Moving down the list…

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29th January 2023

Over the last few weeks, I’ve been having coaching sessions.  I’ve mentioned the challenges I’ve been having lately at work, and the difficulty I have continuing to work for “the organisation” that let me down.  The hope has been to find some clarity in terms of whether or not I can remain working as a GP in the NHS, and if that is not the case, to help navigate through whatever that new landscape might look like.  It’s been helpful and there were some valuable exercises. 

The first week was an opportunity to tell my story.   Exploring what had brought me to this point, including a potted history of my cancer journey.  We talked about my disappointments along the way – there have been many!  Who had disappointed me throughout the process?  The list was quite lengthy, but the coach kept pushing, “Anyone else?”

After a while I felt I had exhausted my list.  “That’s probably enough to be going on with!”, I said.

We reflected on the list briefly, and then moved on.

I thought a lot about the session afterwards, and it didn’t take long for me to realise why he’d been pushing me, and the one answer in particular, he was pressing me for.

It is the first time in 3 long years that I wasn’t at the very top of the list of “people I have been disappointed in”.

I’ve blogged on various occasions about how difficult I have found my response to cancer and recovery. Shaped by pretty much 40 years of striving towards, and in the main, achieving, every goal that I set out to achieve, the fact that I didn’t “bounce back” was so incredibly difficult to deal with. I just fell so far short of my expectations in so many ways.

At the start of the second coaching session, I told my coach about my reflection.  “What do you think that says?” 

Perhaps a little flippantly, I said that I felt it demonstrated that 2 years of psychotherapy and all the associated expense, had perhaps started to pay off! 

But on a more serious note I think it demonstrates a huge amount of progress.  I mentioned that I was still on my list, but I have somehow managed to move myself down the rankings. 

To recap, I had expected to get back to work within a few weeks of concluding treatment. To return to business as usual within a month or so of return.  My professional and personal experience up to that point in my life, had given me no reason to believe this would not be entirely possible.  Indeed, it wasn’t that it was just possible – it is what I expected.  Nothing else would fit with my self-imposed “rules of response”, remembering that I was not a patient, I was a doctor. As such, the standard rules for everyone else most certainly did not apply.

I have started viewing my response and reaction with a modicum of self-compassion.  Finally talking to myself as I might talk to my patients – with genuine care and understanding.  

I just hadn’t felt that I had deserved that level of self-kindness.  I felt I had disappointed so many people: My family. My partners at work, who were dealing not just with the whole Covid nightmare, but my absence in addition. My patients. The list went on…

It might now seem daft to say, but I also felt that I had let my wider GP colleague community down.  We are a fairly close-knit band and my worry was that as a coper, all of a sudden, not coping, could have ripple effects.  I’ve talked about my super woman complex, but I’ve realised that I’m not alone in this belief.  I work alongside a lot of “supermen” and “superwomen”. 

I think we’ve all seen it before.  We all assume that we will cope, and when we see a colleague crumble, it makes us question our own assuredness, our own foundations. We don’t like to be reminded of our possible vulnerability.

Reflecting on the above, it sounds incredibly full of my own self-importance, almost deluded. But I felt so responsible to my fellow GPs, and so guilty about the impact my response could potentially have on them. 

But of course, top of the list of people I had let down was… myself.

Before cancer, I led. 

I did.

And I did a lot. 

And I absolutely crumbled under the weight of it all:  

Delay, eventual diagnosis, the complaint process…

Not bouncing back.

Psychotherapy has helped me unpick all those strongly held, and I can now see hugely unrealistic, expectations about recovery. 

I can see now that my response wasn’t really unexpected at all.  I think it was clear to everyone except myself.

And I am starting to give myself permission for the way I have responded.

“What would it take to move you off the list completely?” I was asked in that second session.  

I’m not sure I have the answer to that yet.  There are, after all, nearly four decades of hardwiring to continue to unpick. But I feel confident, in a way I have never felt before, that one day, one day, that list won’t have my name on it.