: the limits of what one human being can do for another.

Modern medicine has accomplished things that would have seemed miraculous in Fildes’s lifetime. Diseases once considered fatal can now be treated. Surgical procedures can restore function, replace failing organs and extend life. Diagnostic technology allows physicians to examine structures that earlier generations could scarcely understand.

Nevertheless, medicine remains a profession practised by human beings upon other human beings. And neither is immune to suffering.

Consider the doctor who has just informed a family that their loved one will not survive. Months of treatment, difficult conversations and cautious hope may have preceded that moment. The physician must find words that are accurate without being cruel, compassionate without offering false reassurance.

The family may never forget that conversation.

Neither, necessarily, will the doctor.

Within minutes, the same physician may be expected to attend another patient, answer another question or make another decision. The suffering witnessed in one room cannot be allowed to diminish the quality of care offered in the next.

There is something admirable about such discipline. There is also something troubling about a system that can begin to mistake composure for the absence of feeling.

We speak frequently about the emotional strength required to practise medicine. Yet strength is often understood as the capacity to endure without complaint.

A doctor who cries may be considered overwhelmed. One who remains detached may be accused of lacking compassion. One who admits uncertainty risks disappointing a patient who has arrived expecting certainty.

We have created an almost impossible standard: to possess exceptional knowledge without arrogance, authority without intimidation, compassion without emotional exhaustion, and confidence without pretending to know what cannot be known.

Of course, doctors must be held accountable. Their decisions can have irreversible consequences. A medical mistake may alter an entire family’s future. The trust invested in physicians must be matched by competence, honesty and responsibility.

But accountability and compassion are not opposing principles. Recognising the humanity of a doctor does not diminish the suffering of a patient, nor does it excuse negligence.

The question is whether we can demand professional excellence without demanding emotional invulnerability.

A doctor may devote years to acquiring the knowledge necessary to preserve life, only to spend much of a career confronting the reality that life cannot always be preserved.

For families, the death of a loved one may divide life into before and after. For physicians, death may become a recurring part of professional life. Some losses will be anticipated; others will arrive despite every reasonable effort to prevent them.

The doctor must remember the medical details, review decisions where necessary, and continue practising. But human memory does not necessarily organise grief according to professional schedules.

A patient’s face may remain long after the name has disappeared from a hospital list. A physician may privately revisit a conversation, wondering whether something different could have been said or done.

Not every doctor carries these experiences in the same way. Many find profound satisfaction in their work and develop effective emotional boundaries. Others struggle with the accumulation of difficult decisions and painful outcomes.

Yet the expectation that physicians will continually absorb the suffering of others without adequate support deserves serious examination.

Then came COVID-19.

In 2020, the world confronted a disease that tested medical knowledge, overwhelmed hospitals and exposed the vulnerability of those we had long regarded as our protectors.

Doctors entered hospital wards knowing that the patients they were treating might carry a virus that could threaten their own lives. Some worked exhausting hours and watched patients deteriorate despite their efforts. Others isolated themselves from their families, fearful of carrying the infection home.

And some never returned home.

The World Health Organization estimated in 2021 that approximately 115,500 health and care workers worldwide may have died from COVID-19 between January 2020 and May 2021, its central estimate within a substantial range of uncertainty.

Among them were physicians whose lives had already been devoted to saving others.

In Brooklyn, New York, Dr James Mahoney had spent nearly forty years practising medicine. At 62, he was preparing for retirement when the pandemic struck. Instead, he postponed it, continuing to treat patients in hospitals serving some of New York’s most vulnerable communities.

On 27 April 2020, he died from COVID-19.

After nearly four decades of caring for others, he had earned the opportunity to rest. He chose to remain.

Across the Atlantic, Dr Amged El-Hawrani, a British consultant surgeon, died from COVID-19 on 28 March 2020, aged 55. His wife, Pamela, later recalled that pandemic restrictions prevented the family from being beside him during his final illness. They were also denied the funeral they would ordinarily have held.

