Thirty years ago this year, my first experience of August as a qualified doctor was of exhaustion and fear at being out of my comfort zone, despite reasonable engagement during my five years of university. During my general medical training, August became the month to watch others go through the same experience and to learn to know when and how to support them. I continue this today, at a bigger distance, with educational supervision of foundation year one doctors. Their training is much more orientated towards realistic medical practice but the increasing complexity of medicine and rising patient expectations means they still have concerns about their knowledge and practical skills. The absolute hours worked are less and should lead to less severe physical exhaustion but the lack of team cohesion and continuity of care can cause its own fatigue and worry.
As a consultant, August is a paradox, with many colleagues away on leave so there are fewer departmental meetings, implying quietness. However, covering the work of absent colleagues that cannot await their return can make work both busier and lonelier as there are no friends to phone. As someone who has tried to avoid annual leave in peak school holiday season, RCR duties make this very tricky as external meetings crowd up to the start of the school holidays and then resume the minute schools return. Fortunately, I have been around so long the school age children of my colleagues have given way to empty nests or new colleagues with preschool children, so I do manage to get a break.
Annual leave is necessary for us all to restore and recharge our batteries, connect with friends and loved ones, and have time out of the workplace away from the relentless intrusion of emails and clinical demands. We all need down time – time to process what we have seen, to find once more those interests that stimulate and fulfil us. The clinical pressures will remain, whether or not we are there to see and respond to them. We need to accept that our capacity to deal with them is finite, without the accompanying nagging guilt that it should be otherwise.
For me, August is a month where time passes at different speeds. Longer days, sunlight and the “out of office” combine to give it a childlike feeling of never-ending timelessness. There is a rather rude awakening when you realise that September is next week and you have done none of the catch up you thought you would fit in. Or the preparation for the meetings booked in.
This year a number of sister colleges are in the vanguard of opening up – events and conferences with formal diner invitations face to face. A sense that the community want to return to something resembling what might have previously been seen as normality. Trying to manage a diary with a fusion of face-to-face and virtual meetings is proving more challenging than either alone. The concept of travelling significant distances to deliver a short lecture (once a tiring norm) is coming up against the relative indolence of constant Zooming from the comfort of one’s own home. Balance will come but coping techniques will need to be learned again.
In addition to the start-up of business as usual, I have agreed to deliver five lectures in September, one of which I need to travel for. Unfortunately, (seriously bad planning on my part) none on the same topic, so no recycling possible. There are also two networking dinners, one in a venue I have never before attended, so a novel experience to look forward to. The responsibility of carrying the Presidential medal through bits of the city I don’t immediately recognise weighs heavily.
Last week I was one of a select group of medical representatives invited to sit at a virtual ’round table’ event with the new Secretary of State for Health and Social Care, Sajid Javid. My first impressions are of a man used to managing a large complex ministry who was surprisingly knowledgeable about the challenges facing the NHS despite only a few short weeks in post. Refreshingly, he seemed to understand diagnostics and the challenges faced in radiology.
A sign of the importance placed on both our specialities, the RCR has secured an invite to give evidence to the Health Select Committee on the cancer backlog. Not the first time I have done this, but a nerve-racking event where I have the chance to land the issues affecting the specialties and our patients to those who might be able to influence more resource to improve conditions.
By the time I next write to you, I may be a shadow of my former self.
Dr Jeanette Dickson