“Having it All” as a Woman in Medicine

[00:00:00] Rachel: The question can women really have at all has become a cliche that’s formed the basis of countless articles in the New York times, the Guardian, the BBC, even. And balancing a successful career in medicine with childbirth childcare, a relationship and all the expectations that come with it, it’s a daunting prospect.

[00:00:19] That’s why I was delighted when my guests, this week, Dame Carol Black gave me her very own take on this seemingly impossible issue. So for this summer special You Are Not a Frog is once again, teaming up with the PMG UK Facebook group. This is the community of UK physician mums who’ve come together to support each other through their personal and professional lives.

[00:00:41] And as with all of our episodes, you can also download a workbook to fill in with space for reflection. Some personal development questions to work through. And some additional resources, so you can land and claim CPD as you listen. So to get this totally free worksheet, just click on the Lincoln show notes or go to youarenotafrog.com/233.

[00:01:01] If you’re in a high stress, high stakes, still blank medicine, and you’re feeling stressed or overwhelmed, burning out or getting out are not your only options. I’m Dr. Rachel Morris, and welcome to You Are Not a Frog.

[00:01:17] Carol: I’m Carol Black. I’m a physician by training and I’ve done a lot of work for government in the health and wellbeing workspace and also worked on illicit drugs and help the government, uh, design its new strategy from Harm to Hope, which is a new drug strategy for the United Kingdom.

[00:01:40] Rachel: It’s wonderful to have you with us, uh, Carol. And we really want to hear about some of your experiences both sort of coming through the ranks of the women and rising to, um, all the various very interesting positions that you’ve had. Um, but also I’m really interested to hear, um, your learning from when you chaired the reporting to workplace wellbeing. Because I, I know I first encountered you in a, it was in a lecture, I think in a workplace wellbeing week at, at Cambridge University, and I was really blown away by some of the insights that you had. And that really actually started my journey into looking at. How we can work happier and, and work better.

[00:02:18] For, for people that don’t know you, just give us a little bit of background and history of, um, yeah, what, how you sort of, how your career went really from, from, from the start of it.

[00:02:28] Carol: I was born into a poor family in the Midlands, went to grammar school, did a degree in history, um, became a medical social worker and then started medicine. So I’m a late entry into medicine qualified, almost when I was 31. Became a physician, became a professor of rheumatology, specialized in an uncommon disease called scleroderma, for which I set up the national service and, and the, um, National Center.

[00:02:58] Then got very interested in the social determinants of health, the Michael Marmot agenda. So where we’re born, what nutrition we have, whether there’s good. Transport around us, what educational, opportunities we have, what do our parents do, all the things that determine, uh, how you are going to be able to develop in life.

[00:03:20] And that led me to be the government’s national Director for health and work. I had before that being the president of the Royal College of Physicians and the Chair of the Academy of Medical Royal College. So I’d done a lot, if you like, in uh, professional organizations and, uh, represented the, uh, physicians, uh, in government, so to speak.

[00:03:43] And then I spent seven years as, uh, head of one of the Cambridge colleges, but did some work for government during that time. And then in 2019, probably one of the most important pieces of work I’ve ever done, uh, was to write the independent review of illicit drugs, which to the government’s new strategy on drugs.

[00:04:05] Rachel: Wow, so such a, a wide, varied career doing all, all sorts of different things. and then that, that report recently, that’s really led to to, to real policy change. Have you been pleased about the response that, that the government have had to it?

[00:04:21] Carol: Oh no, enormously please. I mean, when I wrote the report, there hadn’t been any investment, financial investment in, uh, addiction for nearly 11 years, and I managed to persuade with other colleagues, the treasury to give nearly three quarters of a a million of a billion. Um, we had some 750, uh, million pounds, given to, uh, addiction, both to reduce the, the crime levels and all the awful things that happen as a result of people taking drugs to treatment and recovery and to prevention. And, um, I’ve really been very pleased with the way the government’s endeavoring to roll out the new strategy.

[00:05:05] Rachel: You’ve been quoted as saying, and I, I’m interested in, in, in where it all came from. ’cause you talked about, in, in one of the articles I’ve read about putting on your tin helmet and Teflon coat and just getting the job done. Where did that, where did that come from for you?