A man who had spent his professional life caring for patients was now beyond the reach of his own family’s comforting presence.

There is a painful connection between these lives and Fildes’s painting.

The mother’s bowed head embodies the helplessness of a family confronted by serious illness. The father can offer comfort, but neither parent possesses the knowledge that might save the child. Their hope rests upon the physician beside the bed.

During the pandemic, doctors’ own families occupied that same position. The person they had watched leave home to care for others was now lying in a hospital bed, while they waited for news from another doctor.

We honour the dedication of those who continued working through those frightening months. But admiration must never become a convenient substitute for responsibility. Their courage does not absolve healthcare institutions and governments of the obligation to provide adequate protective equipment, safe working conditions and support.

Nor should every death be reduced to a story of heroic sacrifice. These were people whose lives extended far beyond medicine. They were parents, spouses, children, friends and neighbours. They had families who needed them and futures they had every reason to expect.

The pandemic also placed an extraordinary psychological burden upon those who survived. Doctors witnessed the deaths of colleagues, continued working while grieving patients and relatives, and sometimes developed lasting health problems of their own.

We applauded healthcare workers. We called them heroes. We thanked them for their service.

But those who died could not hear the applause.

Their families were left to live with the absence.

And those who survived were expected, eventually, to return to the ordinary business of saving lives.

Yet the difficulties facing doctors did not begin with COVID-19, nor did they end when the emergency measures were lifted.

Within Britain’s National Health Service, physicians continue to confront demanding workloads, staffing pressures, difficult working conditions and disputes over pay.

Medicine requires years of education, demanding examinations, continuing professional development and decisions that can carry consequences for the rest of a patient’s life. Yet financial reward does not always reflect the responsibility, particularly during the earlier stages of a medical career.

In July 2025, the Nuffield Trust estimated that average real-terms earnings for resident doctors in England in 2025/26 would remain between 4 and 10 per cent below their 2010/11 levels, despite substantial improvements since 2023/24. A further 3.5 per cent pay award took effect in April 2026. The figures depend partly upon the inflation measure and starting year chosen, both points of contention in the debate over fair pay.

But remuneration cannot be understood through salary figures alone. They reveal little about the demands of medical training, the hours devoted to professional development, or the personal sacrifices accompanying an unpredictable working life.

Doctors also have responsibilities beyond medicine. They raise families, pay bills, support relatives and encounter personal difficulties that do not disappear when they enter a hospital.

We rarely imagine the physician in Fildes’s painting beyond the boundaries of the room. His chair, the lamp and the sick child seem to define his entire existence. Yet the artist has captured only one night in the life of a man whose own needs, relationships and responsibilities remain invisible.

The painting celebrates his devotion without telling us what that devotion costs.

The same tension persists in modern medicine.

Some doctors continue to offer extraordinary empathy despite circumstances that leave them physically and emotionally depleted. An exhausted physician may sit beside a frightened patient and explain a diagnosis with patience. Another may remain after the official end of a shift because a family needs to understand what happens next.

Such moments rarely receive public recognition, but they can shape how patients remember their experience of care.

Their compassion should be valued. It should not be exploited.

There is something deeply contradictory about praising the selflessness of doctors while treating their requests for reasonable pay, manageable hours and adequate resources as though they undermine the moral character of their profession.

Medicine may be a vocation, but it is also work. A sense of calling does not eliminate the need to pay rent, raise children, maintain a household or prepare for the future.

Nor should financial hardship be regarded as proof of professional virtue.

When doctors ask to be properly remunerated, they are not necessarily placing money above patients. They may be asking for the conditions that allow them to continue serving those patients without sacrificing their own stability.

The consequences of sustained pressure extend beyond personal exhaustion.

In a survey conducted in 2025 and published in August 2026, the General Medical Council found that one in five UK doctors was at high risk of burnout. The same survey found that 41 per cent experienced difficulty providing patients with sufficient care at least once a week.

The GMC’s report Workplace Experiences 2026 also documented experiences of moral injury among doctors who felt unable to provide patients with the standard of care they believed necessary.

