Reconnecting Clinicians to Healing

In the USA, doctors have the highest rate of suicide of any profession. In the UK, a similar picture unfolds. Why is it, that 69% of all physicians suffer with depression at least one time in their career? It could be because of the high workload, high stress, high demand, an increased sense of professional isolation coupled with a growing powerlessness to effect change to the systems that often work against the real healing of people.

 

I think all of those reasons are there for sure. But I also think that as doctors become increasing slaves of a system, they lose touch with themselves, the things that make them unique, and are expected instead to act like robots, or cogs in a machine that get people just well enough to return to work and be of benefit to the economy. We have managed to disconnect clinicians from their own sense of humanity. But the art of healing is so much more holistic and profound than the science of clinical medicine.

 

23ec23_61a12bbd059d4b3bbb53f656c3e7eaf7.jpg_srz_p_490_490_75_22_0.5_1.2_0_jpg_srzIf I were to design a health centre, it would not look like any of the places I work in. They are all far too clinical and are probably not very conducive to healing. For starters, there would be a whole lot more natural light, with beautiful artwork (I have some amazing pieces in my room now, by a brilliant local artist, Emma Hamilton) and sense of a continuum with the landscape. There would be places for people to talk with each other around tables where food and drink could be served, isolation broken and community restored. There would be places to encourage exercise or mindfulness through colouring. My room would have a piano in the corner and it would be filled with art, poems, quotes and there would be huge windows with magnificent views of the sea.

 

And my consultations (which could be conducted outside whenever possible!) would use not just my clinical knowledge, but would reflect more of iu-1who I am. Even now, I spend a lot of time laughing with my patients. Laughter is so good! It is healing in and of itself. There would be time for music. I would sing to my patients (they might well leave faster!)……Every doctor I know has talents, gifts, hobbies, and hidden depths that are rarely used when they encounter their patients. I wonder how much more effective we might be as healers, if we reconnected with the God-given sense of who we are and what makes our own hearts sing.

 

I love the story of the Obstetrician from Pittsburgh, who sings to every baby he delivers. What a beautiful thing. What might we all do more of as clinicians, if we thought of ourselves as healers? What spaces might we create? What might our consultations become? I wonder if we did this…..would we be less depressed and more happy in our work? And might we be more effective in gifting wellness to our communities?

 

 

 

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Changing Health and Wellbeing Through ‘Self-Care’

imgresBetter Care Together is the way in which health services are now being redesigned and reorganised around Morecambe Bay, so that we can provide the best care we can for the people who live here in a way that is safe, sustainable and accessible. It is an on-going process and involves the breaking down of barriers between General Practices, the Hospital Trust (UHMBT), Community Nursing and Therapies, Mental Health Services, Social Care, Allied Services – like the Police and Fire Service – and the Voluntary Sector.

Here in Carnforth, we are piloting some work around ‘self-care’ and exploring what it means to be a healthy town. This is now beginning to spread like wild fire around this area, which is exciting to watch! Part of this work is rooted in the fact that currently 1 in every 5 pounds spent in the NHS is due to our lifestyle choices. If we’re going to have a NHS in the future, then we need to try and choose to live more healthily together. We must also recognise that being healthy and well is far more than just physical health. It includes mental health, social heath and systemic (or environmental) health. A few months ago we hosted a number of conversations in Carnforth about what it might be like if Carnforth was the healthiest town in Lancashire. Some really interesting ideas emerged from the community about singing together more regularly, having less dog poo on the streets, creating safe places for the children to play, getting more exercise into our schools, encouraging healthy eating, a mental health café, help for carers and many other brilliant suggestions.

From these conversations, a ‘Self Care Tree’ has grown with four roots and three clear branches that we believe will help us grow together into a healthy and well town. The roots are straight forward –tn_TreeRoots_resized_b-300x300[1] 1) Really learning to engage with our local community instead of assuming that we know what they need and learning to do things with them instead of to them, 2) being part of an Integrated Care Community – see below, 3) Being part of Better Care Together, 4) Understanding Wellbeing – shifting our mindsets from an ‘illness model’ of health to a ‘wellness model’.