[00:05:20] Carol: Um. That putting on my, um, my, uh, Teflon coat and, and my helmet came from a man who helped me greatly when I was at the College of Physicians and the Academy in communication and the media. He was, um, he trained people in the media. But he became a very good friend and he really enabled me to deal with difficult media because when you take on these jobs, you always have to deal with the difficult, they’re always difficult topics.

[00:05:54] And he, he really helped me understand that I didn’t need to be afraid. And one of the easiest ways for me not to be afraid if I think it’s going to be a difficult day, I metaphorically put on my armor, if you like, and my Teflon coats and my helmet off I go.

[00:06:13] It’s a sort of, it’s an ability to not worry too much about it, but to settle myself in a place that then allows me to try and be as effective as possible.

[00:06:27] Rachel: And I can see how that’s really helpful, particularly when it, when it comes to media who are sort of almost looking to criticize, aren’t they? They’re looking to pick holes and stuff. Did you ever have to use that in any of your leadership roles with the committees that you sat on with, with colleagues that you worked with?

[00:06:41] Carol: Oh no. It’s useful in every, everything you do. So, um, when you are chairing committees, usually you’ve got a very diverse group of people sitting around the table, and your job as a chair is to make sure everybody’s voice is heard. And sometimes those voices are difficult and it’s your job to deal with that in as fair a way as possible, not to show any preferences and to give everybody a fair chance.

[00:07:15] And sometimes you hear things that are really quite opposed to what you believe, but you still have the job of, of staying centered and able to cope with that, but also you have to know and have the courage. If you hear things being said that are way beyond what any normal board or committee would accept, you have to have the courage to say, excuse me, but this is not the way we do things in this committee. This is not acceptable. And that can be quite tough, ’cause you know, often people sitting around those tables are important people.

[00:07:54] Rachel: Did you ever think that people treated you differently because you were a woman? ‘Cause obviously you were only the second female president of the, um, Royal College of Physicians, or do you think you were treated in, in exactly the same way that the rest of the man men ran the table? Or you, if, if you had been male, um, president, you would’ve been treated any differently?

[00:08:14] Carol: I think of course at that time there was still relatively few women at the top of, of, of any branch of, of medicine. So of course in a way you were a bit unusual. But the first woman to be president of the Royal College of Physicians was Dame Margaret Turner-Warwick, who was a fantastic mentor and role model for me. And I remember early on in our relationship, she said to me, Carol, do not ever talk to me about being a woman doctor. You can talk to me about being a doctor and any of the problems you experience as being a doctor, but I don’t want you making special pleading.

[00:08:58] And that was, it helped me because I really thought, I am a doctor. I’m not a woman doctor. I’m a doctor and I should just do this job as well as any other doctor does it, and as there will be challenges for male doctors, there will be challenges for women doctors, and of course they need to be dealt with, but don’t go on pleading all the time. It’s just because I’m a woman doctor.

[00:09:30] Rachel: You mentioned that um, she was a really amazing mentor for you. Did you seek her out as a mentor or was that just something that, that happened through the various roles that you were doing?

[00:09:41] Carol: I’d met her through, um, my, my medical specialty because she was a lung doctor and, uh, was Dean of Medicine at the Brompton and scleroderma has a very major lung component. So first of all, we became colleagues, uh, me, a very junior Colleague and my dad, but colleagues, um, on the journey to help patients with, uh, scleroderma.

[00:10:06] And as I got to know Margaret, she was a tough woman. There was nothing easy about her. She was tough on herself, tough on the people who work for, I think they would say, but I found that she was always very honest with me. She made me, you know, realize what it would take if I wanted to be present into the Royal College of Physicians. She, she made it quite clear to me, you know, the journey I was on that was then willing to support me. So, I suppose it started in a medical relationship, but moved on, you know, once I became, um, willing to stand and then was elected.

[00:10:50] Rachel: And how, how important was that for you in your journey having, having her as your mentor?

