Being a doctor and staying a person
Here, a doctor tells us why she decided to develop a course on emotional intelligence, and the benefits she and her course attendees have gained from it.
'Life is messy, being a doctor is messy. There are always things that happen unexpectedly, things that can make us angry, upset, frustrated. These can be due to things that happen in our workplace, our learning environment or just everyday life. The problem I think is we aren’t always aware of how our emotions affect us.
People often say to me “I understand how to keep things in check, I am aware of my emotions and I know how to keep myself safe.” My response is always “that’s great - but can you always do that? Do you recognise how emotions can drive your conversations with colleagues and friends, especially when you might be tired, anxious or feeling vulnerable. What are those tools you have, that help you keep safe?” That’s usually when things get a bit tricky and the responses aren’t always clear. Some call themselves resilient because that’s what they think they need to be, that’s what we tell people to be, resilient and strong if you are going to survive medicine. If you ask people about what they mean it’s often about shutting out emotions. What is interesting, most definitions of resilience have the word resilience in them!
I am not sure resilience is the best way in keeping us safe as practitioners, and so I have been doing some work in this area about developing our emotional intelligence, running a course for medical students and trainees. I believe we can all build and strengthen our own emotional intelligence wherever we might start from. A beautiful quote from a trainee who came to one of the courses I ran with a Norwegian colleague: “I thought being resilient was about being like a ninja, tough with a hard shell, now I realise it’s more like being a Buddha”.
So, what can make the difference? Reflection is an important skill we can all develop. Maybe not the way you have been taught or think about it at present though. I base the work on Schön – The Reflective Practitioner.1 He talks about reflection ‘in action’ (in the moment) and ‘on action’. This is about your own emotions in the moment – not what you observe in others.
Try spending five minutes a day, for a week or two, thinking about what you feel whilst you as a patient question or listen to it - this is a powerful tool. Keep a few notes about how you feel/felt, then check out your notes and try to write down how this might help or has made you change how you speak or listen to patients.
It is possible, as the trainees and medical students who have been on the course can attest to - read their change stories to see for yourself. Trainees have talked about how this has brought the ‘joy back into medicine’ for them. Students say how it has made them understand more about what it is to take a good history - and really listen to a patient. This is so much more powerful than observing others and what they do. Your own emotions are the ones you must own, manage and get pleasure from. The strength is using emotional intelligence as a basis for this - it has a clear concept and can be defined. So it’s about recognising those emotions, understanding that it’s happening to you and then being able to manage them.
Students on my course now frequently give feedback that they didn’t know everyone else felt like they do. They say it’s very empowering.
So we need to think and reflect more on our own emotions, not hide from them or just use a looking glass to try and deal with them through watching others.
As the trainee Dr Aoife Abbey ged a few years ago: “Five years since qualification, I have learned that if I truly felt the sadness and enormity of the things that passed through my hands, I would drown. It needs to be OK to talk about that”.2
1 Donald A. Schön, The Reflective Practitioner: How Professionals Think in Action. Basic Books, 1983
2 BMA Live and Learn. If we absorbed all that sadness, Aoife Abbey, 2016.