Today, 10th October, is apparently World Mental Health Day. The World Health Organisation apparently endorse this, and I guess it's one of campaigns aiming to raise awareness of mental health and illness globally.
I always find the concept of a topic as vast as mental health being squashed together in one day a little odd, but although there are a vast number of mental health issues which are lumped together under one heading, they do have something in common and I can't criticise anything aiming to improve people's awareness of such a common and yet seldom discussed group of problems.
Any regular readers of my blog will be aware that my own mental health issues are longstanding so I can't pretend I don't have a personal stake in this. For that reason, I always feel slightly guilty pushing the mental health agenda. However, it's an important issue that will affect 1 in 4 of us (I think that's probably a conservative estimate) so I won't avoid talking about it.
My first experiences with mental health problems were back when I was a teenager. The support I received was less than ideal, my parents and school didn't really understand what was happening or how best to help me and even the professionals I encountered seemed out of their depth. A lot of my experiences were covered in this pseudo-anonymous post, which I initially wrote as a presentation to give at work. It's now nearly 15 years since that first consultation in that dreadful old building and I still remember it vividly. I can't ever change that, but I hope that when I meet young people in my professional life who are struggling, they remember their encounter with healthcare in a more positive way - someone cared, someone listened.
Unfortunately, it's not just a teenage problem. Although it's pretty common for mental health difficulties to begin in adolescence, they frequently persist into adulthood. Mine certainly have. Despite my struggles, though, I'm doing ok. I'm in a stable relationship. I'm holding down a (fairly intense at times!) job. Not everyone is so lucky. Mental illness is one of the most common reasons for claiming incapacity benefit. Plenty of people struggle and suffer, and yet stigma still persists.
Once again, my blog has become a ramble with no real direction or structure. I'm not sure it says much. But, if you're reading this and you're struggling, you aren't alone. Help is out there. And remember that just because you've been unfortunate enough to get unwell, doesn't mean you aren't awesome.
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There are a number of places you can get help should you need it. The
services I've listed are free to call and open 24/7. A more
comprehensive list is available through the NHS choices website, but not all services are free or open at all times.
If you're struggling today, or any day, the Samaritans are there to listen for free - call 08457 90 90 90.
Children and young people can contact ChildLine on 0800 1111 whilst adults who have concerns about a child can call the NSPCC helpline on 0808 800 5000.
If you feel in danger of hurting yourself and don't have a crisis plan, please call 999 or go to your local A&E department.
If alcohol is a problem, you can call Alcoholics Anonymous on 0845 769 7555.
If you need help with drugs, you can speak to Frank on 0800 77 66 00.
Men with any difficulties can use the online chat/email service here
If you're struggling with an eating disorder, Beat can be called on 0845 634 1414 (adults) or 0345 634 7650 (for under-25s)
Showing posts with label Life. Show all posts
Showing posts with label Life. Show all posts
Monday, 10 October 2016
Thursday, 7 April 2016
Paediatrics? That must be heartbreaking...
It's not unusual for people, on hearing that I work in paediatrics, to ask how I can do it. "Gosh," they say, "isn't that really upsetting?". When I mention that I have a particular interest in children with cancer, they start to look at me like I've sprouted a second head. Even medical colleagues of mine, who deal with illness, pain and sufferring on a daily basis, sometimes struggle with the idea of these things happening to children. My response, generally, is a little blase. "Oh but it's so much fun!", "I get to cuddle babies as part of my job!" or "Well the tough bits are tough, but they're so rare!". What I don't think I ever say is "Yes, it is. I love what I do but it breaks my heart".
There's a lot of talk about burnout and resilience at the moment. I find it difficult to understand what's really meant by either term, but I certainly find myself worrying that admitting things are tough is somehow suggesting that I'm not cut out for this. I know different people mean different things when they talk about being "resilient", but I have to say that a lot of the time when I read headlines saying we need to "improve resilience" amongst doctors, it feels like someone in an ivory tower is telling us to "man up". I know a lot of people say that isn't what's meant by it, but I also know that I'm not the only person who hears it that way.
Increasingly, I'm realising the need to be honest about how tough my job can be at times. I'm not complaining - I love it and I genuinely can't see myself doing anything else - but downplaying the stresses and strains does no one any favours.
