Hold that thought…

So Discoteers…best laid plans n’all…

…this General Election is causing #TwitterDisco no end of chaos…we have had to delay our very important announcement [which we thought we could make tomorrow] for reasons that will become clearer once we are able to make our very important announcement!

We genuinely do have some really, really fab news that we are desperate to share but we now have to wait until Thursday 11th May.

Not to worry though…we’re still planning a mEga birthday-fuelled #TwitterDisco tomorrow night…simply because we can…

Obstacles

I have written previously about the fact that life has a funny way of throwing obstacles in my way and here I am, in yet another week of my life, where as one truly great and pure experience emerges into the limelight [think #TwitterDisco] several other extremely challenging events have risen up to greet me.

I have spent a goodly portion of this week in contemplation, grappling with unsettling and adult truths, trying to work out exactly who I am in order that I can stay true to myself, my values and everything that I hold most dear. An ethical Easter with the potential for life-altering considerations, as it were.

As I step up to a new [and very exciting] challenge in my career, I have felt a responsibility to reflect my humanity and my humanness, to share my insecurities and my fears. I feel this as a teacher, and perhaps I am, in part, writing this for our medical students who we ask to share so much of themselves with us as our learners. But I am probably also writing it for anyone reading this who has the potential to do amazing things but has, thus far, been deterred by lack of confidence or an inability to perceive themselves within ‘that’ world where people call themselves ‘leaders’ [I too am uncomfortable with this word but use it here as it acknowledges the situation I now find myself in] and set out to try to change the world. And I know that there are many of you out there, particularly amongst my female colleagues, who shy away from a culture that feels alien and unpleasant, where ivory towers remove decision-makers from direct contact with the situations that they create for their subordinates.

I spent much of last year with a strong visual image of myself standing in an open doorway, looking into a room and wondering whether to step in and join the party. The welcome that I have received and the excitement that I have felt has been highly intoxicating and alluring. I have felt more alive in my career than I had for many years. And so, I have had to work very hard to temper that feeling, and remain grounded. And I have started to understand exactly why [some nice and some not very nice] people gravitate to such work environments…and how this intoxication heightens the divide between senior leaders and their colleagues.

It is important to me to know that I am not simply trying to find ways in which to justify myself and defend my choices…and whilst I grapple with that, what has really surprised me, and given me some small reassurance, is that I am finding myself to be actually rather good at what I am being asked to do…little old me!

Over the last twelve months, I have been privileged to have the opportunity to challenge and influence decisions at a momentous time in our city’s history. I have championed for radical changes to the way that we view the answers to Deprivation and inequality in healthcare, kept difficult issues on the agenda and held us accountable for the well-being of our colleagues as the NHS stuggles on around us. And what I am trying to remind myself, as I constantly question my motives and my reasons for being here, is that, if I am not here, there may be someone else, less prepared to speak out, in my place.

The limiting factor in any of this self-deliberation is that I only know what it is to be me. My only reference point is a complicated and vivid imagination, creating fairly constant turmoil within a head which doesn’t seem to have the required ‘off switch’ to allow me to ‘just be’ for the vast majority of the time. Maybe this is the same for everybody. Maybe life is one steady stream of obstacles and insurmountable challenges for most…certainly many of my patients would share this view. Maybe other people are just better at navigating this smoothly, or making it look like they are navigating it smoothly or, at the very least, better at faking it than I am. I guess I will never really know.

I don’t always help myself…I am [almost certainly] more challenging than most, tricky at best, obstinate and [it has been said more than once] ‘a complete nightmare’ on a pretty regular basis. But what is interesting during this week, as I have forced myself to talk more honestly than I have in years with a few trusted friends, is that each of those confidantes has also shared uncertainties about themselves, as well as trials and tribulations of their own. And so it has gotten me to thinking that one of our flaws as grown-ups is that we do not share enough of what makes our life hard and us vulnerable, leaving everyone to feel that it is just them that struggles to make sense of a pretty crazy and often brutal world.

