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Only Human – Episode 4 – Simon

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We are more than doctors and nurses and paramedics and patients. We are the sum of the stories we tell. Stories that have a beginning, a messy middle and, one day, an ending.

In this series, we want to remind you that we are all ONLY HUMAN.

Becky Platt: 0:01 Welcome to Only Human, a podcast from Don’t Forget the Bubbles. This is Becky Platt with Henry Goldstein, and these are the stories that reflect the diversity of our community and the multitude of life events that come our way, that shape us as professionals and as humans. Simon is an Emergency Medicine consultant, and his story is about having a breakdown and how this has affected his career. Interestingly, asking him to describe his role is complicated.

Simon: 0:34 It’s a difficult one, it’s one of the things I struggle with these days. I had a breakdown in 2015, so getting on for my sixth birthday anniversary, back in September 2015. And although I got back to clinical medicine initially, actually, that didn’t happen long term. And so now I do sort of medical education and pastoral work, and I don’t actually do any clinical medicine. So I find it odd to describe myself as an Emergency <edicine consultant, because I don’t think I do what Emergency Medicine consultants do, but I’m not really sure what to call myself.

Becky Platt: 1:12 Interesting, isn’t it? Because it kind of talks about your professional identity.

Simon: 1:19 I still think of myself often I suppose, internally I still I think of myself as an Emergency Medicine consultant. That’s who I was, and now I’m somebody who can’t do that anymore and has had to try and come to terms with that, and come to terms with, or what does that make me now? What makes me of any value to anybody? I’ll be honest, I’m not entirely convinced I understand why I’m here. I don’t, I don’t understand sort of, you know, I’m losing track. Sorry, this is this is what happens. I’m really sorry.

Becky Platt: 1:52 The stress and demands of the roll had been taking their toll on Simon for quite a while. But one day, everything just got too much. He was no longer able to keep all the balls in the air.

Simon: 2:05 So Emergency Medicine Consultant for about 13 years. And I think like everybody’s this was 2013, things were getting difficult. I’d certainly struggled with the stresses of the job. And I remember, I had a difficult meeting the day before this happened, which made me feel a little bit vulnerable, I think, in terms of what if something was to go wrong? What would happen to me? And it was not a particularly busy shift. And I was sat at the staff base, and a junior doctor showed me an ECG. And I think I managed to deal with that. And I just sat there, and I don’t know what happened. And the nurse who was in charge of the department just looked at me and said, ‘Are you okay, Simon’? And I remember just saying back to her, ‘No, I don’t think I can do this anymore’. And something had changed. I don’t know what it was Beckly. But I could feel that something had happened.

Becky Platt: 3:05 How did it feel to all of a sudden not be able to do a job that had come so easily to before?

Simon: 3:11 It was petrifying. I went to see the GP the next day. Actually, he had been one of my junior colleagues, as a registrar. So that was that was really nice that I you know, like most doctors that I barely see my GP at any point, but it was nice. And he was really comforting in terms of ‘look, it’s, it’s gonna be alright, we’ll sort this out’, and he signed me off for two weeks, and I was thinking a week, we’ll be fine. He said ‘Let’s make it two weeks’. But I went home and, and the only way I can describe it to people is, I’d completely lost the ability to multitask. So I could do one thing at a time. And you know, what, emergency medicine is like. You’ve got multiple things going on at once. And actually, it’s what drives us. We love it. You know, we have that sort of adrenaline junkie thing of spinning plates and keeping everything going. And that’s what we do. And here was I now in a position where I remember I was trying to hang some washing out a couple of days, and I was hanging some washing up on on the line, and I was just doing that. And my wife came in to tell me something. And as she started talking to me, I remember getting really angry with her and turning saying you can’t talk to me while I’m doing something. I can’t listen to you and do this at the same time. I’m saying this as I was I was stuck. I knew if if this is what I’m going to be like, I can’t work again. But emergency medicine is the ultimate plate spinning gig. But just being a doctor involved at night. And all of a sudden it all crashed down and…what what I going to do for a living? How was I going to pay the rent? How was I gonna look after my family. All of that just came crashing in on me and I didn’t know what was going to happen. So, yeah, it didn’t feel great.

Becky Platt: 5:07. Left reeling from this realisation, Simon began to seek support and to develop coping mechanisms in order to navigate his future as a medical professional.

