Hello, lovely friend.
Welcome to my tiny corner of the internet! Thank you for visiting, please, pull up a chair, stay for a hot chocolate and a chat.
Anatomy of a Decision is my creative home, designed to be a calm space for deep thinking where I explore themes around career transition, life decision points and values-led living in the form of essays, poems and photographs. I’m so glad you’re here. Will you stay a while?
If we’re meeting for the first time, my name is Louise, and I’m a writer and a non-executive director of Lemon Jelly Press CIC, an independent publisher with a mission to amplify unheard voices and bring humanity to the page. I am finding my way in the creative world after an 18 year career in medicine as a paediatric, neonatal & trauma surgeon.
Like many careers, medicine can be all-consuming. In a long and obstacled training path I lost a lot of the sense of who I am underneath the identity of ‘surgeon’.
After a year as a consultant surgeon, but never having held a permanent contract, I became unemployed in summer 2024. The timing was - honestly - perfect. I’d been working away in a city more than two hours from home. When my post ended in July, I was able to spend a whole summer holiday with my children for the first time. I realised how much of their lives I was missing, and also how much of my life I was living inside the walls of a hospital. So when another post was advertised in another city even further from home, I decided not to apply.
There is so much more to me than ‘doctor’. I am creative. I care deeply. I love hard. I have fallen in love with writing, and poetry, and the freedom to chase dreams. So that’s what I’m doing here.
My dream now is to weave a career where love and joy are centred. Where storytelling and creativity are used as tools of empowerment. Where connection brings solutions to our most difficult problems. And where this incredible gift of life is appreciated for its every stunning moment.
What to expect
My essays, published every 1-2 weeks, are full of stories from my life and career, but all are written with a view to getting to a point, whether that’s a disruption of the status quo or a particular insight from having had such an up close and personal view of life and death. Fair warning, though, as you might have noticed here, it sometimes takes me a while to get to the point, and I’m quite good at going off on tangents.
My poems are an entirely new thing. I didn’t know I liked poetry until the New Year (2025), and now I can’t go for a walk without thinking in poetic words. It seems to be that when my brain wants to communicate something important at the moment, a poem is how it comes out. I’m still not entirely sure where the words come from. It’s somewhere deeper than conscious thought. I was recently invited to a meeting with a very important CEO. Half an hour before the meeting, I was feeling nervous, so I wrote a poem. And then I read it to him. Still can’t quite believe I did that. Luckily he liked it (or at least, said he did, maybe he was just being kind to the weird redhead who read him a poem!
As a subscriber to Anatomy of a Decision - thank you! - essays will arrive in your inbox the moment they are released. Poems are published into the poetry section and you can switch on and off the options to receive posts from each section here.
You can access my entire archive of work using the index:
There’s also an option to receive posts only in the app rather than by email if you’d prefer (highly recommended if you read several writers on Substack), this can be found in your profile settings - choose ‘prefer app’ in the delivery preference section.
Free or paid subscription - what’s the difference?
In terms of your experience as a reader - there’s no difference.
I’ve chosen to keep my writing free, because I want to maximise the chances of these words being read by the people who need to read them. That said, I also believe that writers should be paid for their work. The archetype of the starving artist is a harmful tool of the capitalist patriarchy we live in, and I don’t believe that any of us should have any time for it.
If you feel able to support my work by choosing a paid subscription, your generosity allows me to dedicate more time to this work and keeps my writing freely accessible for all, and for that I am incredibly grateful.
You will find no advertising in this space. I will however, occasionally share updates on my my other projects and invite readers to ways that they can work with me in my membership spaces or upcoming workshops. There is of course no obligation to do so! Readers with a paid subscription are welcome to apply the entire cost of their subscription here at Anatomy of a Decision towards any of these alternative offerings in the form of a discount code - just send me an email or DM to request.
There are many, many publications on Substack, so why should you decide to subscribe to this one?
If you enjoy raw, honest, oversharing, you’re in the right place.
As a late-diagnosed neurodivergent (I mean, I missed it for 40 years, and I have a medical degree…) I have always had a tendency to do things my own way. Socialised as a ‘good girl’, I was twice told I was ‘too nice’ to be a surgeon, and should choose an alternative specialty. I’ve always far preferred collaboration over competition. I don’t use a title, and instead asked patients and trainees alike to call me Louise. I’ll bake and hand out cakes with hugs to anyone who needs one.
But don’t let any of that make you think there isn’t a core of surgical steel running through me - when the shit’s hitting the fan I have the words to whip a trauma team into action, the ovaries to stand up for my people if they’re being given a hard time, and the hands to place a 2mm line into a 2mm vein, even when it’s the last remaining vein in a baby the size of a bag of sugar. None of that disappears just because I’m no longer doing the job. (The line skills will, at some point, admittedly. I haven’t found a use for those outside an operating theatre yet).
Genuinely though, I’d love it if you’d join me here because what I’m really trying to create is a community of humans who are one or more of:
creatives, dreamers, individuals, joy-seekers, lovers, mothers, career-transitioners, mid-lifers, crafters, feminists, bakers, poets, writers, readers, stationery-appreciaters. (I may come back to this list!)
And if you’re interested in events related to any of the above in person(!) then come over to my LiveStack directory and newsletter!
About me
A born and bred Yorkshire woman, I now live in the Nottinghamshire Wolds with my husband and two children. I have always been creative; back in 2016 my husband and I planned a wedding that was almost entirely DIY, even down to award winning homemade marmalade with individually hand-stamped vintage silver teaspoon gifts for our guests. I also love ducks, so the main image above is a photograph of me in a wedding dress, duck herding (I loved it!). These days, alongside writing I find much joy in sewing, crochet, baking, cake decorating, notebooks, candles and cosy cardigans!
To read more about my journey from surgery to Substack, my introductory essay is in two parts; you can click here to read them:
If there’s anything else you want to know, or you just want to say hello, please send an email or a message, I’d love to hear from you! Thank you so much for stopping by, I appreciate you coming to visit.
See you soon…
Louise x