There is so much for me to continue to consider and explore…there is something about being a ‘new’ leader…although my little brother would say there is nothing new here! Something about the need to challenge the status quo, especially where there is reluctance to share personal difficulty within a culture where this is seen as weakness and risks calling one’s ability into question. And there is definitely something about being both female and a mum in a [very frustratingly] male world. There is another blog to be written somewhere on this latter consideration.

Rightly or wrongly, I feel a responsiblity to set out my stall and show that things can be done in a different way. To dare to believe that sharing my humanness and vulnerability might actually make me a better leader. And to be blatant about the fact that I don’t park my personal self at the door when I come to work each day. Whilst this heightens my own personal risk, I think that I have concluded that I would rather be me somewhere else than pretend to be someone else in a culture that needs to be both more truthful and more humane than it presently is.

If I am going to achieve what I want to, and live out the [somewhat ambitious] goals that I have set myself as I further integrate into ‘that’ world, I am going to need to find a way to hold onto the principles that motivate and drive me forward on a daily basis. I need to use my new-found place in this world to best effect. And I think that being honest and transparent about the turmoil that accompanies such grown-up decisions and responsibilities may be one way in which I can continue to hold myself to account and not lose the most important parts of both my morality and my innermost self in a extremely big and scarey and complex world.

Writing this down is one small step in that direction, making me hold myself to account for my current deliberations. I have to go on…there is too much potential to change our city for the better. But I am going to try my very, very best to do this my way and the right way…continually remembering to challenge the system within which I have now been allowed to established a role.

And so, I promise both myself, and the folk for whom I am trying to make things better, that I fully intend to stay ‘me’ and I sincerely hope that this is exactly what makes it okay for me to be where I am right now…

#TwitterDisco…gets a song…& a tram stop!

So…we’ve been teasing you all for weeks and it’s time to put you out of your misery…suffice to say #TwitterDisco has made it to the [relative] big time…& it’s largely thanks to all of you, our amazing Discoteers.

Over the last few weeks Louise Brady, John Walsh & I have been plotting behind the scenes, meeting producers and talking with music directors, & we have an amazing fun-packed summer ahead.

We are delighted to have been asked to join in with an “exciting large-scale creative music collaboration” working with “The Bridgewater Hall, Transport for Greater Manchester, Metrolink, The Bridgewater Hall Community Education Trust and music services, arts venues, cultural institutions, schools, community groups, transport networks and media outlets across Greater Manchester”.

We will be an official part of the 25th anniversary celebrations for our tram [and it is well documented just how much I bloomin’ love t’tram] by writing a song. And, as if that wasn’t thrilling enough, we are to be ‘given’ a tram station…our very own dancefloor!

So, here’s what’s going to happen next. We are going to write and record a song. And this includes you Discoteers.

What we need from you is…lyrics. And, in true #TwitterDisco style, we want you to share them with us on Twitter. Time to get your thinking caps on…

On Friday 21st April between 9pm and 10.30pm we will be asking you to tweet us lyrics using #TwitterDisco #TramTracks. You can link them to your own blog or attach pictures and links to give you more creative space OR you can be very cunning indeed and limit yourself to the 114 characters remaining once you have added our #!

We will then collate all the responses from that night and take them into the recording studio to cut & paste [I am almost faint with excitement as I write this last sentence!]. Whilst we can’t promise to curate all of your words, we will do our best to honour the sentiment of what you share with us and we hope that the finished product will do justice to how you feel about #TwitterDisco.

After that, we will be back with news to let you know about how & when we are recording because we want you all in on that part of the project too.

In case you’re looking for inspiration, this is what we’re telling the world about #TwitterDisco…

“We are a virtual health & social care disco that believes in ‘caring for those that care’. We come together once a month & share music that lifts us & makes us happy. We are a Twitter community that support, inspire and nurture. There is no agenda…we just enjoy doing what we do!”.

