Guest Blog: Amandip Sidhu reflecting on the harms of a "get on with it culture"

#NHSmetoo #Doctorswellbeing #Doctorburnout #NHSStress

There is a growing trend of NHS Doctors burning out and with their wellbeing severely affected, tragic outcomes can occur if they don’t look after themselves. 

I approach this topic as a non-medic (I am a pharmacist). My brother was a consultant cardiologist until November 2018. He was overworked, stressed and eventually burnt out. He sadly died as a result and from this story, what I think the profession should learn from this. 

My older brother was an amazing individual, from his early years he was a high achiever and was a straight ‘A’ student. He even did an extra ‘O’ level (for those mature enough to remember what they are!) off his own back as the teachers couldn’t support him - he taught himself from a textbook. After winning the usual prizes in medical school he went through the system and as a junior doctor worked 90-100 hours a week. I remember him coming home knackered and exhausted but largely satisfied with the challenge. He then took the route of doing his MD thesis and his MRCP exams and was then appointed cardiology consultant in 2007 across two hospitals. He was an active member of the trust and expanded service capabilities & cross collaborated with other hospitals. Very well respected, both professionally and by our community, he was seen as the golden boy and everyone loved him – deservedly so. 

All was good until about Sept 2017. I remember him telling me he was very busy at work and was quite stressed and started to get a little depressed. I thought this was normal and perhaps a sign of getting older as the ability to work at a hard pace was now catching up with him, the “on calls” being very hard. The family helped him through it and he found ways to relieve his stress by exercising and making household time an important part of his non-work routine. Outwardly, he appeared to feel better. 

Things started to then really deteriorate around April 2018. He was starting to show signs of disengagement with us and often spoke about work being a stressful place, working in a busy hospital with very heavy workloads and patient numbers. Coupled with the added responsibilities of teaching, training, admin and the other usual duties of a lead clinician he had his plate full. To lighten the load, he gave up his night shifts which helped in the short term as it turned out he wasn’t sleeping much at all. 

We reached mid-November, which was the low point. He was very down, felt hopeless and perceived himself as unable to help all his patients fully. He started to suffer from chronic anxiety, lost the ability to focus clearly on his cases and believed “he had lost his edge”. Day by day, week by week he gradually declined and felt he couldn’t speak up to ask for help at work. It seemed the cultural expectations were to “just to get on with it” as the NHS was under strain and that was the norm. 

He phoned me up one day late November and said he was signed off sick by his GP for anxiety & stress and had been referred to occupational health. At that point he was of the opinion that his career had come to an end and couldn’t work in the hospital due to resentment from colleagues as having let them down. He felt so guilty about having been signed off and was primarily worried about who was going to help his patients now he was off, his number one thought was always for them... 

I went to see him over that weekend and for this first time in my life I gave him a “brotherly chat” and talked him through my own personal experiences of burnout and what I did to come out of it. I told him there was light at the end of the tunnel and he would get through this with family support. He thought everyone thought less of him and he had lost all self-respect and confidence. Of course, this was all in his mind but he couldn’t get past this thought process. He lived his life being seen as the indestructible high achiever, society & patients appreciating and respecting him. He felt, incorrectly, that status had all crumbled away and his inner being was gone. 

Two days after that weekend I was copied into an email from him to his wife. It was a practical email detailing his finances, instructions on pensions & life insurances and even reminding us to pick up his daughters’ regular prescription from the pharmacy later that week. The last line of his email said he was at Beachy Head cliffs with the car. This was the last time we ever heard from him, he was 48 years old.

I write this blog some 6 months later, still not believing he has departed this world. The family is devastated, he left behind two wonderful kids and a loving wife. Likewise, my mother is distraught and for those that read this who are parents themselves you can understand that losing a child is the most torturous thing that can happen to any mother or father. Equally stunned are his colleagues and all that knew him and I feel for them too. 

The family is going through some very tough times but through this experience I have been motivated to get involved in this space and help raise awareness of his plight to encourage other doctors in the same situation speak up and ask for help. Currently Doctors/Physicians in the UK (and indeed elsewhere) are under enormous pressure and workload. In the UK the NHS is widely perceived as a system that is under stress and “creaking”. My brother felt he had to push himself inhumanely for the sake of the patients and colleagues, despite his own wellbeing suffering over a period of time. He felt he had nowhere to turn to and the culture within the profession seems to put all doctors on a pedestal with the expectation of being infallible, coping with unreasonable workloads and long hours as “that’s the way it’s always been”.

I, along with the Doctors Association, want to help those in similar situations and to help them realise that their wellbeing comes first. Speaking up when they need help is NOT dishonourable and is done with patients’ best interests at heart. This is one of a few remaining taboos in the NHS that must be eradicated. 

Doctors cannot look after patients unless they look after themselves, the carers must be cared for first. 

With that in mind, I am intending to setup some sort of charitable organisation and I have created a simple survey which will help shape some structure and ensure the aims of the charity are meaningful and relevant to current & future needs. All opinions welcome: 

My aim here is not to win any popularity/sympathy or a social media “likes” but to continue the ethos and memory with which my brother showed in his life – selfless service to others and for others to learn from this tragic story by raising awareness to drive cultural change within the NHS. 

Thanks to the Doctors Association for engaging with me on this issue and followers for reading this blog.  Let’s start to influence and drive for the required change to better protect those that work within the NHS. 

More to come. 

Amandip Sidhu

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