The three main branches we have developed in Carnforth are as follows: The first is that we have some ‘culture change’ to undergo, both in our medical and nursing teams and also as a wider community. Over the coming months we will see the emergence of what we are calling an Integrated Care Community – first modelled for this area in Garstang. As part of Better Care Together, we have appointed a fantastic new Care Co-ordinator, Sarah Baines, who was part of our District Nursing team. Sarah will work alongside Dr David Wrigley at Ash Trees Surgery to help co-ordinate care more effectively in the community for people with more complex health problems and provide more stream-lined care, preventing unnecessary hospital admissions and enabling faster and smoother discharges back home from hospital. Secondly, we are learning to take more of a ‘coaching’ approach to how we consult with patients, to encourage more partnership working with people, rather than telling people what to do (which isn’t actually very effective). Staff are training in ‘coaching practice’, ‘motivational interviewing’ and ‘shared decision making’. We are trying to be more proactive with information. If you look on our practice website, www.ashtrees.co.uk, you will find a tab entitled ‘self-care’. Here you will find videos (many more to come and some of which we are re-doing!) that talk about various common conditions you can treat yourself without having to go through the often difficult task of finding an appointment with one of our team. Our local pharmacists are a hugely valuable resource, who can offer excellent health advice and treatments over the counter, saving local people time and inconvenience.  Also, not too far away, we hope to have a brilliant new facility called ‘e-consult’, which will allow our patients to manage their own care more efficiently ‘on-line’.

Stack-of-British-one-pound-coins-1516897[1]The pressure on General Practice is huge. The government only allocates £136 per person per year to General Practice. this money accounts for all GP consultations, appointments with nurses, blood tests, investigations and referrals and indeed the payment of staff. If you want to know what this compares to, then for £136, you can buy 11 months worth of pet insurance for a rabbit or 3 months worth of coffee every day on your way to work!! No wonder the system is under strain! If we want to have a NHS that is free for everybody and still standing in the years ahead for future generations, then we do need to be careful that we don’t abuse the system and take care of ourselves better and think about whether we really need an appointment before booking one!

 

The second branch we have seen is the emergence of ‘community leaders’, who have seen a community need and have stood up to do something about it. We know there are already loads of il_340x270.575369125_lhd6[1]community leaders out there doing great stuff, like sports clubs as just one example. So, we have seen the start of a mental health café, called “Serenity” every Wednesday afternoon at Hunter Street in Carnforth, 2-4pm. A carer’s café has started on the 3rd Saturday of every month 2-4pm, again at Hunter Street. Carnforth Community Choir meets at 7pm every Friday evening at the Civic Hall – singing is well known to improve our health and wellbeing! We have volunteer dog poo wardens, trying to help our streets be cleaner (it’s amazing what dog poo says about a town), and people cleaning up our parks to give the children in our community safe places to play outdoors. We have trained 22 “health champions” who will be starting with various initiatives soon, and many others have volunteered to help in lots of exciting new ways. All of this serves to break down social isolation and encourage us to take care of ourselves and one another.

 

The third branch is ‘clinical leadership’. Right now, Morecambe Bay has some of the worst health outcomes in the country. We have terrible heart disease rates and people die here far too youngimage[1] of preventable illnesses.  It would be wrong of us, as clinical leaders in the community, to stand by and let these statistics continue as they are. Morecambe Bay deserves better. So, we are working with schools to encourage more exercise in the children and young people in our community. Two local schools (‘Our Lady of Lourdes, Carnforth’ and ‘Arch Bishop Hutton, Warton’, with ‘St John’s C of E, Silverdale’ soon to follow)  have started running a mile a day – all children and staff! This is an amazing achievement and there are some wonderful stories emerging already of the great impact this is having on pupils and staff alike. We’re seeing huge improvements in sleep cycles, behaviour, concentration and general health. Under the banner of ‘Let’s Get Moving’ we hope that all the primary schools in the district will soon be participating in other similar initiatives. We have also started a couple of programmes of work with Carnforth High School, in line with needs they have highlighted to us. We are also going to trial a new NHS shopping list and menu to try and encourage us as a community to eat more healthily and avoid some of the unhealthy ‘bargains’ that the advertising giants try and tempt us with, cutting down on meat, alcohol, sugar and too much fat. If we don’t learn to manage our appetites and our spending habits better, we will never overcome the alarming rise in diabetes rates and heart disease. We are responsible together and really can make a change! So, not long from now, people in this area won’t even need to stress about what to cook for the week ahead, because they will be able to turn up to their local supermarket and get some really healthy and tasty ideas, all costed out and easily affordable (with huge thanks to our amazing chefs, Andy Bickle and Lee Till, from our hospital trust, working with us)! By eating more healthily and taking more exercise, we can genuinely change the health and wellbeing in this area for the next 50 years! On a different tack, our district nursing team is also beginning a leg-ulcer café for those who have been housebound. Such cafés have been proven elsewhere to break social isolation and improve healing rates for patients. All of this work is being undergirded by amazing research projects with the University of Lancaster.