So get writing and we look forward to hearing from you on Friday 21st April.

PS. Just in case that wasn’t enough excitement for one week, we still have a few tricks left up our sleeves so…keep a close eye on this blog. We will be releasing further announcements throughout April. There is evEn more yet to come…

#TwitterDisco: Caring For Those That Care

If you haven’t joined us for a #TwitterDisco yet then why not?

You don’t even need to leave the house.

Our next event is scheduled for Friday the 20th January at 9pm with JennyTheM as our host DJ.

All you need to do is…

  1. Find leg warmers & disco shoes
  2. [Bloomin’] smile
  3. Imbibe*
  4. Follow @JennyTheM or #TwitterDisco
  5. Play links
  6. Dance & sing

*optional [mine’s a Babycham #justtheonemind]

As with most things, there’s a back story and so, I’ve been asked to tell you a little of what this #TwitterDisco malarkey is all about…

Last year, as I grappled with the guilt of leaving my GP partnership…a decision which resulted from intolerable pressures and too many days where I didn’t see my children awake…I made a vow to find a way to help my colleagues, many of whom remain struggling at the coal face. In recent years, and in the aftermath of Mid-Staffs, my academic work has increasingly focused on delivering the message that we have to ‘care for those that care‘. My move into strategic leadership was, in large part, motivated by a need to find ‘another way’ for both my patients, living with the devastation of Austerity, and for my colleagues, working with an expanding, often unsafe, workload and increasingly limited resources .

Now, I am not going to tell you that #TwitterDisco is that ‘other way’. And I have been extremely careful not to trivialise the serious impact that the current status quo is having upon many of my colleagues’ mental and physical wellbeing. But there is something about giving oneself permission to have fun that provides an important release from the solemnity of our working lives. And, whilst we negotiate for long-term, sustainable, systemic changes that incorporate an agenda for the well-being of all our NHS staff, it feels okay to to share joy with my colleagues and to promote our humanness and our right to participate in activities that restore us in our time away from work.

For me, that restoration increasingly comes from playing my music, and singing loudly and, of course, the most fun of all is to be found in having a bloomin’ good dance.

Rumour has it that there’s an evidence-base to using singing and dance as therapy, as a way to meditate and to heal. And that’s great. But I’m not very good at being told what to do and so, very much like gardening, I prefer to love it just because I do.

And even though I forgot for a while…I really do love to dance. Always have, always will. A parent, who shall remain nameless, removed me from ballet classes when I was three because I was so clumsy (and chubby) that I was an embarrassment so I don’t mean that kind of dance, I mean DANCE. Disco dancing, club dancing, party dancing, all-night dancing. The dancing you do with the lights low and the music [almost too] loud. The dancing that happens when you give your body over to the music and just let it happen.

Disco dancing and I have history. Without realising it if I’m being honest, I ‘did’ the Manchester Music Scene. Of course, I went to The Hac darling but in reality it was all about Monday & Wednesday nights at The Ritz…if you were there then you know…hot pants, tights, DM’s (first time round), the bouncy dance floor, cider £1 (or even perhaps 50p) a pint. It was an amazing fusion of Grunge (the state of the carpets, not the music) meets Goth and the Manchester tunes got better as every week passed.

As a medical student, I did the Liverpool Cream all-nighter thing. That was particularly fab. When home from uni, we regularly disco danced on Canal Street, usually dressed in fairy wings. Once upon a time, whilst I danced on a table, a perfect Italian described me as an angel. “I’m not an angel, I’m a f*cking fairy” was my reply, and, in non-medical circles at least, that catchphrase has stuck. I am a fairy, but that’s another story.

