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Tag: doctor

My wonderful moustachioed man at Heathrow.

My wonderful moustachioed man at Heathrow.

When I was 16 years old my big brother went off on a gap year, backpacking around Australia. I was jealous and wanted to go too but there was a problem – I was only 16. Eventually my parents compromised, I could go, but to […]

Part 2: Creative Commons: the best medicine?

Part 2: Creative Commons: the best medicine?

In Part 1: A rising tide floats all boats, I took my position on the side of Us v Them – free open access sharing v the old established order. Naive you may think but that’s led me to more discussions (and ranting) about Copyright […]

I wasn’t expecting that – more encounters with suicide.

I wasn’t expecting that – more encounters with suicide.

I wasn’t expecting this.

I wrote about my next encounter with suicide because I needed to think through how I was feeling. It had come up with some colleagues recently and I boldly claimed that we needed to be able to talk about it more. I shouted nice and loud…. We NEED to able to talk more about suicide!

I never ever said though, that it was going to be easy.

It all started out as a simple personal reflection on being able to recognise and cope with personal biases, especially as a medic. Suddenly I found myself with a huge number of readers, many of whom shared my post so more readers came.

They didn’t come for any horrific photos, they didn’t come to hear about the gruesome or to be peeping-Toms to the misery of others. It seemed to strike a chord in another way.

The bit that seemed to hit home was when I described how I felt about my personal encounters with suicide and how I dealt with it all. Or didn’t deal with it, as it turns out. I had a lot of private messages, some saying thanks for sharing and one or two being very long and heartfelt. I haven’t yet replied  to them individually because well, I wanted to take time, to get it right. Silly me, that is the very problem!  If we wait to say what we should say, if we wait to get it right, then too much time will pass and we end up not saying anything at all. Then the next time we see those people, we feel it is too late and we still don’t say anything. That’s craziness.

I am glad people felt that they could write to me. I am glad that they shared the same feelings and I am glad that we started a conversation. It has been hard though. A couple of friends have written to me telling me their stories, things I never knew about them, or that they had gone through. I hope it helped. I feel closer to them. I think about them differently now. Strangers too felt compelled to share with me how they felt about it all. I feel differently about it all now.

This is why we need to talk about it more.

However hard it may be.

Thanks too to all those who messaged simply to ask if I was OK and to let me know that they were there even though it was never about me. That was wonderful and shows that yes, we are looking out for each other. The world of medicine/nursing/paramedicine needs more of that stuff.

I am off to make some individual replies.


What is mildly amusing is that since I wrote that post I did actually end up in a bed on my ward via ED … Didn’t jump out the window though, don’t worry!

Stuff that may help:

From EMS1:  How to save a medics life

NYTimes: Why do Doctors commit suicide?

From PHARM: Are you OK?

From Mind : Suicidal feelings

From Samaritans: Suicide


A rising tide floats all boats.

A rising tide floats all boats.

  I was having a discussion about disruptive technology in medical education (as you do) and in a reply one particular line stood out for me… I think the world is now mature enough to be sceptical about what we see and hear on the […]

It is your reaction that is the problem.

It is your reaction that is the problem.

I’ve been feeling a little uneasy about Scott Weingart’s opening talk from SMACC. It was an extraordinary talk, recorded live on stage for the EMCRIT podcast and it took quite a few people by surprise. He talked about meditation and negative contemplation….all good things, if they work […]

Speaking out: teams, juniors, leaders and what SmaccDUB taught me.

Speaking out: teams, juniors, leaders and what SmaccDUB taught me.


Landing on the wrong runway has left with me a story to tell for life. It probably gets more animated each time I tell it over a drink or two…but for once, I’m not the guilty party…ish. I say “..ish” because I wasn’t flying the aeroplane, I was sitting there, holding on with white knuckles and a voice in my head saying “he’s the pilot, he knows what he’s doing”. I said nothing, so perhaps, I too am guilty as charged.