As part of our on-going conversation with this community, we are hosting a further 781-T[2]evening, alongside our Mayor, Malcolm Watkins. It will be on Wednesday 6th April, 7pm at Carnforth Civic Hall. There will be other conversations in the next couple of months in Warton (for those living in Warton and Silverdale) and in Bolton-Le-Sands, for those in BLS, Halton and the Kellets. On Saturday 25th June 2016, we will also co-host a huge Health Mela at Carnforth High School. If you live in the area, please do come along to either of these events and talk with us about what is already going on and how we can all work together to make this town and district a truly healthy place.

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5 Ways to Wellbeing 2) BE ACTIVE (Changing the culture of the NHS)

In my last vlog, I started looking at how we might use the 5 Ways to Well-being  to help build resilience and promote health, particularly for those who work within the NHS (though it can apply to anyone). This second vlog takes a look at the being active and how it can improve health and well-being.

 

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Better Care Together – Hope for the Future

iu-4My last post, “Time to Face The Music” was deliberately provocative. We cannot simply keep on doing what we’ve always done or nostalgically hold onto the ‘good old days’. As previously stated, it simply isn’t sustainable and we’re only deceiving ourselves if we think it is.

 

We find ourselves in a a different (post flood) landscape, a terrain that requires a new way of being together. And we are fast learning, here in Morecambe Bay, that it’s not just enough to break down the traditional barriers between Hospitals, GPs, Mental Health, Community Nursing, the Emergency Services and Social Services. No, we have to go much wider and deeper than that if we’re going to develop a radically new way of working that is sustainable. We need to develop a Wellness Service that is of high quality, able to continually improve and offer compassionate, excellent, affordable, safe and accessible health and social care to everyone in our community. In order to do so, we need every person in every community to partner with us. We need partnerships with education, business, sport, justice, housing and the voluntary sector to name just a few. Old silos must be broken down and centrally driven targets must be re-examined to give communities the ability to creatively flourish together.

 

We need big conversations across the sectors of society about what it really means for us to be well and how we can take better responsibility for ourselves and each other. It is so much more than just physical and mental health. It must include a wider understanding of social and systemic health also (see earlier posts on this).

 

And this is exactly what our team in Morecambe Bay is trying to do.images We’re not always getting it right and we’re learning some really tough lessons along the way, especially that our old habits of trying to fix things die hard! Real engagement takes time, but in the process of doing so, we are seeing 3 core principles emerging out of our focused work in Carnforth that we believe to be important keys to unlock this process in every community.

 

As we listen and engage with local people and communities, firstly we are seeing community leaders naturally rise up to make a difference and help increase the well-being of their area. We have many varied examples of amazing initiatives beginning. Secondly, we are seeing clinical leadership that is evidenced based and responsible, but empowers others to make a change. Thirdly we are seeing culture change beginning to emerge, with a more effective coaching culture and a focus on the wellness of those who deliver the care within our communities.

 

iuConversations really matter and carry within them the dynamic potential to make significant and lasting change, as we learn not only to talk differently, but to act differently as well. In the NHS, we have some expertise, but the true experts of their own lives and communities are the citizens we serve. We must change to be much more in conversation with them rather and lose the role of ‘grandma knows best’!

 

 

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1) CONNECT (5 Ways to Wellbeing) – Changing the Culture of the NHS

Here is the first of a series of little video blogs about how we can change the culture of the NHS. The first cohort look at using the “5 Ways to Wellbeing” from the New Economics Forum to help us on our way. This vlog also gives a bit of an intro into the series, so is a little bit longer than the others which will follow.

