“We all need somebody to lean on”

In the run up to returning to work I tormented myself for days about how I was going to explain my absence to my colleagues. What words could I use to justify being off sick for a year? Should I make up some excuse, pretend I had had another child? Perhaps if I was suitably vague people would get the hint and not ask. A friend jokingly suggested I should explain I’d had really infectious and deadly disease and then cough all over them!

Facing my colleagues was the real hurdle of returning to work. The medicine per se felt like the bit I could do. The rest…. I was returning to a culture that didn’t get me. I was a broken doctor, a doctor who couldn’t cope. A failure.

This is genuinely what I believed.

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Whilst I had been off work things had got pretty bad. Large crowds, busy places and travelling on my own had all become fraught with panic and overwhelming upset. I had isolated myself in order to avoid triggers. I had a few ‘safe’ friends, but gatherings with more than three people…. arghhhhhh. I can still feel it now: tightness in my chest, an irrational fear mixed with dread and panic. Unsurprisingly, I wasn’t exactly relishing the idea of returning to work and having to face a room full of people I didn’t really know.

The first few times I uttered it I remember my voice sounding wobbly: “I have been unwell and had some time off sick.” It sounded so wrong, so foreign. Admitting vulnerability is not something that we do as medics. You could see in people’s response that it isn’t something we are used to hearing  either. A sort of embarrassed “Awww” followed by silence. Why do we find it so hard?

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After a few weeks of being back I started to talk a bit more. I found myself using the phrase “Mental health problems” and surprisingly, nothing bad happened. I began to realise that the worst mental health stigma was in fact what I was inflicting on myself. As I looked around, I saw other doctors struggling, trainees talking about the pressures, the rota gaps, the constant unrelenting demands on them. And then I found Twitter, which has given me access to people, ideas, discussions, support that I cannot begin to describe. My twitter world has made me realise I am not alone. I am not broken. I am human.

With that in mind, I decided that I would speak out. Silence had got me nowhere. Now it was time to share my story. As I described my experience, I hoped that someone somewhere might take solace from knowing they weren’t alone.

And so I talked. I talked to colleagues over coffee, I listened to them share their struggles. I talked at departmental and regional teaching sessions. Because mental illness can happen to anyone and no one should feel ashamed of it. And as I talked, I felt empowered.

Disclosure isn’t for everyone and potential consequences need to be considered carefully. I certainly haven’t shared all the details of my history and what I speak about varies depending on the situation.

But the shame has gone. I feel like I now have permission to be me.

De-stigmatising mental illness in doctors is clearly not going to happen overnight but we can all make a start. Dare to share how you feel. Talk to your colleagues about what you do to relax or wind down after a busy day. Discuss mental health. Prioritise well-being. Let’s face it, if we don’t, no one will.

And in the words of Bill Withers:

“Sometimes in our lives
We all have pain
We all have sorrow
But if we are wise
We know that there’s always tomorrow

Lean on me!
When you’re not strong
And I’ll be your friend
I’ll help you carry on
For it won’t be long
‘Til I’m gonna need
Somebody to lean on”

 

I broke

Three weeks today I return to work after a long period away. This wasn’t leave that I had looked forward to or planned. It was imposed on me by my health, or perhaps I should say my ill health.

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Back in June 2017 things had got pretty bad. In fact I hadn’t really realised how bad. It had all crept up on me insidiously. A thick dark fog had descended on the world. My soul, my passion and my enthusiasm for life seeped from my exhausted body. Yet my mind was racing, my thoughts so jumbled that at times that I could not make sense of them. I was worn out by the constant indecision, the questioning, the anticipation and anxiety. I felt like I was at breaking point but was compelled to carry on. Giving up work was not an option. In fact I despised myself for showing any sign of weakness; having time off epitomised failure as a medical professional.  People tried to tell me otherwise, but when it came to my situation, all I heard were empty words.

 

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There is a culture ingrained in medicine of not asking for help. Fragility and vulnerability are not desirable attributes in a doctor.  This misconception silenced me for years. I tried my best to be tough, to repeatedly pick myself up, dust myself off and crack on. So, when my psychiatrist advised me to take some time off work, I sat opposite him and sobbed. I was broken. I was a failure. My job had finally defeated me.

As I left my local GP surgery the following day with a sick note in my bag, all I felt was guilt. My colleagues, my patients, their families… nowhere in that moment did I think to spare a thought for myself. Medicine teaches us to be kind, empathic and caring. Maybe it’s time that we started to treat ourselves with that same level of compassion…

What do you do for yourself?