Simon: 5:18 The only support I got from work was that ‘look just fine, it’s fine. If you’re off, you’re off’. Okay. And I think at that time, that was probably all that they could offer and all that they knew how to offer. And I am again, forever grateful for the fact that at no point during all of this story that I tell, did I ever get any pressure from my nursing colleagues or my junior colleagues, from my consultant colleagues, from my direct line managers. At no point that I get any pressure about sort of ‘What’s up? Why aren’t you back? That never happened. I’m not sure they knew what to do. But they knew not to do that, which is, which is at least something. And I spent a lot of time going to the GP, and the GP would just keep telling me, it’s going to be okay. And he said to me, ‘you’re looking at six months’. And I said, ‘Oh, no, no, no’. ‘You’re looking at six months before you’re going to be back’. And he was very patient with me. And I just, I just took time to I started doing little bit more running, just going out and walking, just trying not to be doing anything. And I suppose it took about three or four weeks. And suddenly, one morning, I realised that I was doing two things at once. Okay, I was making some breakfast and making my wife a cup of coffee or doing something. And it wasn’t like something a light bulb went off, it was just ‘oh, right, maybe I can do more than one thing at once’. And it came back, not to where it was not, and it never has come back to it like it was. But also I was doing more than one thing at once. And there was some perhaps an inkling of, okay, maybe there is a way out of this. Maybe there’s a way back, I suppose at that point is what I was thinking

Becky Platt: 7:09 A way back to work, or a way back to normal functioning at home, or what did what did you want the way back

Simon: 7:17 I think I think it was a way back to you know, I broke to be? here. I’m here. Can I go back to there? So there’s my journey. There’s my story going along like this that’s broken. And the idea is, what can I get myself back? There’s a little bit of a hiatus here. Yeah, I’m gonna get back there. And off I go. . You know, and that was my assumption that that’s what would that’s what would happen…initially.

Becky Platt: 7:41 So at that stage, getting back to the same as before was the goal.

Simon: 7:47 Yes. To begin within the first few weeks? I think that was that was absolutely what was what was the plan?

Becky Platt: 7:53 Having begun his recovery, Simon began to process the impact this experience had both on his professional identity, and in many ways, the way he viewed himself as a human. What would the future hold for Simon? And who is he now?

Simon: 8:08 My badge says Emergency Medicine consultant. What does an Emergency Consultant do? They stand there, they deal with the resoresusurce cases, they fix the printer, they teach others. You know, the whole gamut of what you do is, is what I am. So that’s surely what…if I’m going to I’m going to wear the badge? You do the job, don’t you?

Becky Platt: 8:29 Yeah, I’m really interested in this kind of how your professional identity and I think this is true for certainly for me, and I’m guessing for a lot of us, that our professional identity is really tangled up in how we view ourselves as whole people.

Simon: 8:45 The breakdown itself that the feeling of being broken, was unpleasant. And I think the next stage for me was coming to terms with how I had broken perhaps why I’d broken and, and who it was had broken. And that’s where I think my focus started to shift slowly. Because I start to recognise that the person who broke wasn’t a terribly nice person. And the job that he was doing, was taking its toll, and to be that person who could stand in resys, run the department, fix the printer, do whatever, for me to be that person, I’d had to give up. And so much of who I thought I was, and yet, when I stopped and really looked at the 360 feedback, stopped and thought about, well, what do I think people really think I am? It was pretty unpleasant.

Becky Platt: 9:55 Who were you at that point? Well, if you could describe it. that person…

Simon: 10:01 The person who broke, oh, yeah, right. I think that, you know, I think I become, I think that the the stress of the job sent me into full threat mode. And you know, the survival mode where all I’m concerned about is myself, yeah, everything becomes about me. So I know in the months leading up to it, you know, I would, I was angry with every ambulance crew that turned up in the department with a patient, I was angry with junior doctors who didn’t know what they were doing, I was angry with almost everybody that made my life worse, by my reckoning. And that’s not a great place to be, and I accept that. And I think I’d got there over time. And I was, you know, naturally, I was one of those people who felt that they coped. So I was very judgmental of other people. I suppose I still am to a degree, I’m just slightly less and I try my hardest not to be. But I was very judgmental, I was self righteous. I wasn’t a great person at that point, and that has hopefully changed. But that but that journey back was unpleasant. All of a sudden, you have a mirror being held up to you, that you have to look in, and mine was not a pretty reflection. And that’s where I suppose that the positive that comes out of this, you turn it around, okay, I’ve seen this, I’ve seen who I become, I don’t want to be that person. I want to be different. And the mantra that I developed at that point was I don’t want to get back to who I was, I want to become who I who I’m going to be. And it sounds a bit self-help a bit. But it was this recognition, okay, the future is going to be different. Going back to where you were is not a solution to this problem. You see, I’m still a problem solver. And it’s not, what I’ve got to do is I’ve got to decide, okay, how can you be the person you want to be, the person you are supposed to be? And at the same time, do your job? And if those two things aren’t compatible, which bits are you going to sacrifice? Or which bits have to be sacrificed? So became a little bit more of what is going to be different? It’s going to be different? I’m going and moving forward, not going backwards. I’m not going back to who I was, I’m going forward to who I’m going to be. You know…

Becky Platt: 12:32 And who are you now? Professionally, you’ve said, you’re you’re a better husband and father now.

