I have written in the BMJ every week without fail for over seven years, with my columns informed by my day job as a hospital doctor and my experience in health policy and medical leadership roles.
I always check in to see how the articles are received – in terms of the BMJ online use and sharing metrics, the social media reaction, the public online rapid responses and my own digital mailbag.
I don’t write for clicks and reaction, but over 330 articles, you do get a sense of what flies with the readership.
Nothing I have ever written, in the BMJ or any other outlet has generated the response my column of 13th July did. Entitled “My personal pandemic experience is just one of many” I just spoke from the heart about my work (and those of my colleagues) during the pandemic and the impact it made on me and on them.
I had spent many months looking after acute covid wards and clinical areas where all the patients were infected and witnessed their tragedies, those of their families and the traumas for frontline staff, many of whom also found themselves in difficulty from their own Covid infections and in turn worried about the risk to their own loved ones.
The NHS workforce, already depleted, already over-stretched is now also facing a crisis of morale, physical and mental health.
In my piece, I admitted to being signed off clinical work sick since mid-May having caught Covid and also become burnt out, anxious, depressed and losing my confidence. I have been in the job 33 years and have had no health problems or significant time off before.
I also told my readers that having been elected as President of the Royal College of Physicians in April – a job I had wanted for several years and which my peers placed confidence in me to do – I had felt forced to resign because I still don’t have the energy levels to start such a busy role in September and didn’t think it was fair to the College to go forward.
I am still deeply upset at my decision
But a huge consolation has been the reaction – on Twitter, via direct messages, by email, by text or in the online rapid responses to the column. It has been an extraordinary window in the soul of NHS clinical staff and their pandemic experiences.
A more skilled writer than me could have a field day weaving together the personal stories they shared with me – which put my own first world problems in context.
The bottom line? NHS staff are as human and vulnerable as anyone else. We face our own health problems and only personal and family challenges. We suffer moral distress when we are unable to deliver the standard of care we would like to. We are not immune to being victims of Covid (in fact more likely to catch it than any group) or Long-Covid. But beyond that, two years of Covid medicine has left many people tired, disengaged, or low in mood at precisely the time when the service faces a huge existential threat and is struggling to deliver across acute, elective, primary and community care.
The workforce and the workforce gaps and the workload those workers face are the defining challenge we now face. And it goes well beyond pay.
I have yet to see a serious commitment to challenge any of it.
The one consolation for me is that of all those who wrote to me, very few care that much about my College Presidency. They have made it clear, en masse, that in the end one’s health and family life are far more important than career ambition, they don’t respect me any less because I stepped away.
Most importantly, the decision of someone as senior and well known as me and someone who others assumed to be robust, to admit to vulnerability and put health before ambition, seems to have sent a powerful signal to others that it is “OK not to be OK”.