 

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Floods, Fire and Fresh Thinking in the North

imgresAs I was driving along the A6 today, between Carnforth and Morecambe, on my way to visit an elderly patient, I experienced in the space of a few moments both exhilaration and dismay. I was exhilarated by the magnificent view of the mountains of Cumbria, just across the Bay in the beautiful sunshine and felt very grateful for living in such an inspiring and spacious place. And then onto my radio, came the voice of the Prime Minister in response to Jeremy Corbyn at PMQs. He was asking David Cameron about the lack of government response to the floods in Cumbria of 2014. This direct lack of action across the North of England (despite clear warnings) contributed to the appalling flooding that thousands of people have experienced over the last month. That, coupled with de-forrestation and the clearing of land upstream was a recipe for disaster once the storms hit us. Mrimgres Cameron, however, seemed to think it more important to mock Mr Corbyn on his shadow cabinet reshuffle rather than address the very serious questions in hand. The floods have been no laughing matter for the North. They have been devastating and could have been avoided had the North been treated with equity to the South.

The North is a remarkable place, filled with people of great heart and courage, a people who have historically had the ability to unite at a level to bring about significant change. As one example, it was a petition of the people of Liverpool, Manchester and Sheffield that saw the end of the slave trade in the UK. So, when the people of the North get a fire in their bellies, you can guarantee that change will come.

imgresWell, the floods are serving as a catalyst for this fire. The floods are only another indication of the injustice the North suffers in favour of the politically lucrative South. The South is not to blame and nor is this post intended to be divisive in any way, but it is high time that the North stood up to be treated as an equal partner and not a poorer brother. In my area of passion, health and well-being, the differences between the North and South are completely unacceptable and indeed detrimental when it comes to making effective change to health outcomes.

As already stated on this blog, despite all the worst health outcomes being in the North, 94% of all health research money is currently spent south of Cambridge. We have conclusive evidence from the Academic and Health Science Network, that health outcomes are significantly better in places where research is carried out , because funding follows the research.

We also know, from Health Education England, that when a direct comparison is made head for headimgres between the North and South when it comes to recruitment and staffing levels there is a £17million deficit in the North. It’s not that we can’t attract people to work here, we’re just not given the money to pay for them in the same way.

imgresWhen it comes to council cuts, again we see the North punished in comparison to the South, even though the need is greater here – which area has the highest use of food banks? The answer is the North West! If you study the map on council cuts (deep red = heaviest cuts, blue = increase in spend) – you will see just one blue area in the North, but major areas of protection and even significant growth in budgets for the South.

 

In Lancashire alone, the county council has to cut £262 million from their budget in the next 2 years. This is going to have devastating consequences to public health provision and social services, which is in in effect a cut to the NHS also. We are already seeing severe bed blockages in our hospitals and without social workers to support our elderly citizens, the crisis will only deepen.

 

imgresMy hope is that the North harnesses the emerging fire to come to a place of equal partnership with the South, raising its voice for justice and love rather than in vindictive, competitive vitriol. I hope that the North will together decide what it is to become a “Northern Powerhouse” rather than being prescribed what it will mean via the ideas and ideals of the Chancellor in Westminster. From my perspective, the North is about a different way of doing things. The North stands for a more equitable and co-operative society. In this moment the North can stand for a forward looking culture in which:

Men and women are equal.

Children are prioritised.

The environment is stewarded well.

Hospitality is an art form, practised and adhered to, where all are welcome and all can find a home.

Inter-culturalism thrives as mutual respect for difference is a core value.

The elderly are honoured and cared for with dignity.

Justice involves much more restoration and less retribution.

The rich do not become ever richer whilst the poor become ever poorer, but cycles of poverty and deprivation are broken through hope and aspiration.

Work is done, not simply to earn money and pay debt, but to create more joy, beauty and care in the world.

Well-being is more important than economic growth which involves people being used as fodder to drive the ever hungry machine.

People take responsibility for themselves and each other leading to more sustainable systems (health/education/social services etc) for all.

Healthcare and education is free and accessible to all.

The North must rise up, not to dominate but to become a different kind of “powerhouse”. A house in which power is poured out for the sake of those who need it most in order to create a more fair, just, loving and peaceful world. This is the new politics, not the farce we are seeing in the corridors of power. People learning to live together differently, having important conversations together to create a future that is more beautiful. Come on the North – let’s use this passion for good!

 

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New Year’s Resolution

imagesI’ve been thinking about making a New Year’s Resolution. So, this year, taking my role as lead for health and well-being seriously, my resolution is simple. In 2016 I want to improve my well-being and encourage others to do the same.