Looking back, it felt as if those disco days would last forever. But life has a funny way of throwing obstacles in my way and before I had time to bid my youth farewell, dark days arrived. There followed a period of time when joy was lost to me, when I became a doctor and my Dad died. Life was very serious and somehow the fun dropped out of my world. Other things took fun’s place. In the middle of all this chaos and loss, we had the kids and we all know that ‘Rhythm & Rhyme’ on a Friday morning in the church hall does not a disco make.

As our kids got a bit bigger, and we eventually started to sleep again, we realised that we’d somehow made it to 40 and, with renewed effort, we remembered to dance. And when it was my turn to be 40, my h’Uncle Roger brought me a new guitar, all the way from Canada, and I started to play my guitar again. Music became an increasingly important part of our family’s social life. Now, instead of our children keeping us awake, we lost sleep playing guitar and YouTube karoake. And when death suddenly came to our door again, I was reminded, albeit in the saddest possible way, that music  binds us, lifts us, moves us and, in time, has the ability to heal us.

Last year, because of my sabbatical, for the first time in a long time I frequently found myself blissfully alone. Without really thinking about what I was listening to or why, I was taken back to the music of my youth, music from the last time that I remembered feeling truly good.  This process made me indescribably happy and, for the first time in a long time, I felt free. I had serendipitously rediscovered [the old] me. And as I explored & gained confidence with Twitter, I began to tweet about my music. Mostly cheesy, usually from the 80’s, the soundtrack to my day found its way onto my timeline.

Somewhere along the way, other folk started joining in the fun and sharing their music too. Cue stage left…with a mutual love of Fame & leg warmers…Louise Brady entered my world. And she thought that #TwitterDisco could be a ‘thing’. It is her enthusiasm and encouragement, as well as her unshakeable belief in the value of human relationships and mutual support that has brought us to where we are. I have been extremely grateful to experience her warm support and to be welcomed into a new group of healthcare professionals, patients and carers, all working towards the same goal…caring for those that care. A good proportion of the rest of this story belongs to Louise.

In a very short space of time, this novel way of sharing our delight in music has gained momentum. And one of the big attractions is that it can be enjoyed by those, who by virtue of ill-health or caring responsibilities, cannot easily leave their home.

Our last #TwitterDisco had a reach of 142,000. I don’t really know what that means but it doubled from the time before, sounds impressive and we all had a fantastic night in.

We have plans…we’ve a live #TwitterDisco in place for February…that’s one where you can still play along at home or, if able, you can actually leave your house and join us on a bouncy dancefloor…and we’ll be closing a national conference in July.

So here it is…#TwitterDisco is now a thing. A fun, liven up your day, raise some money, do some exercise, sing at the top of your voice kinda thing….a thing all of its own accord, taken to a different level by Louise Brady, John Walsh  and their many colleagues. Warm hearted enthusiasts with confident souls who embrace the world and see the best in everything and everyone.

And the energy and evolution  of #TwitterDisco now rests with them and, we sincerely hope, with you. We’d love you to join us, to sing along and share some of your favourite tracks. And, apart from having tremendous fun, we hope you leave the #TwitterDisco experience a teensy bit restored.

As for me, when not agonising over which leg warmers to wear, I will be watching with interest to see what happens to #TwitterDisco next.

 

a sad goodbye

This coming Monday, sometime around midday, I will leave my practice for the very last time. And whilst the last few months, back at my desk after sabbatical, seeing ‘my’ patients, has tested my resolve, I remain convinced that, for my family at least, taking a break from GP partnership is still the right thing to do. My children know what I look like again, and frequently tell me to go away and to stop bothering them. A once very anxious son is now coping well with life. An often very grumpy husband still has his moments but does not carry the strain of family life on his own and sometimes (almost miraculously) smiles a little.

I have taken time for a few, mostly introspective and teary, reflections as I have silently said goodbye to patients, many of whom I have cared for, often very deeply, and some of whom I genuinely love. And  it is with this sadness in my heart that I share these thoughts about the privilege that being a GP is, and still remains, despite everything that can overwhelm us and make our job near impossible at times.

