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A faulty production line

We must be forced to care for ourselves

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I had already written my blog for this month when I stumbled across a news article, that has left me with a lump in my throat. So I’ve decided to use the visceral emotions I’m feeling right now to write another.

Another junior doctor is reported missing, exactly a year after Dr Rose Polge went missing from Devon. This time it is much closer to home for me because Dr Lauren Phillips works in Bristol, and the active police search for her has been called off after her abandoned car was found in Devon.

Every single one of us has a duty to care for ourselves before others

Descriptions of Lauren have included ‘a very sweet doctor’ who ‘stays three hours late every day to get things done’. It is these words that make me angry and choked up in equal measures. We don’t know what has happened in either of these cases, and it is risky to speculate, but I can’t help wondering who is there to stop us from working all these extra hours and burning ourselves out?

The huge, faceless NHS monster is ready to exploit anyone vulnerable, chew them up and spit them out without the slightest concern for their health. The GMC plays its part backstage, putting the rights of patients over those of doctors.

Let us not forget the GMC’s statements during last year’s junior doctor strikes: ‘The duties of a doctor are set out in Good Medical Practice, which says doctors must make the care of their patient their first concern.’

This statement sums up the emotional blackmail inherent in this toxic NHS culture. No matter that junior doctors may be working 12-hour shifts on a 14-day stretch with none of the sense of being part of team that may have existed in earlier years. No matter that many feel compelled to work an additional three hours a day to provide care in an underfunded system. No matter that they are so indoctrinated to put the patient first that they will dismiss their own needs, even if it may mean ignoring the clinical depression simmering inside them.

Every single one of us has a duty to care for ourselves before others. It is the basis of Maslow’s hierarchy of needs, which can be summed up as ‘put on your own oxygen mask before anyone else’s’. The GMC rightly tells us to keep up to date, ensure patient safety, work together in teams and maintain honesty and trust. But nowhere does it tell us to maintain our psychological health first – through self-love and self-acceptance. It does nothing to encourage assertiveness skills, psychological awareness or survival skills – all key to surviving a career in medicine.

Recent GMC guidance has paid lip service to the concept of ‘resilience training’, but this is contaminated by its introduction purely as a strategy to reduce the number of suicides among doctors awaiting a fitness-to-practise hearing. If doctors were truly encouraged to put their own needs first, the NHS would collapse, as it is run on goodwill. Perhaps that is why this has never been pushed.

I will leave you with the wisdom of Paulo Coelho, author of The Alchemist.

‘When you say “yes” to others, make sure you are not saying “no” to yourself.’

Wherever you are Lauren, we are thinking of you.

Dr Shaba Nabi is a GP trainer in Bristol

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Readers' comments (11)

  • There is zero support for these young doctors. Yes , we may have worked longer hours but there were times of respite . You had a team around you , a doctors mess to unwind , accommodation on site to escape to and have a few moments peace.
    The pace is frenetic now there is no escape , the camaraderie that kept us going has been smothered and extinguished. No wonder the younger generation is finding intolerable and cracking under the strain .
    It is shameful how they have been treated and made to feel they are to blame for cracking - the Chinese water torture system is to blame.

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  • I sincerely hope Lauren is OK and any other young Drs who are feeling low.
    It the NHS was run on the same safety principles as the airlines, the cracks would be immediately evident and it would collapse overnight.
    I agree with your thoughts about the GMC Shabi. It is a willing Governmemt accomplice in actually managing to decrease patient safety. Time to sink it.

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  • Great blog. Yes the hours in the 80 s were much longer but the teamwork got you through. Doctors mess own room on site and close by off duty pub.

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  • Vinci Ho

    Totally forgotten to follow up the search of Rose last year . Thank you for reminding us the way this government has been treating our profession , especially our young ones leading to tragedies:
    Rose Polge inquest: Junior doctor had doubts over profession

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  • Vinci Ho

    The nonsense of GMC chair's resilience training on NHS doctors in the same fashion as soldiers in Afghanistan reflected the whorship of a bullying culture well propagated by a government ruled by a 'nasty party'. As long as we are trained to be emotionally numb and 'resilient' , we can carry on serving faithfully for NHS no matter how broken the system has become as a result of the lies and hypocrisies laid by our political leaders.
    Here is the famous quote when George Orwell wrote a critique on Bertrand Russell's book , Power, in 1939:
    ''If there are certain pages of Mr. Bertrand Russell’s book, Power, which seem rather empty, that is merely to say that we have now sunk to a depth at which the restatement of the obvious is the first duty of intelligent men. It is not merely that at present the rule of naked force obtains almost everywhere. Probably that has always been the case. Where this age differs from those immediately preceding it is that a liberal intelligentsia is lacking. Bully-worship, under various disguises, has become a universal religion, and such truism as that a machine-gun is still a machine-gun even when a “good” man is squeezing the trigger—and that in effect is what Mr. Russell is saying—have turned into heresies which is it actually becoming dangerous to utter.''

    Circumstances may not be entirely identical when history rewrites but the answer , my friend , is still blowing in the wind..........

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  • Cobblers

    "Whorship of a bullying culture".

    Nice typo.

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  • The GMC will have no interest as it is an "isolated case". When I joined the profession in the 1990s I saw it is a strong and powerful group. How wrong I was.

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  • Someone (one of her senior colleagues) should have spotted that she was struggling to cope. There is conscientiousness in ones work and then there is obsessive pathological conscientiousness which is ultimately
    self destructive. Where were her mentors?

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  • 11.49 That's kind of the point. The mentors in the true sense of the word have gone. SHOs are now called 'trainees', they don't have firms any more. In many places, the mess has gone and doctors have to live off site and commute round massive regions in a series of short term posts. Instead of valuing some of the most talented and brightest in a generation, we treat them like cattle.

    Incidentally, I think the line about 'making patients your first concern' was probably more about avoiding profiteering when viewed in its historical context and was not intended to see our profession pathologically destroying itself.

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  • Senior colleagues help? Really??!? When I was a PRHO and an X-ray had not been completed that the Registrars had requested they in front of the consultant asked why I didn't take them down to radiology at 8pm. I responded the reason was I finished at 5pm. Their expressions indicated that this was not the expected answer.

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