You Can’t Please Everyone: Why I try to remember the rule of thirds

I don’t think that anyone enjoys being disliked, but some people are much better at dealing with it when it inevitably happens than others. That’s because trying to please everyone people is frankly exhausting and ultimately futile as people are so varied as to make it impossible. I don’t know about you but after 2 years of COVID-19 I’m too tired to do it anymore. I think having reached acceptance that I can’t and won’t be everyone’s cup of tea has come with a feeling of freedom, so I thought I’d share some thoughts of how I got here.

How do you know if you are a people pleaser?

For many years I didn’t realise that everyone wasn’t like me. It meant I also didn’t understand why some people were able to behave like they did (not always badly but with independence) without suffering the crippling shame spirals that happened to me. So how do you know if you are a people pleaser? Some great examples are below.

https://www.scienceofpeople.com/people-pleaser/

You may not be a dyed in the wool people pleaser all the time. It’s true primate behaviour to become more extreme in this behaviour during times of stress, meeting new groups or in high stakes situations. Which is why I suspect that for me it’s been made worse by COVID-19. Being aware of your tendencies so you can undertake a review of whether or not they are helping you is key. For instance I have a tendency to over compensate initially when I’m annoyed at someone whilst I process that irritation. This can lead to me having less good outcomes in the long than if I’d taken a more neutral stance, as I am guilty therefore of sending mixed signals.

Playing well with others

This pleasing people can be especially challenging when it comes to working on group projects or when running events. I’ve been running events and working in groups/teams for most of my life and for all of my NHS career. Most of you won’t know this but for many years, even in my spare time, I ran role playing conventions or live role-playing events for dozens or even hundreds of people. The main thing that I have learnt in my time doing these is that it is actually impossible to please everyone. The things that were one person’s highlight will inevitably end up on the list of another’s persons disappointments – especially when events reach a certain size. Everyone is different and therefore it is almost impossible to tick the boxes of everyone attending.

When I was putting myself through the ringer and getting upset about the not universal love for a freeform I’d spent a year and over 150,000 words writing a good friend turned round, hugged me and whispered in my ear ‘remember the rule of thirds’.

Now I had never heard about this but on follow up questioning it turns out as follows:

  • A third of the people will love it
  • A third of the people will be ambivalent or think its OK
  • A third of the people will hate it

You will hear most from the lovers and the haters but what you actually need to know is how many of the ‘good enough’ people there were. If you manage to get over over a third you are probably doing something right (unless the extras all come from the lovers category). Those are the people you won’t be able to judge the numbers of unless you specifically go out there and seek their feedback – otherwise you respond to the most vocal and may react incorrectly.

The thing is as I go through my career I think the last part is really becoming a key part of my thinking. Am I or do I respond to the things that are shouted loudest or do I take the time to actually evaluate the situation that is beyond the noise to make an action plan which may work for the quiet majority?

It isn’t just about groups

I’ve started off talking about groups but obviously people pleasing can have challenging aspects in 1:1 settings. In fact overcoming people pleasing tendencies in these 1:1 settings can be key to maximising your own effectiveness both at work and at home. I’d like to state for the record that this is very different from me advocating for selfishness. We should absolutely all be team players, but it is important to also ensure that you have the capacity and reserves left to be the best version of yourself so that you deliver as fully as possible.

Below are some of the things I’ve been thinking about/learning in order to handle some of these 1:1 settings better.

Set your success criteria without bias

When I have someone in front of me asking for something I find it incredibly challenging in the moment to say no. Especially when each individual request doesn’t feel unreasonable or large. This year though I’ve been trying to move towards not seeing these 1:1 moments in isolation, but rather to measure them against a holistic whole of what is happening in my life. One important step towards being able to judge whether taking something on is people pleasing or appropriate, is to set boundaries and measure your responses against these.

These decisions can be very challenging in the moment and so one of the things I’ve started to do is to set my own success criteria, before I start projects, but also for my year. These are not another rod for my own back but are a way of checking in with myself about whether something is going in the right direction and whether the decisions I’ve been making are actually serving me and the goal.

It’s important to do this before being in the moment. When I’m in the moment emotions and other pulls can make it difficult for me to evaluate. By having a list that is done before I get into the situation it enables me to have made an unbiased set of judgements that are more reliable for me to use as benchmarks.

One example of this happened recently. This year I had promised myself and my family that after the last 2 years of work coming first I would start to regain a balance where actually my family would be my priority for a while. In May we had some news that meant that this was even more important. In that moment I was able to go back to my list and goals and re-evaluate commitments against my stated aim for this year. Although it was sad I then stepped away from a number of things I was agreeing to that were interfering with my top goal for the year, spending time with my family.

I’m aware other people may think I’m barmy to have to do things this way, but I really easily slip into a default of yes, and in many ways that’s great and where I aspire to be. Not at the costs of my main goals however.

Communicate and manage expectations

If you are going to do this though, communication is key. One of the reasons that I can get more drawn into things than I originally intended is because either myself or the other side haven’t accurately communicated their expectations.

One of the things I dropped in the above example was being a school governor. I only started the role in September 2021 and I had been told that it involved 3 2 hour meetings a year. This I had decided I could manage even in a pandemic and that giving back to my community was sufficiently important to me that I could make it work. Then the mission creep occurred. Suddenly it was 3 meetings a year plus a governor monitoring day per term, then that plus, as Health and Safety governor, I needed to do an inspection visit per term, and finally I became governor with responsibility for science teaching review. Suddenly my 3 evening meetings a year were replaced by at least 2 day visits a term plus the other meetings. Something that was simply incompatible with my goal for this year. In previous years I would have just made it work, I’d signed up after all. This year I reviewed against my goals and found that it just didn’t fit with me achieving the things I’d prioritised for my life so I quit.

The lesson for me from this is that we have to be very clear in communicating our expectations and what the situation will actually look like. That works for both sides. I should have been clearer about the commitment I could actually make and they should have been clearer about what they needed. So many things in my career have been subject to mission creep and I’m trying to be much more aware when I take on new things what they should look like and how much variability from that I’m prepared to accept.

You can’t fix everything

One of the situations that I know is a real challenge for me and my people pleasing tendancies is when I’m presented with a situation where I feel like I should help or ‘fix’. At times like this I become a real helicopter friend/manager and I try to ride in on my white horse and make things better (mixing my metaphors all over the shop and I don’t care – see that’s what I call growth). It comes from a good place, I don’t like seeing people upset or struggling. The problem with this is that a) I often then take on unexpected extra work as part of the response and b) I actually take the learning away from the person I’m trying to help. There is a big difference between assistance/support that enables learning and development and ‘fixing’ which then takes the learning experience away, although fixes the situation in the short term. I struggle to know when in the midst of these situations when to step away or hold my ground to allow space for development to occur and how much help is too much.

This brings me onto something I’ve mentioned previously. It is sometimes just not possible to please everyone. Sometimes you have to have the courage to be disliked and honestly this is definitely harder 1:1. This can happen for a number of reasons: sometimes it’s because it’s a collective decision and not everyone in the group is going to be on board, sometimes you have to make a decision that is in the best interest long term but may not garner immediate approval or understanding, and sometimes (especially in IPC) you make difficult decisions on the basis of safety. I have found this the most challenging aspect of leadership, but I have come to one conclusion and that is I need to acknowledge the noise but not be deafened by it. I have to put it into context to be able to deal with it. If I believe that have done all I can, communicated/collaborated as well as I possibly can, then I have done the best I can in the moment and I have to put my people pleasing aside.

Remember context is key

You can only control you, your responses and what you have decided to put out there. You can’t control how it is received and you definitely can’t control the responses of others. Often these responses are not even about you or what you have put into the world. They will be intrinsically caught up in the perceptions of others, their prior experiences and their current emotional state. Fundamentally it is not all about you and you have little to no control over the people you are trying to please. The more we recognise this, the more we can put our energy into focussing on success criteria and moving forward in the wider landscape.

I’ve found the below image really useful in addition to checking against my success criteria. If my only motivation in saying yes is to please, then actually my answer is really no and the sooner I deal with that the better it will be for all involved.

People pleasing isn’t a zero sum game, by prioritising something over something else there is always a resource cost. If you like me have spent energy for years trying to please in situations where you have little or no control of the outcome my plea is to stop. Think. Why I am doing this? Is it actually helpful? Does it align with my values? Does it move things forward? If the answer is no, then the answer is no. You are allowed to decline, you are allowed to choose where to focus your energies, you are allowed to have your own goals. So say it with me now ‘No’ ‘Thank you for thinking of me, but I can’t right now’ ‘It isn’t the right time for me right now, but please do contact me again in the future in case I can help then’. Your world will be a better place for embracing the power of N O, you will succeed more, do more and in my case I will get to spend time with the people I love who are, after all my reason for being.

Responding With Grace: The art of learning to take a complement

Last month I was fortunate enough to be asked to present at the 40th anniversary celebrations for the Healthcare Infection Society, I gave a talk that was pretty OK and seemed to land with those in the room. In it I spoke about the impact that the society had made on my career with the funding they had awarded, I also spoke about the impact and learning that had happened on those occasions they hadn’t awarded me funding – my CV of failure. For the rest of the day lovely people came up and spoke to me about how much they’d enjoyed the presentation, especially the section on failure. I spent most of the day a little thrown by it, not just because I didn’t feel worthy of the response but because it dawned on me that I just don’t know how to take a compliment. Those conversations felt like a social contract I had entered into without fully understanding the requirements and I just didn’t know what to say or how to appropriately respond.

This has led me to reflect on why I was so out of my depth. Was it the setting? When I give academic presentations at conferences I am usually prepped for questions and critique as a result of what I am saying – therefore compliments are usually less on my mind. People are often very kind about this blog and other things I post on twitter and other forms of social media, but when responding to those comments a nice gif is easily available and so the terms of the social contract are more easily fulfilled. So setting certainly plays a part, but even so the fact that I have reached the ripe age of 42 and I am so unskilled in this means I need to step up my game.

Why is it hard to just say thank you

Arrogance is not a good look and vanity is a deadly sin (I’m not religious but it’s all kind of embedded in society and subconscious lessons learnt) therefore it can be really hard to judge what is required as part of the social contract when someone gives you a compliment. The obvious choices are to say thank you – but that shuts down further conversation if not done correctly, or to dismiss it as not something you are not worthy of – which is hard to do without coming off as rude. It feels like a paradox that compliments are something I want to regularly give out but I am not sure that societal rules enable me to navigate appropriately when I receive them.

You’d think that these concepts of arrogance and vanity in terms of acknowledging success were old hat and not something present in todays workplaces, but I’ll never forget being told not to put the first award I won out on my desk as ‘my success makes other people feel uncomfortable’. When responding to unexpected compliments it can almost feel like a trap, be gracious but not too responsive, accept the compliment but don’t take it to heart. I am in no way saying that any of the wonderful people who spoke to me after my session were anything other than lovely and genuine, but more reflecting on the way that society and societal rules can make it difficult to be fully present in the moment.

The horror of the compliment circle

The worst example of compliment horror I’ve ever experienced was as part of a leadership programme. We met every 3 months for 2 days, at some point during the 2 days we were all made to sit in a circle and offer a compliment to someone else in the circle, I found it tortuous. The giving out of the compliments was easy enough but the receiving them I found deeply uncomfortable. The forced nature of the setting meant there was nothing spontaneous in either the giving or the receiving. I was filled with so much horror that these moments were coming that I would do homework of prepping my list for all 29 others before I went. It was like being picked for team sports if you were selected last because no one could easily think of a compliment for you. It wasn’t really acceptable either to use a compliment that someone had already used for someone else and so you were forced to be either highly superficial or super inventive. For an exercise that was supposed to bring us together and support us getting to know one another it succeeded, but not for the reasons the instructors anticipated, it brought us together in our hatred of the activity. I’m sure this type of activity lands differently in different societal or cultural environments, but for that group of 30 women it was universally an unpleasant and challenging experience.

NB – In all honesty the compliment circle was not the most horrendous part of this course, at some point I will share the horrors of being forced to communicate my leadership challenges through the medium of interpretative dance or the dream journaling where I basically recounted plotlines from TV or the movies just so I had something to say.

Once it’s out there it’s no longer yours to control

I was speaking to the ever wise and wonderful Nicola Baldwin the other day and mentioned the fact that I was thinking about this and she said ‘what you need to understand is that once you have put it out into the world the response to (whatever it is) is no longer yours to control, you’ve given it a life of it’s own’. Nicola as a playwright obviously has a lot of experience with this and it was really interesting to hear her thoughts. Once you have written the paper, given the talk or shared the blog your duty really might lie in bearing witness to the response rather than controlling it. Fundamentally, at the point you have put it out there it is no longer about you, it is about the response of others.