[00:10:54] Carol: Mentors and, uh, people who’ve been able to really champion me in a way, you know, have been incredibly important. And I’ve had a series of people in my life who’ve played different roles. And I think that is. Incredibly important.

[00:11:16] I mean, mentoring in a way, if you do it well, is not about telling anyone what to do. It, it’s very much about listening, understanding where they are, and then helping them find their own solutions. So she never ever gave me the solutions. She never criticized me when I chose not always to do what she said, and there were times when I didn’t. But that ability to sort of have my back and to be there for me was crucially important. And you know, I’ve been lucky, I think, throughout my professional life to have people like that. It gets more difficult as you go up that sticky pole because, you know, you become more lonely. The, the more important the role you do, the less people there are around for you to talk to.

[00:12:10] Rachel: I was just thinking that I, I think it is quite difficult to find a, well, A, a good mentor, or B, someone who has time to do It. How would you suggest that people go about finding a mentor if they thought that that would be helpful to them? And I think I agree. I think it’d be helpful for everybody really.

[00:12:27] Carol: I used to write to people and ask them. I mean, Margaret, I didn’t have to because we, we, we started off on a different, but, but I have, I have at times in my life when I’ve needed different kinds of help or I’ve used friends who knew people and asked them to ask that person if they would talk to me. And sometimes people don’t have the time. And sometimes when you meet them, you realize this is actually not going to be that sort of a relationship. I think the difficulty is finding the courage to do that.

[00:13:02] And, and, um, when young people write to me, I, I can’t obviously help them all, but I will always try and be helpful in the sense of if somebody’s taken the courage and the time to actually just write to me outta the blue, people do write to me outta the blue. Um, then I, I remember what it was like when I was much earlier in my career and, and you need people to give you a helping hand.

[00:13:31] Rachel: I guess it’s all about, like you said, the courage to ask and then the, the grace if that person doesn’t have time to go. No, that’s fine. Thank you so much, you know.

[00:13:39] Carol: And also the courage to fail. I mean, you are not failing if somebody doesn’t want to, to engage with you. But women more than men, if they get pushback, seem to think it’s the end of the world. It is like, you know, I only tick two of the boxes in applying for this job, so I won’t apply. I need to tick nine at least, and preferably 10. A man will, you know, tip two and think I’ll have a go. And we, I think as women are not quite as good at that.

[00:14:12] Rachel: I agree. I think we also take stuff quite personally. So if, if I know that if I was to write to someone and they said, actually, no, I don’t have time. I might go, oh, oh, they didn’t, they didn’t want to mentor me, where it’s probably much just, they actually just didn’t have time, right?

[00:14:25] Carol: Well actually, you know, you, you have to be honest. And if you don’t have time, but you, you know, I think it depends the way you write that letter, of course, and say, look, I, I can’t do it. And you may have some other, other suggestions, but it’s not taking things personally is really important. Otherwise, you know, life is gonna be really quite difficult.

[00:14:50] Rachel: Agreed, agreed. It, it sounds like though, that you had lots of different mentors. Did you seek different mentors for different types of role and in different areas of your life?

[00:14:59] Carol: Yeah, very definitely. Once I had a few, like left hardcore medicine and I was being a government advisor, and a national director for health and work, I needed quite, I didn’t need a medical mentor then, I needed someone who understood government or, you know, had worked with, uh, with civil servants, I needed to understand about how government works and you know, what to do, what not to do, how to do it, et cetera, et cetera.

[00:15:29] When I came to Cambridge, uh, to be head of house, that was quite different. And you, you know, you then needed, really needed people who understood the University of Cambridge and understood the interaction between the university and the colleges, and they’re very different things. So I got quite good at just asking.

[00:15:49] Rachel: Yeah, I think that’s something, uh, I don’t know whether it’s particularly a female thing, but yeah, we, we, we, we just so worry about asking in case we, in case we get turned down, but, uh, if you don’t ask, you don’t get.

[00:15:59] Carol: And you can always ask in a way that says, I know you may not have time, but you know, do you know someone else who might?

[00:16:08] Rachel: And Carol, I, I presume that you have mentored other people in your time yourself.

