The bleep has gone off for the third time in the last few minutes. Patients are piling up on the assessment unit waiting to be seen. We currently have no free inpatient beds. Parents are unhappy on the ward. One wants to make a complaint. We are all tired. Nobody has had lunch. Everyone feels stressed and uninspired. It is 12:00 on Thursday.
As I sit there in that handover, trying to keep track of everything that is going on, I notice how negative we all seem. The language we use. The things that we remark on. The jokes we make.
One of my biggest realisations whilst I was off sick was how easy it is to get swept up in the vortex of service provision, of covering gaps, doing two people’s jobs and just getting on with it. It’s what we are all doing, out of necessity. It seems normal. But it is fire fighting. We don’t have time to notice what is going on around us. We don’t have time to listen and appreciate. We no longer have time to enjoy medicine, we just fire fight.
As the handover comes to a close, there is no mention of the families who were grateful, or the juniors who correctly identified and treated the septic child, the nurse who delivered exceptional care or the patient’s sibling who made a glittery thank you card for everyone. We may not speak of this stuff, but it is there and it is plentiful if you look. Helping each other to notice these things might just contribute to restoring a sense of value and worth beyond that of service provision. We are all human, we deserve to feel valued.
Two years ago, at the end of my first meeting with my therapist, she handed me a printed sheet about mindfulness. “Have a look at this, I think it might help you”. I took it but was pretty sure a bit of meditation wasn’t going to fix me. Now, some many hours of therapy later, I can really appreciate the value of being present in the moment. For me it isn’t so much about sitting down for 15 minutes and meditating. Instead I am learning to live more in the here and now, focusing on sensations, on my breathing and the things around me. And suddenly I am noticing things, things that have always been there but that were hidden behind the fog of depression and anxiety. For example, the soft deep humming of a bumble bee by the side of the footpath, the high pitched chirping of the birds outside or the gentle whirring of the air conditioning unit.
On a busy ward, in the midst of a chaotic assessment unit or a clinic that is running late, sometimes we just have to pause and notice things. Let everything else drift past us for a minute or two and appreciate the here and now. As I do this I notice the glittery card made by a patient’s sister propped up on the nurses’ station, hear the laughter of the ward clerk and family who have just arrived, notice and appreciate the kind words of a family who are passing by.
Maybe next time you are in handover, try pointing out something good that happened, something that you noticed in and amongst the daily grind. Let’s work together to find value again as a cohort of doctors. Value comes from noticing all the good in and amongst all the crap.