Showing vulnerability is not a failure\u2014doctors could learn from Biles\u2019 example, says Clara Munro<\/p>\n
Accepting imperfection is hard and something that, like athletes, doctors are famously bad at. The vast majority of us struggle hugely with the concept of failure and relinquishing control. We are self-selected, usually as teenagers, as over-achievers with ambition, most with the noble mission of \u201chelping people.\u201d We are then cultivated in a medical school environment that is a fertile ground for competition, pitting us against one another, creating a partisan world of winners and losers. Vulnerability is not framed as courageous, but as a failure: admitting we cannot do something, or we are not up to it sets us back against our peers, so we are encouraged to get our heads down and be better, plastering over these cracks with rehearsed confidence that is too easily equated to competence.<\/span><\/p>\n This method may have relative success in producing a cohort of individuals who can draw the brachial plexus on demand and recite side effects of peculiar antiquated medications, but it significantly limits us from being \u201cgood doctors\u201d\u2014to our patients, to our colleagues, but arguably most importantly, to ourselves. When faced with the inevitable failure that doctoring brings, we are all too often woefully unprepared for the emotional fall out this brings, and the realisation that we are flawed, imperfect humans who will make mistakes.\u00a0<\/span><\/p>\n Simone Biles is not a team-mate who ducked out of the \u201crace\u201d early. She won national competitions with broken toes in both feet, won a world championship with a kidney stone, and spoke up about the sexual abuse that she faced at the hands of Larry Nassar, The USA gymnastics team physician. She has shown great courage and mental strength and we should absolutely respect that she knows when enough is enough. There is no textbook that can teach any of us when this time is, but if we know we are not safe to perform, whether it\u2019s because we have the \u201ctwisties\u201d or are unable to make safe clinical decisions, it is time to step back. This is not failure, this is leadership.\u00a0<\/span><\/p>\n Leadership has become a buzz word, a box to be ticked on an application form, or a course to attend in order to progress to the next stage in your career. What leadership is really about is knowing when to push on and when to step back. By doing so, you can set an example to those who \u201cfollow\u201d you and have the humility to know what you can do and what you can\u2019t. Knowing your limitations is not a weakness, it is strength, both in a sport where you could sustain a physical injury and in a job where the effect of your decision making can mean the difference between the life and death of another human.\u00a0\u00a0<\/span><\/p>\n While we talk endlessly about leadership, we do not give enough time to what it means to follow, and a huge part of this involves knowing how to support our leaders or our team members to make these hard decisions. We need to be better at trusting when those who lead us, or work alongside us, hold up their hands and say they have reached their limit. When a doctor has the courage to say\u2014\u201cI can\u2019t do this right now, I am not doing the best for myself or my patients, I need some time,\u201d we need to be better at saying, \u201cit\u2019s ok, take the time you need\u201d\u2014just like Simone\u2019s teammates publicly said to her\u2013not branding them a \u201clet down\u201d or \u201cweak.\u201d If we are to place individuals in high-stress, high-stakes performance-based roles, such as those of athletes or doctors (to name just two), we need to be far better at fostering an environment that gives those individuals the opportunities to say they are not ok.\u00a0<\/span><\/p>\n
\nOn Wednesday 28 July, US gymnast and Olympian, Simone Biles made the decision to pull out of the woman\u2019s all-round gymnastics final at the Tokyo Olympics citing the need to \u201cprotect her mental health.\u201d While the decision was met with a great deal of praise at her bravery, a not insignificant minority were vocal in accusing the 24-year old of being selfish and \u201cletting her country down.\u201d What strikes me is that Simone\u2019s decision is not only noteworthy for the bravery it required for her to step back from what was expected, but also from the lessons we can all learn about how it is \u201cok to not be ok.\u201d What can we learn about how to step back when you are not doing your best for yourself or your team? How can we sit more comfortably with not doing what is expected and shouldering the burden of perceived failure?\u00a0\u00a0<\/span><\/p>\n