[00:16:13] Carol: And still do. I, at the moment, I mentor a, a Cambridge medical student.

[00:16:18] Rachel: Wonderful. And you, you’ve already mentioned sort of listening is, is really important and not expecting to, to give loads of advice. Are there any other things that, that in your experience have been particularly helpful for the people that you’ve been mentoring that, that you’ve done?

[00:16:31] Carol: Well, very often people have aspirations and hopes and uh, ambitions and I think it is very important to listen to those very carefully and not to squash them, you know, even if they’re quite big ambitions, to help that person work through themselves. uh, where they’re going to go. So, you know, it only even at a more, a smaller level.

[00:16:57] So I met my, the young lady I mentor this, this week, and she’s at the point now, she’s nearly finished her course. And she’s trying to decide what specialty she’s gonna be, a physician. But you know, it is between, um, a, a rather. Intensive specialty and one that’s less busy in the sense of you being called in at unusual times, et cetera.

[00:17:21] And so there she is saying, well, for home life balance, I really might want to do the less demanding on my personal time. Really, I’m very interested in this other one. And, and really it’s your job then to listen very carefully, but also to try and help her think not just of the immediate years.

[00:17:46] So, you know, if really doing the more difficult one is difficult for a few years, is that going to be better in the long run? And, and you know, uh, I’ve often said you can’t have everything all at the same time. I think you can have much of what you want as a woman doctor, but you can’t, for example, want to be, let’s say a clinical academic and write grants, and run a, let’s say, laboratory and do some clinical medicine and have four children.

[00:18:19] So a lady who is at the moment, a professor in, in Cambridge, I mentored her many years ago, and she used to say to me, it’s terrible, Carol. I, I’m not able to write as many grants as the men. Um, and, and you know, I can’t write my papers as quickly, and I used to say, but you’ve got four children. You know, and to say, look, life is long and you don’t have to do it all at the same time. You’re going to take a bit longer. You may not be a professor as quickly as they are. You’ve chosen to have four children, you’re very happy with your four children.

[00:18:59] And the other thing, and it’s, this is one of the tough things I think I have to accept is if you do want that sort of a job, I’m afraid it sounds awful, that a lot of one of your salaries if you are both earning, is going to go on childcare.

[00:19:15] I mean, if you’ve got four children, you cannot be a hospital doctor with a lot of on-call trying to run a, a scientific endeavor without a, a lot of help. I know it’s, it’s hard to think while I’m earning this money, but three quarters of, of one of our salaries has to go to childcare. So I think some really realistic assessment of what you can do and the speed at which you can do it. So it’s not that you can’t have everything, but you can’t have it all together.

[00:19:50] Rachel: That would’ve been really helpful for me to know when I first started my, my, my career in, in medicine. Because, you know, when you go through university, you just, well, I, I didn’t think anything was different to me from the boys that I was with. You know, you just assume the career’s gonna be exactly the same, et cetera, et cetera, but you just don’t factor in that, that you have, you have the kids, you have to take the time off, things don’t go as fast. I ended up yes, choosing a specialty because I thought it’d be more family friendly actually, there other specialties, I think I would’ve, I would’ve preferred. Um, but I didn’t do it, so I was so worried about what the impact was gonna be. But if I’d have had a mentor saying to me, you know what, you can still do that, but actually it’s just going to be a bit slower, that would’ve been helpful.

[00:20:31] Carol: And, you know, it doesn’t matter that it’s a bit slower really at all. And, and that’s sort of trying, you don’t have to do it all at the same speed as, you know, your friend who’s decided to have one child, and chooses a specialty or a part of medicine that isn’t quite as clinically demanding.

[00:20:50] Rachel: Because you, you do have to make sacrifices, and you make your choices, don’t you? And if you do one thing, you can’t do another. But when you look at other people, all you can see is the amazing things that they’re doing. You can’t see the sacrifices that they have made or the things that they’re not doing in order to do that.

[00:21:03] Carol: No, and people do make different choices, and as long as they’re thought through carefully and, and you are contempt with them, that’s fine. If it’s your choice. But I, you know, I don’t think you should put off the ambition, let’s say, to be a neurosurgeon, just ’cause you think, oh dear, is neurosurgery gonna be compatible with me having some children?

