I was a doctor.
I lived and breathed medicine.

Then burnout & mental illness happened.

Upset & angry, I left medicine.

If you care about the #NHS,

And you plan to vote in the #GeneralElection

You NEED to know these 3 things.. 🧵 1. The NHS runs on goodwill

Healthcare staff go above & beyond for their patients.
They stay late, miss meals, rearrange child care, skip family events in order to prioritise safe patient care. This is expected. Needed.

Often it comes at a price to their own health & wellbeing.

3 yrs ago, my daughter had open heart surgery.

As a mum, I was terrified
As a paediatrician, helpless.

As we waited to be taken to theatre,
My eyes filled with tears

A parent approached me...
A 🧵👇 It was mid lockdown.
Rules were such that my husband was unable to accompany us.

We'd waited all morning whilst another child had been in surgery,
The anticipation rising.

I tried to be calm for my daughter.
To play & distract.

But in the hour befor we were due to go down...

I was an NHS doctor,
Then burnout and mental illness happened.

I left medicine but
Without it... I felt lost.

Here are 3 things I learnt from leaving the NHS,

3 things everyone should know. 1. The NHS runs on good will.

The system inadvertently takes advantage of those who struggle to say no, staff who cancel plans, stay late, do extra shifts, put others first...

People who are already at high risk of burnout...

The system relies on them to say yes.

A short but important story.

I was a children's doctor,
Then life happened.

Maternity leave spent in therapy & on medication for postnatal depression.

As I returned to work,
My rota dictated I would be on call on my second day back.
A specialist hospital I'd never worked in
🧵 I told my boss the responsibility might be too much.
That I'd not been well.

They seemed stressed.
I'd further added to their workforce crisis.

Then the day came.
Rota gaps, staff absence...

I was handed the crash bleep & told to get on with it.

It was 2010. I was 25.
He was my supervisor.

We were on a home visit, sitting in his car.
He leant in.
Told me I was beautiful and he dreamt about me at night.

Wanted to leave his wife and kids.
He touched my thigh then began to cry.

I sat there
Nausea... shock..
🧵 And then I did what I knew best.
I pushed my feelings aside,
leant towards him & hugged him.

I apologised for not feeling the same way.
For perhaps giving the wrong impression, for simply being me.

That night, I went home to my now husband
And I said nothing

Harry was 6.
He was autistic.
I was his teacher.

September started with violence & aggression.

Other children became scared.

Relationships broke down.

Harry became his behaviour.

So I watched and I noticed... Patterns emerged.
Transitions were hard.
Playtime was spent in a corner, stimming.
Lunchtime was overwhelming.

It was obvious.

Harry was an anxious autistic boy,
Overwhelmed in a world that was not suited to his needs....

My daughter was 5 when she had open heart surgery.

As a mother, I was terrified.
As a paediatrician, helpless.

We had been waiting for 5 hours when the phone rang.

Nausea. Anticipation. Fear.

I heard 3 words. 3 words he didn't even say... She was alive.

It was 8pm, the sky was dark and the ground covered in snow.

I zipped my coat up as I stepped outside, staring up at the hospital.

I could see the Christmas lights in the window of the cardiology ward. I squeezed my husband's hand and we set off.

My daughter was 5.

Recovering from open heart surgery.

Tentatively walking up the corridor, she met a nurse.

"Come in here," she said.
"I want to show you something."

The nurse led us into the quiet room
That room on every ward with a box of tissues & a picture on the wall... A tightness in my chest.

So many families whose lives I had changed with bad news broken in rooms like this...

"Come to the window", said Emma, the nurse with a smile.

My daughter tottered over slowly.

I saw it before she did...

I was a children's doctor.

He was 7, maybe 8.
Full of smiles.

I'd looked after him for months.

Grown to care.

I told him I was going on maternity leave, that I'd see him next year.

A couple of months later

I was in a car park with my new baby

and I got a call...

🧵👇 It was my registrar.

"Hi, sorry to call you out of the blue but I wanted you to know something..."

Silence.

"He got sick. Really sick.
They did everything but...

He didn't make it"

My eyes filled with tears

"I know how much he meant to you.
I thought you deserved to know."

I was a children's doctor.

Then I became a primary teacher.

Overwhelmed & unsure of myself, I felt like I was drowning.

But the children kept me going

6-yr-olds who taught me to be a better person.

Their stories will warm your heart: 🧵👇 1. Joseph was 6.

An anxious boy who'd cry coming into school. He often complained of abdominal pain which settled with gentle reassurance.

He had a lot going on at home. I talked to him about it when I could.

And then one day something happened that I didn't expect...

