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We must be forced to care for ourselves



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