DAVID HASLAM: “REGRETS? I’VE GOT A FEW, HAVEN’T YOU?”

“What do you wish you had done differently?” 

It’s such a great question, and a challenge that I was asked at one memorable Next Generation GP evening. It really set me thinking.

Outside medicine the answers are relatively simple. The one that really bugs me is that I wish I had fitted a loft ladder in the house where we lived for 36 years, but which I put off for year after year because it didn’t seem worth the hassle. At least once a week I had to use a wobbly step ladder which chipped bits off the ceiling, scratched the landing wallpaper, and involved hazardous balancing to retrieve whatever I needed from the attic. I’ve just calculated that I must have gone up into the loft well over 1500 times, but “it didn’t seem worth it”. Trivial annoying inefficiencies build up. Sort them out now.

But as for my career, I’m not sure I have any regrets. This isn’t because I didn’t make any mistakes. Of course I did. (And we don’t have anywhere near enough time here for me to list the clinical mistakes!) I’m looking at decisions that I made, career options that I followed, or opportunities that I failed to pursue. And I don’t have regrets because I’ve always felt that if you change anything in the past, you change everything – and who knows what the unintended consequences might have been. Solve one problem and you probably create a hundred more.

You’ve probably seen the film “Sliding Doors”, a Gwyneth Paltrow movie which alternates between two story lines, showing the two paths that the central character’s life might take depending on whether or not she catches a train. It’s a great premise for a film, and I’m sure that you – like me – can look back at such moments in your life – the extraordinary random nature of how you met, or equally might not have met, your partner, for instance. But I’ve also always believed the premise was flawed for one particular reason. We don’t have just one “sliding doors” moment in our lives – we have an infinite number. The things that did or didn’t happen are indeed infinite in their possibilities.

There were definitely moments in my life when a clear bifurcation in options meant that my career took one direction, not another. I recall going for an interview for a very senior regional role in postgraduate medical education, realising half-way through the interview that I was both bored and irritated with the educational jargon that the interview panel was spouting, and so when we got to the inevitable “Have you any questions for us?” at the end of the interview, I said “No – but I do have a suggestion. If you’ve got any sense you won’t appoint me. You’ll appoint…” and I named one of the other candidates.

They took my advice.

I’m actually delighted that moment of interview madness turned out the way it did, even though my career up to that point had seemed to be on a logical trajectory. But if I had shifted onto that all-consuming educational pathway, I don’t think my subsequent career would have turned out to be half as interesting as it did. Though one young doctor who interviewed me at a conference pointed out that my secret of success was that “every time something goes wrong, you redefine it as a success”. I think he was probably right.

So – regrets. Yes, more than a few. But an equal number of lessons learnt, and a recognition that it is absolutely pointless agonising about the things you can’t go back and change.

And the lesson, if a blog has to have a lesson, must be that there’s absolutely no point in losing sleep over the things you can’t change, and that applies to everything that’s already happened. And that old tale that says “when one door closes, another one opens” is absolutely true.

Though I still wish I had installed that loft ladder.

WHAT MAKES A LEADER?

GP TRAINEE, DR NISH MANEK, ON GETTING PEOPLE BEHIND A PURPOSE

A podcast about big ideas in health and care. We talk with experts from The King’s Fund and beyond about the NHS, social care, and all things health policy and leadership.

New episodes monthly.

NEXT GEN NABS: RACHEL STEEN

NEXT GEN NABS: RACHEL STEEN

What role(s) do you hold at the moment?

I’m Rachel and I am a GP ST3 in Sheffield. I do a number of things alongside clinical work.

I run the Trailblazer GP scheme, supporting GPs working in areas of deprivation across Yorkshire and Humber; I sit on the RCGP Health Inequalities Standing Group; and I’m also part of a group of GPs who have created a website called fairhealth.

Fairhealth is a website which provides an educational resource for health professionals on health equity.

Rachel Steen
@rmsteen

As part of this online resource, I have been developing a podcast (Finding Fairhealth) interviewing experienced colleagues sharing some inspirational and interesting stories on some of the challenges and solutions to tackling health inequity. I also tweet about health inequity so do get in touch!

What brings you the most joy at work?

Put simply, working with likeminded colleagues to improve the lives of others. If I feel like I have made even a tiny step to achieve that then Iusually finish the day with a smile.

What is your biggest challenge?

At the moment it is thinking about practical ways in which we can minimise the impact of Covid on those who are most vulnerable. We are already seeing that the most vulnerable are feeling the worst impacts of this disease. I am concerned about the long term ramifications of lockdown too.

What would you like to achieve by the end of your career?

Wow this is a big question and I could probably write an interview answer for this if I was pushed! In reality I hope to feel proud of the contribution I have made to society and still be in good enough health to have some fun in retirement.

What have you learned about yourself in lockdown?