We had been out for a day trip. It had been a beautiful day making it slightly hazy which isn’t always the best for flying but for me it was a great view. We flew over our house and flew over my old school in the Worcestershire countryside. We waved at the tiny flecks of sheep in the fields and followed the main roads as they snaked along below us. I love flying and strangely, the bumpier the better. But all good things come to an end and we had to head home.

As we flew back to the airport I listened to control – he was telling us to land on runway 3-4. That’s definitely what I heard, he said it a few times. The problem was, as we came in to land, in an unsurprisingly windy and bumpy descent, I couldn’t see a 3 in front of me. There was, however, a giant, white number 2 painted on the runway. Something didn’t add up. This wasn’t the right runway but I wasn’t the pilot. I didn’t speak up. I just thought I must have it wrong. He knows what he’s doing after all.

It was a very bumpy ride but rather skilfully, he managed to land without incident. There were no other aircraft or obstacles to hit and we got away with it. That doesn’t mean the pilot wasn’t in trouble!

Last week I flew (as a passenger) back from SmaccDUB to Aberdeen. The lady in the seat next to me was not a happy flier. It was another bumpy one, the weather was rubbish (welcome to Scotland) – she hated it. She sat there hyperventilating and holding on to the armrest and then my arm. I was loving the turbulence but I didn’t think it was a good time to tell her my story. I did tell my colleagues who had been on the same flight as we stood waiting for our baggage – and their immediate (just back from SmaccDUB) critical care doctor’s style response – “Why the hell didn’t you speak up – have you learned nothing?”.

Well, that’s easy for them to say. I think flattening hierarchies is easier said than done. If you’re the boss, just allowing me to call you Rob at work isn’t suddenly going to make me question my judgement less or yours more. That’s a confidence issue that as a junior doctor, I’m not the only one who struggles with. There’s a lot of work to do to make the team understand your reasoning and play along.

The talks at SMACC were delivered by experienced and thoughtful bosses. There was a lot of discussion about leadership, team working and vulnerability in this line of work, about looking after each other and watching your choice of words. Will it help me develop leadership and understand team dynamics? Yes.
Will it shape the direction I go in? Probably.
Will I speak out when I need to? Well, I spent my week in Dublin surrounded by grown up doctors from my hospital. I probably didn’t contribute much because I didn’t feel I had much to contribute. I love this picture of us…and I am not stuck on the end but right in the middle. It will make life easier to have discussions when I am back at work, of course it will. They aren’t as scary as they look 😉


Would I speak up? Yes, now I would but it isn’t easy. Speaking up or calling someone out isn’t easy, whether or not they want you to “just call me James” when you’d rather say Mr Surgeon-Sir. Some of us just find it easier having rank slides. Dealing with team dynamics and leadership is not easy – wherever you fit along that flattened ladder. Some of us don’t find it easy to walk into a room of 2000 people and end up friends with everyone even if there is a free bar and Guinness is flowing. We are all different. I’m not necessarily quiet, I sometimes do say it how I see it. I sent a peace offering to someone the other day and have been met only by silence…you can’t have everything but you have to try.
These so called soft skills are anything but soft just as Liz Crowe (@lizcrowe2) told us in her fabulous talk about love in Dublin. For me, they are harder than learning renal physiology or anything anatomy related for exams. I don’t think I’m alone in that and that’s why we need conferences like SMACC. This week I have managed to keep up my life-long 100% pass rate for exams…but I think when it comes to the soft stuff, one way or another, I fail daily. SmaccDUB taught me that.

A Touch of Mountain Medicine

A Touch of Mountain Medicine

WMT’s Mountain Medicine Course You have the chance to be an expedition medic. Which group would you choose to join? A charity walk with thirty people climbing Kilimanjaro? A school trip to India with thirty 14-18 year olds? A high altitude climb with a small […]

Small town excellence

Small town excellence

Sometimes you have to turn things on their head and look at them in another way. I was made to recently by the boss…who had a slightly different (and of course far more experienced) point of view. I was grumbling to some colleagues about a subject that seems to […]

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