Look, I've just come off a twelve-hour shift where I talked a woman through a panic attack because our mental health liaison won't pick up until Tuesday, and I watched a lad with a compound fracture wait four hours because we're short two registrars. The entire NHS runs on the assumption that nurses will absorb infinite demand with finite resources and call it dedication. Real autonomy isn't some libertarian fantasy — it's the difference between a system that treats you as a problem to be managed and one that trusts you to make decisions about your own work, your own body, your own life without asking permission from someone who isn't in the room when it matters. We've spent decades optimising for control instead of competence, and it's killing us quietly. I want autonomy not because I distrust institutions, but because I've seen what happens when institutions don't trust the people actually doing the work — they burn out, they leave, and the system eats itself. That's not freedom, that's just slow collapse with better PR.
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