How Bad Does it Have to Get Before You Act?

[00:00:00] Rachel: A few years ago in the middle of a ski village, in the middle of the Alps, a friend of mine had a cardiac arrest. I was part of the group that was there, and I witnessed him collapsing. And because I’m a doctor and I used to run the arrest team and I’ve been trained, I spotted really quickly that he was in cardiac arrest rather than just having had a faint or having a fit or something like that. I was able to act really fast, get to him and start CPR within just a few seconds of him collapsing.

[00:00:34] Rachel: Now doctors, healthcare professionals, this is what we’re trained to do. We can spot danger in other people, we can spot sepsis, we can spot red flags, we know we can act fast. But when it comes to ourselves, we are very bad at spotting the signs. Maybe it’s gone on for a long, long time, and just like that frog, because it’s building up so slowly we don’t realize how bad it’s got. Or maybe we just think some of these signs are normal, or maybe it’s because everyone else is exhibiting the same signs. Or maybe you are spotting the signs, but you think it’s gonna get better.

[00:01:09] Rachel: This is often what happens in burnout. You think, well just got another week until the appraisal, or just another year until they appoint somebody, or yeah, in six months time, we’ve got two colleagues starting and, and it’s gonna be much, much better. And meanwhile, the heat’s rising, you are feeling worse and worse. And you know that you’re exhausted, you’re running on fumes. You know you need to do something. The danger isn’t that you don’t know this. The danger is that you wait until things are totally catastrophic before you jump out of the pan or do anything to turn the heat down and sometimes that’s just too late.

[00:01:47] Rachel: Beause here’s the problem. We think that doing nothing is just neutral, but it’s not. Doing nothing is a choice. It’s a choice to damage your relationships and neglect your family and to lose all your joy. So my question to you today is how bad does it have to get before you actually do something?

[00:02:07] Rachel: This is a You Are Not a Frog quick dip, a tiny taster of the kinds of things we talk about on our full podcast episodes. I’ve chosen today’s topic to give you a helpful boost in the time it takes to have a cup of tea so you can return to whatever else you’re up to feeling energized and inspired. For more tools, tips, and insights to help you thrive at work, don’t forget to subscribe to You Are Not a Frog wherever you get your podcasts.

[00:02:34] Rachel: And I’ve been pondering on why we don’t act early, why we don’t act until it’s too late. Because if a patient came to you with dreadful symptoms, would you say to them, oh, well it’ll probably get better in six months, let’s just wait until it gets really, really bad? Or a friend came to you saying, this is just awful, i’m not quite sure how long I can carry on like this. And you say, well, you know what, any year’s time there might be some more funding. So that’ll be okay then, why don’t you wait till then? Course you wouldn’t. You would never say that to. You’d say, well, it’s much better to start now, to start early, to prevent stuff happening rather than wait till it gets worse. But we just wait.

[00:03:10] Rachel: It’s not because we’re lazy. There are some very significant psychological barriers sometimes towards acting. Sometimes it feels safer to stay put. It feels safer to be in the known, ‘ cause We flagged it up. We might feel shame. I can’t cope. I’m a doctor. Other people are managing. What does that say about me? Does it say I’m not good enough? We might be really afraid, you know, if I stop, what will people think? What if I let people down? Who am I if I’m not this the superhero here? What if I get complaints that I’m not always available? What if something terrible happens if I put in a boundary? Or we just feel really guilty about letting other people down, letting down our colleagues, letting down our patients. Weirdly, we feel more guilt about that than letting our families down by not being there.

[00:03:58] Rachel: And here’s a little bit of the psychology behind it. We have this bias towards the status quo. We actually prefer the misery we know to the uncertainty that we don’t. Uncertainty is actually quite stressful. So in a way, we feel like we’re choosing the lesser of the two evils.

[00:04:15] Rachel: Human beings also have this loss aversion. The fear of loss is actually much worse than the, the gain of something else. So the fear of losing money, respect, or status, that’s actually much worse than the hope of gaining wellbeing, time and joy.

[00:04:32] Rachel: And there also is this sunk cost fallacy, and I know exactly how this feels. You know, I’ve given medicine 20 years of my life, or I trained for 10 years to get to this position or this job, or I’ve done this master’s in this and I’m not really enjoying it. I can’t stop now. Just because you’ve given all that time doesn’t mean that you can’t change, or you can’t realize that actually you’re not enjoying it so much now.

[00:04:55] Rachel: Nothing is ever wasted. Whatever we do, we’ll use everything that we’ve been through. So these known pains are much safer than unknown change. And as a frog, you know the pan is hot, but it’s familiar. You know exactly how it works and what happens if you jump either to a different pan or you try to turn down the heat and actually you end up turning it up, what then?