There are phrases that make all paediatric trainees break out in a cold sweat. "Category 1 section, obstetric theatres" - something has happened during a delivery and they need to get the baby out now. You sprint to theatres, check the oxygen is working, get out tubes and catheters in varying sizes. Someone hands you a white, floppy, lifeless baby. You hear an anxious parent ask "why aren't they crying?" as your anaesthetic colleague tries to reassure them that sometimes babies born by Caesarian are a little bit shocked and take a while to wake up - and you know they're trying to convince themselves as much as the parents. Mostly, it's ok. You dry the baby off, position their airway, sometimes give a few breaths, and then they gasp, cry and pink up. Except the times they don't. The times they stay white. The times the heart rate doesn't improve and you start chest compressions and give adrenaline and do everything totally right and it just doesn't work. Maybe you detect a heart rate after 10, 15, 20 minutes. You start trying to explain cooling and neuroprotection and know that nothing you're saying will be taken in because up until half an hour ago, these people were having a healthy baby - a normal thing that millions of people do - only it's not quite gone to plan. Sometimes, a well meaning senior tells you to get a sense of perspective. Your day was pretty bad, but nothing compared to what those poor parents are going through...
It's not just the very sick children that can upset you. Part of our role as paediatricians is in child protection; assessing children who have been abused or neglected, usually by the very people who were meant to love and protect them. You might be treating a child for a chest infection and realise that this three year old, ill and in pain, turns not to his own mother for comfort, but to a doctor or nurse he's never met before. You might be listening to his chest when you see a hand-shaped bruise on his back. You could be just walking into the room when you realise he's malnourished and dirty. You have to act to protect this child in the best way that you can.
There are so many things that can get to you as you go about your work. Sometimes, it's seeing a parent struggling to come to terms with a horrible situation and realising that you can do nothing more than offer a hug, a listening ear and a cup of tea. Other times, it's watching a child undergo futile and sometimes painful treatment because their family aren't yet ready to accept that nothing more can be done to help them. It might be being hugged by a gorgeous little one and then finding out that Mum is actually foster Mum and she doesn't understand why no one will give him a forever home.
The point of this post is not to attract pity, sympathy or praise. I chose this career with my eyes open and it's a wonderful, rewarding, fulfilling one. But it can be difficult, and admitting that should be something that it's ok to do. Would you want your child to be cared for by someone who didn't care? If you can deal with the situations I've mentioned above (and yes, all of them have happened to me over the past couple of years) and not be saddened, I would genuinely wonder whether you were in the right career. I once described paediatrics as "the little girl, with the little curl", a reference to an old nursery rhyme...
There was a little girl
Who had a little curl Right in the middle of her forehead; And when she was good She was very, very good, But when she was bad she was horrid.
I still feel like it's the best way of summing the job up. When it goes well, when good things happen, it's brilliant. And when they don't go so well, it's fairly dreadful.
Paediatrics? I love it, but it breaks my heart. And that's ok.
There's a lot of talk about burnout and resilience at the moment. I find it difficult to understand what's really meant by either term, but I certainly find myself worrying that admitting things are tough is somehow suggesting that I'm not cut out for this. I know different people mean different things when they talk about being "resilient", but I have to say that a lot of the time when I read headlines saying we need to "improve resilience" amongst doctors, it feels like someone in an ivory tower is telling us to "man up". I know a lot of people say that isn't what's meant by it, but I also know that I'm not the only person who hears it that way.
Increasingly, I'm realising the need to be honest about how tough my job can be at times. I'm not complaining - I love it and I genuinely can't see myself doing anything else - but downplaying the stresses and strains does no one any favours.