Simon: 12:39 I think we probably have to let my wife and she’ll decide, I think maybe.

Becky Platt: 12:43 We can ask her…let’s hope she’d say yes.

Simon: 12:48 She does. She thinks I’m a better husband now than I was before. And my kids do as well. They recognise that,.

Becky Platt: 12:54 I’m relieved to hear that. Who are you professionally now?

Simon: 12:58 Yeah, that I think that’s something I’m still wrestling with. And so I’m not a clinician, so I don’t see patients and deal with them myself. I think I define myself, one of the ways I define myself is I’m a medical education Polyfilla. I sort of, I fit the gaps – wherever there’s gaps that need to be filled, I tend to do this. I spent time doing medical education and pastoral work, I suppose is the best way to describe what I do. And I do that from a place of I’ve got a lot of clinical experience. So I can still teach clinical skills. And one of the wonderful things about my career as an Emergency Medicine doctor is I’ve got a broad skill set in terms of making diagnosis and recognising there and the diagnostic process. So I’ve got a lot of that. And that gives me some credibility with people. It gives me credibility with medical students, certainly, for now.

Becky Platt: 13:57 Although Simon has found a way to continue working as a medical professional, it feels like the absence of clinical practice within his new role is something he hasn’t quite yet got used to.

Simon: 14:09 I find it very difficult to be in the Emergency Department. When I got back into this more educational role now, I got into that and I would go to work and do that and I would help juniors with their clinical stuff. But I consciously wore civilian clothes shall we call it. And then COVID came along and that wasn’t really appropriate anymore to wear that, for infection control issues, and I had to put scrubs on. And every time I put them on, I feel even more of a fraud than I do on a day to day basis. I’m a fraud. A stolen valour. I think is the phrase the Americans use. I miss it. I miss the clinical work. I missed that connection with patients. I don’t think you realise just how much you miss it until it’s gone. I miss, you know, making a scared child feel, you know that it’s going to be okay. I miss going in and seeing a patient, and it’s not about me, that’s about them. And that connection you get with a human being in that moment. And I will never get that again.

Becky Platt: 15:20 You talked earlier about having to make sacrifices. So it feels like, that’s the sacrifice that you’ve made for improved mental health.

Simon: 15:32 Yeah, I don’t think it’s a sacrifice that I made, or you know willingly set out to do, it’s something that I’ve had to realise. And I suppose it’s, I can be sad, I can be bitter, I can be angry, I am very capable of being all of those things. I choose not to be. I choose not to do that. I have to make that choice, because those emotions come up on a regular basis. But I choose not to be. I choose to try and be happy. To try and be useful. To try and and find value in ways that I didn’t recognise were valuable before. I have good days when I feel like I make a difference. And I have bad days. And I think I said to you beforehand, there are days when my diary looks completely empty. And I wonder what am I here for? What’s the point of me? And then there are days when somebody knocks on the door and says, ‘Have you got a minute?’, and I look at my diary and go, ‘yeah, I’ve got a minute’. And then I spend the next number of hours just being with someone, I’m having to learn that there are good days, there are bad days. And the ordinary is okay. I think we see a lot of stuff online, of the people who are the super, you know, educators, the super clinicians, and they’re brilliant, and they give us something to aspire to maybe. Well they have pushed the boundaries of what’s going on. But the overwhelming majority of medicine, of education of pastoral care is delivered by ordinary people just doing their best. And I think we should be celebrating the ordinary. I’m incredibly ordinary. I don’t, I don’t think that I’m anything inspirational, what I think is I’m incredibly ordinary. And if there’s something inspirational, what I do is the fact that I’m an ordinary doctor, who gets up, puts his socks on, puts his shoes on goes to work, and tries to do his best. And I think there are loads of people out there doing that. And we stop worrying about being up here. And understand that being here is okay. Yeah, we don’t want to be down here. We want to try and be a bit better. But sometimes just being here is what people need. That’s where I sit. I’m comfortable sitting there trying to do a good job for people and that’s the value of the world gets out of me. I come to work, I do a decent job. I’m not brilliant. I’m not exceptional. I’m just ordinary. And actually, you know what, I think we should celebrate ordinary a little bit more.

Becky Platt: 18:06 I really like that. The ordinary is okay, and we should remember that. Thank you, you’ve share your journey with us, and we’re very grateful to you. Thanks for listening. You can find more episodes of Only Human as well as details of events, courses and other resources at DontForgetTheBubbles.com Until next time…

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