The other thing that this conversation sparked in me was some thinking about how I would react if the reaction was not positive. Would I find a negative reaction difficult to deal with? Would I think about it differently? Interestingly I think that in fact negative reactions might be easier to manage as I psychologically already move to the place where it is acknowledged that it is about how the person received it not how I intended it to be received. Although I don’t enjoy criticism I suspect that I have much greater resilience in dealing with failure than I have in dealing with responses to success. Making the mental shift to knowing that neither of these situations are really about you makes it easier to have strategies to deal with both.

So how should I respond?

So having done some thinking I’ve come up what I know are some really obvious phrases that most of you already use – I acknowledge that this is not going to be news to many people but just thinking about it has helped me.

Options are to say thank you and leave it at that:

  • “Thank you! You made my day!”
  • “Thank you! It means a lot to me.”
  • “Much obliged!”
  • “That’s very kind of you.”

You can also use it (after the thank you) as an opportunity to follow up and offer more info/develop the relationship further:

  • Use it as an opportunity to acknowledge others contributions
  • Ask questions to gain insight so you can improve things further
  • Get to understand the person better – understand what resonated with them and why

Knowing that for good or ill it’s about being in the moment and having some of the pressure removed to ‘do it right’ by knowing that bearing witness to the reaction of others might be all that is required of me is a tremendous relief. As someone who, you may have noticed, has a tendency to over think, strategies are important to me. So next time someone comes up to me and says something nice, instead of responding in fear and wanting to run to the bathroom and hide, I intend to say ‘thank you that’s made my day’ and follow up with a question that builds the relationship. In the end after all it is not really about me.

All opinions on this blog are my own

Daring to Be Imperfect: Celebrating the joys of imperfection

The last few weeks have been pretty stressful, for a whole bunch of reasons. The last few years even more so. The pandemic has made me highly aware that one of my responses to stress is to jump into the rabbit of hole that is perfectionism. This is dangerous territory for me as the deeper I dive the more I feel like I don’t match up, that I’m just not doing a good enough job and that I’m letting my colleagues and patients down by not being ‘more’. I have to consciously remind myself that being good enough is not about being perfect……..its about being open to improvement and learning. I have to actively remind myself that nobodies perfect. Trite I know but its true.

The truth less told

My husband and I often sing the following lyrics to each other:
“Raggy Dolls, Raggy Dolls
Dolls like you and me
Raggy Dolls, Raggy Dolls
Made imperfectly
So if you’re not at ease with your nobbly knees
and your fingers are all thumbs
Stand on your two left feet,
and join our Raggy Doll chums
Cause Raggy Dolls, Raggy Dolls
Are happy just to be
Raggy Dolls, Raggy Dolls
Dolls like you and me!”

Video for those of you who weren’t kids in the 80s/90s

Singing this is something we do when we get carried away into a shame spiral. When our actions have demonstrated imperfection and we feel bad as a result, when we have jumped into the perfection rabbit hole and forgotten that just being normal is OK. It acts as a reality check in the standards we are setting for ourselves and for others, a tongue in cheek way of grounding each other when the stresses of life get too much.

The fact that we even need to do this has recently left me wondering……….if nobodies perfect, and we all acknowledge this to be true, why do we spend so much time trying to be? Do we think that rule doesn’t apply to us? Are we somehow better than everyone else that we could reach perfection? If the answer to that question is no (and I suspect it is) why do we constantly beat ourselves up for not reaching a target that we have pre defined as unattainable? What is it about perfection that seems to be so alluring that we will all put ourselves through so much emotional anguish to strive for?

My journey to imperfection

In some ways I completely get the striving for perfection, we’ve been told it’s a good thing all our lives. When as a child I got 96% in a history exam I still clearly remember my father asking ‘what happened to the other 4%’. Failure is uncomfortable and (because we are trained to see it this way) often humiliating. Worse than that if we fail in medicine the consequences are not just for ourselves but have significant impacts on others. It’s a reflection that we aren’t enough, haven’t tried hard enough, aren’t smart enough. The truth is however that the world isn’t split into black and white, good and bad, perfect and imperfect. There is a spectrum, a pathway and instead of obsessing about moving from one ‘category’ to the next the process should be about moving forward on the pathway. We are neither failures or successes, we are all in fact just works in progress.

Since becoming a Consultant my ‘perfection’ moments have become more frequent, partly because the shoes I’ve stepped into were considerable: I’m benchmarking against someone who was not only superb but also had 30+ years of experience. I joked with a friend the other week that what I have become best at since taking up the post is being comfortable with failure. She got really angry at this, saying that not achieving inbox zero etc wasn’t my failure but a failure of the system. I don’t feel her rage as I don’t see failure as being such an abhorrent word and so I’m happy to use it. Maybe however, what I should have said, is that I’m becoming more comfortable with imperfection, both mine and that of the system I work in. This doesn’t mean that we accept the status quo and not try to improve, but that we also shouldn’t spiral into self hatred just because of the fact that we don’t always achieve the standard we set in our minds. Perfectionism can be paralysing and mean that if perfect is the only standard we measure ourselves against we fail to grow and achieve. Instead lets aim high but know that the standard I’m actually aiming for is that in 15 years I can benchmark against my consultant who just retired, not on day 1 on the job.

There is power in being me

In many ways I’ve come to accept that it is my imperfections that lead to my strengths, they are the things that make me uniquely me. It’s my imperfections that led me to start writing this blog as an honest way of organising my thoughts and trying to be a better scientist, leader and human being. In all honesty, if I was perfect they would probably be little to write about or discuss.

One example of this is that I’m not someone who remembers and is able to quote facts, I remember events linked to stories. This means that unlike my consultant I replaced I will never be a walking encyclopaedia of microbiology and infectious disease. It does mean however that I have been able to work with Nicola Baldwin and others to set up the Nosocomial Project where we use stories in order to engage in conversations about healthcare science and infection control, in a way my consultant never would have. The impacts of these two skills are not the same but they both have impact and maybe shouldn’t be measured against each other or have value judgements attached.

One of the other things I’m learning is that I am not alone in feeling the pressures of perfection and by sharing my imperfections it not only helps me but helps others. I work every day surrounded by some of the smartest, most accomplished people on the planet, quite literally world leading experts in what they do. Sometimes it can be easy therefore to believe the hype and to judge yourself against their appearance of perfection and competence. The pressure to live up to appearances is enormous. I am not by any stretch of the imagination in their category but I feel that by being honest about who I really am gives other license to take off the mask of perfection that they wear.

Why striving for perfection could actually be a bad thing

Perfection could be described as the death of learning as once it is achieved then there is no room for progression. Instead of striving for perfection we need to be striving for learning. To take it a step at a time and do each one better than the one before, allowing us to benchmark against where we were, not where we are striving toward. I sometimes think that perfectionism also stops us from being fully self aware, from being able to fully explore where our strengths and weaknesses are to support us in making the best choices for our futures. If we place a value judgement and associated stigma on not being perfect then we may not be able to live with the self judgement required to truly evaluate our skill sets, as instead of being able to enter a growth mindset self reflection drives us into a shame spiral.

Are the dangers of perfectionism the same when we expect perfection in others? When we put leaders, friends, or partners up on a pedestal of perfection are we in fact setting them up to fail? If we place people on pedestals and they don’t achieve are we just doing it in a way that allows us to accept our own failures better? If we accept that imperfection in ourselves is a key way to enable us to truly improve should we be offering this same perspective to other key relationships in our lives? That doesn’t mean we can’t have high expectations of those we have relationships with, but those expectations should be constructive rather than destructive. Otherwise expecting perfection in others may mean we cannot demonstrate the empathy required to build relationships and therefore limit the stability and longevity of those connections.

Acknowledging imperfection is not a way to get out of doing the work we all need to do to be better, but instead a way of freeing us up to actually be fully participant in doing it. If I have freed myself of the delusion that I have to be prefect I’m less scared to take a true look at myself and work out where to begin. It’s about wasting less time in agonising over why we aren’t better and on self recrimination to spend that time on making progress and learning how to improve. So join me in the Raggy Doll army, embrace your imperfections for the learning they offer and for everything they do to make up the wonderful person who is uniquely you.

All opinions on this blog are my own

Wearing My Quitter Badge With Pride: Why FOMO can damage your health

I have written lots of posts on this blog about being brave and saying yes to opportunities. For once I’m going to write about something that for me requires even more courage, and that is saying no. It’s not that I don’t stand by those previous posts, saying yes is incredibly important. The thing is we all need to know why we are saying yes (or no) and to make sure that we are choosing our responses for the right reasons. Neither response should be driven by fear. There are times that for our own health and wellbeing we need to know when to choose our responses in a way that isn’t about career progression or opportunities, and we need to acknowledge that that saying no is also OK.

I’m a FOMO (fear of missing out) addict.  I always want to be engaged, I want to both support and be seen to do so.  I’ve worked so hard to get into the room that I live in some level of fear about not being in it. I worry that if I leave the room I fought to get in, not only will I be forgotten, but I will be barred from re-entry.

Over the last year a number of things have happened which have forced me to put this fear into context. FOMO is a fear of missing out on the possible, but by not being present for my life I’ve been missing out on the reality of my life that is happening every day. Recent events have prompted me to send emails resigning from a couple of things. I thought it would feel awful (it might still at some point in the future) but it didn’t, it felt great. Not because I am not heart broken to step away from those roles but because of the removal of the weight of those responsibilities that I had not realised I was carrying with me.

I feel like not only am I happy that I took the plunge but in fact I want to Marie Kondo my diary i.e. look at each item/commitment and say ‘does this bring me joy?’. If the answer is no then I need to follow up with asking myself honestly ‘why am I doing it?’. Obviously there are many things in our day to day working lives that just need to happen, but I think you would also be amazed at how many of those things that we feel obligated to do are actually just a routine or something that we are doing because we tell ourselves we should. It is these things we need to interrogate ourselves over and ask what it is that they are giving us: joy, experience, contacts? Are they still giving those things to us or are we attached to the memory/habit. Are we just scared to face up to what it would mean to move on?

Reasons to regularly review

What this current experience has shown me is that I don’t review my working life. The last couple of weeks have taught me that I should. I’ve spent some time thinking about it and the thought that has struck me (and you probably all knew this already – I’m often behind) is that you have to let go of the things that no longer serve you to make room for things that will let you continue to grow. I’ve not been letting go of things. Partly because I’ve finally reached the goal I was desperate to achieve in my working life and to be frank I’m so happy about that I’m still scared someone will take it away from me. I’m so used to having to tick so many boxes, often driven by the check list of others, that I’ve stopped reflecting on what was on the list for me.

If you, like me, have fallen into the habit of just taking on more, of just carrying on without reviewing your why, this is my plea for you to take a moment to see whether this is something you need to change. We should take a moment to put a review date in our diaries – I’m aiming for once every 6 months – to go through my lists of committees and responsibilities to see whether they are still a good fit for me and for those I’m working with. After all, it’s not just about my needs but also about making sure that I still offer what was required.

Carve out time to maximise impact

For me its not just a review of task, it’s also a review of mindset that is required. It’s very easy to become a human ‘doing’ and not a human ‘being’. Due to the pandemic I feel I’ve got into the habit of being in responsive mode. Constantly responding to changing information, changing guidance and the hundreds of daily emails. Don’t get me wrong, this is where I think many of us needed to be for the last couple of years, but we need to break ourselves of this habit. It’s nigh on impossible to be strategic in responsive mode. It is also not good for our own well being – at least it’s not for mine. I know get stressed and twitchy if I don’t access emails on the weekend. I worry about being judged for not immediately responding to every demand. The problem is that after the last 2 years I am broken and I can’t maintain it. Not just that but whilst I’ve been taking the time to reflect I’m pretty sure that it’s not where I do my best work. Responsive mode is fine when in crisis. Crisis is time consuming however and leads to focus on specific issues. To work on how to improve services and identify where we can do better requires us to take the time to step back, calmly reflect and then make plans. Switching from responsive to strategic mode is therefore important not just for me as an individual but is also key to doing a better job for patients.

Interrogate your reasons for saying yes

Not only am I a FOMO addict but I’m also a people pleaser. I feel the need to get feedback from others in order to feel like I succeed (I have another post coming on this). This can be an effective driver but when it takes over it can become a really destructive trait. You do not need to say yes to everything in order to ‘show up’. You don’t need to work 12 hour days ever day in order to be successful, in order to be enough. In fact by working those hours and becoming so focussed on the minutiae you may actually be performing less well than if you did your 9 – 5 and had adequate time off to reflect and recuperate.