[00:21:29] You know, I think we’ve got better at that. When I trained it would’ve been really tough. But I mean, the Royal College of Surgeons does an awful lot for women in surgery. it, it is all much better, but it still takes quite a lot of organization and planning to be able to see, you can, you can do this.

[00:21:51] Rachel: And obviously the cost of childcare and then the emotional load that you carry, all, all that, all that sort of thing goes into it. And this sort of brings on to, to the next thing, which I know has been a, a, a massive interest of yours, which is, which is workplace wellbeing.

[00:22:04] What’s your opinion of what the main challenge is today for workplace wellbeing?

[00:22:10] Carol: Well, it, um, if you look at the sort of national statistics, it isn’t a good place to be. So if you look at the number of people in the workplace who say they have a work limiting condition, we have about three point, I think it’s about 3.7 million people who go to work with what they would describe as a work limiting condition, which means they may not be able to work full time, they were earn less than people who can work full time. And that number. Is very close to the number of people in our society who are economically inactive. So that’s quite dangerous that we’ve got, we’ve got almost as many people, if you like, in work, but not able to work to therefore capacity.

[00:23:01] And then if you look at the statistics at the moment, very good report out last week from the Resolution Foundation on Young People’s Mental Health, then that is really staggeringly worrying that in fact many young people are in work with mental health problems. And a very large number of young people do not go to work at all and start taking benefits very early in life. And the biggest reason is mental health.

[00:23:31] Now we are fortunate. We had an education, we have a profession. The largest number of young people who are not in work come from our poorest, most deprived areas. They’re children who’ve been in care, they’re children who haven’t had the benefit of a proper education. They’re mainly children who never would’ve taken a GCSE. And, and if you compound that with the fact they’ve then got mental health issues, that is very worrying that these are young people who are never almost going to see the workplace.

[00:24:02] So the biggest challenge in most workplaces at the moment is stress, anxiety, mild depression, musculoskeletal problems, and then worryingly as people get to middle age, so both women and men working in their middle years, having a combination of chronic health problems. So, you know, you might have a combination, let’s just say, of diabetes, osteoarthritis, perhaps some hypertension, irritable bowel disease, and be a woman in the menopause. You know, you could put together a combination of things that might make it very difficult for you to stay and work. And of course, the long waiting lists that we have at the moment, even for ordinary things like hip replacements, knee replacements. You know, I’m a rheumatologist and, and joint pain is very, very uncomfortable and very difficult if you’ve got bad knee arthritis to get to work.

[00:25:03] So I think it’s a combination of things at the moment. So it’s really asking the employer to do in a way, a great deal to try and accommodate and support people. With their different problems, and people often think we must put in interventions. You know, the idea that you’re going to either put in, let’s say mindfulness or counseling or individual, targeted things. Actually, if you work in an environment where the culture is bad, if the managers do not have a people centered approach, if the leadership of the place you work does not consider health and wellbeing of their staff important, if the board of a hospital chose no interest in their, in the health and wellbeing of their staff, then it doesn’t matter how many interventions you put in. Do you know what I mean? You’ve got to get the culture, the basics right. You’ve got to have people knowing they’re in a good place to work, where people care about them, listen to them and want to make their careers their lives better. And that’s much more difficult to do than putting in fresh fruit and bottles of water and a yoga class and I don’t know, you know? And that’s what is so easy in a way to put in, because you just buy it in. Creating the environment where people feel cared for and looked after is much harder work.

[00:26:39] Rachel: But it’s really hard, isn’t it? Creating that environment when the workload is, is massive. There are targets to be met, when actually people going off sick just creates this vicious cycle of, of more work for other people, and often some of the people that are the hardest work are those managers that are supposed to be li listening and, and, and caring, caring for other people. What would your suggestions be, be for those, you know? Well, I mean, I’m pretty much talking about most organizations in, in the NHS aren’t I. It’s sort of like a chicken and egg type problem, isn’t it?