Consider a physician who knows that a patient requires more time or attention, but whose workload and available resources will not permit it.

Medical knowledge identifies what ought to be done. The circumstances of practice prevent it.

The doctor is left carrying the moral weight of decisions shaped partly by conditions beyond individual control.

Fildes’s painting offers a visual parallel, though it belongs to another period of medical practice. His physician is a Victorian doctor attending a patient in the family’s home, not a modern hospital practitioner. Yet the solitary vigil invites us to consider the loneliness of professional responsibility.

There is no colleague visible beside him. The child’s parents depend upon his judgement, and the viewer’s attention is drawn towards one man confronted with another person’s vulnerability.

Modern medicine depends upon teams, equipment, institutions and systems of care. Yet even within those structures, responsibility can feel intensely personal to the doctor standing in front of the patient.

The answer cannot simply be to demand greater resilience. Resilience may help individuals navigate adversity, but it cannot manufacture hospital beds, recruit missing colleagues or resolve prolonged understaffing.

If we value compassionate medicine, we must concern ourselves with the conditions under which compassion is expected to flourish.

Doctors need colleagues who can recognise distress, institutions that make room for honest discussion, appropriate workloads, fair remuneration and professional cultures in which seeking help is not regarded as weakness.

Patients also have a part to play. We can acknowledge that a doctor may be highly competent without being omniscient. We can ask difficult questions, seek second opinions and expect explanations without assuming that every disappointing outcome is evidence of indifference.

None of this requires us to abandon scrutiny. A profession that acknowledges human limitations may be better equipped to recognise mistakes, learn from them and protect the people it serves.

Who heals the healer? The answer cannot rest upon the doctor’s endurance alone. It must also lie with the colleagues, institutions and wider society that recognise a physician’s right to care, protection and dignity.

We return to Fildes’s painting.

The lamp still burns on the table. Beyond the window, daylight has begun to enter the room. The mother remains bowed in anguish, while the father watches the physician for some indication of what is to come.

At the centre of the composition sits the doctor, his eyes fixed upon the child.

His hands are not touching the patient. He is not administering treatment or performing a procedure. He is watching.

For all his training and authority, he cannot command the child to recover. His knowledge has brought him to the bedside, but it cannot guarantee the outcome.

The dawn promises recovery, yet it does not lessen the physician’s vigil. He has remained through the darkness, attending to a life whose recovery he could not simply will into being. The approaching light belongs to the artist’s vision of hope; the doctor’s devotion belongs to the long hours that preceded it.

That is one of the most difficult truths of medicine. Its practitioners are entrusted with lives they cannot always preserve, expected to offer certainty where uncertainty remains, and frequently judged by outcomes that may lie beyond their control.

We remember the doctors who succeed in extraordinary circumstances. We honour medical breakthroughs, pioneering surgeons and those who dedicate their lives to treating diseases once thought incurable.

But medicine is also sustained by less celebrated acts of care: the physician who patiently explains a difficult diagnosis, the doctor who offers compassion despite exhaustion, and the colleague who recognises when another member of the medical team is struggling.

It is sustained by people whose own lives continue beyond the hospital, with responsibilities, disappointments, relationships and vulnerabilities that do not disappear when they put on a white coat.

The doctor who returns home after losing a patient must still face the ordinary demands of living. The physician who worries about financial security must still make sound clinical decisions. Those who survived the pandemic may continue carrying memories of colleagues who did not.

In our desire to be healed, we sometimes forget that the healer is also human.

Fildes painted a physician watching over a child at the turning point of a grave illness. More than a century later, medical science has transformed the possibilities of treatment, but the fundamental encounter remains: one vulnerable human being seeking help from another.

We see the child lying helplessly across the chairs. We see the parents waiting through the night. We understand why they need the doctor.

What the painting cannot show us is the life awaiting him beyond that room, the burdens he may already be carrying, or the suffering he must sometimes conceal to attend to someone else’s.

Morning has arrived. The lamp is still burning.

And still, he stays.