[00:05:18] Rachel: But there is a real cost of waiting, which we don’t look at, and most doctors only act when they’re forced to, when a catastrophe happens, like they get a complaint, they made a significant error ’cause their brains just aren’t functioning well or their marriage dissolves because you fail to say no to anything at work. Or we’ve ignored the symptoms or the palpitations until we have that cardiac arrest.

[00:05:44] Rachel: My friend who had the cardiac arrest, he was under significant amounts of stress at work. He knew something needed to change, and when the cardiologist looked at his heart, the only reason they could find for the VF arrhythmia he went into was stress. He knew something needed to change. And boy was that a wake up call.

[00:06:05] Rachel: Waiting often costs you your health. It can cost friendships, It can cost you your marriage. And I know and I haven’t acted, I found that my character has started to be eroded. I’ve not been the person that I’ve wanted to be, and it has eroded my joy. But that to me didn’t seem like the urgent thing. The urgent thing seems to be avoiding shame, guilt, or fear, or the stress of the uncertainty about the change.

[00:06:33] Rachel: And in the training that we do, I like to ask this question because I found this once in a book about career and it stopped me in my tracks. I’m gonna ask this question to you now, and you might want to, if you can, pause the podcast and just write down the answer. What is your current way of working, doing to you, your character, your relationships, and your enjoyment of life? Your answers might just surprise you.

[00:06:54] Rachel: Now, I’m not gonna pretend that there isn’t a cost of acting. Taking action isn’t free either. You might feel very real financial pain cutting down sessions or taking sick leave, that might have a financial impact on you and your family. You might feel shame, you might feel that you’ve lost part of your identity, your identity as the strong one in the department, this superhero. You might feel that if I’m not coping, am I still a good doctor?

[00:07:22] Rachel: Other people might think badly of you. Absolutely. They might whisper well, she couldn’t hack it. She couldn’t carry on. All those things have happened to me. And in fact, when I eventually gave up my license to practice so I could focus on doing this sort of thing full time, my father-in-law came to me and said, what do I call you now, Rachel? Do I call you Mrs. Morris, not Dr. Morris? That at the time felt like a sucker punch to the gut.

[00:07:46] Rachel: But you know what? I’ve actually got over that. I got over it very quickly. These things do happen. They’re survivable. Yeah, finances. You can rebuild them. You can’t really rebuild a heart attack. Your identity is so much bigger than your job title, and you know what? Colleagues will cope. They’ll move on. You’ll be replaced. People will cope, and meanwhile, you’re alive.

[00:08:11] Rachel: So here’s another question for you. If your best friend were in your shoes, would you tell them just to keep going, or would you tell ’em to maybe take a hit and save themselves?

[00:08:21] Rachel: And in medicine, we act really fast when we can see that the stakes are life or death. We wait with ourselves possibly because we can’t quite see how bad the stakes are. Sometimes we need to amplify it. In change management, they call this the burning platform. You need to be on this burning platform. Once you can actually see what’s gonna happen, then you are gonna do something about it pretty quick.

[00:08:43] Rachel: And sometimes when we wanna take action, it helps to create this burning platform for ourselves. It’s not that we’re trying to amplify stuff out of all proportion, it’s just that we do need to face reality. Here’s another question, and you’ll be listening to this in September, four months until 2026. You might be listening to it another time. In that case, how long have you got until New Year?

[00:09:07] Rachel: If nothing changes, you already know how starting next year is gonna feel. Do you want another year of feeling like you do now? Do you want another year of maybe missing out on family stuff or your kids’ childhood or not forming a relationship with your partner? Do you want another year of waking up in the middle of the night worrying about stuff?

[00:09:27] Rachel: So imagine it is the next year. Imagine it’s 2026, if nothing changes, what would your health, relationships, and career look like? Is this really the life that you want?

[00:09:39] Rachel: Now for some of you, the answer will be yes, I’m doing really well. In that case, congratulations and please let us know how you did it. For some of you, you’ll be like, well, you know, I’ve made some changes and they’re working. That’s brilliant. I always think that thriving at work is a bit like being in a rowboat, rowing upstream. You need to keep working at it, so that is absolutely brilliant. What do you need to do to keep on like that, to keep feeling like that in 2026? And for the rest of you that are going, oh my goodness, I couldn’t do another year like this, then let’s explore what you could do.

[00:10:10] Rachel: Because a lot of people don’t change ’cause it just seems like too big a step. It feels like, well, the only thing I can do is to completely burn the whole place down, jump out of the pan and I don’t know, go and work in a coffee shop or something. And definitely sometimes I’ve thought to myself, oh, I just wish I could have a really easy, predictable job where I just go in, make coffee and go home at reasonable hour and I have absolutely no responsibility. I know that I wouldn’t cope with that either. I’d probably get bored really quickly. I know that that’s not the answer for me, but often we think that to change something means we’ve got to make this massive change. You don’t. This is how we can do it without feeling like this massive, massive step.

