In mid-November, thousands of junior doctors in Britain will again step away from their posts. Not for comfort. Not for gain. For something harder to name.
They have been praised as heroes and treated as expendable, thanked in speeches while their pay erodes and their patience thins. I heard one young doctor say she still loves medicine, but cannot serve a system that sees her as replaceable. She stayed through staff shortages, night shifts that blurred into day, and holidays spent under fluorescent light. But what broke her wasn’t fatigue. It was the knowledge that her loyalty had become a resource to be mined.
That realization, that compassion can be twisted into compliance, is what most medical strikes are really about.
Duty and defiance
Doctors are trained to stay.
They are trained to keep going.
And place the patient first.
But if that instinct to serve becomes the thing that keeps harm alive, obedience turns dangerous. The line between care and complicity is dangerously thin.
Withdrawing is not betrayal. It is fidelity of a different kind. The courage to say no, not to medicine itself, but to the bargain that distorts it. To walk away for a moment so that healing might one day mean what it once did.
That is why this strike matters. It is not a refusal to care. It is a refusal to pretend.
The cost of staying
Every doctor knows the pull of conscience: the feeling that you cannot leave until the last note is signed, the last patient seen. You tell yourself that one more shift will help, that the system will fail without you. But that is the lie that holds everything together.
In Britain, the health service runs on guilt. On the moral elasticity of those who cannot say no. Governments depend on it. The public expects it. And those inside the machine keep supplying it, until they begin to break.
A strike reveals what routine conceals. It shows how fragile “normal” really is. Waiting lists that stretch for months. Trainees who cannot find posts. Senior doctors who no longer believe their work has meaning.
The absence makes visible what the presence has been hiding all along.
The impact of absence
When doctors withdraw, the silence that follows is not empty. It speaks. It says: This is what happens when we are gone.
For patients, it brings fear. For officials, embarrassment. For the doctors themselves, guilt and grief in equal measure.
Each missed appointment leaves a mark. Yet returning to work unchanged leaves another. The moral burden doubles. It is not a calculation one can solve.
And so the accusations come: irresponsible, ungrateful, disloyal. But the deeper irresponsibility lies elsewhere, in the institutions that made such protest necessary, that taught generations of doctors that endurance was the same thing as virtue.
What needs to be heard
Across the ocean, physicians in the U.S. are watching. Many recognize the pattern. Different system, same disease. Administrators counting revenue instead of recovery. Colleagues driven past endurance. The same language of duty, the same slow corrosion of meaning.
The lesson from Britain is not about pay. It is about dignity. The right to say: Enough. To claim one’s vocation back from those who have turned it into a transaction.
The moral significance of withdrawal lies not in absence but in what absence reveals. The courage to stop, briefly, so that something truer might begin again.
Doctors are not machines. When they refuse to be treated as such, that refusal is not selfishness. It is remembrance of what medicine was meant to be. Of what it could still become.
Patrick Hudsonis a retired plastic and hand surgeon, former psychotherapist, and author. Trained at Westminster Hospital Medical School in London, he practiced for decades in both the U.K. and the U.S. before shifting his focus from surgical procedures to emotional repair—supporting physicians in navigating the hidden costs of their work and the quiet ways medicine reshapes identity. Patrick is board-certified in both surgery and coaching, a Fellow of the American College of Surgeons and the National Anger Management Association, and holds advanced degrees in counseling, liberal arts, and health care ethics.
Through his national coaching practice,CoachingforPhysicians.com, which he founded, Patrick provides 1:1 coaching and physician leadership training for doctors navigating complex personal and professional landscapes. He works with clinicians seeking clarity, renewal, and deeper connection in their professional lives. His focus includes leadership development and emotional intelligence for physicians who often find themselves in leadership roles they never planned for.
Patrick is the author of the Coaching for Physicians series, including:
He also writes under CFP Press, a small imprint he founded for reflective writing in medicine. To view his full catalog, visit hisAmazon author page.