Last weekend I was standing in the middle of a field in Gloucestershire holding hands with a man I had never met before. I looked into his eye and told him that I cared about him. He looked back at me and told me the same, and I believed him.
It was a powerful moment shared with about 20 other men at the Soul Circus festival, following a talk by Nige Atkinson, author of ‘Odd Man Out: Breaking the Vow of Male Silence’. Through the vulnerable storytelling of his own experiences, he had led us through a raw journey where we looked deep into ourselves and the others in the group, the message being ‘don’t be afraid to speak out’.
The uncomfortable topic of male suicide was broached, and the taboo of ‘seeing a counsellor’ was raised. At the close of the session we were asked to take a ‘risk’, and at first it seemed funny that we all paired up and held hands with someone we didn’t know. But, ultimately, the ‘risk’ was only to look another human being in the eye and tell them that we know life can be hard, and that they are not alone.
As a nation, we talk about health and social ‘care’ too. But do we really know what we mean? How do you define caring?
This blog from Rohini Ralby has been at the front of my mind recently, where she defines care as: “Paying attention to a person and wanting what is best for them and facilitating that...care is manifesting Love...care is a bulb shining in all directions, not a spotlight. Everyone benefits.”
When we care, does everyone benefit?
The NHS was built on a foundation of providing equality of care for all but, increasingly, budgets are being squeezed and resources diverted. CCGs are having to prioritise, resulting in variations in provision, even for conditions as common as carpal tunnel syndrome.
In her blog, Rohini talks about the risks of caring: becoming too involved and promoting co-dependency and, at the other extreme, being completely dissociated. We must find the balance in between these two positions.
As a clinician, it is easy to see yourself as the advocate of a patient, becoming ‘lost’ in their problem, treating the one that is in front of you and losing sight of the bigger picture of care for others. As a manager, the opposite is plausible: breaking complicated situations down into simple metrics, in order to make the complex more understandable and relatable in a business sense.
It is clear that neither of these standpoints is productive for patients (as a population) or services, and a middle ground must be established. This divergence in views can serve as the foundation of the tribalism that can occur between clinicians and managers, with each group not considering the issues of the other. It is important that we must move on and begin to work on the same page, understanding and communicating why we do what we do, and how it has to be changed to provide the best possible care for patients and to create a sustainable health system. We can no longer work in silos, with only our egos for company.
It is not only those who work in the NHS who have this responsibility, it is patients too. Where possible, they need to care for themselves, not becoming lost in co-dependency with their healthcare system. Prevention is better than cure, and those who have health behaviours that are known to be detrimental need to think carefully and consider the drain on resources that they will create, drawing services away from those parts of the population who need it. We all need to care for ourselves and each other, or the privilege of free healthcare could disappear.
Finally, to properly care for others, we in healthcare must also care for ourselves. If we are trying to fix people rather than empower them, if we do not listen to each other, or put barriers up to keep others out, then we are good for nothing.
One of our ‘Odd Man Out’ group told us of how he sought help when he was ‘broken’: but this is too late. No one should wait until that point, as an individual or as an organisation. We should not have a vow of silence. Conversations need to begin sooner, rather than later. As Rohini Ralby puts it, when we care for both ourselves and others, ‘interactions should be engaging, respectful, enjoyable, interesting, comfortable, voluntary, relaxed’. Therein lies the root of productive collaboration. All parties are responsible, and should bring what they can to the table.