I have been a partner in a deprived, urban area for 12 years (7/10th of my working life). And whilst I cannot now ever say that I have devoted my whole working life to one practice, and we doctors are competitive souls, I have given the best that I could to my patients throughout this time. And, in a way, part of my reason for leaving at this time in my life, when my family need me too, is because I have sometimes given too much, leaving nothing left for anyone else, especially me.

I found my niche as a GP and have not wanted to be anything else since I realised the power of listening, truly hearing and talking as theraputic tools. Many of my patients have been able to find what they needed in my consulting room and have been able to move on in their lives because of time we have spent together. I have so much knowledge stored in my head about so many of my patients, vital miscillanea that have no place in medical records. I am a respectful custodian  of deep and traumatic secrets that I have been asked to take to my grave, but I have also shared in many tales of life’s joys, successes and triumphs too. And, as I step out of the front door for the last time on Monday, these secrets and tales will leave alongside me.

I haven’t been able to say ‘goodbye’ in any formal sense to either my colleagues or my patients. This change of career path has left me without words for, as I once said, “I cannot tell you how sad it makes me feel to tell you of a decision that has made me so happy”. Today, however, I suddenly felt that some expression of what I have been experiencing, as I’ve treasured my last days and weeks with my patients, was necessary, for me at least.

I went on a home visit this lunchtime to see a dearly loved, long know patient of mine. We hugged, we chatted, we caught up on each others’ family news and then, almost as an after thought, we sorted out ‘the medicine’. And I wanted to distil this feeling, of sitting with a terminally ill patient, who remains generous in spirit despite their pain, whose face lit up when they saw me and whose journey I have been able to share. It is this welcoming that we receive into people’s lives that I will miss, this welcoming that is the privilege of General Practice. It is this that I will miss the most. Being in the same moment with a patient who might just be helped by something that I know or say or hear from what they want to tell me. It is this privilege that, in time, I will seek to find and establish somewhere else.

And so this is my thank-you to my patients. My thank-you that I cannot say out loud because the emotion is too overwhelming to share in any other place than here. It will only ever be these particular patients who formed me as a GP and whose stories have fuelled my passion for my career so far. I may never be able to tell them individually how much they have meant to me, how they have empowered me, how they have enriched my life and made me determined to fight against inequality and deprivation as my career takes a new turn. Perhaps they will never know how much their wanting to see me, instead of another GP, has strengthened my identity and self-worth and how proud I have been to serve them for a dozen years.

As I step out of the practice door for the last time on Monday, I will carry my patients in my heart and I will endeavour to remember the lessons that they have taught me as I continue on my slightly uncertain way.

Forgotten to remember

A somewhat political plea wot I made to some important folk earlier this week…

I was worried about speaking today. I was worried that I would cry, or be too political, and so I thank those of you who have paved the way for me already today. I wasn’t going to say anything, but then I thought “sod it, it isn’t often that a doctor like me gets to address a room full of people who are able to change the system within which we work” and so I wrote these words in Trafalgar Square. (As a complete aside, and as a proud Mancunian, I am always genuinely disappointed in myself when I come to London. It is just so exciting!)

Imagine a deep intake of breath and the need to hold back tears…

 My story is about what has gone wrong in General Practice.

For a long time, I thought that it was just me, that I was weak, that I am not resilient enough BUT that is simply not true. It is the system that is broken and I defy anyone to ‘stay resilient’ indefinitely under the workplace pressures we are currently facing in Primary Care.

Two years ago, in order to focus on my academic work, I began my preparations for a sabbatical. I am the Lead for Ethics & Law at Manchester Medical School and that is a full-time job in itself.

A very difficult 12 months, in both my professional and my personal life, ensued.