I am not someone who finds it easy to stop and slow down but lockdown has rather enforced this. I have noticed spring flowers and new lambs in the fields more than ever. I have read more, painted a few pictures, and spent more time with my husband too. There is something rather soothing when I am not at work knowing that there is no fear of missing out or nowhere else to be.

What are you reading at the moment?

I have just finished reading Nancy Klein’s “Time to Think”. I have been dipping in and out of this book for ages. Lockdown seemed an appropriate time to finish it. Her concepts are simple but I’ve already noticed a huge impact on how I think about conversations, meetings and decisions in and outside work. For anyone, who likeme, finds it difficult to prioritise stopping and taking time to think, this is a good ‘un.

……and (no judgement) the last film you watched..

My husband and I are keen fell runners so we watched a film about a runner called Kilian Jornet summiting Everest in (nearly) record time. He arrives in the middle of the night and has to run straight back down so doesn’t get much chance to look at the view. It seemed such a shame after all that effort. His achievement is incredible but I did wonder about all the sacrifices he made to get there and why he was so driven to achieve this. It reminded me to think about the ‘why’ in what I do and alsohow important it is to enjoy the journey and view on the way there. I also definitely don’t fancy climbing Mount Everest, I’ll stick to slowly plodding up hills in the peak district!

Who do you look up to? 

I am currently working with a leader who I know believes in me. They manage to be supportive and allow me to explore my own interests and opportunities but also hold me to account with high expectations. I don’t think they have ever forgotten to say thank you for something I have done or ask me how I am when we haven’t caught up for a while. It’s the small things that make a big difference.

NEXT GEN NABS: SAM FINNIKIN

NEXT GEN NABS: SAM FINNIKIN

What role(s) do you hold at the moment

Currently, I’m a salaried GP for 5 sessions a week, I work as a senior clinical tutor at the University of Birmingham and I am a Fellow for Evidence and Values at the RCGP. I am also joint Hon-Sec for the Midland Faculty of the RCGP and I undertake research in my spare time.

@sfinnikin

What brings you the most joy at work?

Generally, it’s seeing something I’ve said, done or written having an impact. Whether it be advice I have given a patient resulting in meaningful benefit, or a piece of research influencing policy; I just revel in the knowledge that, from time to time, something I do has a positive influence on the world.

What is your biggest challenge?

Turning my ideas into reality. I have no problem coming up with research ideas, or ways in which I could lead meaningful change in the system, but I struggle with converting these ideas into action. Some of this is due to lack of funding or time, and sometimes it’s just not knowing where or how to start. But it’s something I am working on….

What’s the best leadership/career advice you’ve ever recieved?

That’s a difficult one. I find it difficult to pick out single pieces of advice, they all go into the mix and get mulled over in due course. But I know a lot of people worry about imposter syndrome and I remember someone pointing out that if you’re in a room, at a table, or involved in a discussion, whatever the forum, you are there for a reason. Someone has invited you to contribute. Someone else values what you have to say, so just say it. You may feel that your contributions are na ve or simple, but that’s your own ideas come easily to you – others are likely to value yourcontributions more highly.

Who do you look up to?

So many people. Forced to choose, I’d pick David Haslam as the type of leader I’d like to be. His compassion and generosity are clear, and he’s had a tremendous positive impact on healthcare in this country. When he speaks, he always says something worth listening to. I also admire the research, writing and advocacy of Victor Montori.

 What would you like to achieve by the end of your career?

In the last year or two I’ve given up planning my career. I found that my plans were getting derailed too frequently and I was devoting too much emotional energy to them. Iam now keeping an open mind and taking advantage of opportunities that come myway. So what I want to achieve by the end of my career seems an impossible question toanswer; I don’t know what I want to achieve in a years time! However, I would like to have played a part in leading the rebalancing of the medical model. Reducing the reliance onmedicine and healthcare and putting patients back at the centre of everything we do.

What have you learned about yourself in lockdown?

I’ve gone through all sorts of emotions over the last few weeks. Initially, I was frustrated at not being able to do more. Not being able to lead research, contribute to service planning, bring about positive change. I watched colleagues achieve great things whilst I was struggling to balance my existing commitments let alone take on newresponsibilities. But then I learnt to relax and recognize what’s important and my ownlimitations. I’m not good at relaxing….yet.

What are you reading at the moment?

Honestly, I’m not reading anything at the moment. So I’m going to answer my own question. “What book have you read recently that shows everyone else that you’re a thoughtful and intelligent human and you think everyone else should read?” That’s easy: Thinking, Fast and Slow by Daniel Kahneman. It’s not easy, but it’s fascinating and relevant to anyone who wants to understand people better (including themselves).

……and (no judgement) the last film you watched..

Thelast film I watched was JoJo Rabbit. I love the humour in Taika Waititi’s films.