New Year’s Eve 2017, Hilton Hotel, Amsterdam Airport, 11 pm. I have booked a room with a view. I am watching out over the airport buildings, the runway, the control tower. I see flights taking off and landing in the nightly sky. It is a coming and going. With the seconds ticking away, the clock will soon usher in the new year 2018, in meditative silence.
In a couple of hours I will be up and about, off to catch my flight to the African continent. I will be starting my new year with an adventure I have been dreaming about for my entire life. While gazing at the aircrafts with their mighty wings, carrying the hopes and dreams of people to places all over the globe, I am trying to calibrate my mindset to the journey ahead.
I am told the code word is TIA. No… not a ‘Transient Ischemic Attack’, but ‘This Is Africa!’. It is a phrase expressing the mentality shift that is needed to make it in Africa: a shift towards accepting everything that is coming your way, whether good or bad, and towards accepting it with a smile. I will try to keep you posted on my TIA-progress through this blog. For now, I would like to leave you a new year’s note on something that has been on my mind and in my heart on and off over the last years. It is about rehumanizing health care.
Ever since I started training and working in the medical field, I have come across many forms of humiliation, facilitated by an often too hierarchical medical system and an unsafe work and teaching culture. I have seen several talented and kind-hearted people dropping out or suffering from burnout. When I attended a conference session on bullying in midwifery, the tears of some of the participants and the stories of all sorts of humiliations went beyond anything I had experienced myself. I was struck by the immense scope of the problem and the scars it leaves in people.
I noticed how people who had once started their medical careers full of passion, inspiration and devotion, were left powerless and empty. I realized that this culture is an “infectious disease”, a contagious mentality, something that people submit to in order to survive. Those who suffered from it start even doing it to newbies. It forces people into a state of internal schizophrenia that undermines the very fundament of their own well-being, that of their colleagues, and in the end that of their patients.
After all, how can you give compassionate care to patients when the environment you work in is all but compassionate, safe, positive, constructive and empowering? What happens to you when your professionalism and humanity are not interwoven? When on the one hand, you have to pretend to have no insecurities, self-doubts or lack of knowledge or skills from time to time, while at the other hand you know that you can only see patients as human beings in the full sense of the word, with their inherent vulnerability, when you can drop the facade.
I recently came across a post in a midwifery group on Facebook that turned out to be one of the most inspiring pieces I have read in 2017. Five things I wish I had known as a young doctor was written by Robin Youngson, who founded ‘Hearts in Healthcare’, a movement focused on human-centered health care. I highly encourage you to read the entire article later, but would love to share some of its highlights with you here.
To all those who chose midwifery with their hearts and souls, but are regularly confronted with an environment that drains your battery instead of charging it… I wish that 2018 will bring you many heart-felt connections.
I wish that whenever you doubt your experience or competence, you will remember that “you have a fully formed heart. Even if you are lacking in medical knowledge and technical skills, your compassion and caring can make a powerful difference to the outcomes of your patients. It will also give you the joy of human connection, a warm feeling in your heart, and it will protect you from burnout.”
I wish for you to have the human factor prevail, so that you will be able to recognize the true needs of your patients. Have faith in them, “explore their strength, be positive and encouraging” and “expect miracles”.
I wish for you to keep your sense of wonder and keep seeing the “mystery and awe in medical practice”, as “the reality is that patients have remarkable capacity for self-healing”. This will help you to “care deeply about your patients, bring your heart to work, but let go of striving to save everyone”.
Finally, I wish for you to have a contagiously positive attitude, so that together we may heal the culture of health care. Together we can “re-learn a new way of being”.