These are my reasons for over committing but your may be very different. All of the different drivers we have are both good and bad, it all depends on how they are balanced. In times of stress it can become difficult to find that balance – and we have all been mighty stressed over the last 2 years. Now is a good time to look at ourselves and our decisions to make deliberate and mindful choices moving forward. Our judgement of worth needs to be internal not external if we’re to get out of this loop.

Know your worth

Self worth is a tricky thing. As I said above I’m a people pleaser, my self worth is often therefore derived from pleasing others. It is also linked to success, and like many in my field I define that success linked to outputs – presentations, guidelines, grant funding, papers published. Like many others I have lived, breathed, and focussed on pandemic management for the last 2 years. Therefore my sense of self has become distorted and my self worth has become even more focussed on work.

The thing is there is way more to me than my job. I have passions and interests both linked to work (like writing and The Nosocomial Project) and with my family. It is my family that have paid the price for the shift in how I behave and determine my value, and it is my family that now need to be my focus in order re-establish the balance I need to move forward. As teams, as managers and supervisors we need to support each other in shifting mindsets post this unusual period, and remind them that it’s OK to leave on time, to have weekends and eat lunch. It is OK to be the fullest version of yourself.

Give yourself permission to say no

So moving forward I am going to give myself permission to not just review options and step away from projects, but also to say no to new ones. If I lose traction, if I lose opportunities because I say no on occasion and if I’m not ‘always on’ then that is a price that I have determined I’m willing to pay. Those people who know me and have supported me will not disappear overnight just because I take more time to focus my energies on being the best person I can be.

Opening doors for others

I’m also not going to feel guilty about stepping back. This feeling of guilt has been difficult to manage but it’s not well founded. By stepping back from positions I’ve done for a while I’m opening up progression windows for others to make connections and gain experience in exactly the same that I did. By learning to say ‘no but have you thought about’ I am making opportunities for others and hopefully lifting others up by putting their names forward. Realising this has been crucial to me not feeling guilty about saying no. My saying no means that others can say yes and that is nothing to feel guilty about.

Situations change and the thing that was right for you 2 years ago may not be right thing for you now and that’s ok. Fear and guilt shouldn’t prevent us from letting go of things in order to grow and learn. So as much as I’m an advocate of yes I am also learning to become more comfortable with no. Find your joy, say yes to putting yourself first and know that by doing so you will become even better tomorrow than you are today!

All opinions on this blog are my own

If Not You Then Who? Why seizing the opportunities that come your way is so important

We’ve all had the emails arrive with requests. We are looking for a new member of X committee, a training rep for X group or would you like to give a lecture to Y. For many year when these dropped into my inbox I ignored them. They were being sent to everyone and so ‘they’ weren’t actually looking for someone like me. I wasn’t experienced enough knowledgeable enough, connected enough to ever find success in replying to something like this. Then one year I took a chance and replied. I volunteered to become the HSST lead for the Microbiology Professionals Committee of the Association of Biochemistry and Laboratory Medicine (a LOT of letters I know). They couldn’t reply fast enough with how happy they were I’d replied.

Don’t get me wrong, the ACB weren’t particularly excited that I’d replied……..more they were excited that anyone had. What I’ve learnt since from sending out these emails myself, is that hardly anyone does. The world is full of people who doubt that they would succeed and so don’t put themselves out there and give it a shot. So today I want to talk about all the reasons why, when that email arrives, you should click reply, open the next door in your career and step through it boldly.

You never know where these things will lead

When I sent that email I had no idea where it would lead. Now I know it was the first in a series of steps that took me from where I started to being considered a leader within my profession. At each step I never could have predicted what the one a couple of steps down further down the road would involve. What I do know is that each one I took, I took with purpose. Sometimes I wanted to give back, sometimes I wanted to increase my skills and sometimes I wanted to gain experience. The choices are your own but also not taking those steps and being purposeful is also a choice.

What I hadn’t realised back then is that people frequently ask people they know to get things done, not necessarily because they are the best person but because they are the person they can identify. This means that visibility and being part of networks is key to getting some of the opportunities that would benefit you and your profession.

In my case, that application to be a HSST rep emboldened me to apply for a bursary to attend my first overseas conference in Denver (see pic). After attending my first SHEA conference I was encouraged to apply to their international ambassador scheme, and became the first UK Ambassador. That then led to them paying for me to attend a conference at Disney in Florida, which was not only amazing, but meant I made the connections to sort out a 2 month sabbatical at Boston Childrens Hospital. This helped my NIHR Clinical Lectureship application. That progression helped give me the confidence and experience to apply to become Trust Lead Healthcare Scientist and to become a Clinical Academic.

Gain experience you won’t get in the day job

There are many reasons why it can be difficult to get the kind of experience that volunteering for professional bodies/guideline groups/any external responsibility can provide:

  • Sometimes its hard to be seen in a different way if we’ve been in post for a while, and therefore it can be hard to get identified for opportunities internally
  • Internal committees may find it difficult to accommodate extra people under existing terms of reference
  • Concepts linked to hierarchy may matter more for exisiting structures versus new groups/committees
  • External groups are often specifically looking to engage new people, garner new views and so it can be easier to align personal desires to be exposed to new experiences with the needs of these groups
  • Experienced provided by external groups may just not be provided internally i.e. experience of being a charity trustee

The activities linked to these groups may provide a lower stakes way to get experience. This can include chairing your first meetings, making decisions linked to the success of small pots of grant funding, inputting into a strategic plan. When doing this as part of our day jobs this can feel high stakes and be daunting. If you can gain experience of similar processes in a lower stakes environment you can participate in the learning without some of the stress and anxiety which might otherwise be present.

Often the experience isn’t limited to the activity itself but the experience of working with new people from different backgrounds. This experience helps make us more rounded professionals as well as supporting us in expanding our networks.

Progression is a series of steps

As I described in ‘not knowing where things will lead’ it is often hard to see where taking a series of these smaller steps will take you to. Frequently engaging in these activities is not about ticking off part of a big life plan but about making small progressions that support the whole. If you are a trainee it can be a really nice way of ticking off competencies, if you are already registered it can bring some variety to your CPD for the year. Meeting new people and making new friends is a benefit in itself.

One of the wonderful things about seeing these encounters as small steps is that you don’t have to feel overwhelmed by the big picture, in fact you don’t have to know what that big picture will look like. I talk a lot about having goals in mind, and I stand by that, but there is also joy in taking small steps into the unknown where you just enjoy and value the step in itself. Where you focus on the learning and the experience of that encounter for what it’s offering you in the moment. Taking multiples of these small steps combine to lead to big changes but the little steps have value in themselves and should be appreciated as such.

Don’t be afraid to be seen

I think on some level we all fear being visible, of sticking our heads above the parapet. It feeds into imposter syndrome and our fear that we aren’t ‘enough’. Fear of failure, of not getting chosen, is embedded in most of us from standing in lines to be picked at school if nothing else. I know and understand these fears. Fear is OK, it’s natural, in some cases in the right amount it can even be helpful. The problem comes when it overwhelms, or when we pay it too much heed and therefore we let it stop us from becoming all that we can. I feel this is especially true if it stops us learning, either from the experience itself or from even engaging in the opportunity to start with.

I often sit in my fear for a bit when I’m trying to move forward. This may sound like a strange phrase or a strange thing to do, but sometimes I need to experience the fear to understand it. I don’t dismiss it as I’ve never been able to make that work, instead I allow myself to feel and to ask myself ‘if this fear is real what is the worst that will happen’. What are the worst case scenarios. Then I ask myself, ‘what does this worst case scenario actually mean for me?’. Is the worst case that someone doesn’t pick me? In which case I’ll be a bit bummed out for a few days but there will be more opportunities. Is the worst case that I will make myself look like a bit of an idiot? To be honest I’ve been there before and whether its for this specific reason or not I am likely to be there again. One thing I’ve learnt it that you and your behaviour/embarrassment has way more longevity in your mind than in others. To be frank you are simply not important enough to most other people for them to remember a stupid comment in 6 months time, and those that you are important enough to probably won’t care. Most of the time when I do this I realise that even in the worst case scenarios the event would have little meaning in my life a few months down the line. Therefore the potential cost is still worth it. I don’t talk myself out of fear, I embrace it and that way it doesn’t control me.

Help your community

Finally, and I think this is so important. Our communities survive because of the fact that we engage as part of them. Guidelines don’t get written if people don’t volunteer to write them, events don’t get organised, outreach doesn’t get undertaken and manuscripts don’t get published. It really is a case of trying to make the sum greater than the parts.

As well as learning experiences in themselves, these opportunities are vital for both our profession and our patients. So much of what we do isn’t ‘paid’ as such, so much of our impact is based on the community choosing to engage and work together towards making things different, and hopefully better than they are today. We reap the benefits from the work of this community whether we volunteer or not, but we benefit so much more if we are part of the process. As each one of us steps forward to support our communities the output benefits, as the contribution comes from a more varied group of people and stands a better chance of therefore representing the society/community it is linked to. So instead of seeing your application as a way to benefit you and feeling stressed or worried about how it is received, see it for what it is, something that will benefit those receiving it and something they will be grateful to open.

Since sending that first email asking to be considered I’ve travelled the world, met amazing people and opened up a world of opportunities I just couldn’t have imagined, just because I hit reply and YES. So give yourself the gift of believing in yourself the way that you believe in others, you deserve it!

All opinions on this blog are my own

Girlymicro’s 100th Post: What I’ve learnt in my 1st year as a consultant

It has kind of snuck up on me, but this is the 100th blog post on Girlymicrobiologist.com. I’ve had such tremendous fun and learnt so much about myself writing them. Talking to people about them has also been an unanticipated joy. I don’t therefore think I’d realised how many posts had happened over the last 18 months or so. To mark the occasion I thought about writing some top tips and discussing the things I’d enjoyed most, but I cover a lot of that in my 1 year anniversary blog. Serendipitously this post coincides with me having been in a Consultant post for a year this week, so I thought instead I would share what it’s been like………….

Everything I thought and more

I’d worked with a fairly single minded focus to get here. At some points it really felt like it was never going to happen. The wonderful thing is that it has been everything I hoped for and more, something that isn’t always true for dreams and aspirations.

The interesting thing for me is that the core of my job isn’t really that different from my job before, I kept waiting for it to change but it hasn’t really. The biggest change I think is the weight of responsibility I feel for my team and that, for some of the big decisions, I end up advocating on my own. I am aware some days that I’m on a trapeze without a safety net. That said, as the Consultant Nurse for IPC/DIPC and I talk every day we always have each others back. I can’t imagine having spent the last year in a pandemic doing this solo, and so this relationship has been a god send.

I must however talk about the thing that has been strangest to me. I left work on a Friday and came back on a Monday as a Consultant. From one day to the next a lot of people changed the way they interacted with me. People who had known me in both roles. On the Friday they would challenge me routinely and call me Elaine. When I came back on the Monday, the same people called me Doctor and just agreed to things. When I sent emails that I anticipated would come back with nit picking or challenge from some medical colleagues they just responded with OK thanks. Don’t get me wrong there have been plenty of difficult conversations but far fewer than I had anticipated. Anyone who believes hierarchy doesn’t exist in the NHS should experience this transformation by just sticking Consultant into their job title. I still can’t quite get my head around it.

The other thing that I’d been really fearful of when I switched was using the Infection Control Doctor title and having people telling me I couldn’t as I wasn’t a traditional medical doctor. I agonised about having it in my signature and putting people’s backs up. You know what…..not a single person has mentioned it, let alone said anything bad. I can’t tell you how grateful I am for this. It was that title more than any of the others that held real meaning for me and I was so scared of being rejected in that post. The fact that people haven’t rejected it but in fact embraced it means so much. As someone coming from a different place via a different route it is hard to quantify how much that has meant to me and given me hope for how we embrace change/difference in the future.

The whole truth and nothing but the truth

Now I’d be lying if I said the joy and acceptance described above hasn’t come with a whole of heap of challenges. I’m going to talk about the challenges of becoming an IPC Consultant in the times of COVID-19 below, and some of the bits I’m going to cover here I don’t know whether they are the same or worse because I started in a pandemic. It is worth stating that most of these existed before the big P, but that like many things in a period of change they may have been exacerbated.