 

The New Economics Foundation have done some amazing work on how we can improve our well-being. “NEF is the UK’s leading think tank promoting social, economic and environmental justice. Their aim is to imgrestransform the economy so that it works for people and the planet. The UK and most of the world’s economies are increasingly unsustainable, unfair and unstable. It is not even making us any happier – many of the richest countries in the world do not have the highest well-being.” Have a read about their incredible work (www.neweconomics.org).

 

NEF have come up with 5 simple ways to improve well-being and my New Year’s resolution is to use their 5 steps and blog about the effects I experience personally as a result. I hope that this will be replicated in my work as our team engages with communities. So, here are the steps:

 

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1) CONNECT – this year I am going to be more present. I have found that ridding myself of my

imagespersonal twitter account and spending less time on social media has already helped this. I am going to listen with attention and speak with intention. I am going to listen with attention to my wife, my children, my friends, my family and my patients (rather than assuming what they will say) and I am going to behold them, dig for the treasure in them and be grateful for them. I am also more well when I connect with God, who is love. For me, more than anything this means taking time to be still. Being part of a community, rather than moping around in self-isolation (a tendency of mine at times – surprising for an extreme extrovert!) is also key.

2) BE ACTIVE – This year we are launching a really exciting sports initiative in our local schools to imagesencourage our kids to have better health long into the future. I am going to continue running and swimming, but I will increase this to ensure I am being active on a daily basis.

imgres3) TAKE NOTICE – I have a painting on the wall in my consulting room (done by an amazing local artist) that has these words on it: “Take time to do what makes your soul happy.” I am going to feed my soul good things this year by noticing what is around me. I live in a world, surrounded by beauty – from tiny rare orchids to vast mountains, the sea and the night sky. I am going to notice this beauty more.

4) KEEP LEARNING – I already have some things booked in. I’m going on a refresher skiing course,images
before we take to the mountains in February. I am widening my culinary skills with some cooking lessons. I am re-learning how to arrange some pieces for our local choir. I am continuing to work with a life coach and the NHS leadership program. This will be a year in which I learn a lot! I love learning.

5) GIVE – At the beginning of every year, my wife and I review our finances and make sure that we are giving enough money away. We try to ensure that we give at least 15-20% of what we earn to various friends or charities. Money can have such a hold and I find as I earn more, it is easier to get sucked into an unhealthy imgresview of it. Money is just money. I am determined to have a relationship with it that is joyful and giving rather and anxious and hoarding. I love the phrase – “Live Generously”. I want to live in a way that gives of my time, skills, energy and resources without burning out in the process! My life coach has taught me well about boundaries – very empowering, as long as the motivation is to be able to give. It’s amazing how much a sense of giving/contributing to community and the world really improves our sense of well-being. It’s not an easy path. It’s all too easy to get one’s sense of self-esteem and self-worth by how much one gives, so I will try and remain honest about this.

So, if you want 2016 to be a year in which your well-being increases, why not try the 5 ways above? And if you fall over, get back up and keep walking!

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Christmas

In my last blog post, I talked about the concept of meta-narratives and how they effect our health and wellbeing. For me the Christmas story is the ultimate meta-narrative (the big story with which I align my life). It changes the idea forever that God is a far off hierarchical, imperial, power-hungry megalomaniac. It eradicates the notion that we must go to him where he is in some special sacred space and will only find him if we clean up our act and start behaving in certain ways. No. He comes to us. This story (as JRD Kirk says) is not one of God changing his mind about humanity, but about humanity changing its mind about who God is.

iuHe comes to be with us and changes himself in the process. He becomes utterly human, not some weird, ready-break glowing child, but deeply human and in so doing destroys the stories we have told ourselves about what he is like. He comes to us. He comes right to our very situations, our joys, or triumphs, our brokenness and our shame and says, I AM with you.  And if you run away, I’m there with you. And if you turn away, I’m there with you. And if you hide away, I’m there with you. And if you fail, I’m there with you. And if you don’t believe, I’m there with you in your unbelief.  Because contrary to the caricature of Dawkins, I am love itself. A love that will pour itself out time and again.  A love that is stronger than bitterness, hate and division. A love that is willing to be misunderstood, misinterpreted and misrepresented. This is not the story of a God who slaughters his enemies in order to protect himself and those he holds close (a narrative upon which the nation state is built and uses to predicate the violence it does to others – and if you don’t believe me, then you haven’t read enough history). No, this is a story about a love that will lay its own life down for its enemies and enables us to do the same.