[00:10:50] Rachel: Firstly, shrink the step. Don’t think resignation, completely jumping out the pan. Maybe just say no once. Book an appointment with your GP or practitioner health, phone a friend, or or, or tell the truth or just do one thing differently.

[00:11:06] Rachel: Maybe take a two week fire break gap, which we talk about in our self-assessment burnout toolkit. Giving yourself that gap and that time just to think and face reality.

[00:11:17] Rachel: Get some allies around you. Share the load. Find one trusted person that you can talk to about it. And if you’re feeling shame around this, it really shrinks when you talk about it. Brenna Brown says, shame can’t survive being spoken. Start to tell people how you’re feeling.

[00:11:33] Rachel: I always recommend staying in your zone of power. Work out what you are in control of, focus on what you can control today, your sleep, your food, saying no booking that thing, downloading that app, doing that 10 minutes of yoga a day or that five minutes of meditation. Honestly, these small things, they make a huge difference.

[00:11:55] Rachel: And one suggestion is make a list of your kill criteria. Decide now, where’s the line? Where are you? A hundred percent gonna act? If I cry in the car park, if I cry again on the way home from work, if I have a panic attack in the middle of my surgery, if I wake up with chest pain, you need to act immediately, you wouldn’t ignore that.

[00:12:19] Rachel: And one thing that you might find really helpful is just to ground yourself and, and reset your nervous system. Box breathing is really good ‘ cause actually it’s very difficult to decide what action you’re gonna take if you’re frozen, if you are in your fight, flight, or freeze.

[00:12:36] Rachel: So get yourself into your parasympathetic system before you even consider what you’re gonna do. One way of doing this is box breathing. Just breathe in for four, hold your breath for four, breathe out for four, hold your breath for four again, and just repeat this a few times. Notice how your body will soften and you can start to think a little bit more clearly.

[00:12:56] Rachel: Because you have a choice, and here it is. If you don’t act, when you’re nearing burnout, when you’re feeling dreadful, the water will keep heating up and the costs keep going on up and you will continue the decline. And if you listen to the podcast with Dr. Richard Duggins, burnout is often a cliff for doctors. We go down the slope and then we suddenly drop off that cliff.

[00:13:20] Rachel: Things are not gonna get better without action. And if you do act, yes, there’s uncertainty. Yes, there might be some financial pain. You might have a wobble of identity. It might feel awkward. These costs are finite and they are survivable, and you can get help and support along the way. Both paths have a price. Which pain are you gonna choose on purpose?

[00:13:46] Rachel: So please, if you recognize yourself in anything I’ve talked about, please go and get help. Please speak to a health professional, practitioner, health occupational health, or speak to your team leader or manager. And once you’ve made sure you are getting the appropriate individual help you need, if you’re wondering where else to start, we’ve created a few tools which might help. There’s the burnout self-assessment toolkit. It helps you work out exactly where you are on the burnout spectrum and what to do next, and there’s all sorts of tools and resources in that toolkit.

[00:14:15] Rachel: We are holding a free webinar you can join live or you can catch up on replay, all about how to beat burnout in healthcare where we unpack these tools and it will help you get off the hamster wheel. And if you want a much more structured approach with all the tools that we know will get you out of overwhelm and burnout and into your performance zone, then do check out the Beat Stress and Thrive course. It gives you practical tools like the Zone of Power, the Drama Triangle, and the Prioritization Grid. These are things I wish I’d learned at med school, I could tell you that would’ve made my life so much easier.

[00:14:45] Rachel: So get whatever works for you. Share it with a colleague. Just don’t sit in the pan quietly, watching the heat going up and up and just hoping that something’s gonna change. Because here’s the truth, both staying and acting, they carry costs. The only difference, well, the cost of acting is often sharp and short term, but it is survivable. The cost of waiting is often long, invisible, sometimes it’s final

[00:15:11] Rachel: From when I’m recording this podcast, you’ve got just over three months until 2026, and if you keep everything the same, you already know how it’s gonna feel, so don’t fall for the comfort of familiar misery. By the end of this week, choose one action. Send that text, book the appointment, drop that extra shift, small change, cooler water. That’s how we unfrog ourselves.

[00:15:36] Rachel: And please do contact us if you’ve got any questions, if you wanna find out more resources, we know how it feels. And we have our whole frog community of people in exactly the same position as you who are cheering you on and saying, we see you, and it’s not hopeless.

[00:15:53] Rachel: And this isn’t to add extra guilt or shame onto you. I said in the last podcast, if you are in hot water and you are feeling it, it’s not weakness. It’s not your fault. It’s normal. But you shouldn’t have to stay stuck. You’ve got many more options than a frog.