[00:27:12] Carol: it’s really important that the very top executives and HR ensure that middle managers, ’cause it’s often the middle managers who take the brunt of any of this, are well looked after themselves. So there’s some very good work by um, a Swiss occupational psychologist when he studied the physical and mental health of middle managers. And it probably won’t surprise you that if the health of the manager was good, the health of the people they managed was good.

[00:27:48] If the health, the physical health of the manager or the mental health of the manager was poor, it had an effect on the health of the people they manage. If a manager had poor, physical and mental health, then that was a really bad thing as far as the people they managed.

[00:28:06] So you can’t just pile things on a manager. You got to one, support them and you’ve got to give them training and not just sheep dip them. I hate the idea, you know, I can remember when I was in training, they sent us off to the King’s Fund for I think a day, or I can’t remember whether I went on a course, but you went to be trained, you know, in, in the things around medical management and leadership. But it’s got to be an ongoing, supportive arrangement. It can’t be, I’m sending you off, I’m going to sheep dip you, and you’ll come back with all the knowledge. ‘ cause this is about more than knowledge.

[00:28:47] Rachel: So obviously training is, is, is really important, but often managers are just promoted for their sort of technical ability, aren’t they? Rather than, rather than their, their people skills or, or whatever and then, and we forget, they’re actually managing the people’s with the hardest bit of the job.

[00:29:01] Carol: And you shouldn’t really be, promoting people unless you’re either going to think they’re capable of, of acquiring those people skills, um, and making sure that you are supporting them to get those people skills because they’re absolutely crucial, and you’re going to end up with a very unhappy, and by the way, not productive workforce.

[00:29:24] I mean, people if, if they are truly unhappy at work, are not well looked after, can’t easily be productive. And I know people often say, ah, but that takes time. Well, it’s more than time well spent and if you don’t do it, I mean the net result and by, I don’t think the NHS until, well I, I think probably up to the pandemic gave this enough attention, but there was an attempt during the pandemic and I don’t know really whether it’s continued ’cause I’m not close enough to the front line, where there was a move to make sure managers tried to have real conversations. So the idea of putting aside time to have conversations with the people they manage.

[00:30:10] ‘Cause you know, sometimes you can’t change your situation. There is too much work, there is a great deal of pressure. But I know myself as somebody took the time to listen to what I had to say, just to hear it and to at least sympathize with it, then it was more bearable. I’m not saying it, it should be like that, but there are ways of managing this.

[00:30:37] I’m old enough in my, when was trained, a long time ago to know. The thing I most valued in as a young doctor at night was the ward system made me hot chocolate and toast. I felt looked after. I did a one and two. And the weekends we went on duty on Friday and came off Monday morning. It was grim, but I never felt unsupported. Do you know? So that made a huge. A huge difference to how I felt about what they asked me to do.

[00:31:10] And I think that that just simple caring and at a personal level, um, I, I, I mean I can still remember as a very young doctor, um, a very good ward sister saying with to me one night when a woman was dying and her husband couldn’t come in, sister Kent and I sat by this woman’s bed, but the sister sat with me. She knew I was very, you know, I’d only been qualified, I’d only been on the wards about six weeks. And these are sort of very personal things that make the journey okay.

[00:31:44] Rachel: That people need to feel seen. They need to feel heard. They need to feel supported. Their work. And then actually you can put up with quite a lot of rubbish in the job and quite a lot of trauma and all that sort of stuff if you know you, you’ve just been cared for, right?

[00:31:58] Carol: Yes. And if somebody’s caring for your back, you know, it’s, it’s not, that is an odd sense, is not about more money into the health service. I mean, I’m not saying we don’t need more money. We need more money, we need more workforce, but, but these are very human things.

[00:32:16] Rachel: How do you train that though? How? How do you teach people to do that?