As Steve Chalk says, Jesus never came to start a religion. He came to start a political, social, economic and spiritual revolution. God with us – wherever we are. The God who prioritises the poor, the refugee/marginalised/outcast, the sick, the prisoner, the woman, the child, the environment. The powers have never and will never understand Light in Darkness-02or overcome this light. The promise of the light is peace. Peace on earth. If we embrace the way of love, anything is possible. Even in the midst of all the turmoil in our world this Christmas, I find great hope in the idea of God, who is love, with us in it all. I believe that when we embrace this light and this love as our meta-narrative, as our raison d’être, we find healing for ourselves individually and corporately.

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How Well Are You?

I have the joy of leading some health and well-being retreats with a good friend of mine, who is a life coach. The retreats look at the idea of alignment. Human beings are unique and beautiful, incredibly intricate and are made up of layers, like an onion. Some of those layers are individual and some are corporate, because no person is an island. At the core of who you are is your spirit, your unique self. Then there is your soul – that sweet mixture of emotions, thoughts, ideas, hopes, longings, memories, hurts, resentments, desires, etc. All of that is encased in a physical body, with all the complexities that the intertwining systems entail. And these 3 parts of you are constantly interacting and affecting one anoiuther. For example, physical pain caused to you by another person, may cause you to feel emotionally hurt also (soul pain) and crush your spirit. Or indeed, as I see many times in my work, emotional pain leads to a resentment, which causes a bitterness which manifests itself in a physical pain and so too your spirit is negatively affected.

But you do not just float around in a bubble. You exist in a corporate body, in a family, group of friends and community. You live in an environment of some sort, and your surroundings have an incredible amount of ability to affect your health and well-being. This is evidenced in the effect of air pollution on respiratory disease or the effect of isolation or indeed bullying on mental health. We are all aware of the sights, sounds, smells and stressors in our physical geographies. Added to this corporate body is our corporate soul. And in the corporate soul we find corporate memories, ideas and beliefs, fears and dreams, things we have been taught, world views that shape us and all of this feeds into our meta-narratives, the stories with which we align our lives, that give us some sort of meaning. Surrounding all of this? The corporate spirit. Love. God is Love, not fear, or hatred or violence or bigotry or judgment, but Love. We find time and again in our own lives and in the lives of those who come on retreat the misalignment/disalignment/nonalignment that happens so easily, not necessarily through anyone’s fault, but because life is so complex.

 

It’s not as simple as tweaking one thing and then everything falls into place. Many of us still have to live with chronic and enduring illness of various sorts, be that mental or physical and achieving images“perfect health” may not be possible. But alignment is possible and it is this that gives us a sense of well-being. So, how well are you? Do you know how much you are influenced by the corporate body and soul? What are your meta-narratives? How aligned are you? There are things we cannot change, but we can chose how we respond to them and the choices we make within them. I want to unpack this a bit more in subsequent posts, but this might just kick off some musings.

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Love – It’s a Two Way Street

There is a lie that has been told, to clinicians in particular, that it is wrong to get too close to patients. One is told to keep a healthyimgres separation, perhaps to make the tragedy we often deal with somewhat more bearable. We have shaped medical ethics around the four core principles of beneficence (do good), non-maleficence (don’t do harm), autonomy (respect a person’s own wishes) and justice (treat everyone the same). But as the black eyed peas would ask us (!), imagewhere is the love? Where is the love and compassion that makes us human and deeply connects us to the ‘other’ and even the ‘other, other’ (someone so different to us that we find it almost impossible to connect to them)?

 

I was involved in a conversation recently with Phil Cass, a psychologist and CEO of a healthcare company, from Ohio, about this very subject. He told me some very stark facts. In the USA, the highest suicide rate is now amongst physicians and 67% of medics suffer with depression. Studies found that although these people were motivated by love, they found it very hard to receive love back from those they were giving love to.

 

imgresWe have made the clinician-patient relationship a one way system, and we shut down the reciprocity of the love we give in the name of ethics and professionalism. But this is to our great detriment. Patients love and trust their doctors, nurses and therapists and this love could be a huge source of resilience, courage, support and hope. We must let down our guard and receive back the gift that we give in order toimgres become more healed ourselves. It will allow us to enjoy our work more, reconnect with the core motivation inside us and encourage us, because when we give and receive love it spurs us on to keep going when the system feel like it is against us.

 

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