2 yrs ago today,

my daughter had open heart surgery.

She was 5.

As a paediatrician, I felt helpless

As a mum, I was terrified.

One thing happened that day, one thing the anaesthetic team did that I will never forget... 👇🧵 They sang...

My daughter had been given a pre med. She was giggly & now oblivious to the imminent surgery.

She lay on my lap as we were wheeled to theatre. I bit my lip. An attempt to hold it together... this was not the time to cry.

Then she started to sing...

I was a paediatric trainee.

Then burnout and mental illness happened.

My educational supervisor was brilliant.

Here are the top 3 things that helped: 👇🧵

#MedTwitter 1. Time

In her busy consultant schedule, my supervisor made time for me. I could drop by her office to catch up without it having to be a formal meeting.

In and amongst the overwhelm, she helped me feel safe.

Not every meeting has to be form filling.

My daughter had open heart surgery.

She was 5.

The care was fantastic

but one small thing left her traumatised.

This is it... 👇🧵 1. Ignoring the child

She was not long out of intensive care. A surgical doctor arrived & and told me he was going to remove her drains. He turned around, gathered his things then returned immediately, approaching her with a scalpel blade.

I was a doctor.
3 yrs ago I retrained as a primary teacher.

Here are 3 things I learnt from being a class teacher that make me a better doctor.
👇🧵 1. Snap shot

As doctors we see a snap shot of patients' lives. We make assumptions & plans that we expect patients to follow.

As a teacher, I saw the reality of families' lives. I realised how unrealistic some of our requests are.

Ask yourself, is this plan really achievable?

I am a doctor.

I care deeply about my patients.
So much so that I got sick.

Here are 5 things you should know about the emotional burden of care giving.

If you care about the NHS, read this🧵👇 1. Self sacrifice

For a long time, I gave myself to medicine. I stayed late, cancelled plans, skipped lunch, covered extra nights... all in the name of being a good doctor.

But I failed to see that there was no space for me.

And then...I crumpled in a heap.

Burnout.

I had to ask for an exit interview when I left medicine.
I wanted a regional senior leader to hear what I had to say.

A fellow trainee was sent to do it, as though I wasn't important enough for more.

If you want to be a better leader, read this 🧵👇 1. Being seen
I had been an NHS doctor for 11 yrs (plus 5 yrs of med school).

An exit interview could have been the chance for a senior leader within the organisation to recognise & thank me face to face for my time and service.

It's not about the thanks. It's about being seen

I was a paediatric doctor.

I got sick.
Burnout and mental illness.

Labelled as a "trainee in difficulty", I broke.

Educators & supervisors, this thread will change your practice:
👇
#MedTwitter #MedEd 1. Shame

Up until then, I had been an "excellent trainee".
Suddenly my career was reduced to 3 words:

Trainee in difficulty.

Stigma. Judgment.
A big black mark next to my name.

Because that term suggests failure.

The NHS relies on the self sacrifice of its staff.

But its staff are breaking.
As a doctor, I broke.

If you care about the NHS, here are 3 things you must know

👇 1. Guilt
"Can you stay late today? Can you just see this extra patient? Can you come in on your day off?"...

I couldn't say no.

A culture that breeds guilt.
Fear of putting myself first.
Burdening colleagues.
Letting patients down.

So I'd agree to everything.

Then I broke.

My daughter had open heart surgery last year.

Here are the 5 things that mattered most to her whilst we were in hospital.

Read & learn from a 5yr old.

A 🧵

/1 1. Don't make unrealistic promises

Just after she came out of ICU, she had a procedure. The doctor said:
"Count to 3, breathe in & you'll be able to go home."
She did as she was told but unsurprisingly she didn't go home.

Building trust is key. Don't lie.
/2

My 6yr old had open heart surgery last year. As a paediatrician myself, stepping over onto the other side was hard.

5 things I learnt from being a parent on a paediatric ward.
A 🧵 /1 1. I have a name.
Being referred to as "mum" is fine, I get it and did it a million times, but there was one nurse who used my first name and it meant the world to me at a time when I felt really vulnerable.

I felt seen.

Learn parents' names and use them /2

I want to talk about guilt.
A 🧵

As doctors, we strive to do our best for patients. We often make sacrifices to ensure patient care is as good as possible in what, let's face it, is a system that is breaking at the seams.
#MedTwitter
#MedStudentTwitter
1/7 Many decisions made by doctors are layered with emotional & moral dilemmas.
Weighing up the different elements of scenarios, the pros & cons, the potential consequences & risks.

Generally we can reconcile the outcome of these decisions with the fact that we've done our best
2/7