In 1999, as an undergraduate student in modern languages at the University of Oxford, I stumbled upon a documentary about bioethics featuring an interview with Jean Bernard, a renowned and by then elderly French haematologist, bioethicist and member of the Académie Française.
He described the remarkable changes in medicine during the 20th century – from the development of antibiotics to advancements in genetics – and the ethical issues that accompanied them. I had not, until then, appreciated the moral complexity of medicine and I found it fascinating.
At Oxford it was not possible for non-medics to attend medical lectures, but I was allowed to sit in on the history of medicine lectures delivered to history students. I was struck by the dubious conduct of some doctors in the past, especially during the so called “scramble for Africa” in the late 19th century, when European countries occupied and colonised vast swathes of the continent.
So regular was my attendance that one day the director of the department approached me at the end of a lecture. I thought he was going to throw me out, but instead he suggested that I apply for a scholarship to study for a master’s in medical history. All I needed to do, he said, was obtain a first-class degree.
Somehow, I did. A few months later I found myself in Green College, studying medical history. The two high points of that year were meeting my future wife, Samantha – then a medical student, now a surgeon – and receiving a handwritten letter from Professor Bernard, stressing the importance of the study of medical history (in that order, of course).
A year later, when studying for a master’s in medical ethics at Imperial College London, I met the genial Raanan Gillon – a GP and a pioneer of medical ethics in the UK – and read his little book, Philosophical Medical Ethics. Buried in one of the chapters was a suggestion for a thesis on truth-telling in medicine. I asked him if he would supervise a PhD in the subject. He agreed.
After the completion of my PhD in 2006, I took up a one-year lectureship in medical ethics at Keele University and then a permanent lectureship at St George’s, University of London, where I taught medical students.
I loved teaching but soon grew disillusioned with other aspects of academic life. I would spend months writing journal articles that hardly anyone read. At first, this mattered little because it embellished my CV, but with time it mattered more. In 2007 or 2008, I remember telling myself that I would stop writing articles that no one read. The thrill of publishing in academic journals faded and I was much happier writing a piece for the BBC, where dozens of readers might engage in correspondence, than for a medical ethics journal where publication was followed by a deafening silence.
The next step in my descent into dissatisfaction was the increasingly troublesome thought that no one actually cared what I, a lowly academic, thought about this or that ethical issue. What possible difference could it make? It might, at best, generate a response from a colleague in a journal but the chances of anything I wrote making any practical difference were vanishingly small. After a few years, the whole academic endeavour seemed, to me, trivial and inconsequential. I longed for something more hands-on.
I also became bored of the never-ending cycle of setting exam questions and marking that is part and parcel of life as an academic working in a medical school.
At the time I was a member of an excellent research ethics committee full of senior doctors and lawyers. I discovered that they thought about ethical issues as carefully and astutely as I did. This again made me question my value as an academic ethicist. The most impressive member of that committee was a barrister. When a solicitor friend mentioned in passing that he could see me as a barrister, that was it.
In the summer of 2009, I took a gamble. I resigned from my lectureship at St George’s and became a law student. I was called to the bar in 2011 and have practised ever since, specialising in medical law.
The academic life can be wonderful but it does not suit everybody. I write this piece in case it resonates with anyone out there who is worried about relinquishing a hard-to-get academic job for another career, or newly-minted PhDs who consider an academic post as the determinant of success. There are many alternatives and you may discover that your true talents lie elsewhere.
Daniel Sokol is a medical ethicist, a barrister and the author of Tough Choices: Stories from the Front Line of Medical Ethics (2018).