What happens when you stop?

"It’s not weak to fail. It’s not a failure to be human. Doctors are not gods or monsters but we can feel or be made to feel both, often simultaneously." Serena Haywood, neurodevelopmental paediatrician at St George's University Hospital, writes about her own experiences of mental health, and why it is critical to ask for help.

Good times and bum times, I've seen 'em all, and, my dear,

I'm still here.

Plush velvet sometimes, sometimes just pretzels and beer,

but I'm here.

Stephen Sondheim - I'm Still Here

I was working up quite a Monday morning sweat. I had an imminent neurodisability clinic with medical students and trainees in tow, two weeks of emails to catch up on, urgent phone messages, a pile of post to sign off. Stressful but manageable. A bit of jet lag on top, but nothing to write home about. Anyway, I was a senior consultant with influence, power and people laughing at my jokes. Top of the world. Then Dr X popped her head around the door.

One small comment. Nothing out of the ordinary, nothing dismissive or rude. But it caused something in me to shift, a swift move from confidence to doubt, contentment to self-loathing.

Ten minutes later, I realised I still hadn’t picked my head up from the desk. I was paralysed by fear. And then the tears came. And slowly, the realisation that I wasn’t going to be able to work that day. Or maybe the next. And if I tried, I was convinced I would do things wrong and at worst, I was terrified I would be a risk to my patients and colleagues. I’m not sure how I managed to get up and drag my limp body round to my secretary and tell her I was walking myself down to occupational health. She stopped me from talking and said, “Go, I’ll sort it”.

I was seen straight away. Maybe it was the sobbing. The nurse and then the consultant were thorough and kind. They were keen to know if there was anything about work that had made me crumble, had there been any bullying? They asked twice. We explored my mental health history. 20 years ago I had post-traumatic stress disorder relating to a resuscitation of a baby that had an adverse outcome and the subsequent fall-out. I have a long family history of depression. Three years previously I had finally sought sustained support from what was MedNet (now DocHealth), a self-reporting service via the Tavistock Clinic. I had and continue to have weekly psychotherapy.

My occupational health consultant kindly dug a little deeper. Before I had gone on holiday, a safeguarding situation that I had been managing with colleagues had reached a tragic conclusion. I hadn’t confronted in my mind that I was utterly terrified of an official complaint, a court case and trial by media. But upmost, I was struck by my sense of utter failure to the children I felt I had personally failed. My post traumatic symptoms of insomnia, flashbacks, nightmares and obsessive cogitations were all back. I thought I could solve all of this by ‘thinking’. Doctors are problem solvers, right? But sometimes you just can’t think your way through things. And my general solution to problems is to just work harder.

"How do you do it’’? is a question I get asked a lot. The wiser question is "what happens if you stop?" And that day in my office, my body decided I had to stop.

It’s not weak to fail. It’s not a failure to be human. Doctors are not gods or monsters but we can feel or be made to feel both, often simultaneously. I had triggered an old diagnosis but clearly had burnt out. I scared myself. I’m also hugely proud of myself that I asked for help. I am exceptionally lucky that I have very sensitive and straight talking colleagues and I took the opportunity when I returned to tell them what to look out for in me when I am wobbling for any reason. A loss of sense of humour, more tears than usual (and crying at work is usual - it’s fine - I advocate more crying, we do an emotional job), isolating myself, being grumpy and working increasingly late. Being ‘shopped’ by your colleagues for stress is something utterly mortifying and so having an ability to spot early warning signs is crucial and saves everyone feeling awkward.

Have they told me I’m slumping again since? Yes. Have I said to them, guys, I’m wobbling since? Yes. Have I been back to occupational health? No. But I have helped quite a few people to their open door.

I now write a blog for our Trust and beyond. It’s called Recalibr8. It has practical tips on resilience, funny moments and guest bloggers. I talk about my mental health journey because I hope me being up front about my journey will help others.

So, if by sharing this if it helps just one person, job done. And we’re in this because we care about the children and the families we work for. Knowing that I’m worth the time and money invested in me to do this job has been important. Its easy to forget the positive influence we have on so many people. And things do get better. And it is worth it. And yes, I’m still here.

If you have been affected by any of the issues raised in Serena's story, please seek professional help and advice. We have collated a list of suggested organisations or support that might be able to help.