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The gratitude journal of Dr Heather Ryan, aged 29 and 3/4

Dear Diary,

I’ve never heard of ‘gratitude journaling’ before, but apparently it’s one of the five pillars of the RCGP’s new ‘GP 5 a Day campaign’, which aims to improve GP wellbeing, so I’m going to give it a go! I wouldn’t normally bother, but my boyfriend John is an RCGP Council member and was given a ‘wellbeing box’ at Council last Friday (which contains a bag of chocolate coins, some teabags, a mindfulness colouring book, a pen and notepad and the gratitude journal), so it has literally landed on my lap. He’s running for vice chair of Council, so I’d better not write anything too controversial. I’m meant to write down what I’m grateful for every week in this journal, so here we go.

‘Reflect each day on all you have to be grateful for and you will receive more to be grateful for.’

That’s the first quotation in the journal. Gosh. That almost sounds like a pseudoscientific, patronising rip-off of the Law of Attraction, doesn’t it? But this gratitude journal won’t work unless I give it a fair go. So… I’m grateful that there’s such a shortage of GPs in the area I live in. I’m going to get my CCT soon, and I’d always hoped to become a partner early in my career, but increasingly I’m realising that’s a mug’s game. I’ve heard that locums can fetch almost £1,000 a day here. Or perhaps I’ll opt to earn a little less, but refuse to do any paperwork or home visits. I’m not sure that the current model of primary care will remain sustainable if everyone decides to do that, but I don’t want to dwell on that now – I’m meant to be reflecting on my blessings, after all.

‘See life as it is, but focus on the good bits.’

That’s the next quote. I think I’m going to take that approach to this wellbeing box. It contains this gratitude journal – with a jolly exhortation to, once a month, ‘take the time to reflect on the amazingness that surrounds you’. Never mind soaring indemnity costs, an ever-heavier burden of regulation, and practice closures – at least I’ve got this wellbeing kit. The box also contains teabags, with the instruction to use them to ‘connect with your colleagues’. There are days when I work 12 hours straight without having a wee, but why not add in a tea break and make it 12 hours and 10 minutes?

The obvious joke is that I should save myself a bit of money by leaving the RCGP, but I think that would be rash

The kit also contains a ‘mindfulness colouring book’, which mainly consists of small, fiddly, abstract shapes, which don’t seem to have any relationship with reality. I’m sure there’s a metaphor in there somewhere.

The best part of the box is the chocolate coins. There are two chocolate pound coins, two chocolate five pence coins, and a few coppers, which seems appropriate, as £2.16 is approximately what the typical GP partner takes home at the end of the month after expenses. When John brought the box home, I was looking forward to enjoying these – perhaps with a beverage made from the connect-with-your-colleagues teabags – but sadly the RCGP has other ideas. ‘Pay it forward!’ urges the box. ‘Share and GIVE the coins to someone that you think needs it. Not only will it make them smile but it will make you feel good. Win win!’ So RCGP is spending its money sending its members chocolate coins for them to give to other people. In the spirit of this gratitude journal, I suppose I should be thankful that the College has literally got money to throw away.

‘A grateful heart is a magnet for miracles.’

Another wonderful sentiment – perhaps this explains why College welcomed the GP Forward View so warmly?

‘I will no longer allow the negative things in life to spoil all the good things I have. I choose to be happy.’

This is a laudable aim, and one which I am sure will be welcomed by the wider RCGP membership. Registrars who have failed the CSA, for example, will no doubt enjoy being reminded that a repeat trip to 30 Euston Square means another opportunity to use the White Company soap in the College loos – a pleasure which should not be diminished by paying £1,600 for the privilege. GPs in chronically under-doctored areas – like my new home, south Cheshire – should be grateful that they are struggling to recruit, as the increased workload gives them a greater opportunity to get to know their patients. GPs who are priced out of doing out of hours work, as indemnity renders it unaffordable, should thank their medical defence union for allowing them to spend more time with their family. See? The solution to stress and burnout is simple: choose to be happy.

‘Always remember to fall asleep with a dream and wake up with a purpose.’

I like to think I’m pretty good at this already – you don’t end up with your own Pulse blog at the age of 29 by sitting on your backside playing Candy Crush – but there’s always room for improvement, I suppose. I enjoy sitting on committees – listing them all in my Twitter biography makes me sound far more important than I am – so, last month, I stood for election to become RCGP’s deputy AiT representative for the North West of England. I’ve recently discovered that I’ve been successful – yippee! I can’t wait to go to my first committee meeting and give my feedback about this wellbeing kit. I’m going to suggest they swap the teabags for those miniature bottles of spirits you get on train journeys.

‘Do something today that your future self will thank you for.’

The obvious joke here is to suggest that I should save myself a bit of money by leaving the RCGP, but I think that would be rash. Despite an unerring ability to shoot themselves in the foot, I do feel that College does a lot of good, and I am proud to be an active member. RCGP courses and events provide educational benefits and networking opportunities. Via the AiT committee, and local faculty boards, trainees have the opportunity to influence local and national medico-political issues. And, despite the controversies surrounding the CSA exam, the MRCGP is an internationally respected qualification. Rather than flounce off at the first sign of an initiative that I don’t agree with, I hope that – both in the short term as a member of the AiT committee, and in the longer term – I can work within the College to effect change and represent the views of grassroots trainees and GPs.

Even the mindfulness box is not an unmitigated disaster. I applaud the College’s commitment to its doctors’ health, and I can see that these packs might be well-received in a certain context – for example, if distributed as part of the RCGP’s new wellbeing course. I hope that critical feedback is heeded, and this project is refined and developed with the input of ordinary members of College.

‘Gratitude is the memory of the heart.’

Whew, that was a long diary entry! I’m off to bed with some tea – ‘a hug in a cup’, as the wellbeing box helpfully puts it – and my new colouring book. Perhaps John will ‘pay it forward’ and share his chocolate coins with me. What more could I want? To quote this journal: ‘when you stop and look around, life is pretty amazing.’

Dr Heather Ryan is a GP registrar in Liverpool. You can follow her on Twitter @DrHFRyan