I talked about about how much the IPC Doctor role has meant to me, its been the goal for 16+ years afterall. I think because I assign so much mental value to it that I doubt myself and fear that everyone is going to realise the horrible mistake they made on a pretty much daily basis. The shoes I’ve had to fill are massive ones left by such an impressive and knowledgeable individual, you can’t help but worry you will disappoint. Taking over at this point is therefore challenging when there have been big decisions and big changes every week it feels. I’ve talked before about how failure is key to learning but every action right now feels like it is too important to fail. That fuels my inner perfectionist and means I have a tenancy to spiral. Deep breaths and ‘faking it until I become it’ have definitely been my survival tools for my first year in post. I’ll let you know when the ‘become it’ happens.

The acceptance has been great, I’ve been incredibly lucky but on some level I still know I’m never going to be part of the club. My micro consultant colleagues go for coffee and lunch together but I can’t join them. I’m the person setting the guidance that says you shouldn’t mix, even after work. They will always spend more time with each other in hand overs etc which means they have enhanced relationships with each other. This isn’t a bad thing. I have relationships that they don’t have and my job role is different. I guess it’s human nature to want to be accepted and part of the group however. The strength of my position is that it is different and in many ways my strength is that I’ve always followed my own path. There have been times over the last year that I’ve needed to remind myself of that. They have been nothing but supportive and inclusive when I’ve reached out and so it has been a lesson to me that if I need help I just need to ask for it.

This leads me onto the next thing. I’m a stand alone Consultant Clinical Scientist within my department. I have nursing and medical consultants that I work with but no one like me. This has meant that sometimes it requires specific focus for both myself and others to remember the scientist part of that title. Being a scientist is a huge part of who I am and my concept of self. It’s understandable that others may not always remember that. Doing the bits that mean I am still a scientist is hugely important to me, things like undertaking research and advocating for my professional group. Some of this is tied in to re-discovering my identify full stop having focussed for so long on reaching this point. I’ve crossed the finish line and so what does the next goal look like, how does that fit in with my scientific identity. How do I ‘fit’ whilst still maintaining that of which I am proud and makes me different. This one is definitely a work in progress and as I learn more I’ll share whatever conclusions I come to.

Here’s the one that will surprise none of you = the to do list never ends. I feel like I’m constantly running to stand still, working weekends just to keep sight of what’s going on. Some of this I think is linked to me wanting to do my best and being anxious about it, some of it is because I don’t want to let go of some things I used to be involved with, but to be honest I think a LOT of it is trying to do all the pre-pandemic work on top of a pandemic work load. The ever changing guidance and the constant messaging required to keep people safe. If life is like this three years from now I will definitely need to drop things that I would love to still be engaged with, for right now I’m mostly taking each week at a time and hoping at some point to see what a consultant post in non-pandemic times might look like.

IPC doctor in the time of COVID-19

Until that day arrives when SARS CoV2 doesn’t control my every moment I continue to spin that one enormous plate on top of everything else. One of the biggest things I’ve learnt over the last year is that leadership, in all its forms, could not be more important. There have been some pretty tough lessons about seniority that I’ve had to learn as well.

I’m used to being able to make decisions, decisions based on evidence. If the data is sufficient I’m not used to people challenging or not engaging with those decisions. I’m going to post about this more in a future blog I think, but one of the lessons I’ve had to learn is that my ability to influence has limits. That the risk assessment others are making is not necessarily the same as the one that I am, and the weighting of the different factors within it are not necessarily the same as mine. Sometimes my role is to advise but if that advice is not taken up because that risk assessment is different it is not a failure of me in the role that I hold. It is the reality of advising on a single part of a much greater puzzle. Try as I may therefore I have had to acknowledge that this isn’t a battle for an outcome, but a collaboration where the outcome may or may not be the one that I would have chosen. As long as I advocate to the best of my ability, live up to my values and embody the leadership I want to see, that is all I can do. If I see it as a battle we all lose, if I see it as co-production we all win. Changing my point of view on this has been key to my surviving at certain points, especially linked to Omicron.

Talking about leadership, I don’t think embodying that leadership has ever been more important. Everyone is tired and everyone has gone through a period of extraordinary stress. I’m still asking staff to behave in ways that add to that stress i.e. by not having lunch or even drinks with their teams together outside of work. This means that a key way that we normally support each other is no longer available. We haven’t been able to celebrate or commiserate with each other for over 2 years. I’m a really strong believer in not asking others to do what I’m not prepared to do myself. Over the last year that has included me leading the way with opting in openly and discussing the pros and cons of routine asymptomatic lateral flow testing. Being open with people about my reactions to the vaccines and booster but how I went ahead and had them for the protection of myself, my colleagues and my patients anyway. It has also included me missing out on that same support I have deprived others of by reducing their contact with colleagues. To me its about fairness and showing with actions rather than words that we are all in this together.

The importance of paying it forward

There are some people in my world who went all in to get me this post, people who I will never be able to thank enough. Mentors who have been with me every step of the way and who put their names and reputations out there vocally to support me, fought battles for me that I know no detail about. Those people have changed my life. So now it’s my turn. My turn to fight for others. My turn to act as a shield and as a mega phone. I have thanked those that helped me but I don’t think they will ever really understand the difference they made, so now I honour that by vowing to make that same difference to those who follow behind.

So here I am (successfully?) having broken my way through that glass ceiling. If anything this last year has shown me that this isn’t the end of the journey but the start. If I want others to not have to have the same fights as I did, then I have to work to make sure I keep that hole open and drop a ladder through it to help those who want to follow. Those coming after me will have different challenges but it’s important to share what I’ve learnt to help them where I can along the way. It’s one of the many reasons this blog is so important to me. So as a fitting message in this 100th post I wanted to say that for as long as you guys keep reading, I will keep sharing. Sharing so we can rise up, sharing so we can make change and sharing to make sure that we are seen and to help us all work every day to leave the world a slightly better place than we found it.

All opinions on this blog are my own

Prioritising the Needs of the Many: Great communicators let the message do the talking

Let me start by saying that I am by no way a ‘great communicator’. I’m OK, I’ve never been the one who wins best presentation prizes or anything like that. I have however had the privilege of seeing some truly amazing communicators speak. I’ve also sat through more hours than I’d care to mention of bad conversations,  bad presentations and bad interviews. What these combined experiences have shown me is that truly great communicators focus on the message and not how they want you to perceive them. They let the listener feel like they own the communication and thereby feel like the message is personal to them. They make the audience feel valued and like they matter by creating a shared experience.

We can’t all be great at this, it’s not where everyones skill set aligns. The greats also seem to me to have a bit of magic that probably can’t be taught. For the rest of us mere mortals however there are things we can do, in terms of thinking and preparation, that may make us a little bit better. So what can we do differently?

It’s not about appearing to be the smartest person in the room

We’ve all been there. We’ve probably all reviewed papers or seen talks where the communicator focused on appearing smart rather than the message. They used complex sentences and words to demonstrate just how much of a scientist they are. In some ways it feels like they have done just about everything they can to make it harder to engage with their message, by making it clear that most of the audience isn’t smart enough to understand what it is they are trying to convey.

In fact the real skill with highly complex topics is being able to present them in a way where they don’t feel complex at all. Being able to break down a complex topic into pieces that when combined make the whole process understandable can only be achieved if you yourself really understand your subject. It’s why Feyman utilised trying to teach something as a way to better understand his learning gaps.

Working out what your message is

Before you start the process of breaking down what you want to teach and going into detail you really need to start with the message.  Too many of us when we are trying to plan a lesson or lecture, or even a paper, don’t put in the pre work to think about what it is that we are actually trying to communicate.  What story are we trying to tell.  We don’t often think of communicating science as telling a story but in reality we are, and there is lots to be gained from thinking of it in terms of these structures.  A story has a key theme or message that it is trying to be communicated to the audience.  Stories also build, they are comprised of sections, even if these are simply: a beginning, a middle and an end.  Before starting to communicate we should therefore think the same way about the topic we are trying to get someone to take away.  We can make sure that everything else we talk about comes back to and enforces this key message. 

The next thing is to then flesh out this message by planning learning objectives.  What are the 3 – 5 things you would hope that someone who has attended will be able to know/achieve after they leave.  These effectively are used to give you your beginning, middle and end.  Your learning objectives for sessions delivered to different audiences may be at a high level the same i.e. raise awareness of the work of a microbiologist. In order to maximise their effectiveness however you will need to tailor them for different audiences to ensure that they can be achieved i.e. talking about AMR will be different for lay pubic audiences versus researchers. This is where the specific and relevant components really come into play.  Everything you put into your session should be based around these learning outcomes in order to support the audience have a clear sense of direction with your overall message.

Remember who your audience are

If your message is going to land then designing your way of communicating it and the learning objectives with them in mind is key.  If you have an audience of 4 year olds then your method of communication is going to be very different to if you are talking to a room full of post graduate PhD students.  If you have a drop in 15 minutes with a large group at a science outreach stand you will need to have a very different method to if you have a small group for an hour as part of a workshop.  You also need to bear in mind whether these audiences are ones you have a relationship with because they’ve met you before, or are they a one off encounter.

When you are writing items like lay summaries for research grants and papers this is especially important.  Most lay summaries should be aimed at an audience with a reading age of 12.  You need to be very conscious of abbreviations and scientific terms that we may all use without even thinking about them.  There are some good websites that can be used to check wording and language, but even more simply you could ask a member of your family (or even ideally a lay focus group) to read through it and see what the message is that they take away vs the one you think they will take away. The same is true for verbal presentations as well. Think about the language you use and whether it invites the audience in or acts as a barrier for engagement.

Try out a metaphor or two

I’m presenting tonight at an AMR event and I have one slide to talk about my work.  The audience is likely to be mixed and I want to talk about the differences between phenotypic, fragment based sequencing and whole genome sequencing, and how different techniques are best in different circumstances. These are challenging concepts to describe in under 5 minutes and so I’ve picked something I think most people will be familiar with for them to hook their knowledge onto…………cake. A good metaphor puts your audience at ease as you are discussing something familiar. You are also able to take shortcuts in explaining some concepts as you are hooking new knowledge onto a pre-existing framework. Hopefully your audience will walk away with your message and if you’re really lucky as someone they will remember.

Take it one step at a time

No one wants to sit in a talk and feel lost or read an article that makes them feel stupid for not understanding it. It makes the person engaging feel bad about themselves. It also makes them disengage which can be distracting for the audience as a whole, depending on how they behave when it happens. I’ve been that person in immunology talks at conferences. I’ve been fully engaged and listening for 15 minutes and then the presenter either takes a step assuming knowledge I don’t have or I blink for a second and miss something and I spend the next 30 minutes with no idea what on earth is going on playing with my phone.

The lesson for me here is twofold. Make sure that every progression step your audience needs is present, you can rarely make assumptions about your audience. If the information is key to understanding the information to come, make sure you give it however briefly. This is where we come back to knowing your message and learning outcomes. By only having the info in your session that is essential to serve those you buy yourself time to spend on the blocks of info needed. The second lesson is to make sure you refer back to previous building blocks of info in your talk. That means that if someone misses something they are given a repeat opportunity to contextualise and understand prior to you moving on. It also means that you are embedding the previous knowledge because the next step builds upon it.

Know when to present yourself vs your CV

Connection between yourself and the audience is always key to getting your message across. There are times when, as much as I wish it wasn’t, that standing in front of an audience as a living version of your CV is required in order to be taken seriously. When establishing your credentials before you start communicating is key to your message being heard. At these moments I’m Dr Elaine Cloutman-Green who leads X and has Y amount of research funding. When you are trying to speak in a lot of other settings however it’s important to remember that credentials can in fact get in the way of the message you are trying to present. Remember it’s about the message and not about you. If I stand in front of audience to talk about science being for everyone and reel off my list of fellowships and leadership roles I have immediately moved myself into a box of ‘other’. Someone not necessarily like them, someone with different professional experience who doesn’t share their experiences and aspirations, someone that it is hard to connect with. When doing sessions like these I’m definitely not my CV, I’m Elaine or Girlymicro.

The best way to get better is to practice

As I’ve said I encounter people all the time who are so much better at all of this than I am and I’m always super attentive when I hear them speak, not just to hear their message but to also learn ways to do it better myself. There are obviously some people out there who are born great at this, but even they needed to learn and improve how they did it. The best way to do that is to practice. Write blogs and get involved in writing papers with others who you think are good at this. Try out thinking about messaging and designing learning objectives, until it becomes easier because you’re used to it. Most importantly practice talking to people, practice one on one conversations with those you supervise, with your colleagues who are in different disciplines and with your friends. See what bits interest them, which bits they respond to. Be brave and book in to do some outreach and volunteer to give that departmental seminar you’ve been dreading. Doing is in essence how we learn, you can only get so far by reading about something. Once you’ve had a go its then important to take the time to reflect in order to learn how to do it better next time.

