Medicine, as a profession is surrounded by, and embedded in, fear.
I’m yet to meet a doctor who doesn’t hold a deep seated fear of error, or harming a patient.
‘First do no harm!’ is engraved very closely to the heart of every doctor I’ve ever spoken to about this.
Beyond fear of harm, is fear of being sued, which is very real in today’s litigious environment. Closely related is fear of criticism from colleagues and seniors.
Then there’s the fear of being powerless to help – and failing. Not through error, but failing because everyone must die. And sometimes people die on your watch through no fault of your own but fate or destiny – it was simply their time to die.
Even more primeval perhaps, is the raw fear that each and every person brings with them when they are not well. Is this symptom serious? Is it life threatening? Will I have pain I can’t manage? Will I suffer? Will I be harmed by those trying to help? Will I die?
Most of us, on some level, fear mortality.
We’ve all been sick, or had loved ones who are sick, and know how much fear, on so many levels, illness and sickness can bring in its wake.
Fear is contagious. Just like dogs can smell fear in humans, in some sense we pick it up from each other as well. Whether it’s mirror neurones or something else, when the person we are speaking to is in fear, we can’t help but be affected by it. Patients can pick it up from doctors – and vice versa.
And fear is toxic. Living in fear all the time is not healthy for our body, mind or soul. It undermines everything we do. It impacts performance, confidence, relationships and even healing.
I can’t think of a single doctor I’ve worked with over the past few years where we haven’t had to work on managing fear as part of the coaching. Sometimes fear of failure, sometimes fear of success…all types of fear that you can imagine.
I’ve stopped being surprised by the level of fear I hear about…instead I now wait for it to emerge in the conversation as it inevitably does.
So how do people get to the other side of fear?
Managing fear is a bit like the 12 steps program of AA. It’s a process and multifaceted… and something you do every day.
First people must accept and acknowledge the fear – and acknowledge the real impacts it has on their work and their lives. Nothing can change without that first step.
Then comes acceptance of fear in their patients…and seeing it as something that needs respecting, validating and healing as much as the illness itself.
Other elements of managing fear include finding a deeper meaning and a different way of making meaning out of being a doctor.
I’ve noticed people letting go of fear the more they can see themselves as there to serve their patients rather than fix them. The idea of service as a fundamental human to human encounter flattens the power differential, helps build strong relationships, and perhaps most importantly helps build trust.
The other side fear is trust
In the end, it seems to me, that trust is what really lies on the other side of fear. And trust in its fullest sense.
It’s so valuable when doctors and patients develop a therapeutic relationship that foster the trust a person has in their doctor.
It’s even more powerful and beautiful when doctors nurture trust in their patients.
That means building trust in the power of the human spirit to transcend suffering. Trust in the patient as a person who has something valuable to say about their health that needs to be heard. Trust in the person to grasp onto the responsibility and autonomy they need to engage in as part of managing their own health.
And finally, being able to trust in yourself despite your vulnerability and the inescapable fact that all humans make errors and have limitations to their knowledge.
What is this trust really about? It’s building a trust in your capacity to learn, it’s trust in your capacity to be with a patient and witness them as a human in pain, it’s trust in your capacity to share the journey with your patients. It’s trust in knowing your limitations, and knowing your strengths too, and knowing where to look and who to ask when you don’t know.
It’s trust in ways I don’t yet know how to put into words – perhaps it’s more of an experience than anything else.
How to get to the other side of fear and build this type of trust is a whole story of its own. This is a journey I continue to explore and understand better every day in managing my own fears. And it’s a journey I see many of my clients embracing as they find their own way to other side of fear in their work as doctors. It’s helped many return to work with renewed enthusiasm, and it’s helped many decide to stay on as clinicians rather than leaving.
Building trust takes courage, commitment and time. It’s an orientation to the world that must be lived and created continuously.
Ultimately trust is not something you achieve, but something you choose.
So if you are ready to let go of fear and start building trust get in touch today…it’s never too late to start.
