I came out late in life; I grew up in this country at a time when the idea of being gay was viewed with a huge degree of negativity and hostility
At the time that I was realising I was gay, the prevailing cultural idea was that gay men were a threat, specifically to children
Powerful voices, including the then Prime Minister, made it clear that homosexuality was something to be seen with concern and suspicion; that children and young people should not be affirmed if they said they were gay, and to do so would “cheat them of a sound start in life”
Those attitudes were enshrined in law
The “promotion” of homosexuality in schools was made illegal
Schools were forbidden to teach homosexuality was acceptable, and the law described homosexual relationships as “pretended”
The message, from the Prime Minister down, codified in law, was that being gay was wrong, it was harmful, immoral, that gay men were a threat to others (specifically children), that diseases like AIDS were the consequence of a “lifestyle” that was seen as sinful and wrong
Daily Mirror, 1991, after Freddie Mercury died: “For his kind, AIDS is a form of suicide”
Daily Mail, 1993: “abortion hope after gay genes found”
Boris Johnson, 1998: “tank-topped bum boys”
In my teens/20s it was still seen as acceptable to talk about people like me like this
If you’re a young person realising they are gay, growing up with that political and cultural attitude around you causes harm
It makes you afraid, makes you scared to speak about how you think and feel, internalises all of that negative emotion - and that has consequences
We know that growing up in the 80s/90s caused harm to huge numbers of LGBT+ people
The story of the damage it causes is literally told by scars on my body
BUT
Thatcher was wrong
Section 28 was wrong
The papers were wrong
The churches were wrong
The prevailing attitude was wrong
Just because powerful voices say something, just because the media echo and amplify, just because official voices prevaricate or pontificate, it doesn’t mean they’re right
What I needed more than anything as a kid growing up was to hear the voices of those standing in opposition
The attitude towards trans people in this country today is hostile, driven by ignorance, often by bigotry and by a determination by some to portray all trans people as a threat, to individuals and to society
Just as in the 80s gay men were caricatured as being a threat to children, much of the public discourse about trans people today is filtered through a lens of concern about trans people being a threat to others
If individuals commit offences they should be prosecuted, whoever they are
We must not demonise an entire group of people because of an inflated sense of perceived threat by some
Trans people just want to be themselves and to live as safely and happily as they can
When prominent voices in media and politics amplify ignorant, outdated and wrong ideas about trans people, harm ripples out and gathers the strength of a tsunami
It makes trans people, especially young people, feel isolated, scared, makes them turn inward
We know that as a consequence trans young people are at significant risk of harm to their mental health, to self harm, and to attempt suicide
Those young people need to hear voices around them challenging those who amplify those hostile attitudes, need to be able to feel safe
As paediatricians, I think one of our most important responsibilities is to give voice to children/young people where they themselves find it hard to speak up and be heard
We know having just one supportive adult in their corner can make a world of difference to LGBT+ teens
We have a responsibility to educate ourselves, to be aware of the issues, and to be able to clearly advocate on behalf of young people who absolutely need us to be an ally
(usual caveat that, because this was published in the BMJ, “healthcare professionals” was changed to “doctors” in the headline but, clearly, this isn’t just about doctors)
And this, more than ever:
“When the pandemic is over, and we return to some sense of “normal” again, we will need an even more vigorous discussion about what safe staffing, safe resources, and a safe model of care really mean in the modern NHS.”
Whether you’re the parent of a toddler (or an adolescent) or, like @WelshGasDoc, an overtired shiftworker, many people know the frustration of trying to get themselves or someone else to sleep but, no matter how tired they seem, they just won’t do it
Sleep has rhythms
How sleepy we feel, and how much we *need* to sleep don’t always match up
The simplest example of this is the post-lunch sleepiness many of us feel
Even if we don’t sleep, we usually feel *less* tired a few hours later when we’ve been awake longer
Weird, huh?
Sleep is a complex process, but we can simplify how we think about it into what is called the “two process” model of sleep
This describes sleep/wake as the interaction of two elements: Sleep Pressure (S), and Circadian Rhythm (C)
As always there is lots of granular data in the report but at the high level:
~25% of trainees & ~20% of trainers score “high” or “very high” on Copenhagen Burnout Inventory questions in the survey
40% of both trainees and trainees describe work as emotionally exhausting
And almost half report feeling tired/fatigued at the end of the day
(though, as always, I think the phrasing of the question “are you exhausted in the morning at the thought of work” is quite an existential way of asking it!)
Maybe I’m not educated enough either but I genuinely struggle to understand how this Government can’t find money to support this, when so much has been frittered away elsewhere
That Tory MPs, including a consultant paediatrician, can in conscience vote against this amazes me
Also: @RCPCHtweets@RCPCH_and_Us ... I know @MarcusRashford has an MBE now, but surely he deserves recognition from us as well, in view of how determined he is to give voice to children and young people and advocate on their behalf?
I had a wee stint in our adult ICU team as part of COVID19 redeployment and, for some of that time, had an actigraph on
Actigraphy, worn like a watch, uses a number of sensors (mainly motion and light) to give an overall impression of sleep routine and pattern
Shift pattern was 3 long days/3 days off/3 nights/3 off, then repeat cycle
LOTS of caveats about this data:
- on shift, actigraph was in a scrubs pocket, often under PPE
- it isn’t directly measuring sleep
- one day I forgot to put it on at all...
- etc
But...it gives an idea
Some other points/caveats:
- black lines: motion/activity
- coloured lines: light exposure
- blue shading: sleep
- yellow: wake
- red: night shift
- purple: day shift
- I took some time to rest/recover on “off” days, but was generally doing “normal job” work on those days as well