[00:32:20] Carol: Well, I think if it’s, if it’s the culture from the top, it has to be at the top. And I do think that the top of the house, both, whether it’s the admin, you know, the, the managerial side or the clinical side or the nursing side or whichever bit of the top it is, needs to be the example of how you behave, and to call it out when they see things that aren’t okay. Because you can’t just tell people below you, you know, you really need to behave like this. If you yourself are not doing it,

[00:32:55] Rachel: What do you do when that seems to conflict with the targets you’ve got as an organization? Which often are very d very high. You’ve gotta sort of get this amount work done, get these amount of patients through, and so care, having a caring organization where you might, people might need to take a bit more time doing stuff, whatever it, it is actually going directly against what, what you are being judged on.

[00:33:17] Carol: I know it is difficult, isn’t it? I don’t think there’s, there’s any easy answer to that, but I think it, it’s beholden on us as, as professionals to point that out constantly that, I mean, let me give you sort of, it’s not an acute example, but the work I’ve done for government on addiction, as I did the work, I couldn’t believe how badly we treated people with addiction. We stigmatized them. They don’t get parity of care with physical conditions. There’s nobody advocating for them. Now, how could that have happened in a profession that’s, you know, in our own profession?

[00:33:54] So I asked myself, why were there no doctors standing up for these people? Why did nobody advocate? But we let it go on, and you think it was just a collective, oh, there’s nothing I can do about it. There’s no money. Nobody is really pushing for addiction services, so I just have to put up with it. Well, I don’t buy that. I don’t buy that at all. I believe there should have been people saying to government, this is not good enough. You can’t treat people this way, rather than saying to government, all these services are bad, but not saying this is, this is at a point when you’re going to have to do something different.

[00:34:36] So, you know, it’s very easy to blame the other person, and I know it’s difficult to be a whistleblower. It is very difficult, but it’s sort of, we get into that circle, don’t we? Because we feel helpless. We feel helpless. But actually we are not helpless through our professional bodies. We are not helpless through our organizations. Medicine has very good professional bodies.

[00:35:03] Rachel: So we can access our professional bodies to advocate for us. We can, we can raise issues.

[00:35:08] What can individuals do themselves though, in the workplace if they’re feeling. uncared for and, and, and unsupported? And often if they are, you can bet the bottom dollar the rest of the team are. And often obviously the people that listen to this podcast, they will be GPs, they’ll be consultants, , they will often be those managers who are, are leading teams, whether they see themselves or not.

[00:35:31] Carol: They are leading teams.

[00:35:32] Rachel: They are leading teams. Yes. And so if they’re feeling supported themselves, what can they do to get the support that they need? Is there anything that you can do yourself to try and, and I guess that it all circled back to mentoring. I get a little bit as well.

[00:35:48] Carol: Well, no, and I, and I know this is not always easy, whether it’s in a hospital or a company. I think if a group of people can, can at least bond together to show the evidence, I think you, you know, if you want things to change, it is very good to be able to have the evidence of why change is necessary. And still, I know there are places where this doesn’t happen. And I think often, even if it is happening to you in your own organization, there is nothing is there to stop you using your regional rep from your college of, you know, if it’s the College of Physicians or, you know, what are the, the other structures around where you could seek advice or support? Because I’m, I’m very conscious that there will be organizations where it’s very difficult to go up the normal ladder, but nearly always, um, they’re either people in your own environment or I think through our professional organizations that at least, are going to be able to listen and maybe act.

[00:36:59] Rachel: I’m, I’m just thinking back to some, something. In, in, in, in my organization, we were very, very busy. We had a lot of stuff going on, all, all at once. And, um, one of the team had the sort of foresight, so actually I think we just need to pause meeting. We just need to get together and just check in and go how are we all doing? Just take a pause, like, what’s going on? And so we all met, it was only 15 minutes and, and, and someone was able to say, actually, you know, I have been feeling quite, quite stressed recently and this and that and, and we didn’t try and solve, we just listened.

[00:37:27] And actually the next week that person said, you know what? That meeting was just so helpful. I felt so much better after we had this meeting and we didn’t, we didn’t solve anything. We didn’t change anything, but almost it was just being able to express it and, and listen, made a huge amount of difference. It was amazing really.

[00:37:42] Carol: So I think having that sort of grouping locally is, is really helpful. ‘Cause there are some situations it is very difficult to do anything about immediately. But not feeling lonely about them is, is quite helpful.

