'I never thought I'd end up here but I'm so glad I did'

This blog post by Dr Charlie Baczyk-Bell is part of the Thrive in Psychiatry campaign.

I will admit that becoming a psychiatrist was not the plan! I really enjoyed my psychiatry placement at medical school, but my research was in immunology and inflammation, and I was quite sure that physical medicine was the direction of travel.

I spent some time following my PhD doing some work in cancer immunology, and I was pretty sure I was set.

In the year between Foundation and Core Training, I took time to work in the House of Commons and National Audit Office – as COVID-19 hit. It gave me space and time to work out what was next. I still felt a draw to oncology, but there was a nagging voice, made louder by my experience of a psychiatry placement, that maybe psychiatry was the way forward.

In the end I applied for both IMT and CPT, and when it came down to it, I realised that the thing that had most interested me whilst I was on the oncology wards was speaking to people about their state of mind – their existential worries, the holistic impact of cancer on them.

When the possibility of doing an ACF in psychiatry came around, where I could make use of my previous interest and experience in a new field that was crying out for more research, the decision was made. I would be a psychiatrist.

So how on earth did I go into forensics? It certainly wasn’t the plan, and I thought I would stay in the oncology space, making use of my dual interests.

Yet the more patients I got to meet who were involved in the criminal justice system, the more I wanted to know: why?

Why was it that some people ended up going down one path and others, with similar life experiences, ended up going down another? What was nature, and what was nurture? What might be done to intervene? And what did recovery look like when the impact of mental health conditions had bled into crime and punishment?

Two other parts of my life probably played a part in this kind of curiosity. Some of my time I spend serving the Church of England as a non-stipendiary priest – essentially, a priest who doesn’t get paid! Some of the rest of my time, I’m a Fellow at Girton College, Cambridge, where I have responsibility for undergraduate medical formation. Both of these, I think, have stimulated my interest and intrigue about the human person, and about how people tick – or don’t. Neat separations like ‘good and bad’ don’t really work for me, and the opportunity to work with patients who are so frequently ignored and stigmatised – by others, but also by themselves – was a really exciting opportunity. Now I’m in forensic psychiatry, I can’t imagine being anywhere else.

I love the job because you are brought face to face with people who society so often rejects, and you can actually make a difference in their lives and in the lives of others with whom they share their lives, and who have been impacted by their actions. I particularly enjoy working with patients with personality disorder, because here is a group who are complicated and whose treatment is complex, and yet with whom hugely positive results are possible – if sometimes challenging to come by.

I never thought I’d end up here, but I’m so glad I did. The work is varied, even if the hours are sometimes long and the risks – and responsibility – higher than in other parts of psychiatry. But the rewards are worth it, and I wouldn’t do anything else.

Dr Charlie Baczyk-Bell,  ST6 in High Secure Services, Forensic Psychiatry.