Many of us working in the healthcare sector often find ourselves clinging on a cliff-edge. Many will again, find themselves creeping towards that same cliff-edge, time and time again, as our shifts get longer, we become more overworked, the system becomes more corrupt. And many, have already tumbled that cliff-edge, both literally and metaphorically speaking. I’ve seen doctors quit, and I’ve heard friends of colleagues, of other colleagues, take their own lives, in desperate measures, where between themselves and that cliff-edge there remained an eerie stillness. A vacuum in communication. A hard gulp of words. An unwanted silence.
Time and time again, we are taught, through medical school, the importance of communication, the importance of patient language – the language of Medicine. We are taught how to take histories, ask our patients open-end and closed-end questions, how to deliver news – the wanted, and the unwanted. But when are we ever taught how to communicate with our colleagues, again, through that language of Medicine?
As someone who is passionate to specialise in the field of Palliative Medicine, communication is deemed especially important here. It was only the other week that I was discussing with two colleagues, on a visit to London, the importance of language, and what constitutes as acceptable, professional, and necessary, without being dishonest or setting out false hopes. Death. Dying. How many times have you personally had to say this word? Can you say it? Then, put yourself in front of another person, can you still say those words with the same meaning, intention? I somewhat think not.
But, with these words, statements, the language of Medicine also very much comes in the form of doings, actions, too. You may’ve been alerted to the recent discussion over whether doctors should be ‘allowed’ to cry in the workplace environment. When is it professionally okay to let go of your emotions and share a life moment with your patient and their relatives? When is it then, not okay to let go of these emotions, with the danger you forming unprofessionally familiar bonds with your patients, that you begin to get invited to their dinner parties, celebrations, births, funerals. Lives. You become too embodied in every single person’s lives you encounter through your career, and sadly, there’s, quite bluntly, a time and place for that. And there isn’t always that time and place. The real question beyond all this is, when do our patients want us to be human, rather than just bodies of responsibility, leadership, trust, and when do our patients need us to just be human, or the latter.
It wasn’t until I attended a conference earlier this week on the importance of Wellbeing in Healthcare Education that I realised, all of this, our language, communication, physical interactions, with our colleagues, is just as important as is our relationship with our patients. I fear that much of its content was hypocritical – a metaphorical horn-blow to show that we, as a system, are supporting our colleagues and own workforce, when in fact, many of us still aren’t. We’re slipping through the net and we’re tumbling over those big jagged cliff-edges. And in huge numbers too.
Those who weren’t hypocritical though, were the ones who shared their own stories, personal narratives of the hardships and ordeals they had dealt with through their medical careers, and how, beyond those cliff-edges, they have lived to tell the tale, to not only inspire others, but to reassure, to engrain, and embody much-needed change in the language of our working culture. Because, stories – the power of a narrative, is the best and most empowering way we can trigger change – because they are all, deep down, so, SO relatable.
The language we use between colleagues, although praising and encouraging at times, can also be patronising, dumb, diminishing and awfully hurtful at times too. Speakers spoke their stories of how they weren’t heard, through battles of mental health illness, how many were verbally knocked down after expressing their passion in certain specialties. Many spoke of the hatred and discrimination they faced for being ‘different’, from a ‘different’ background, of a ‘different’ approach. I too, have been bullied for having two disabilities and questioned why I even bothered embarking into Medicine in the first place. I was “incapable”, “a waste of space”, “too disabled”. These words – words of hatred, discouragement, and belittling power, are not what the language of Medicine was written for. It is not how the language of Medicine should be told. Our language of Medicine, should be positivity, motivation, collaboration. And kindness.
I recently visited a patient of mine who had lost all vision in a traumatic accident. Being registered blind myself, I was able, to some degree, emphasise and personally understand the new world my patient was now feeling their way through. But it also occurred to me, that now, more than ever, language, more than actions, sights, facial expressions, was far more important than anything else, in helping their recovery and mind-set. I said five words. That’s all. “The sun is shining today”. And the patient smiled. I had engrained, through the language of Medicine, a positive, warming image, to cheer them up. It really doesn’t take much to be kind, and kindness goes a long way.
As my patient nears the top of a new cliff-edge, blindfolded, I can offer them my long white cane to hand. At the tip of the cane is a ball, which rolls off the kerbs and uneven flooring. It can also tell you when you’re about to roll off something, or hit the base of a step. Without that cane, the next step would be daunting, almost impossible, in fear of not knowing what lay beyond that next step. How many feet down you might fall. If, through language of negativity and hatred, I told you the very worst, there would be flames licking up the side of the ragged ashen rock, the hollow drop many feet below. But, if I told you that I had placed a ladder to the side of that cliff, and that, at the bottom, only a feet or two down, there lay an extensive meadow of thick, soft flowerbeds, blooming in colour and sweet, floral scent, that leap would be far more controlled, optimistic and encouraging. In either scenario, it still doesn’t change the fact that you are still standing at the top of that cliff-edge though, does it?
And there you have it – that’s my little narrative for the end of this week. Choose your words carefully, not just with patients, but also with your colleagues too. Embrace your narratives and share your stories of insight and empathy, but be mindful of what impact your language has on everyone else in the hospital around you. This, comes long before any Medicine.
The Language of Medicine – How Narratives shape the Career Experience