There are phrases that make all paediatric trainees break out in a cold sweat. "Category 1 section, obstetric theatres" - something has happened during a delivery and they need to get the baby out now. You sprint to theatres, check the oxygen is working, get out tubes and catheters in varying sizes. Someone hands you a white, floppy, lifeless baby. You hear an anxious parent ask "why aren't they crying?" as your anaesthetic colleague tries to reassure them that sometimes babies born by Caesarian are a little bit shocked and take a while to wake up - and you know they're trying to convince themselves as much as the parents. Mostly, it's ok. You dry the baby off, position their airway, sometimes give a few breaths, and then they gasp, cry and pink up. Except the times they don't. The times they stay white. The times the heart rate doesn't improve and you start chest compressions and give adrenaline and do everything totally right and it just doesn't work. Maybe you detect a heart rate after 10, 15, 20 minutes. You start trying to explain cooling and neuroprotection and know that nothing you're saying will be taken in because up until half an hour ago, these people were having a healthy baby - a normal thing that millions of people do - only it's not quite gone to plan. Sometimes, a well meaning senior tells you to get a sense of perspective. Your day was pretty bad, but nothing compared to what those poor parents are going through...
It's not just the very sick children that can upset you. Part of our role as paediatricians is in child protection; assessing children who have been abused or neglected, usually by the very people who were meant to love and protect them. You might be treating a child for a chest infection and realise that this three year old, ill and in pain, turns not to his own mother for comfort, but to a doctor or nurse he's never met before. You might be listening to his chest when you see a hand-shaped bruise on his back. You could be just walking into the room when you realise he's malnourished and dirty. You have to act to protect this child in the best way that you can.
There are so many things that can get to you as you go about your work. Sometimes, it's seeing a parent struggling to come to terms with a horrible situation and realising that you can do nothing more than offer a hug, a listening ear and a cup of tea. Other times, it's watching a child undergo futile and sometimes painful treatment because their family aren't yet ready to accept that nothing more can be done to help them. It might be being hugged by a gorgeous little one and then finding out that Mum is actually foster Mum and she doesn't understand why no one will give him a forever home.
The point of this post is not to attract pity, sympathy or praise. I chose this career with my eyes open and it's a wonderful, rewarding, fulfilling one. But it can be difficult, and admitting that should be something that it's ok to do. Would you want your child to be cared for by someone who didn't care? If you can deal with the situations I've mentioned above (and yes, all of them have happened to me over the past couple of years) and not be saddened, I would genuinely wonder whether you were in the right career. I once described paediatrics as "the little girl, with the little curl", a reference to an old nursery rhyme...
There was a little girl
Who had a little curl Right in the middle of her forehead; And when she was good She was very, very good, But when she was bad she was horrid.
I still feel like it's the best way of summing the job up. When it goes well, when good things happen, it's brilliant. And when they don't go so well, it's fairly dreadful.
Paediatrics? I love it, but it breaks my heart. And that's ok.
Sunday, 23 June 2013
The Impact Factor
As a budding academic, I hear all too often about the importance of the 'impact factor'; that is, how likely articles from a journal are to be referenced in a later article. It's a somewhat controversial measure of how "good" a journal is, but the journals with the biggest reputations (eg Science, Nature) do seem to have the highest impact factors anyway. Frankly, at my stage, I'm still happy enough if anyone seems interested in publishing something I've been involved in writing so it doesn't particularly bother me if the impact factor is 0.01, but no doubt if things progress then at some point I'll probably have to start choosing to submit to higher impact journals.
Despite just writing a paragraph about it, this blog entry wasn't meant to be about the impact of journals and articles. It was about the impact we have on patients. Sometimes, I think it's easy to get wrapped up in the numbers and figures. A busy day of surgical receiving becomes 4 query appendicitis, 6 diverticulitis, a renal colic, the stab wound in A&E and 3 from GP still to be seen. Another 5 blood results awaited, 3 abdominal films to chase and would radiology please hurry up and report that CT scan. Yes, we care about our patients deeply, but sometimes what we do becomes so routine that we may forget that although this is our 24th acute abdomen, for the patient it's the first time in hospital or the most terrifying thing they've ever experienced. Even for those patients who we see regularly - the chronic pancreatitis after another alcohol binge, the poorly controlled Crohn's disease desperate to avoid a stoma - their interaction with the health service is likely to have a significantly greater impact on them than it does on us.