The other key part of practicing and learning how to communicate better is to make sure that you are building evaluation into your sessions/activities. We often try to guess at what well, what audiences actually heard and what we could improve upon. Guessing is fine to a point but you will never have the backgrounds of everyone you are engaging with. The only way to really know what they are responding to, what worked well and what didn’t is to actually ask them. This is where the measurable part of your learning objectives is important. As scientists we respond well to data, it gives us concrete direction in which to improve. Lets apply that to the way we communicate so that we make the most of every opportunity, every moment, in order to succeed in getting our message across.

All opinions on this blog are my own

An Homage to Douglas Adams: Reaching 42 and therefore becoming the answer to life the universe and everything

I’ve been lucky enough to make it to the big 42 this year. 10 years more than my sister and according to the wise, funny and wonderful Douglas Adams the number which is the answer to life the universe and everything. So as an homage to this great writer and to celebrate I thought I would share the knowledge I have gained whilst turning this wonderful number.

It will never make sense, that’s part of what makes it brilliant

When I was a kid I thought that adults knew it all. When I was a teenager and in my 20s I thought I knew it all, whilst simultaneously knowing I was out of my depth and knew nothing. In my 30s I felt like I needed to know it all and put myself under all the pressure that came with that to succeed and to be seen as knowing. Now I’ve reached my 40s I’ve realised that one of the biggest joys is in the not knowing and enjoying that there is still so much more to learn, explore and achieve.

Its not about how fast you get there, its about remembering to enjoy the ride

I spent my 20s and 30s racing towards an imaginary finish line. I had a list of tick boxes and I ticked fast and I ticked hard. Having reached my imaginary line I now realise that the joy was mostly in the journey and not in the completion. I know a lot of people right now in the ticking phase and the thing I most wish they knew was the boxes WILL get ticked, but that they should get the most from ticking them. Sit back and smell the roses, feel the sun and enjoy the pleasure of each achievement for its own sake, rather than immediately looking towards the next.

In a world where you can be anything, be kind

I don’t remember the smartest people, I don’t remember the people who had the most experience or the most knowledge. The people I remember for having the most impact on me and my career are the ones who were kind. The ones who took the time, the ones who lifted me when I stumbled and the ones who had faith in me when I had none in myself. If you want to maximise the impact of your time on this planet then being kind is the way to do it. Be kind when it’s the last thing you want to be, be kind to the people who are pulling you down. People are fighting battles you know nothing about and one act of kindness can change a day or life.

Not everyone will like you and that’s OK

I find this truth hard as I am, by nature, a people pleaser but its true. No matter how hard you work, no matter how hard you try, not everyone is going to love or even like you. That’s ok you won’t love everyone either, the key thing is to not let that drive you. I’ve been described as ‘marmite’ and it taken me some time to grasp the fact that someone doesn’t have to like me to work with me, we just have to set differences aside and find enough common ground to focus on a shared goal for a time. Not everyone needs to be a tea and cake buddy.

Understand what aids you and let the rest of it go

Sadly I don’t think anyone gets this far in life without having some challenges and quite frankly dealing with some shit. These are the fires that forge us. The thing is knowing that those fights and struggles that have got you here have made you who you are, honour that but don’t let it define you. It’s all too easy to carry our scars with a little too much pride and to give them a little too much weight in our present. I’ve learnt to acknowledge the drive they have given me, the armour they have provided, to try and take the good but leave the bad. To let them help make me but not to let them tell me who I am.

Understand what matters to you

What matters changes over time, it isn’t always a static state of being and requires regular reflection. I’m often described as driven but I mostly think that’s a nice way of people saying I’m following my own path, all I do is put one foot in front of the other. What I do know is that there is a continuous signal amongst the noise of my life and that is that what matters most to me is my family. The people I love are my world, they are my centre and keep me grounded. They are the calm in my storm. What I want most is time with them and to live my life without drama, I did ALL the drama in my teens and early 20s and I don’t enjoy it.

My husband and I have a phrase that we use with each other ‘let me just check my bothered pocket’. When I’m getting into a shame spiral when I’m panicking about the conversation I had yesterday or the imagined upset I might have caused him or visa versa it’s a phrase we use to bring some reality back. The answer is almost always ‘its entirely empty’. Everything is almost always completely OK and there is almost always nothing to worry about. This simple phrase grounds me and enables me to focus on what matters most, the people I love.

The struggles you feel now will fade and change into new and different ones

You have probably gathered that I’m not a very chilled out person, as my husband says ‘my mind is a hell to me’. The biggest lesson I’ve learnt is to step back when I’m in the midst of my storm to try to get the distance to understand whether this is something that actually really matters. The ability I have to focus and be tunnel visioned is great to achieve tasks but is somewhat of a hinderance in this and it’s something that I have to practice. I sit and ask myself if the worst case is true would this matter in the way it feels now next week? next month? next year? in ten years? By asking myself these questions I give myself the structure to work out quite how important it is, or if in fact it is not important at all. This also helps me choose the battles that I want to engage in and the ones that I’m happy to walk away from.

Finding your tribe makes it all worth it

We talk a lot about making sure that you have insight from beyond your echo chamber, and this is true. Right now though I’m going to talk about the joy of finding people who just get you, people who are part of your tribe. None of us are strong all the time, none of us can always be our own advocate. Life is an exhausting merry-go-round and sometimes we all need help. Find the people that see you for who you truly are, good and bad, and who like/love you anyway. Find the people who will see your worth even when you can’t and who will lift you when you fall. Once you have them life will never be quite the same as you will be able to share the load. Once you find them never let them go.

Have the courage to choose the unconventional path

We spend a lot of time getting told what should matter to us, where we should want to be, who we should want to be with. I’ve never been very good with instructions. I’m a strong believer in ‘you do you’ as long as what you are doing isn’t hurting others or taking away their right to choose the same way. I don’t really believe in doing things the way others have done them. I’m the only one that wears this skin, I’m the only me, therefore only I can choose the right path for me. Being different, being you takes courage and self belief, but it’s worth it. Choose the right path for you, otherwise you’ll spend your whole life questioning what might have been and that’s a cage that’s hard to escape from.

Travel the road using the 3 Ps and you won’t go far wrong

The 3 Ps are my rules I set myself to live by: purpose, passion and principles. They apply across my professional and personal life. Do the things that make you wake in the morning with a smile on your face, do them consciously and in a way that doesn’t hurt others. For me, if I live by the 3 Ps I don’t question my life choices because I’m following a path, no matter how challenging, that I’ve set on because I believe in it. When life gets hard therefore, and believe me it does, I know at the core of my being why I made the decision I did and it makes it easier to carry on. These Ps are mine but you have a whole alphabet of choice to decide on what your guiding stars might be!

All opinions on this blog are my own

I’m Not Lucky, I’m a Badass: The importance of owning your success

It’s Heathcare Science Week 2022 and I wanted to start the week by posting about something very close to my heart – owning it. I believe very strongly that we should own our failures and use them as learning experiences to make us better. I also believe that we should own our successes, but this is something that I struggle more with getting comfortable with.

Like many people my first response to any form of compliment linked to my career and the success (I feel) I’ve had is to say how lucky I’ve been. This is true, I’ve been incredibly fortunate, I’ve had amazing opportunities and great success. The thing is,  I’ve been thinking recently is this luck? Is it luck or is it because of hard work, tenacity and opportunities made?

The other thing is this. Claiming success and owning it as anything other than luck is a thought process that makes me feel uncomfortable. Not just that but I’ve worked in teams with some amazing people in order to achieve it and so is it mine to own? Just privately thinking how good my success make me feel also makes me realise how much acknowledging that openly would not be a good look. It could be seen as being arrogant. Being considered arrogant we are taught is never a good thing, especially as a woman.

Then I saw the tweet below and it really made me stop and think. What is the problem with us owning our success and the work it took to get there. Is being happy with your success really arrogance? Or is it, in reality, about having the confidence to own it?

Where Does the Fear of Owning Your Success Come From?

Working in healthcare means that very little we achieve is as individuals, we work in teams and I think most of us are very aware of team dynamics. We succeed and fail within those teams and therefore I think it is often difficult to see ourselves as individuals and having individual success within those team dynamics. Now I’m not in anyway saying we shouldn’t be good team players, I’m all about collaboration but I do think it’s OK to recognise your own role in the success that your team has and to be OK with acknowledging that (with due credit given to others). It takes a lot of voices to make a chorus after all.

My evolutionary psychology days are some time ago, but when I think of how we are taught lessons linked to pride and arrogance I always think back to my days studying primate behaviour. Group behaviour, especially female group behaviour, is about co-operation and fitting into hierarchy. Essentially it’s about helping others and not sticking out. Females that stick out make themselves available for conflict and are considered to be challenging the hierarchy. Now, I haven’t studied in this area for a long time but it feels like a lot of our early behavioural lessons are still based on this structure and if, like me, you are not very comfortable with conflict then your position should be ‘to be seen and not heard’.

I was told repeatedly as a child that ‘Pride comes before a fall’. It was drummed into me from a young age that pride/arrogance was a sin and to be frank it just wasn’t a good look. This definitely plays into, or maybe is, part of the source of my imposter syndrome – where I believe that people actually believe I’m not very good at what I do and the only reason I’m here is that people are being kind to me. If you put those two things together you end up with a belief system where you know that being prideful could lead you to screwing up and embarrassing yourself AND that others may cease to like you and so you may also be called out as not being very good. The pressure we place on ourselves to be liked in order to succeed may therefore itself get in the way of us owning the very success it creates.

Confidence is a tool. Arrogance is a weapon. Confidence invites people in and arrogance pushes people away. People use arrogance as a wall to prevent others from challenging them. 

Amy Cuddy 2018

You all know I’m a bit of an Amy Cuddy fangirl and I like the quote above. We live in fear of being considered prideful or arrogance but that is different from being confident. Confidence builds trust, it enables others to feel they are in a safe pair of hands. To me the big difference between confidence and arrogance is how it deals with failure. People who are confident acknowledge their failures and failings and use them as a learning tool, whereas those who display arrogance are about denying weaknesses and failures and therefore don’t learn from encounters. I for one need to accept these differences between arrogance and confidence, acknowledge that there is a fine line to walk, but know that if I don’t display confidence I am doing myself and others a dis-service. Owning my successes is part of this.

Changing Your Mindset

There is a certain irony in trying to work on this at a time when my I’ve been feeling particularly stressed and anxious and therefore my imposter syndrome has been on over drive. I’m working on the internal validation piece in order to see my own self worth but I’m also really glad of some of the external recognition I receive which aids me in benchmarking in a more neutral way. Some of that is from twitter, awards, committee work etc. All of it is important to me as it stops me getting too much into my own head, I think this is something that people who don’t have a strong critical voice struggle to understand. At the same time as needing this validation to help me manage at the moment I struggle to respond all the nice things people say as I don’t want to come off the wrong way. It’s also hard to know how loud to shout about things like grant success as others who are struggling could be placed in a more challenging head space if this information isn’t shared in the right way.

In order to make the leap into owning my success therefore I’ve needed to work out how to change my mindset #workinprogress. Some of this is linked to being in a safe space where you can try on and practice some of the changes in order to feel comfortable. As I’ve decided that a lot of the barriers to me owning my success are linked to my imposter syndrome it’s been important to practice this within the aspects of my role where I feel more confident first. It’s also been important to look at how others are doing this in public spaces, how do they share in a way that is inspirational not challenging?

The biggest shift for me has been trying to move from a position where the best thing to do is not be seen to ‘rub others faces in it by talking about success’ to ‘you can’t be what you can’t see’. As leaders if others can’t see what we are managing to achieve how are we supporting the aspirations of those following behind us? How are we supporting them to dream bigger than we ever have? I’ve given myself permission to be seen by others.

