Lesley Morrison - The Wellbeing Toolkit for Doctors: A Supportive Guide to Help Everyone Working in Healthcare

Dedicated to Kath and Ian, my parents

This edition first published in the UK and USA in 2021 by

Watkins, an imprint of Watkins Media Limited

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8993 Shepperton Road

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Design and typography copyright Watkins Media Limited 2021

Text copyright Lesley Morrison 2021

Lesley Morrison asserted her right under the Copyright, Designs and Patents Act 1988 to be identified as the author of this work.

All rights reserved.

No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, without prior permission in writing from the Publishers.

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ISBN: 978-1-78678-521-3 (Paperback)

ISBN: 978-1-78678-518-3 (eBook)

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Contents

Introduction

I am the master of my fate,

I am the captain of my soul.

W E Henley,
quoted by Nelson Mandela

Have you ever felt that youve lost a sense of purpose, that youre not being the kind of doctor that you wanted to be? That youre so caught up in other peoples agendas, so drowning in protocols and guidelines, that youve lost a belief in yourself? Of who you are and what you can contribute?

Then this book is for you.

In it, I offer ideas and suggest ways in which you can enjoy your work and be yourself. In order to look after others, we need to look after ourselves. We need to keep our creativity alive and stay connected to our inner voices. And the more stressful the situation, the more important this is. The Covid-19 pandemic has required new levels of dedication, commitment and sheer hard work, and the impact on you, and other health professionals working through it, has been huge.

Youve read the books, youve attended the skills workshops, youve reflected (then reflected on your reflections), but still there are times when you feel overwhelmed, when it seems that youre unable to do anything useful to help the person sitting in front of you. When you feel like a very small cog in a very big machine. That sense of powerlessness is a major contributor to low mood and poor self-esteem (dont you know it), but there are nearly always ways in which you can reclaim some control, take some initiative, do something to make yourself, and anyone fortunate enough to be your patient, feel better.

Even with the high levels of resilience that many doctors have, the numerous factors contributing to stress result in the risk of mental health issues among doctors and dentists being higher than that of the general population, and this, along with a culture which has traditionally not been supportive and the negative effect of patient complaints, contributes to the increasing prevalence of burnout. Accessing healthcare can be problematic, either because of frequent career moves, difficulty getting time off work or concerns about confidentiality and the potential impact on career prospects.

There are a lot of c words in healthcare: communication, curiosity, creativity, compassion, collaboration, connection, continuity of care And one very important k word: kindness. A thousand years ago when I was at primary school, I had a learn to read book which gave every letter a memorable attribute. K was kicking k. And kindness can, indeed, include some kicking. Its not necessarily soft and sentimental; it can be tough, even hard. However, whether its kindness to yourself (essential for mental wellbeing) or kindness to others, true kindness comes from a place of affection and caring, and honesty.

To thine own self be true

And it must follow, as the night the day,

Thou canst not be false to any man.

Hamlet, Act I, Scene 3

So said Mr Shakespeare, and it applies even more to being a doctor than to most occupations. How do you stay true to yourself while working with colleagues and patients who may hold very different social and political views? How do you strike a healthy, honest balance between the professional and private demands put upon you?

As doctors, we are privileged to share peoples stories and, through them, to gain insight into the wider world. A doctors role, as stated by the General Medical Council, is to care for individual patients health and to promote the public health. Economic, climate, food and social injustice are all bound together, perhaps in the life of the person sitting in front of you. How can you combine helping that person and engaging with the wider issues? When youre feeling exhausted and stressed by those wider issues, or by the intensity of the work youre doing, how do you maintain your energy levels and your ability to care?

From the laying on of hands, centuries ago, to the traditional patient care of the 1950s exemplified by John Bergers A Fortunate Man, to making use of the scientific and technological bonanzas of the 20th and 21st centuries, the practice of medicine is constantly evolving. A science and an art, it requires scientific knowledge, clinical acumen, technical skills and, most importantly, the ability to listen and show kindness. What patients will often most remember and appreciate, and what unlocks the relationship with them and gives power to all the other ingredients of good care, is the small act of kindness, of humanity, and the person who offered it. How do we find space among all the daily demands for these small, perhaps random, kindnesses to our patients and ourselves that simply make life better for everyone?

These questions, and so many others, have come under the spotlight, or perhaps the microscope, since the Covid-19 pandemic struck. How has the experience of the pandemic affected you? You may have lost family members, friends or colleagues either directly or indirectly as a result of it. Did you question your choice to be a doctor? Are you the kind of doctor you would ideally like to be? And, the next time such an epidemic occurs because, sadly, it will how might it affect you then? Internationally, the attitude towards doctors contribution and sacrifice has varied. Reports from India and some other countries described doctors being prevented from returning to their homes, being spurned or worse, because neighbours were scared they were carrying the infection. In many parts of the global south, accessing handwashing facilities, never mind ventilators, is problematic, and doctors roles may be very different.

As doctors, we deal in stories; we use science to interpret and act on the stories, and we work in a societal and political context that affects what we do and how we behave. All of our lives have changed as a result of the pandemic. Freedoms that we may have taken for granted now feel more valuable. Assumptions about entitlement may have altered. Self-images about being healthy and immune to disease may have had to be reassessed. Different forms of communication and work patterns have been developed; technophobes have had to adopt technology as a friend.

How will these lessons translate into the future, to the new normal? Thanks to you and your health and social work colleagues around the world, this pandemic will be brought under control. But, sadly there will be others and we will also have to deal with the ravaging and lethal effects of climate change becoming even more widespread and dramatic. In May 2020, the movements Build Back Better and Black Lives Matter began to engage the public in discussion about the kind of future that they want for themselves and their children and grandchildren. From the health community, the message is clear: health, justice and sustainability need to be at the heart of our future planning. People need to come before profit, and how we measure success should not be in terms of gross national products and consumption, but in terms of quality of life. Quite a challenge for us all.