Every physician has a story to tell, about their medical training, about their clinical work. Every story is unique. Simultaneously, there are common shared themes about the joys and the difficulties. These experiences are universal, regardless of gender, specialty, or geographic location.
I asked two physicians, a female ER doctor on the East Coast in the U.S., and a male trauma-informed physician-coach in the U.K., to tell us how their experiences and struggles led to their passion and what they are creating today. Their stories speak of empowerment and hope.
Brittany Lamb, MD
When people find out I’m an ER physician, their next question is typically, “What’s it like? What’s the craziest thing you’ve seen?” I usually lie, sharing a light-hearted anecdote, avoiding the morbid, depressing, or visually disturbing truth my brain immediately goes to.
The perspectives I’ve gained are both a blessing and a curse. I have a deeply rooted desire to live with purpose and experience everything I can with the people who mean the most to me.
Many patients feel similarly. They tell me they don’t want to live with a poor quality of life.
I worry for them. The status quo we call advance care planning isn’t enough when people hold these values, especially for people living with dementia.
We tell people to choose a surrogate decision-maker, fill out advance directives, and consider what kind of care they may or may not want in hypothetical situations.
What we don’t do is give people who want control over what happens to them a practical way to understand the conditions they are at risk for, how they might impact their day-to-day lives, or what the pros and cons of the corresponding treatment options are in layman’s terms.
There isn’t the time to explain, or help them plan in our 15-minute visits. We feel pressure to check our boxes, meet metrics. We’re missing discussing and documenting what actually matters to patients so they can receive care they’d choose when unable to speak for themselves.
Four years into work as an attending physician, I kept asking myself, why are patients coming into the ER every shift with foreseeable medical situations, and yet the people speaking for them aren’t prepared and often over-relying on unhelpful advance directive documents?
I don’t want to do things to patients that they wouldn’t want done and regularly felt I was (I still do).
I became more and more bothered by this, another layer of moral injury from working inside a system that often forgets the individual.
Instead of continuing to complain and feel powerless, I decided to do something different.
Two years ago, I came online to educate medical decision-makers of people living with dementia. I now teach a process so they can plan ahead for their responses to the medical conditions their person is most likely to face.
I’ve packaged all of this inside an online course to use on their own time. I call it, “Make Your Plan with Dr. Lamb.”
Empowering people who share the same values I do, on my terms, outside the walls of the ER, has given me a new sense of purpose and hope. For now, it has extended my career at the bedside.
Adam Harrison, MD
I want to talk to you about my personal experiences of workplace bullying and harassment in medicine. Why? Because I want you to know that it is much more common than physicians might think. In fact, it’s likely that you too have been on the receiving end of it or at least know a fellow physician who has.
I also want to let you know that people like me, privileged white men, are the bullies’ targets less often than our female/BIPOC/LGBTQIA2S+/disabled colleagues.
It is important to state at this point that there are very few studies that look specifically into the prevalence of workplace bullying in medicine. Health care (generically), yes. Nursing, yes. But medicine? Not so much.
It all started for me when I was a teenager bullied at my all-boys school. Aside from the usual name-calling, ridiculing, and shaming, I was also physically assaulted and required stitches to my right pinna.
So, when I left school and, indeed when I left medical school, my notion of what bullying was only really encompassed its physical manifestations and name-calling. Then I joined the world of work and experienced workplace bullying at the hands of my medical seniors, and my field of vision as to what bullying could involve expanded beyond belief.
As you would expect, when I was working as a trainee surgeon, there was no name-calling in the schoolyard sense of the term, but there were comments like “You’re [insert your expletive of choice] useless,” “How did you even graduate from medical school?,” and “Just get the **** out of my OR,” most of which took place in the presence of colleagues and sometimes in front of patients too, which only served to magnify my already burgeoning sense of imposter phenomenon.
There were also the more subtle, less overt forms of workplace bullying, like ostracization and passive aggression, more often delivered one-to-one so as not to alert my colleagues. Added to these were the more specific work-related types of bullying, which included (but weren’t limited to) withholding praise, excessive and unjust criticism, withholding training opportunities, undermining my decisions, and over-monitoring my work.
This is why one of my missions is to actively raise awareness of this insidious practice in collaboration with other activists globally, including some fellow physicians. I also support institutions and individuals on their post-bullying journeys of recovery.
I certified as a life, leadership, and executive coach over three years ago and completed my trauma-informed practitioner training this year. I help both the victims recover from workplace bullying and the perpetrators rehabilitate themselves. I also help detoxify organizations by encouraging them to embrace cultures of kindness and kind leadership in their workplaces.
Kim Downey is a physical therapist.