Women often suffer from being said to display arrogance when displaying confidence when if they were male this would be seen as a more positive character trait. That is something that is not going to go away and I for one am not someone who feels confident enough to challenge it on a daily basis. I am however going to be purposeful in owning things linked to me and my success, not in a way to discourage others but as a way to empower them and help us all to shine. My pledges for 2022 are therefore to:

  • Be open about my successes and not hide them from others
  • Not agonise about posting things linked to success on social media
  • Amplify others successes by sharing them, talking about them and congratulating them
  • Encourage others to challenge themselves by talking about routes that I have undertaken which have been successful (and also where I haven’t) to support those coming after me
  • Stop down playing my own successes by defaulting to luck narrative

Our success does not diminish others, it gives us all permission to shine, so pledge like me to own your success and support others in choosing paths to their own. From now on when someone congratulates me I will not respond with ‘thank you, I’ve been so very lucky’ I will respond with ‘thank you, its been a brilliant journey’ and maybe if I’m feeling strong ‘thank you, turns out I’m a bit of a badass!’

All opinions on this blog are my own

How Do We Stop, When the Person We Are Competing Against is Ourselves?

I’ve talked a lot previously about the fact that we should only really compete with ourselves. We are all different as are our lives and therefore it makes sense that all of our success criteria will be different too. It’s too tempting to bench mark against others and find yourself wanting. This can be a great driver but it is also something that I for one find difficult some days as I don’t know if it can be turned on and off.

Three years ago today I ended up in a cast from shoulder to wrist. I fell out of a lift at work and protected my work laptop and phone and failed somewhat to protect myself. I’d never broken anything before and so was convinced I’d just sprained something (despite not being able to straighten my arm). I therefore took ibuprofen and paracetamol, went to three more meetings and told everyone I’d be back on Monday – this was a Friday morning. On Saturday morning I was forced to admit that maybe there was something wrong and finally went to A & E (after checking my emails). There I was told I broken my elbow and that I’d have a fracture clinic appointment in the week. I shrugged and said well it’s only and elbow and so worked from home as that didn’t mean I couldn’t type……..right. I finally turned up at fracture clinic and I had broken not only my elbow but also my wrist and then put a full arm cast on me and signed me off sick for 6 weeks. I’d never had a sick note before, I hyperventilated in the appointment and burst into tears saying that they couldn’t do it. They pointed out they could, insisted I took codeine for the pain and put me in the hands of my friend to take me home. What’s my point? My point is that that I don’t know when to stop. I was told by multiple people I should have gone to A & E on the day. I was told by many more to go home and not go to meetings? My husband was adamant that I was in pain and shouldn’t work prior to the fracture clinic as I had a broken arm. I made my wrist much worse and heal out of alignment because I typed on it for almost a week because I couldn’t stop.

So how do we stop when the person who is driving us to continue is ourselves?

I posted last week about the fact that I am often not that well, in fact today I am writing this post in bed as I just feel pretty rough. I’m used to needing to push through because if I didn’t I wouldn’t ever achieve anything very much. What’s probably worse is that I think I’m a fundamentally lazy person. Honestly if I could I would lie on a chaise longue in a library all day reading books and drinking tea. As I’m painfully aware of this aspect of my personality I do try (although my hubby may point out not always successfully) to counter it by being pro-active about doing things. The combination of these two mean that I don’t often know when it’s OK to take my foot off the gas and rest and when I need to knuckle down and push on.

There are times when this is useful

There are times when not knowing when to stop is actually useful. Pre-pandemic I used to run, badly. I’m not good at it, I’m not fast. What I am is stubborn. I continue to put one foot in front of the other no matter what. I’ve finished marathons and half marathons with blood up to calves and enormous holes in my feet but I get into a zone where I just put one foot in front of the other and the pain doesn’t matter so much.

When it comes to working in healthcare I find the same thing happens mentally as well as physically, you just keep going. No matter what the warning signs in terms of burn out of physical health, you keep going because that’s what we do. My auto immune condition entered a whole new phase when I was doing my PhD and I’d just finished a half marathon (whilst in my 3rd year of PhD) when my husband noticed I’d lost a patch of my hair. None of it stopped me. I still submitted my PhD a year early so I could do FRCPath and complete my consultant training.

I succeeded because I just pushed on, because of the habit of putting one foot in front of another. At the time finishing was everything, now I wonder if there were more sensible ways and if I should have listened to those around me, but I was on mile 9 (which I hate) and I just wanted to get the equivalent of mile 13.

Medicine and healthcare are hard places to break the habit

I work in an amazing organisation, filled with the most amazing people. They are all also super smart and world leading experts. I’ve worked there for almost 18 years, I trained there, I’ve grown into an adult there. Being surrounded by people that smart, that successful becomes an embedded driver in itself. You want to succeed for yourself but you also want to succeed for them. As someone who thrives on doing things differently I wanted to follow my own path, break glass ceilings and set the way. To do that however you have to succeed, you have to tick the boxes that people think you can’t tick and so you have to find the drive to continue even when it feels impossible.

As a Healthcare Scientist there is track that needs completing in order to reach the consultant end point I was determined to achieve, for me it was supposed to look something like this:

  • Masters (years 1 – 3)
  • State registration (year 4)
  • Membership of the Royal College of Pathologists (year 4)
  • PhD (years 5 – 10)
  • Fellowship of the Royal College of Pathologists (year 11)

Even though I’ve talked about not benchmarking against others the need to complete these goals become embedded in your psyche. You become very focussed on the track that you are on, in the same way that I run, you get into the zone and take one step at a time. Sometimes however when you are in that zone it’s hard to hear the voices that say you could do it differently, that you could take a break between stages, that you could take that afternoon off to refresh. In my case it was hard because I was on fixed term contracts for the first 13 years of my career, until after I had my PhD and FRCPath. There was therefore a ticking clock in my brain that if I didn’t demonstrate enough commitment, get enough done, that I would lose my job and a career I loved. Not only was I competing against myself but I was competing against time.

So how do we stop?

All of this drive has definitely had its benefits, as I said there are times when this self-competition is really helpful. I would not have managed to get a consultant post or tick all the boxes that needed ticking without it. The issue is that how do you stop when it is no longer useful or even harmful?

I’m still working on this one but here are some things that I’ve found useful. The first one being is to listen to the balancing voices. There’s a lot of good in social media but it’s sometimes easy to only hear the things that re-enforce the fact that we should be working harder and doing more. There are other voices out there however that should make you stop and think about whether you can stop and take a break or just do it in a different way altogether, try and pay as much attention to these as the ones that drive you to keep doing what you’re doing.

Think more about who you are listening to when getting face to face advice. The day I broke my arm at least 3 people told me to go to A and E. I knew something wasn’t right but I listened to others that re-enforced my inner voice to keep going. It was my friends and family who were the ones that said to stop, the ones who prioritise me over Dr Cloutman-Green. Do yourself a favour and listen to these people more. Their priority is you, not the roster, not the deadlines and not the work. Amplify their voices in your mind rather than listening to others.

Finally I’m trying to become my own critical friend. If I was giving advice to someone on the situation I find myself in, would I tell them to push on or would I tell them to stop and rest so they can come back stronger? This is definitely a skill and I am definitely at amateur level right now, but I am working on giving myself permission, permission to leave on time, permission to eat lunch and permission to do things I enjoy that have nothing to do with work. I know some of you out there are so much better than I am at this, and as I said, I am a work in progress. I’m trying to remember therefore to enjoy the learning and the journey. Life after all is just a ride.

All opinions on this blog are my own

When Heroes Fall: How the intersection between fandom and public health can change who you root for

Today is the day, we have reached Super Bowl 56 and for those of you who know me well you will know how much I love Super Bowl Sunday. This year its the LA Rams up against the Cincinnati Bengals. We will be a divided household as the Rams are one of my secondary teams and my husband is a lifelong Bengals fan. Now I’ve been a big NFL fan for many years, after my husband introduced me to the game – I describe it as chess with violence. For all of this time I have supported the Green Bay Packers. Unlike in the Premiership because of the divisionary structure you can have secondary teams, such as my liking of the Rams, but the Cheese Heads have always had my heart. One of the reasons for this is because of the ethos of the team, they are owned by the community and include community service in all of their contracts, why oh why therefore would I be secretly quite glad that my team have not made it to the Super Bowl this year?

Who is Aaron Rogers and What Did He Do?

Aaron Rogers is the Quarter Back for the Green Bay Packers, in effect he is the leader of the team. He is currently on a 4 year contract valued at $134 million (remember this number when we talk fines later). In November 2021 it emerged that Aaron Rodgers had COVID-19. These things happen I hear you say, you can get COVID-19 even if vaccinated. All true, what also emerged linked to this however was the Aaron Rodgers had lied/obfuscated about being vaccinated for SARS CoV2. He had also followed NFL guidance for vaccinated players when unvaccinated, leading the Green Bay Packers to also not be compliant with NFL COVID-19 guidance.

The NFL COVID-19 guidance is:

If a vaccinated person tests positive and is asymptomatic, he or she will be isolated and contact tracing will promptly occur. The positive individual will be permitted to return to duty after two negative tests at least 24-hours apart and will thereafter be tested every two weeks or as directed by the medical staffs. Vaccinated individuals will not be subject to quarantine as a result of close contact with an infected person.

If an unvaccinated person tests positive, the protocols from 2020 will remain in effect. The person will be isolated for a period of 10 days and will then be permitted to return to duty if asymptomatic. Unvaccinated individuals will continue to be subject to a five-day quarantine period if they have close contact with an infected individual.

https://operations.nfl.com/updates/football-ops/2021-covid-related-operating-principles/

Everyone makes mistakes. It’s the learning from those mistakes that matters. However when it came out that Aaron Rogers had lied, instead of demonstrating learning he doubled down and used the coverage to talk about his scientific opinions and the research he had done. Again, I support people gathering information. When you gather that information from known discredited sources and use your platform to continue to spread that disinformation however I have an issue. So much so I tweeted about it and how it made me feel as both a scientist and a fan:

So What Did He Say?

Aaron Rogers admitted that he had misled others by avoiding or implying he was vaccinated when he had instead chosen to take a homeopathic approach to COVID-19. He appeared on a Friday night American talk show called The Pat McAfee Show in order to respond to the detail that had been released:

“I believe strongly in bodily autonomy and ability to make choices for your body: Not have to acquiesce to some woke culture or crazed group of individuals who say you have to do something. Health is not a one-size-fits-all for everybody.”

Aaron Rogers – The Pat McAfee Show

Rodgers then went on to say he had received monoclonal antibodies and taken ivermectin for his COVID-19 infection and went on to thank podcast host Joe Rogan – whose podcast has been criticised for spreading SARS CoV2 disinformation.

“I consulted with a now good friend of mine Joe Rogan, after he got Covid, and I’ve been doing a lot of stuff that he recommended,”

Aaron Rogers – The Pat McAfee Show

If you’re not part of the solution you’re part of the problem

A lot of the science quoted by Rogers has been disproven time and time again and it wasn’t just me that was upset that he was spreading mis-information, even when challenged, under the guise of him ‘doing own research’:

When you are acting as a spokes person for information that has been shown to be incorrect then this isn’t a zero sum game. People who look up to you may not have the scientific knowledge or background to unpick what you are saying and challenge that information. Those same people may follow on and take up your advice and so your actions could actively result in harm. I feel this is especially true if you are an athlete and therefore you make money from sponsorship and other activities linked to your physical health, which could be viewed as being based in increased health knowledge/awareness.

It’s a matter of leadership

Quarter backs act as the leaders of their team, Rogers has been in the NFL for a long time and acts as one of it’s senior leaders. Whether you want it or not that position comes with a level of social responsibility. One of the reasons I fell in love with the Packers is that social responsibility is imbedded throughout the culture of the team. It is therefore even more jarring when the leader of such a team goes against that culture. During his interview Rogers even went on to state that his actions were themselves imbedded in his role as a leader:

Rogers claimed he had a “moral obligation to object to unjust rules and rules that make no sense.”

Aaron Rogers – The Pat McAfee Show

My issue with this statement is that if it was true then true leadership would have been standing up and owning your opinions and being open to challenge. He even went on to challenge the NFL and their medical team by saying he had been told that it was impossible to catch COVID-19 if you were vaccinated and it was this untruth that added to his lack of willingness to be vaccinated. The NFL however responded by saying:

“No doctor from the league or the joint NFL-NFLPA infectious disease consultants communicated with the player. If they had, they certainly would have never said anything like that.”

NFL statement on Aaron Rodgers’ claims about a doctor saying COVID-19 can’t be caught, transmitted by vaccinated players.

This interaction makes me question the response that states it was linked to leadership, as leadership to me does not lie well when linked to deceit.

