Dr Louise Randall, GRIT Founder
My journey with GRIT has been a long one that started as an adolescent with dreams of wanting to ‘change the system (NHS)’ in terms of how it dealt with adolescents.
It has taken me on a few twists and turns, and now, two decades in, this is becoming something of a reality. Despite my original aspirations, a stint on the psychiatric ward as a medical student changed my mind and I changed my focus to obstetrics and gynaecology. For six years I worked solidly towards that goal. Yet the reality of working within it was rather different to what I had anticipated.
‘This is Going to Hurt’ has started many much-needed conversations about the reality of being a junior doctor in the NHS. There are many online reviews, opinions and personal stories being shared. A lot of these are from doctors, perhaps for the first time feeling validated about their own challenges and mental health during their medical career. A lot are from women, perhaps feeling validated with their own feelings about their care during delivery and on the maternity wards when previously they might have felt the need to stay quiet and just be grateful that they had a healthy baby. Then there are the blaming ones calling the medical profession misogynistic and disrespectful towards women followed by the counter reactive ones who disagree with this. Whatever they are this programme has clearly touched a nerve with a lot of people.
I’ve watched the whole series and yes it did hurt. It made me feel slightly sad for my younger self, ashamed of feeling emotional and never feeling quite good enough. I recalled the fear and trauma that went with a delivery gone wrong. And nostalgic for the dreams of my even younger self who couldn’t wait to deliver my first baby. I did Obstetrics and Gynaecology for three years before switching to GP training after deciding that it wasn’t for me. I could launch right here into my own story of what it took for me to get there in the first place, what it was like and what it took for me to change career direction. To do so, however, would be missing the point. Whilst these stories of doctors and patients are valid no-one is right or wrong.
What is clear is that something needs to change. At the very heart of it both patients and doctors are asking to be seen, heard, and validated. Doctors are not heroes and to put them on a pedestal is dangerous and unfair. They are human and have the same needs as any other human. At the same time patients are not numbers or a suspected miscarriage waiting to be seen in A&E. They deserve to be treated by someone who can treat them with the compassion and respect they need. That can only happen when the needs of the person treating them are also met and they are allowed to flourish in an environment that nurtures and encourages them.
I can almost hear the cries of “In my day we did 100-hour weeks, looking after 500 patients and we just got on with it” from some colleagues. However, although we live in the days of evidence based medicine, I have yet to see any double blinded control studies that look at patient outcome when treated by a doctor who is fed, refreshed and supported compared to one who is tired, hungry and burnt out but I would hedge my bets that the outcome would be very favourable towards the former. Instead of lowering the standard of medicine I would suspect that rather doctors would be more resilient, less likely to leave the profession and would enjoy their jobs a lot more leading to higher patient satisfaction as well.
I also believe that the cultural change that needs to occur doesn’t need to happen at the NHS level but rather at an educational level in schools. Change will only work if both parties (the NHS, anyone who has dealings with the NHS and patients) are invested in it which means that both need to be clear about their needs and what they need to feel supported and empowered. Therefore, investing in young people and teaching them how to connect with themselves and others, how to create equality in a relationship and how to be an advocate for themselves is crucial in making future changes at big institutional levels. If this programme demonstrates one thing it should be that we teach young people that the most important things in life are the relationships we have with ourselves and others, to be empowered and communicate our needs. Finally, and perhaps the most important lesson, is that we need the courage to be true to and value ourselves, and live the life we want, not the life that we feel expected to lead by others. By teaching young people this we are setting them up for a future in which they can thrive.