Hospital doctors are among the worst at caring for their own mental health, but Covid-19 means they cannot afford to take shortcuts on wellbeing, writes Rebecca Caulfield.
As World Mental Health Day approached, I paused in the avalanche of my workload to consider the impact recent events have had on the wellbeing of healthcare professionals.
As a community paediatrician who mainly works in the outpatient setting, I have witnessed the effects of Covid-19 insidiously seeping through the very fibre of the teams who work so hard; from the medics, surgeons and intensivists striving to provide excellent care with increasingly frequent shifts, to the community therapists, nurses and teachers, who are straining at the seams, attempting to "hold it together".
Doctors are renowned for their often unceremonious attitude to "getting the job done"; often in sacrifice of their own wellbeing. I can recall one bank holiday weekend on call when I contracted a urinary tract infection due to poor self care; specifically my perceived inability to take a break and simply hydrate.
The medical profession has always attracted high achievers; this personality trait is a perfect match for many aspects of our work. Yet when it comes to self-care, many of us are the facilitators of our own undoing through negative thoughts and self-destructive behaviours.
One of the first times in my career when I experienced this was upon discovering the concept of "imposter syndrome". I remember the sheer relief that I was not alone in living in fear of someone "finding me out" as a fraud, less capable than my peers, and barely able to hold it together.
Through conversations with colleagues on social media, phenomena such as imposter syndrome have been particularly devastating throughout the pandemic; the immense effort involved in "keeping up appearances" at work demotes the ability to cope with mundane tasks such as keeping on top of the household budget, weekly shopping, or simply opening the mail.
In the United Kingdom, the Office for National Statistics survey found that almost one in five adults were experiencing some form of depression in June, almost double the prevalence recorded in the pre-lockdown period. An American paper from June showed an increased risk of suicide among surgeons, physicians and dentists who had issues such as conflicts with superiors (odds ratio 1.79, 95% CI 1.49-2.17, P<0.001), legal problems (OR 1.61, 95% CI 1.15-2.26, P=0.006), or physical health problems (OR 1.40, 95% CI 1.19-1.64, P<0.001).
As we brace ourselves for a second wave amongst increasing fatigue, I encourage my fellow professionals that this is a marathon, not a sprint; the aftermath will be with us for a long time, and we must look after ourselves before we can truly care for others.
Dr Rebecca Caulfield is a community paediatrics registrar at Alder Hey Children's Hospital. She has worked in the NHS for nine years. As a senior registrar with an interest in training, Rebecca is one of the leaders of a mentoring scheme for junior doctors at Alder Hey. Her clinical areas of interest are ADHD, autistic spectrum disorder, and adoption/fostering.