This isn’t all about Rogers to me though. The Packers leadership has also been questionable. From statements made it is clear that they were aware of the way that Aaron was both feeling and behaving. When he came out with comments accusing the NFL or mis-leading scientific commentary the silence was deafening. Both Rogers and the Packers were fined linked to COVID compliance penalties: the Packers $300,000 and Rodgers was fined $14,650. Speaking of leadership however, how does that fine stand up as leadership? It is likely less than a weeks pay for Rogers and a drop in the ocean for the team. Leadership is linked to culture and if that culture allows the behaviour we’ve seen this year then I can’t help but be disappointed.

When you lie its not just you you put at risk, you remove the choice from others

Before the season started, Rodgers was asked if he had been vaccinated and he said he had been “immunized.” In the same answer, he said of unvaccinated players, “I’m not gonna judge those guys,” seeming to imply he had received the jab. Rodgers during his interview insisted he wasn’t lying in that answer, but conceded he didn’t want to answer more questions about vaccination.

“I wanted it to go away,” he admitted. “Everyone on the squad knew I was not vaccinated. Everyone in the organization knew I wasn’t vaccinated. I wasn’t hiding from anybody. I was trying to minimize and mitigate having this conversation going on and on.”

Aaron Rogers – The Pat McAfee Show

Medical information is personal and therefore it is not a matter that the public have the right to ‘know’, to be honest its none of my business as long as you keep it to yourself and don’t use it as a platform. There is a difference however between not getting drawn into a conversation about it and lying/misleading others. If he followed guidance for vaccinated individuals when he was unvaccinated that is deceit, and it is deceit that could have posed a risk to others. It is not the lie that matters as much as the actions that could have affected others. For instance he was filmed attending a party and other events and even on the side lines speaking to journalists where he breached guidelines for unvaccinated players. That means he knowingly put his team mates at risk, as well as risking the performance of the team as a whole if an outbreak had resulted. If the Packers leadership knew that makes it worse, but I remain to be convinced that everyone he exposed was actively consented into that exposure by knowing his status. I doubt he told the cleaners he interacted with, those who served him food in the canteen. Those people may have been at high risk of severe infection or truly unable to be vaccinated and were under the impression their risk was being controlled. When we assume consent we remove choice and that is not acceptable no matter how amazing your throwing arm. When you say you have the right to make a choice for your body that is correct, but not when by doing so you lie and remove that same choice from others.

Should we reward when off pitch behaviour hasn’t kept to the standard we proclaim to hold?

Last weekend Aaron Rogers was awarded the 2022 Most Valuable Player (MVP) award. I must admit to never having been more disappointed. NFL is one of the few sports that claims to care about off pitch conduct and in holding players to account in terms of behaviour. For a player to be awarded MVP in the same season that they were fined for the way they have behaved seems counter intuitive.

To me this whole situation has sent the wrong message. It says that if you are talented enough, rich enough, important enough the rules don’t apply to you. Even if you get caught out you get a minimal slap on the wrist and you will move on with no consequences. Rules are for the many and not for the few, especially public health rules which rely on us all coming together for the good of everyone. If you opt out the consequences are not just yours but ours. This isn’t just an issue for NFL, but for society as a whole. When those who are seen as ‘special’ are allowed to opt out it means that the rest of us are less likely to comply. In a world where compliance has never mattered more leadership is key.

Finally, I want to clear that this post isn’t about cancel culture. I’ve struggled with the way I feel over this. I’ve struggled with the fact that the behaviour of one individual and the lack of censor from the owners of the team has led me to feel less warmly about the other 52 players on that team. The rest of those players for the most part, won’t have the shield that Aaron Rogers is provided because of his talent, most of them will have obeyed the rules and done nothing wrong, even worse some of them will lose their jobs this year as well as the opportunity to get a Super Bowl ring and the opportunities that come with it. I don’t believe the rest of the team should suffer, but I do believe that when leaders in our communities break the rules they should at least learn from the experience. They should not be permitted to use the platform they have to then spread mis-information and pile on the harm and then be rewarded for it at the end of the season because they have talent. To me it gives out all the wrong messages. Leaders have responsibilities, talented people are not immune from the rules of society………be that beating up your girlfriend or putting others at risk of COVID-19. Until we are all held account to the same rules and the same law holds for us all there is no fairness and I for one will no longer count the likes of Aaron Rogers as one of my heroes, I’ll be sticking to the likes of Ruth Bader Ginsburg instead!

All opinions on this blog post are my own

Celebrating International Day of Women and Girls in Science Day: A view from the Girly Side

This topic means a lot to me. It wasn’t by accident that when, in 2012, I chose my twitter handle: I chose Girlymicro/Girlymicrobiologist. It has felt to me, since I started as a working scientist in 2004, that it was considered unprofessional to bring my whole self to work: to like pink and purple, to bake, to talk about science fiction and gaming. It was the start of the journey that I am still on, to show that we are better scientists when we bring our whole selves to work. Anything that acts as a barrier to that not only harms us as individuals, but also harms what we can achieve as a collective.

The Road Is Long
With Many a Winding Turn
That Leads Us to Who Knows Where…

You may not know this, but I started out as a zoologist. I adored it, I loved it, but there were no jobs in it. My undergraduate dissertation was on the ‘Demographics of Witchcraft Accusations from 1625 to 1715’. You may think that has nothing to do with what I do now but you’d be wrong. Studying human and animal behaviour helps me all the time in understanding some of the group decision-making that occurs in healthcare. The hours of my life spent learning how to undertake statistical modelling was not wasted. What I didn’t study a lot of was microbiology: I did a single module of microbiology during my whole degree.

I then went on to study not microbiology but the physics of biological interactions at surfaces as an MRes. This was where I learnt some microbiology and developed a love of applied science. When I started as a trainee Clinical Scientist, I had so much less experience of microbiology than any of the other more traditional trainees. I once asked why they hired me and the wonderful Dr Margaret Sillis, who acted as my mentor, responded ‘We can teach you microbiology, it’s much harder to teach you how to think’. I still think about that and the transferable skills I picked up by studying other disciplines still come in use all the time.

This trend of not following the standard path has continued. It’s why I ended up in Infection Prevention and Control rather than microbiology. Although the traditional paths are in some ways easier, as you will be able to walk the path that others have walked before you, don’t be afraid to wander the path untrodden if you think that it will be a more satisfying journey for you as an individual. You will learn so much along the way and open up new roads for others to follow.

Making the Invisible Visible

During the last 10 years, one of the things I’ve consciously decided to do is to be visible. In 2015 I was asked if I would be filmed for a project that the Royal Society of Biology were organising called ‘Biology: Changing the World’. For some years I had been told, by my lovely (male) boss, that I shouldn’t do media and shouldn’t be seen as ‘courting attention’ as it a) detracted from the work, and b) people were looking to make a story out of you. Don’t get me wrong, there is some truth to this. It also results in a fair amount of negative feedback, often from female colleagues, about grandstanding and attention seeking. You know what it also does, however: it hopefully means that when a girl in 20 years time is asked the question I’m asked in this video about what female scientist inspired her, there is a chance she will have a name. Not that I think I’m going to be that person. I’m not going to win a Noble Prize or have a Wkipedia page. I do, even today, remember very clearly the male science undergraduate who came and spoke to my primary school class about his job, I can be THAT girl. The one that someone meets up close and personal and shows that normal everyday women can work in science. That the door is open to them. I can shine a light and make the career path visible to those who might follow. So, next time you are invited to do that piece of outreach, that radio interview, that blog and your mind questions your worth, ask: if not me, then who? I promise you that the next person will not be more qualified than you, more worthy than you, more appropriate than you. So please say yes.

The Importance of Valuing Difference

The above point brings me onto something a bit trickier. I’ve been fortunate enough to win a number of awards for myself and with my wonderful team and partners for undertaking STEM engagement. Doing this work requires energy and time, both of which are frequently given on weekends and evenings. Or, in the case of today’s blog, annual leave. I feel a moral obligation to do this work as well as it being an important part of maintaining my registration to practice. The interesting thing is that it is frequently not viewed this way in either my clinical or academic environments. It is not seen as ‘work’ and I have on more than one occasion been told that if I was serious about my career progression I needed to ‘do less of that nonsense’. Sadly this isn’t a unique situation for me, but is something that many women in science face, especially in academia. In these areas women spend a greater proportion of their time undertaking public engagement and utilising ‘soft skills’, which are not valued when it comes to promotion panels.

Over time I believe I have started to change perspectives, but it takes even more work and investment in time. I’ve taken on additional positions, such as Joint Trust Lead Healthcare Scientist. This position has enabled me to speak to senior leaders about the benefits of the work in order to raise awareness and to capture impact. By actively working with wonderful colleagues on projects nominated for awards, such as the Advancing Healthcare Award for Reach Out for Healthcare Science, with Dr Philippa May, and with Nicola Baldwin for the Antibiotic Guardian Awards and CSO Awards for Nosocomial, I have started to make inroads into changing the conversation. Awards aren’t everything, but they do support you in re-positioning what you are doing in a way that fits into the ‘traditional way’ success is captured.

Whilst I’m on this particular topic, I would also like to make one of the points I often respond with when talking to colleagues who aren’t so engaged in public engagement and outreach. The days of healthcare workers being considered to be ‘the authority’ are quite rightly coming to an end. Those of us working in healthcare need to be engaging and working collaboratively with patients and the public to co-create what the future of healthcare might be and should look like. We can’t begin this work until we get out there and start having conversations. Rather than being ‘nonsense’, this work is key to future of the NHS and, especially, Healthcare Science.

“Amplification” is Where It’s At

During the Obama administration, despite it’s progressive nature, women found it hard to get their voices heard.

We’ve all been there. The meetings in which you make a comment or a response and you’re ignored, only for a man in the room to repeat the comment and have everyone react as if it is the first time they’ve heard it. As women in science, we are often the only women in the room and so making ourselves heard can be difficult.

The women in the Obama administration came up with an “amplification” strategy, where women in meetings repeated each other’s ideas as well as deliberately crediting the women who came up with them.

I work with some amazing women in Healthcare Science (Jane Freeman, Anna Barnes, Ruth Thomsen, Kerrie Davies and so many more) who do an excellent job of this amplification. I’d like to think that we all have a definite and deliberate attitude of amplifying each others voices and not falling into the trap (that happens way too often) of competing with each other. Be deliberate when you are in spaces with other women who may not be heard, actively listen and repeat. Focus on those moments that could make a difference and ensure that everyone in the room is heard. It requires active effort, but it definitely changes the course of conversations.

So how our male colleagues can help? This is definitely one of those areas. There are often not the women in the room to do this and so having allies who are happy to support in the same way is a definite help.

Change the View for One That is More Pleasing

One day the super-inspirational Dr Lena Ciric and I sat down over a cup of coffee and engaged in one of our regular consolation sessions. This was because, yet again, I had written a grant that had been successfully funded but it didn’t have my name on it. It had the name of one of my male professors. Lena had experienced similar things over the years and also the reviewers’ response of ‘not enough experience’ as a result of grant after grant that didn’t credit us. This cup of coffee was different: it was during this session we decided that, if we couldn’t change the playing field, we could change the view.

What do I mean by this? Academically, we were applying for funding within the clinical microbiology environment. A landscape that was already filled with vastly experienced and (mostly) older male medics. We were not going to succeed in breaking through the glass ceiling by applying within this space. Life lesson: we needed to find another space. So we very deliberately looked across the different funders to see where there was a landscape that wasn’t crowded with people like us and where we could constructively add something. We found it. We ended up putting in our first million pound grant to the EPSRC, an engineering research council who were looking to fund healthcare research and were not getting applications from researchers with enough clinical experience. We got the grant first time! Now we had a million pound grant AND we had the track record that means we can not only continue to apply in the new landscape but that also enables us to apply in the old arena.

Sometimes, if you continue to bang your fist against a closed door all you will get is a bloody fist. In these circumstances you need to take a step back and review whether there is another way to get to where you want to be. If there is, do it, you may not only succeed in your original goal but learn some other valuable skills along the way.

Finally, I wanted to finish with the above image of Shonda Rhimes. I am as guilty as the next person of talking about how lucky and fortunate I am, and it is true. That said, own your success: you’ve earned it, you’ve put in the hours, you’ve sacrificed, you’ve made it happen whilst balancing families, health issues and all kinds of other demands.

Be the badass I know you are!

All views in this blog are my own

Celebrating International Day of Women and Girls in Science Day: A view from the Girly Side

I’ve been asked to write a number of blog posts this year for International Day of Women and Girls in Science. I wanted to write an extra one that wasn’t so much a career guidance document, but more to celebrate some of the great approaches I have seen as a woman working in science. This post is based around some of the points that came out of a twitter conversation last week.