A year ago, I left my practice (at the end of a 13 hour day) for a ‘year off’. My family think that description is the world’s biggest joke; I worked harder last year than ever before! On that same day, a year ago, my burnout score was 68/75. This equates to ‘you are at severe risk of burnout-do something about this urgently’. I knew that I was burned out. I did not need numerical confirmation. I did my score on purpose. I did my score to make sure that I did not rely on easy choices and easy solutions as I moved into my sabbatical year.

I was really pleased when, five months later, my score had dropped to 40/75. But this still meant ‘be careful’. Looking back now, it surprises me how long my recovery took.

This morning, on the train at 6am, my score was 24/75 (‘little sign’) and I think this simply means that I am awake, not fast asleep. This score is despite a pretty challenging and important situation that was still being resolved late into the evening the previous night.

Over that last five years, I have vicariously watched my patients’ lives devastated by Austerity. Carrying their pain became too much for me to bear. As you watch this film, please don’t pity me. I have a rich and varied life, meddling in DevoManc, having Twitter discos, inciting medical students and seeing a small number of patients once again. What I want, is for you to watch, and to remember, that my patients, devastated by Austerity, have one less GP who cares for them. And, whilst some of my colleagues are just about hanging on in there, many too are dropping like flies.

http://www.patientvoices.org.uk/flv/1005pv384.htm

 

Half a life…


Some days, when I wake, I am paralysed by the pain of my loss. Today is one of those days. I experience a deep seated, aching pain, absolutely in the middle of my chest, and I wonder if I will be able to face the day ahead. I am, and will always be, a bereaved child.

Today would have been my Dad’s 72nd birthday and I am still so, so angry for all the birthdays, high days and holidays that we haven’t had.

My Dad died in October 1999 after two years of life-prolonging but devastating medical treatments for his leukaemia. They were the most brutal of years and yet the most heightened and precious too. Most of that time, especially in the aftermath of his death, is a haze for me. I was finshing my medical degree. I was getting married. I was renovating my first home. I had no idea what to do in this situation that was beyond human steer or emotional control.

And in many ways, I still have no idea what to do. What to do with this part of me that never wanes. But, most of the time at least, I have learned to live with my life as it is. Acceptance is all that I have to ease my way. And a knowledge that this happens, in one way or another, to us all.

I have ‘outed’ my grief this year. Taken to the brink by the emotional pain and agony of my patients. Becoming unable to sit firmly any longer on the lid of the box that I had closed tight shut nearly seventeen years ago. Needing to find some spiritual peace. Enabled by sabbatical and time for me, by a maturing in my own sense of self, empowered by Twitter as a forum where my colleagues are brave enough to be ‘human’, I have trusted myself to speak out and my world has not, as I once feared, disintegrated.

I was ashamed of my grief. I felt that I had to bury it deep inside. That I had no right to feel the depth of pain that I did when the world is such a treacherous place for so many. I am extremely privileged in so many ways. But now I see that I am my grief and my grief is me. That I am dishonest if I do not confess my ‘conflict of interest’ in matters pertaining to life and death. Because my most formative experiences of dying and death were lived alongside my Dad’s leukaemia. They have informed my professional aptitude and empathy. They have made me the doctor that I am.

My dad was angry when he was ill. He felt that he had only had the opportunity to live ‘half a life’. He still had so much to give and to gain from the world. There was no peaceful resolution, and, in the end, no hope.

This is not the place to expand upon the experiences of my other family members, suffice to say that, because of her loss, my Mum has only lived ‘half a life’ too.

When my Dad died, I did not foresee that the path of my life would be changed forever, but now I live with the understanding that to have loved and lost my best man ever, means that this is the only way that it could possibly be.

So, what do I do?

I live on in my Dad’s shadow, chanelling my time and energies and beliefs into work that I know he would value. Facing the world through his legacy. Trying to live a life that is full and vibrant. Giving daily respect to my own mortality. Prioritising only the things that are important and the people that matter.

And, on days like today, by taking one day at a time…and sitting quietly…and remembering…and being at one with my grief…