Facing Difficulties (Part 1)

Welcome back to Serenity. We’ve talked here about looking after ourselves, finding out identity and last time some simple rules to help get us through life. Today I’d like to talk about facing difficulties. Throughout our lives – personal and working, we will face difficulties and challenges to our happiness and balance of well being. How should we deal with these challenges? You might think that this is just common sense but there are some things to consider and ways to approach these situations that might make life a little easier.


Don’t Panic – when things start to overwhelm us, and we face a difficult , one of the most important things is not to panic. As a general rule doctors are fairly good at this. We are trained not to panic, we learn and practice not to panic and to deal with emergency situations. We have algorithms and flow charts, we have contingencies and protocols, we are usually the ones patient’s and other people turn to in an emergency situation. Unfortunately that very training and long list of protocols which make us good to deal with those scenarios can make it daunting to deal with things we don’t expect, or to deal with things that have to do with us rather then a patient.


What would Batman Do?

What would Batman do? An amusing line that comic book fans say, has some relevance here. First take a deep breath and exhale slowly. Now think what would Batman do? He would grab the problem with his hands, choke the resistance out of it, and beat it into submission! Now does that image appeal to you regarding your current problem? If you’re sitting there with a half smile and some of that tension and anger or fear has leaked out good!  Fear and anger can paralyse and stop you thinking, so what ever you need to do to clear that head and kick-start that smart brain that has got you this far in life, do it!

The quip about Batman is to suggest that you need to view the problem or difficulty with an outside perspective and approach it in a calm and intelligent manner. Besides Batman or Yoda, you as the doctor or GP are often a source of sage advice and guidance to patients. I know I’ve been asked many times by a patient facing a difficult situation or time in their life what to do, and how to face those problems.  I’m sure most of you would have as well. So what would you advice a patient coming in with the problem or difficulty you face?

Start with slow deep breaths, and pushing that fear aside, getting that cognitive part of your brain working again, and start dealing with the issues in front of you.

Identify what the actual problem or difficulty is, and how and why it’s there in the first place. Are there any immediate things you can do? Are there immediate things you should not do?


Get Help – beyond not giving in to panic, the second most important thing to do is to get help. This is one of the areas that we tend to not do too well. We are taught through our training as doctors to know when to ask for help. However, at the same time I think there is an underlying implication that we should be able to deal with things, and often there is a perceived sense that we can be seen as failures if we do have to ask for help.

Why is this?

Basically I think it comes down to pride. We have to learn to put aside that pride, and reach out to others. To admit that we are fallible and that we need help. So start with people close to you who love you and care for you, because they probably already know something is wrong, and not having to hide that from them will ease off some of that burden. From there look at mentors or senior colleagues, there are services like the Australian Doctors Health Network (adhn.org.au) which I mentioned in an earlier post. There are groups like Share GP and GPDU where you can get some advice on certain things (though do have caution on posting certain things online). Family and friends, can provide, insight and support. RACGP and other college bodies, and MDOs often have some support services. Reach out, don’t shut yourself in, and falsely believe that you are alone.

So what now? You’ve quelled the initial panic, you’ve started to formulate a strategy and plan, you’ve reached out for help. Now what? Now comes the hard part…


Acceptance – having done what you can, the hardest thing to do is to accept the new situation you’re in. Whatever happened, the world you live in now is fundamentally different from the one you were in before. Its easy to loose yourself in ‘what ifs’, ‘this shouldn’t be happening to me’, and the old ‘its not fair!’. Whatever the situation, whatever has happened, and however unfair or undeserved it is, it has happened. Now you need to accept and own your situation. Until you can do that you can’t move forward.

Think that’s enough for today’s post, I’ll continue the – dealing with difficulties, in part 2. Apologies if the above seem blatantly obvious… It is… But sometimes when you are in that hole and things are overwhelming you, the blatantly obvious isn’t so obvious or easy.

‘Medice, cura te ipsum’ – Physician, heal thyself



Welcome to Serenity – the idea came from a sci-fi show, but the word “Serenity” is defined as:

Noun : the state of being calm, peaceful, and untroubled.

Reading that I thought it would be an interesting name and idea for a blog here. I hope to discuss some things that pertain to the above state of being calm, peaceful and untroubled, as well as some other random thoughts and musings in my head. To start off the blog, I thought I’d lay out some thoughts on the way we look after ourselves.