I was recently in a bar with a colleague when a lady approached us. "I know you" she said to him. He looked momentarily embarrassed and I assumed he had no idea who she was. Her next sentence took me (although I suspect not him) by surprise. "You're the doctor who saved my husband's life". I didn't go into details with him about what had happened, but it was clear that in the course of going about his daily work he had made a huge difference to this family (and, I suspect, many others). She was very pleasant, updated him with how things were, wished us a good night (and said it was great to see that doctors were humans who you saw drinking in pubs in town like normal people - but that's definitely a different topic...) and went on her way. I was surprised by how very uncomfortable my colleague seemed with this. He muttered something about "just doing my job" to me and returned to his pint.
The "just a job" attitude is an incredibly difficult one to get right. After more and more guidelines about what we can say on Twitter or the photos we shouldn't put on Facebook, many doctors have become fed up with the constant attempts to control our out of work lives. This has resulted in many of us (myself included) taking the staunch position of "it's only a job". I don't think that this is wrong. I go to work, do my job and hopefully do it well, and then I go home to the kind of social life I choose. I don't believe that drinking more than my recommended alcohol intake or (god forbid) having a cheeky cigarette makes me less competent at what I do. Where this attitude falls down, though, is that it makes us more likely to forget how important what we do is. We're privileged enough to be involved in some of the most important times of families' lives. Let's not forget the impact each of our interactions will have on a patient and their loved ones.
Tuesday, 28 August 2012
That's Life, That's What All The People Say...
Well, the past few weeks have been something of an emotional roller coaster. As well as dealing with some very challenging things at work, I've also split with the guy I was seeing (definitely for the best but I'm still gutted) and lost my Nana (we weren't close but I hate seeing my Dad so upset).
My first run of 12 shifts in a row was really quite exhausting. Being able to switch my alarm clock off when I went to bed on Friday felt like a definite luxury. Even though I don't start work particularly early (9am so the alarm goes off around 7), it's amazing how tiring it can feel just knowing there isn't the option of a lie in at all! The weekend in particular was pretty tough as I was working 12.5 hour days on Friday, Saturday and Sunday with very little in the way of senior support.
Being a doctor is much more emotionally demanding than I had anticipated. I'm not sure whether this is because I've also had other stresses in my life or I was just rather naive when I started. I seem to have a lot of patients who are either essentially dying or medically as fit as we can make them but unable to leave the hospital because there are social/care provision issues. I wasn't quite prepared to be discussing end of life care with relatives after only a matter of weeks in the job, nor was I aware that I'd be representing the "medical team" at case conferences and meetings so early in my career.
I'm now on a week of annual leave, which is a bit strange. I hadn't really anticipated having any length of time off so soon after starting work, but we get allocated our leave so someone will always have it in August - and at least I didn't have the first two weeks of the month off like some of my friends did! I'm not doing an awful lot but I get paid on Thursday so maybe I'll do something a bit more exciting when I have some cash...
Nothing more exciting to report, sadly, but my MSc starts in October so I should have something useful to write about then!
xxx
My first run of 12 shifts in a row was really quite exhausting. Being able to switch my alarm clock off when I went to bed on Friday felt like a definite luxury. Even though I don't start work particularly early (9am so the alarm goes off around 7), it's amazing how tiring it can feel just knowing there isn't the option of a lie in at all! The weekend in particular was pretty tough as I was working 12.5 hour days on Friday, Saturday and Sunday with very little in the way of senior support.
Being a doctor is much more emotionally demanding than I had anticipated. I'm not sure whether this is because I've also had other stresses in my life or I was just rather naive when I started. I seem to have a lot of patients who are either essentially dying or medically as fit as we can make them but unable to leave the hospital because there are social/care provision issues. I wasn't quite prepared to be discussing end of life care with relatives after only a matter of weeks in the job, nor was I aware that I'd be representing the "medical team" at case conferences and meetings so early in my career.
I'm now on a week of annual leave, which is a bit strange. I hadn't really anticipated having any length of time off so soon after starting work, but we get allocated our leave so someone will always have it in August - and at least I didn't have the first two weeks of the month off like some of my friends did! I'm not doing an awful lot but I get paid on Thursday so maybe I'll do something a bit more exciting when I have some cash...
Nothing more exciting to report, sadly, but my MSc starts in October so I should have something useful to write about then!
xxx
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