Crazy socks for docs!!

 

Mental health affects a lot of us in the health profession as previously highlighted in my blog post about doctor suicide. Wear your odd socks today to show your support and have a conversation about how vulnerable we all are…

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Adult tantrums

I know they say that you go through the terrible twos and then after that, you apparently learn to regulate your emotions. Well, I currently have a 3-year-old and I can attest that although the tantrums have eased somewhat to what they were from about 18 months of age, we still have periods where someone is clearly losing the plot. How I cope with it is to think that he is briefly possessed by an energy he cannot control and as a way of asking for help, he has to cry and throw himself on the floor. Usually, this is not anything a cuddle won’t fix. I guess it is still somewhat expected at his age though so it’s all good in a way.

Have you ever, as an adult, had a moment where you feel like you were having a tantrum? For example,

• You enter into a store to browse and potentially buy something only to have the store attendant follow you suspiciously around the store as you might not look like the “type” of customer who would buy anything, or they do the exact opposite and don’t even acknowledge your presence. You figure its best to leave the store without buying anything although there might be something you would have bought had they been more welcoming.
• You go for dinner and have to ask for every minuscule thing for your table despite everyone else having the menu/water for the table/glasses/cutlery being brought to their table without having to ask. You then leave the restaurant occasionally before the food arrives and often without leaving a service tip.
• You are a patient and present to the doctor reporting that “I need antibiotics for my sore throat” as a presenting complaint only to storm off yelling profanities when the doctor makes a clinical decision that your ailment is likely viral and they will not be prescribing any antibiotics “in case the infection goes to your chest next week” illustrated in my previous blog Things I wish patients knew…
• You are driving when another driver cuts you off and suddenly you have to make them pay for what they did by honking the horn, flipping the bird, driving erratically and yelling profanities at them.
• You are invited to a party at a certain time only to get there at the time stipulated or a few minutes later and people are still in the early stages of meal prep and the party is at least a few hours from being ready and you think it might be better just to leave. You are thus unable to enjoy any of the party as a result and spend the day on your phone or sulking.
• You come home and despite your partner being home all day and you at work the whole time, you found the house in the same state as you left it in the morning and the dreaded “what’s for dinner?” greeting you at the door. You have a shower and go straight to bed after making yourself a sandwich to see if your partner will sort something out for themselves.
• You have been leaving hints everywhere about what you would love for your birthday/mother’s day/anniversary/Xmas only for someone not to heed your advice but instead get you something you feel you have no use/need for. You smile whilst slowly dying and trying to control the emotion inside.
• You have been dating for a few years and have been talking about getting married but your partner is not proposing “at the perfect time”. You have been overseas together, spent times in secluded beaches/on top of the Eiffel tower/on the edge of the Grand Canyon or other “perfect proposal locations” where you were pretty sure he would pop the question only to leave empty-handed.  You don’t want to ask him when he will propose but you sulk for a little while after every disappointment.

These are some examples that have happened to a few people around me and, I must admit, may have occurred to me at some point and make me realize that there are things called adult tantrums. It can be really hard to regulate your emotions when you are in certain situations and sometimes you end up crying/yelling/sulking in response. I have read an amazing book called Don’t sweat the small stuff, and it’s all small stuff by Richard Carlson, (reviewed on my blog entry titled Books I have fallen in love with… ) and sometimes I can’t help but be carried away by my emotions despite knowing that whatever it is will certainly not matter in a few months let alone in a few days. I, however, thought I would pen a little something to say, it’s okay, adult tantrums happen to the best of us. The key is to acknowledge them for what they are and learn not to dwell on the negative mood for too long. Hopefully, with time, you learn to identify it early and diffuse the inner tantrum before it becomes a full-blown meltdown.

 

 

Doctor suicide

I have recently completed a book by Dr Pamela Wible in which she responds to suicide letters from doctors and their family members (Link is below for the free audiobook). It’s a sobering statistic to learn that on average in the USA, about 300+ of our colleagues call it quits by their own hands ANNUALLY!!!. Unfortunately, there seems to be similar statistics globally among medical students and doctors. I have read about 8 RIP statements to doctors and medical students in the past few months and saddened to hear that the powers that be respond to such findings as “we need to pick a more resilient bunch next time” which I find completely appalling.

I have as a result tried to figure out, what about medicine drives people to this extreme option in dealing with their stress. It must be the culture of medicine that does this, because I would think that we are all very similar when we start high-school compared to when we finish college. I have come to conclude its either medical education or medicine as a vocation as I will elaborate below.

Medical education

• In Australia, before you are even admitted to the university to start studying medicine, there are multitudes of tests which I understand are to ensure you are indeed the cream of the crop. This is in addition to having to pass your final high school examinations with a very high score or like me also having to do 18months of “pre-medical education” before even starting the medical degree. So, most of the people who are eventually admitted to med school are typically some of the smartest of their cohort with commonly type A personality.
• As the career is basically an apprenticeship model of learning, in that typically your lecturers are also doctors, there is always a comparison between trends of the day and how things were when the lecturer themselves was going through training. “In my days we…… or do they teach you anatomy these days?” are common and sometimes very unhelpful comments from some tutors. This model of training can also leave the trainee very vulnerable to the inherent power hierarchy of their supervisor as their evaluations can make or break speciality training applications for example. There are also many different personalities to supervisors and unfortunately, some are the type that is hell-bent on destroying some peoples careers and with the stroke of a pen, are able to do just that.
• From undergraduate degree to full consultant can take up to 15years or hard work ridiculously long hours of often unpaid work, expensive training and frequent examinations which increase the pressure and stress. This protracted learning can lead people to delay life generally i.e. dating, starting a family etc which obviously with the ever-ticking “biological clock” also adds to the pressure, especially for female trainees.
• Usually, to complete medical school and speciality training, there is an expectation that you will be moving houses frequently to do the different rotations required. This comes with learning new staff protocols, meeting new supervisors, learning new systems etc. Also, the usual contract times with hospitals are 12 monthly which means, you are applying for a job annually with no real guarantee unless you know someone who might know someone. Applying for a mortgage with a 12-month contract is one of the many hurdles one might have to deal with as they navigate everything else.

Medicine as a vocation- this profession is one of the options parents of multiple backgrounds give their kids as career choices. “You can only be/marry a doctor, lawyer, engineer, accountant/banker etc”. So by the time you get to start training in the field, the pressure invariably also starts and can trend up with time. Its also a career where one mistake can cost someone their life, where asking for help or asking for time off is sometimes seen as a weakness or where admitting you need help can lead to a report to the regulatory agency.

Without writing a whole new book about doctor suicide, reading this book and watching the related content has certainly been eye-opening for me. Why read such a morbid book or evaluate such morbid statistics I hear you ask…  well, when you seem to be losing colleagues like flies, it’s important to take stock. It makes you take a closer look at how things are and what got us here to hopefully reduce the risk to yourself, your colleagues, your loved ones and the next generation of doctors. At the end of the day, we often forget the fact that we are all human, doing the best with what we know to somehow help humanity in some little way. And, in doing all that, sometimes it can become too much and there is nothing wrong in asking for help. I am here to listen if anyone needs to chat…

http://www.idealmedicalcare.org/blog/physician-suicide-letters-answered-free-audiobook/

*Kindly share the book and this blog post- it might save a life.