As GPs we are naturally very good at or learn to become good at telling people how to live their lives, how to make adjustments, and what is good for them. Rather then being judgmental ‘know it alls’ this comes from a want, a need, and a duty, to care for and help others. We base these words of advice on evidence based studies, and recommendations from experts, yet how often do we apply this same advice to ourselves, and how well do we take advice dished out by others?


Recently I’ve gone through some difficult situations in my personal life that have put a lot of pressure on me, and though stressful, have helped me find some clarity and insight into some of the things that I often tell patients.

As I explored mindfullness, CBT, and meditation I found that though I saw myself as very organised, calm and untroubled I was far from that – my life was far from serene. As I examined and continue to reflect on myself and what I do and who I am, I have found that a lot of the characteristics which I thought made me a good GP could have a detrimental effect on my own health and well being.



Doctors in general tend to be driven, analytical, self critical, independent, and intelligent. They are encouraged to be empathetic with their patients, but not cross the patient doctor boundary, so that they learn not to take the worries and concerns of a patient home with them. So you have this package of an analytical, self critical person who is often fairly independent and who is told to listen to people and understand what they’re feeling but not feel too much, and at the end of the day remember to see them as patients and not take their concerns home with you – does that sound like a good mix? What would you say to a patient (let’s say a high level executive) who came to you with that lifestyle – adding in long hours, insomnia, a lot of bureaucracy, demands from regulatory boards, expectations from customers/clients, and high risk decision making multiple times a day?

With the above patient we would have a strategy in place, we would give them advice on lifestyle changes, on behavioural adjustments, we would go over the risks of that sort of lifestyle, work pressure and work life balance. We would talk about exercise, diet, mindfullness, taking breaks, general health assessment etc….

But do we apply these things to ourselves? I’m lucky in that I have a very supportive and understanding wife who often calls me out and tells me to pull my head out when I’m getting too stressed about something at work, and I have some close friends that are also doctors who help remind me to look after my own health. So recently I have tried to be a little bit more proactive in that department of looking after myself.

I found a GP for myself – the Victorian Doctors Health Program is a great service for Doctors which you can call up (03 9495 6011) to find a GP near you who takes on other doctors as patients. Australasian Doctors’ Health Network | Doctors’ Health Advisory Services in Australia and New Zealand – has lots of useful information, and support services for each region. I called up, found a GP, made an appointment, saw him, and started ticking off a few things that I would have expected any of my patients to have already done including general screening bloods, evaluating weight and lifestyle, stress and BP.


There is a sort of relief in doing this, those concerns or worries you had about yourself- that you shelved to be done another day is cleared, and you pass them onto someone else. I often get that same feeling when I see my accountant and am assured that he’ll look after my taxes and finances. It’s true that he may berate me for not putting more away in my super or not claiming a certain deduction on tax, but I acknowledge that he’s there to look after my financial well being. There’s a release and de-stress in handing over that baton. So why are we so bad at doing this? Why do we feel that we are invincible and that our health doesn’t matter that much, or that we will be fine and this or that issue won’t affect us?

The answers are varied and complicated, but I think one of the key things is that we as doctors see our identity entrenched in that very image or ideal of being “the good doctor”. I think we can’t extract ourselves from this concept or identity as a doctor. This is perpetuated by our regulatory bodies, public expectation, government , media, and of course ourselves. I think one of the first steps to heal ourselves, is to start with a separation of that identity of ourselves as a person from that of the ‘Doctor’. We need to see ourselves as a person, with wants, needs, failings and weaknesses. We need to accept that we are fallible and that it’s ok to be so. When we are “off-duty” we need to remind ourselves of that fact, and be constantly aware that there shouldn’t just be small compartmentalised and scheduled time for family given we have a family all the time. In the end when we look to describe ourselves to someone else, being a doctor shouldn’t be the first thing that comes into our head.


That I think is a good a place as any to leave this conversation for now, I’ll leave you with a quote from the very wise Douglas Adams –

“Well the hours are good…’ … ‘but now you come to mention it, most of the actual minutes are pretty lousy.”

Douglas Adams, The Hitchhiker’s Guide to the Galaxy