In medicine, we should remain calm and professional at all times, but there are days when it is a challenge for me. I get emails that annoy me, demands I know I can’t meet and phone calls that just make me want to scream. Actually, it’s always the emails that wind me up the most (I used to keep a folder of the ones that upset me, but I know now that there are much healthier ways to deal with my feelings.)
Sometimes it is hard to work out exactly what has wound me up. Maybe it’s a Monday thing, maybe it’s just irrational, but there are certain times and situations that just make me want to go and do something pointless so I don’t scream.
When you want to blame everyone but yourself
If I get numerous interruptions, non-stop phone calls and a pile of emails, I know I will get tetchy. If it seems like I am being blamed or not trusted in some way, I know that, however irrational it is, I will be frustrated. When I can’t work out what’s wrong with someone or they are not getting better and people keep telling me about it, I will be on edge. What I have come to realise is that, when I feel like this, there is almost always something I am missing, some context that I’m not aware of. It might be a wrong diagnosis, a decision I have been too quick to make, or a flaw in my plans. I am blaming everyone but myself.
In Life, The Universe and Everything, Douglas Adams wrote of a clever way of making massive objects completely invisible. You just cover them with the patented ‘Somebody Else’s Problem’ force field. His device relied on people’s natural disposition to not see things they don’t want to, weren’t expecting to or can’t explain. Their brains just edit it out, like a blind spot – they become completely invisible.
So when I want to blame the patient, the family, the lab or a colleague – basically, anyone but me – for whatever is going wrong, it is my brain editing out the problem by telling me it is not my problem – it is someone else’s.
Take a moment to reflect
If, like me, you get those feelings, treat them as alarm bells. Take a moment and ask yourself a few questions when the bells go off:
- Am I missing something here, have I explored all possibilities?
- Is my plan appropriate and safe?
- Did I listen to everyone and consider lots of opinions, even the ones I didn’t like?
- What might I have failed to take account of?
- Am I ignoring a test result, or something else that doesn’t quite fit?
- Did I act professionally?
- Was anything else going on that could have distracted me at home or work?
- Is this actually someone else’s problem and should I clearly leave it with them?
- Am I creating a drama where there is none?
- What is actually the worst that could happen here – is this something very important or really just something daft?
Know when the problem is yours
You have to decide what to do when you realise the problem could be yours. Sometimes just knowing when you get irrationally angry is enough to give you that awareness. Sometimes the problem is small and you can just forget about it. But the issue in medicine is that most of the things we worry about are pretty big, so you need to deal with them.
Talk things over with a colleague, take some time to review notes, results or the situation. Reflect on what was being said to you and how you reacted. Be rational, realistic and reasonable to work out what you can and can’t do in the time you have. If you need help, say you need help and go and get it. Never be ashamed to say you don’t know. Never be embarrassed to change your plan, your diagnosis or your mind.
Showing weakness is not a bad thing. People respond well to humility, especially more junior colleagues. Beware the hierarchy that is unconsciously in place. Your juniors need to know you are not infallible and that you know this yourself. Make sure they feel they can question you, point out inconsistencies or suggest alternatives. Creating the environment or culture where it is okay to speak up or be questioned is safe. You are surrounded by brilliant people who can help you. Be friendly, keep up to date, be a regular reflector (no you don’t have to write your reflections down), share problems, delegate and have plenty of strings to your bow.
The various pressures of clinical practice can make doctors unwilling to take on other roles but balance and variety will help you get through harder times. Be a regular and opportunistic teacher with all your team, consider time in research, don’t be frightened to be a manager, mentor or supervisor. As well as helping you cope, you can then make sure others get looked after too.
Medicine is an amazing career but there will always be hard days, so be willing to forgive and forget. Learn what your own alarm bells sound like, so you can do things like deleting emails that annoy you. Always listen carefully to colleagues and never make assumptions. Look after your health and make sure you get your holidays – you deserve them.