[00:37:57] Rachel: And I always think that doctors really don’t make enough effort to get together with each other and, and do that for each other, even if they’re not, not working to together. In your professional career, have you had a, a, a group of Pearse that you sort of got together and sort of chewed the fat with the, you know, and stuff like that?

[00:38:14] Carol: Yeah, and, and at different phases of my medical career, I’ve had different groupings. of, of people that I would chew the fact with. And, and certainly once, once then I, I sort of was in the college, you know, there were certain other presidents that, that gave me great support and I hope I gave them some support. And really throughout my career, I’ve, I’ve, I’ve sought out groups, maybe it’s only two or three people with whom I still, to this day meet up. And although we are not discussing work issues now, you know, they, if you like, they’re part of your support group.

[00:38:51] Rachel: You have to be quite intentional about that. Sometimes I think we often just leave it to chance, don’t we?

[00:38:56] Carol: Yeah, no, no. You, and you have to. Someone once said to me, oh, you don’t have to worry about friends. They’re always there. I said, no, no. You have to work at Friendship. And so if you want to have people who are going to be, if you like there to chat to for you, I put a lot of effort into holding onto my friends and, and value them and, and really they’re an essential part of my life.

[00:39:22] Rachel: So, so important.

[00:39:24] if you could wave a magic wand, what would you get every workplace to prioritize, like really urgently? I, I guess I’m asking for a quick win, ’cause you’ve already talked about the, the caring and the, that, you know, that training the

[00:39:35] Carol: No, I would say train your managers. If I had, if I had only one thing that I could do, because they can have the biggest effect. Support, and train your managers to support the teams so that the team can be functional and support each other, I wouldn’t, I wouldn’t put in any particular intervention, cause as I say, often interventional intervention, individual interventions, if you’ve got a bad culture, just doesn’t work.

[00:40:02] Rachel: And what have you found the one thing that’s made a real difference to you in your wellbeing at work throughout, throughout the years? Running. Did you always manage to go out really regularly?

[00:40:14] Carol: um, from about the age of, um, late thirties, I didn’t really take up running till I was in my late thirties, but I, it, it’s essential to my mental health. And I like it. I don’t want to run with anybody. I run alone. it does something for me that no other sport has ever done. I don’t, I used to run every day. I certainly, I run about three times a week.

[00:40:38] Rachel: So often it’s, it’s those things that, that we just drop when we get too busy, don’t we? Um, when the workday builds up. But did you, have you made sure that you’ve, that’s always, always been a priority

[00:40:47] Carol: I I get up very early and exercise early I couldn’t do it in the middle of the day now. I used to, when I was a younger, in my forties, fifties, I used to run at the end of the working day, I. I, I certainly wouldn’t do that now. So I, I exercise, you know, before I do anything else.

[00:41:08] Rachel: The, the imp the impact of just physical activity. Just moving your body on, on your mood, on, on one’s productivity. It’s just astronomical, isn’t it? Totally brilliant.

[00:41:17] Great, well, um, Carol, it’s been wonderful talking to you. Thank you so much for, for giving up the time. If people wanted to sort of find out more about your work and read the various things, what, what’s the best place for them to find all the various things, you know, you’ve obviously done such a lot. Maybe you suggest that they, they start?

[00:41:32] Carol: Well, all, all the reports I’ve written for government are under government publications. The drugs report was, part one was published through the home office, part two through the Department of Health. But that’s, that’s the latest, uh, thing I’ve, gone for, for government, but I get, you know, just as much pleasure outta chairing the British Library, which is a long way from medicine.

[00:41:55] Rachel: Wonderful. Well, thank you so much for being with us, um, that I’ve meant to be hugely valuable to lots and lots of people.

[00:42:02] Carol: Thank you. Thanks for listening. Don’t forget, we provide a self coaching CPD workbook for every episode. You can sign up for it via the link in the show notes. And if this episode was helpful, then please share it with a friend. Get in touch with any comments or suggestions at hello@youarenotafrog.com. I love to hear from you. And finally, if you’re enjoying the podcast, please rate it and leave a review wherever you’re listening. It really helps. Bye for now.