The positive from the pandemic
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Annabel crossed the threshold, she knew there would be no human contact for a long two weeks. Putting down her suitcases, she looked out the windows, the view stretching above the buildings of the Inner West of Sydney, with the hazy lower Blue Mountains in the far distance. Her loved ones were only 3 hours’ drive beyond the mountains, so much closer than where she had just been.
The saga had started two months prior, when she received the dreaded phone call from her home country, the UK, that her mother had cancer. Annabel had pleaded with the Border Force government department, to travel to England and stay with her mother for a month. The first application was rejected which was galling for her. She had come to Australia to work as a doctor almost two decades ago, and set up a life for herself, yet in this moment she didn’t have the freedom to leave. Annabel was approved to travel with her second application and breathed a sigh of relief. Her mother had been diagnosed with lymphoma at the start of 2021. In the past two months she had been hospitalised twice with repeated pneumonia after chemotherapy started. She was still in hospital when Annabel got on the almost empty Airbus. Her mother had been widowed less than a year ago and was coming to terms with so much. With different quarantine rules in the UK, Annabel was able to go straight to her mother’s home, the family home, driven by her brother from Heathrow Airport, masks on. She intended on setting a few things up for her mother’s return home, but fell asleep at 6pm unable to stay awake any longer. Her mother self-discharged at 9pm that Sunday evening and was sitting at the breakfast table with Annabel and her brother the next morning. An unexpected and so welcome start to her stay. Overall the trip was a great success with in-home rehabilitation by Annabel (a specialist in rehabilitation medicine) for 4 weeks. She left a freezer filled with home made meals, and a much more energetic and capable mother in her own home.
The fortnight in quarantine was one of the unchangeable conditions of international travel at that time.
So what was Annabel to do with her time in hotel quarantine….? Walking around the hotel room, doing yoga and live-streamed Pilates classes. She played her violin and had a couple of lessons by Zoom. Of course she had daily video calls with her family and watched Netflix series she had never got around to. She thoroughly enjoyed the mindset themes shared in the Ted Lasso series and finished it in two days. But work? In this situation and environment? Opening the pandora’s box to being available to private patients in this once in a lifetime period? Telehealth had been easier to do since the pandemic and lockdowns. She had time on her hands and knew her patient’s waiting list was building up while she had been away. It was time to be decisive and intentional. This was two weeks in the country she now lived in, without the usual family and work routine, but not a holiday either. At times it did feel like a retreat, minus the woodland walks and sharing stories by candlelight.
With this space to reflect without any dependents under the same roof, she gained awareness of what was no longer a low stress part of her career, rather a source of high stress. It was impacting on her self-esteem, her satisfaction with work and connection with her family. The source was her private clinical practice. At times she thought she was less efficient than she had been. Sometimes she could not answer all the queries patients brought to their consults and was disappointed in herself. She had always had high self-expectations and this translated into every area of her life. Wondering if she really made a difference to those who chose to consult with her, she became cynical about her work. She had never mentioned this to anyone, not even her husband, also a medical practitioner. Keeping her cards close to her chest, she hid her emotions under the carpet so she wouldn’t really feel them nor show them. Her kids may have picked up on some changes, or the way she was might have been all they had ever known in their mum. Was this what burnout looked like?
Brown paper bags with repetitive food offerings were dropped at her door three times a day. She had been instructed to wait ten seconds before opening the door to allow the delivery person to walk away. The few times she did see a human, in full PPE, were for COVID swabs done on day 2 and 10. Hardly the time to look forward to being within two metres of another human. Friends dropped food parcels at the front door of the hotel. These fresh home-made offerings were so gratefully received with a sense of support from outside.
This space and time was a place to process what had been auto-pilot for the past 5 years, and the option of quitting had never occurred to her. It just wasn’t the thing to do in a career where you had invested years of time, given up nights of sleep, paid a significant amount of money for training and grown your identity to be 100% related to work. There never was a lecture at medical school that informed you what to do with the emotions created through the scenarios you were exposed to. What to do with what was hidden behind the professional persona had got stuck inside her.
Annabel got over the jet lag and realised this was a fundamental moment in time for her and her medical career. She would continue her public hospital work part time but cease her private practice clinic by December that year. Yes others might be disappointed in her including family, colleagues and patients, but this was her life and career and she wanted to determine how it would continue. She could not control how others felt about her decisions.
The previous year, Annabel had enrolled in a coaching program through a physician-coach based in the USA. Every week she had a 15 minute 1:1 session with a coach. She started to become aware of why she did what she did and didn’t do, appreciating how her feelings drove the decisions she made. Talking about thoughts and feelings was a whole new concept that she hadn’t been exposed to in her medical training, at least not on a personal level, perhaps in psychiatry for diagnostic purposes. One of the biggest changes was that of self-judgement to self-compassion. It needed frequent practice to make the changes to stop the self-deprecating mind chatter to one of kindness and acceptance. Annabel increased her understanding and naming of her range of feelings, realising that life is not all happy, joyful moments. That the negative feelings like discomfort, courage, and fear were normal and part of life. These feelings were ok to feel and process, and they could be helpful in moving forwards.
During the fortnight in hotel quarantine she continued to receive coaching sessions by Zoom. It was a safe space to express what was going on to a non-judgemental, non-opinionated coach, who mirrored her thoughts back to her and helped her see her blind spots. It was always a different conversation to that with a good friend, relative or her partner, who nearly always brought their opinion and advice.
After almost a year of being coached by inspiring and experienced physician-coaches, with results beyond what she had expected, Annabel decided to invest in coach certification herself. She was always curious as to how things work, and the tools used in coaching intrigued her. As a client she was not fully privy to what the methodology was. The coaching certification was delivered virtually and she met a range of peers, also in healthcare, from around the world. It was intense, with live assessments via Zoom in front of peers and her mentor. One main difference with medical training and coach training was that failure was encouraged! Trying out new things before one felt ready and seeing what happens was normalised. It was a safe, refreshing space where she felt welcomed.
Once she finished the certification she was clear in her next steps. Rather than just using this new skill set for herself, she knew she wanted to share the tools with others as a coach for healthcare professionals. Athletes and executives had coaches, but coaching for doctors wasn’t commonplace yet.
The clients she coached were often overwhelmed and wanting something to change to relieve them of this feeling, that would wake them in the night, and greet them with the alarm clock. They judged themselves harshly and related to achieving goals through pain and strife. They had high expectations of themselves, just like Annabel had, and hadn’t yet considered any other way. Imposter syndrome turned up time and time again, in these individuals with incredible intelligence and success despite thinking the talent police were around the corner. They expressed relief at learning about the human brain in a different practical way than all the anatomy, neurology and psychiatry lectures had taught them. That we are wired to be cautious, seek pleasure and minimise energy expenditure if at all possible. Any easy source of a dopamine hit was exactly what the reptilian brain was searching for! And yet the pre-frontal lobes were the source of higher thinking and allies in managing our minds. By anticipating what might go wrong, what might be an obstacle along the way, and making a plan for it we could stay one step ahead of our primal urges.
For Annabel, she had stepped outside the norms of her profession and added a new string to her bow. She maintained her clinical practice in a public hospital and offered fellow physicians a place to grow into a more confident, energised and satisfied version of themselves.
The meaningful event in her life had been the fortnight in hotel quarantine. This was a turning point in her life where she paused and reflected, and decided to do something different. Annabel believed that by coaching healthcare professionals, she connected with them as a peer facilitator. They created change in their own lives in a way that she had never felt able to do as a doctor in medicine. It was a gift she had and she could share it with the world.