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Square Pegs...

9/10/2020

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By Dr Emily Amos
I'm a square peg.

I’m a square peg who only very recently realised that I had spent my life trying to squeeze myself into round holes.

​Since burning out, I’ve come to realise that in order to try and fit these round holes, what I had begun to do was shave off my corners. To take away small pieces of myself bit by bit, very slowly, imperceptibly over such a long time that I almost looked like a round peg on the outside by the time I burnt out. I certainly fit in the round hole I had created for myself.
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Yet, I was still a square peg.
An unhappy, in-authentic, now piecemeal, square peg.

What I’ve realised in the process of break down and re-build is that some of the best things about me exist in those ‘corners’. My creativity for one. My self awareness- that innate sense of who I am and what I need. My ability to connect with other humans in a really meaningful, two-sided kind of way. My unquenchable thirst for knowledge in the most obscure and broad ranging topics.
The things that made me ‘square’ were some of the things that were most valuable to me. My ‘square-ness’ was actually made up of some of the best things about me and it took my candle going out to realise that those were things I really didn’t want to lose.
Specialty training programs. Hospital jobs we have to apply for each year. The way "things have always been done". 

It's easy to think that we need to be 'round' to fit in and succeed in medicine. To some extent we do. The medical world has a way of doing things and there is always going to be round holes that we cannot change. What we can change is how we talk about this and how we support people who like I did, find the endless round holes of the medical world to be exhausting at times.
Since burning out I found that there are a lot of people with advice on how to avoid burning out. Usually, it’s people who themselves have burnt out. I’m no different really. I’ve been through an immense amount of pain, I’ve been exceedingly fortunate to have been well supported during that time and I have come out of the other side passionate about preventing someone else from also going through this experience.
Except this isn’t that kind of advice. This isn’t about burn out. This is about self-awareness. 
Because burn out comes from a constellation of events that litter the path away from self awareness.
My self awareness existed in one of those all important corners that I had shaved off on my path towards trying to “fit in”. I didn’t realise that I had lost it and therefore didn’t realise how much of myself I was compromising as I tried harder and harder to make myself happier or less stressed. I had jumped onto the "medical treadmill" (the seemingly unstoppable inertia that takes us through graduation from medical school, through internship, residency, specialty training and beyond) without ever giving myself permission to consider other paths until I was so burnt out I needed to step away for a while. The thing about losing your self awareness (or not having it to begin with) is that you don’t know why you feel awful. You can’t see what it is that is making you so unhappy and you begin to feel like you just have to "keep going" because you've lost sight of any other options.
​This isn’t about every square peg saying “well this is who I am the world just has to learn to like it”. If you’re a square peg like me and you’re unhappy or searching for meaning, I'd encourage you to explore the places you find yourself within this world and see whether perhaps that round hole you’re trying to fit into can maybe be adapted a bit? A reminder to question yourself (and the familiar foe of 'Imposter Syndrome') but also question the hole you're trying to fit into. To be willing to ask yourself the question if it is in fact truely a place you want to be or are you just "on the treadmill"?
So here I am telling other empathetic individuals it's not about simply "not caring as much" to avoid burning out (which I was told more than once in my career)  but rather about giving yourself the space and permission to really 'know' yourself, what is important to you and what you need. About having the courage to be introspective, even if it means you might find things about yourself that you wish were different (for me personally it was that medicine was perhaps never the "calling" that I thought it was for me) and holding strong and healthy boundaries based on that new found knowledge. 

This is a story from a square peg, about finding happiness in a world full of both round and square holes without compromising yourself or expecting others to change for you. It’s an encouragement to keep searching both within and outside of medicine until you find fulfilment in places you might not expect, without shaving off the best parts of you. The Creative Careers in Medicine website is an amazing place to check out if you end up finding yourself searching for other avenues within medicine. Or you could seek out mentors who might not be professionally where you aspire but personally they have a lot in common with you to seek their guidance in how they made their path work. But mostly, it's to let you know that you're not alone.

Because there really are enough stories from round pegs about how everyone just needs to be flexible and change to fit into round holes to avoid burning out. It’s not what I needed to hear. And it’s not my story.
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The 'Other Side'.

16/8/2020

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By Anonymous
I have always thought of myself as an empathetic person. I felt that as a physiotherapist I was considered in my approach, thoughtful in my words and understood as best I could what each individual I met may be experiencing. I saw myself as strong but kind, able to help others through their rehabilitation. ​
​My relationship with my patients was as a knowledgeable ‘healer’.
These beliefs all changed significantly when I found a lump in my breast and underwent a bilateral mastectomy. I felt as though I had been catapulted to the ‘other side’, having never appreciated there might be such a thing.

​My experiences as a patient had a profound impact on my practice thereafter. In sharing some of these experiences, I hope it may allow you to reflect on your own practice as a ‘healer’ or ‘therapist’ and how it shapes our identity as health professionals and humans.

Whilst in hospital I did not share that I was a physiotherapist.
In fact, I did not openly share with many that the surgery was happening. There is a mix of reasons why I didn’t share (and still don’t) but the overarching theme is of fear, of admitting a weakness. Medical professions can polarise the world into two very distinct groups.
 There are those who are sick or sore and therefore in need of help or healing, and those that ‘do the job’. ​
Having always been strong, fit and healthy and part of the ‘doing’ group, becoming a patient challenged my identity. I also had fears that others would no longer perceive me as strong, fit, and capable. Which ultimately I believe, is part of what led me to remain silent. 

I had assumed breast loss to be hard but had not fully thought through the impact this has on the whole self. It wasn’t that I was particularly proud of my breasts prior to surgery. I was small-busted and thanks to breastfeeding there was nothing I’d show off. But the tissue was my body, had served a practical function in feeding my babies, and was part of my sexual identity as well. Comments from well meaning nurses or therapists after the surgery (comments that I too had previously made) such as “the surgeon did a good job” or “your scar is so neat” were met by my own resistive thoughts like “there is nothing neat about this at all”. The truth for me is that, despite a “successful surgery”, my body will never be the same, and for that I feel grief and loss. What I longed for was for someone to acknowledge that loss, to recognise that none of this was wanted, and that change is difficult.

Having never previously had major surgery, I had no appreciation for the utter exhaustion that comes with recovering from surgery and anaesthesia. This exhaustion encompassed mind, body and my sense of self. I returned to work after four weeks, much to the bemusement of my surgeon. I remember his words clearly, "What makes you so different from anybody else that you would heal at a faster rate?"

For some reason as health professionals, we believe we are different, that somehow physical or mental health and healing would be different for us. But truthfully, it’s not. ​
​We are no different, and in fact this belief that we are somehow stronger, more capable of healing or better able to navigate health issues, leaves us vulnerable to poorer outcomes and isolation in our struggles.
I believe this professional facade can permeate our attitude to our own personal health challenges and risks ultimately causing greater anxiety and distress.
It has just marked two years since my surgery.  
As more time passes, I wish that I had spoken up at the time.
I wish that I had shared this significant health event with more family, friends and colleagues so that they could be part of my life, this journey and allow them the opportunity to take on the role of ‘healer’. I recognise now, that in not sharing at the time, it has denied those around me that chance to help me when it was needed most. Two years on, it feels a little foolish not to have shared more than I did. 
If you are in the midst of health challenges, whether physical or mental, my encouragement to you is to say so. To share and allow that breaking down of the ‘us and them’ mindset, which ultimately only hurts us. ​
Sometimes life is very hard, but it does also get better. Wounds heal, strength returns and life marches on. Kindness, compassion and understanding ourselves as health professionals along the way can make all the difference.
​
Peace.
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