This topic means a lot to me. It wasn’t by accident that when, in 2012, I chose my twitter handle: I chose Girlymicro/Girlymicrobiologist. It has felt to me, since I started as a working scientist in 2004, that it was considered unprofessional to bring my whole self to work: to like pink and purple, to bake, to talk about science fiction and gaming. It was the start of the journey that I am still on, to show that we are better scientists when we bring our whole selves to work. Anything that acts as a barrier to that not only harms us as individuals, but also harms what we can achieve as a collective.

The Road Is Long
With Many a Winding Turn
That Leads Us to Who Knows Where…

You may not know this, but I started out as a zoologist. I adored it, I loved it, but there were no jobs in it. My undergraduate dissertation was on the ‘Demographics of Witchcraft Accusations from 1625 to 1715’. You may think that has nothing to do with what I do now but you’d be wrong. Studying human and animal behaviour helps me all the time in understanding some of the group decision-making that occurs in healthcare. The hours of my life spent learning how to undertake statistical modelling was not wasted. What I didn’t study a lot of was microbiology: I did a single module of microbiology during my whole degree.

I then went on to study not microbiology but the physics of biological interactions at surfaces as an MRes. This was where I learnt some microbiology and developed a love of applied science. When I started as a trainee Clinical Scientist, I had so much less experience of microbiology than any of the other more traditional trainees. I once asked why they hired me and the wonderful Dr Margaret Sillis, who acted as my mentor, responded ‘We can teach you microbiology, it’s much harder to teach you how to think’. I still think about that and the transferable skills I picked up by studying other disciplines still come in use all the time.

This trend of not following the standard path has continued. It’s why I ended up in Infection Prevention and Control rather than microbiology. Although the traditional paths are in some ways easier, as you will be able to walk the path that others have walked before you, don’t be afraid to wander the path untrodden if you think that it will be a more satisfying journey for you as an individual. You will learn so much along the way and open up new roads for others to follow.

Making the Invisible Visible

During the last 10 years, one of the things I’ve consciously decided to do is to be visible. In 2015 I was asked if I would be filmed for a project that the Royal Society of Biology were organising called ‘Biology: Changing the World’. For some years I had been told, by my lovely (male) boss, that I shouldn’t do media and shouldn’t be seen as ‘courting attention’ as it a) detracted from the work, and b) people were looking to make a story out of you. Don’t get me wrong, there is some truth to this. It also results in a fair amount of negative feedback, often from female colleagues, about grandstanding and attention seeking. You know what it also does, however: it hopefully means that when a girl in 20 years time is asked the question I’m asked in this video about what female scientist inspired her, there is a chance she will have a name. Not that I think I’m going to be that person. I’m not going to win a Noble Prize or have a Wkipedia page. I do, even today, remember very clearly the male science undergraduate who came and spoke to my primary school class about his job, I can be THAT girl. The one that someone meets up close and personal and shows that normal everyday women can work in science. That the door is open to them. I can shine a light and make the career path visible to those who might follow. So, next time you are invited to do that piece of outreach, that radio interview, that blog and your mind questions your worth, ask: if not me, then who? I promise you that the next person will not be more qualified than you, more worthy than you, more appropriate than you. So please say yes.

The Importance of Valuing Difference

The above point brings me onto something a bit trickier. I’ve been fortunate enough to win a number of awards for myself and with my wonderful team and partners for undertaking STEM engagement. Doing this work requires energy and time, both of which are frequently given on weekends and evenings. Or, in the case of today’s blog, annual leave. I feel a moral obligation to do this work as well as it being an important part of maintaining my registration to practice. The interesting thing is that it is frequently not viewed this way in either my clinical or academic environments. It is not seen as ‘work’ and I have on more than one occasion been told that if I was serious about my career progression I needed to ‘do less of that nonsense’. Sadly this isn’t a unique situation for me, but is something that many women in science face, especially in academia. In these areas women spend a greater proportion of their time undertaking public engagement and utilising ‘soft skills’, which are not valued when it comes to promotion panels.

Over time I believe I have started to change perspectives, but it takes even more work and investment in time. I’ve taken on additional positions, such as Joint Trust Lead Healthcare Scientist. This position has enabled me to speak to senior leaders about the benefits of the work in order to raise awareness and to capture impact. By actively working with wonderful colleagues to nominate work for awards, such as the Advancing Healthcare Award for Reach Out for Healthcare Science, with Dr Philippa May, and with Nicola Baldwin for the Antibiotic Guardian Awards and CSO Awards for Nosocomial, I have started to make inroads into changing the conversation. Awards aren’t everything, but they do support you in re-positioning what you are doing in a way that fits into the ‘traditional way’ success is captured.

Whilst I’m on this particular topic, I would also like to make one of the points I often respond with when talking to colleagues who aren’t so engaged in public engagement and outreach. The days of healthcare workers being considered to be ‘the authority’ are quite rightly coming to an end. Those of us working in healthcare need to be engaging and working collaboratively with patients and the public to co-create what the future of healthcare might be and should look like. We can’t begin this work until we get out there and start having conversations. Rather than being ‘nonsense’, this work is key to future of the NHS and, especially, Healthcare Science.

“Amplification” is Where It’s At

During the Obama administration, despite it’s progressive nature, women found it hard to get their voices heard.

We’ve all been there. The meetings in which you make a comment or a response and you’re ignored, only for a man in the room to repeat the comment and have everyone react as if it is the first time they’ve heard it. As women in science, we are often the only women in the room and so making ourselves heard can be difficult.

The women in the Obama administration came up with an “amplification” strategy, where women in meetings repeated each other’s ideas as well as deliberately crediting the women who came up with them.

I work with some amazing women in Healthcare Science (Jane Freeman, Anna Barnes, Ruth Thomsen, Kerrie Davies and so many more) who do an excellent job of this amplification. I’d like to think that we all have a definite and deliberate attitude of amplifying each others voices and not falling into the trap (that happens way too often) of competing with each other. Be deliberate when you are in spaces with other women who may not be heard, actively listen and repeat. Focus on those moments that could make a difference and ensure that everyone in the room is heard. It requires active effort, but it definitely changes the course of conversations.

Some of the comments on my twitter feed were about how our male colleagues can help. This is definitely one of those areas. There are often not the women in the room to do this and so having allies who are happy to support in the same way is a definite help.

Change the View for One That is More Pleasing

One day the super-inspirational Dr Lena Ciric and I sat down over a cup of coffee and engaged in one of our regular consolation sessions. This was because, yet again, I had written a grant that had been successfully funded but it didn’t have my name on it. It had the name of one of my male professors. Lena had experienced similar things over the years and also the reviewers’ response of ‘not enough experience’ as a result of grant after grant that didn’t credit us. This cup of coffee was different: it was during this session we decided that, if we couldn’t change the playing field, we could change the view.

What do I mean by this? Academically, we were applying for funding within the clinical microbiology environment. A landscape that was already filled with vastly experienced and (mostly) older male medics. We were not going to succeed in breaking through the glass ceiling by applying within this space. Life lesson: we needed to find another space. So we very deliberately looked across the different funders to see where there was a landscape that wasn’t crowded with people like us and where we could constructively add something. We found it. We ended up putting in our first million pound grant to the EPSRC, an engineering research council who were looking to fund healthcare research and were not getting applications from researchers with enough clinical experience. We got the grant first time! Now we had a million pound grant AND we had the track record that means we can not only continue to apply in the new landscape but that also enables us to apply in the old arena.

Sometimes, if you continue to bang your fist against a closed door all you will get is a bloody fist. In these circumstances you need to take a step back and review whether there is another way to get to where you want to be. If there is, do it, you may not only succeed in your original goal but learn some other valuable skills along the way.

Finally, I wanted to finish with the above image of Shonda Rhimes. I am as guilty as the next person of talking about how lucky and fortunate I am, and it is true. That said, own your success: you’ve earned it, you’ve put in the hours, you’ve sacrificed, you’ve made it happen whilst balancing families, health issues and all kinds of other demands.

Be the badass I know you are!

All views in this blog are my own

Guest Blog by Katy Heaney: Pathology: hidden service or hiding? Lets stop being shy

This weeks guest blog is written by the ever talented Katy Heaney. The blog includes the first announcement of some super top secret work that Katy and #PathologyROAR have been undertaking linked to the #IValueLabStaff and #PathologyROAR recruitment videos. Keep your eyes peeled and followed the hashtags for me information from Wednesday 9th February. I for one (Girlymicro that is) cannot wait to finally find out what they’ve been working on.

Katy is a Consultant Clinical Scientist working for Frimley Health NHS Foundation Trust, part of the Berkshire and Surrey Pathology Services network. Currently part-time seconded to the UKHSA working as the Point of care workflow lead for Operational Supplies. She has a passion for science communication, patient focused pathology testing, baking and painting.

A cup of tea in bed on a Sunday was a rarity for me in 2020. It had been a hard year for my Point of care testing (POCT) pathology service and there didn’t seem to be any let up ahead. Recruitment had been like a revolving door – as fast as we interviewed, people moved on and there didn’t seem to be any HCPC registered pathology staff not already employed.

As I meandered through my social media on a Sunday morning I found posts advertising recruitment in other healthcare fields but with a significant lack of inclusion of pathology.

My burnt-out brain, reflected on my teams, and the monumental national pathology effort in maintaining current pathology services as well as implementing and ramping up Covid-19 testing. I reached out to the pathology Twitter community to sing our own praises; how could we have been forgotten?

But internally I wonder; Are we really the hidden service, are we hiding, or are we shy?

In my career I have enjoyed being involved in National Pathology Week events reaching out beyond our laboratory doors to sing our praises and explain our science. The Royal College of Pathologists have a fantastic web page now of day in a life for pathology, example career pathways and events that take place for all ages. I was also lucky enough to be part of the Lab Tests Online UK team when we released the free app of the website; we held an app launch event and invited anyone we could think of to join us in celebrating pathology. Channel 4’s Embarrassing Bodies’ celebrity doctors joining us was a big highlight!

The Pathology Cake; designed and produced by scientist trainees at the LabTestsOnline UK App launch event. Note: all stock was expired and saved from bin for use on this “art”

Being a POCT specialist – I don’t spend a lot of time behind lab doors, far more walking the clinical floors to see how my kit is working or helping non-lab healthcare staff use the kit for their patients. I spend a lot of time explaining pathology to non-laboratory staff. I have always advocated that science communication is a skill in itself. It takes practice and thought; we cannot expect our most fabulous researchers or complex method specialists to also be able to explain to a member of the public what pathology is without working on how to translate our science jargon and considering understandable words.

We are under-resourced and small in comparison to many other healthcare staff groups. Finding the time to advocate and advertise pathology is hard to fit into the day job. The events organised by our professional bodies give us focus, but in recent years they have been stunted by service pressure.

We have jobs available; but seem to fail to reach the target audience

Recruitment for us is a long term process; when someone joins us we invest our time and energy in their learning and development. Finding the right individuals is important for us. Doing so at pace is even harder.

A real smack in the chops recognition last year for me was – I am no longer our target demographic! In a big birthday year myself, I recognise I am trying to recruit a younger generation who use different media. They have different career goals and the things that attracted me to pathology won’t necessarily be attractive to them.

Pathology in the media is VERY different from reality. The cringe worthy moments when medical drama surgeons decide to go run a pathology test to diagnose the rarest of diseases isn’t reality! The timelines of a drama episode don’t tolerate the timeline for a complex diagnostic pathology test and certainly not the staff that it takes to achieve it. Our real-life healthcare system regretfully doesn’t either; my own GP tells me my routine pathology test will take 5 days, while I internally sigh knowing it will be done by the following morning, but my overworked/overwhelmed GP surgery won’t be able to review and report it back to me to match the service we provide in pathology.

Media portrayal of the lab; Nope, nope, nope.

The pandemic gave the smallest of glimpse into the world of pathology. PCR, lateral flow tests, and antibody levels being discussed in the news every night, but not enough spotlight was given to the 1000s of pathology staff it took to stand up NHS testing of patients. In my non-work social groups the jaw dropping shock of real life of pathology pressure on staff and service.

 If a blood transfusion laboratory stops running, an A&E will be closed to new patients: we are critical for so much more than Covid-19 testing. There is still a lot of public ignorance on pathology. I use the word here in this blog but know that for many it describes testing the dead or forensics. We are so much more.

So what is the reality of pathology?

A team of highly skilled, dedicated and evidence focused healthcare scientists. We employ those with degrees and those without, we train our own and do our own research and development. Most of our work is on the living; their blood, urine, poop, saliva; samples supplied for investigation. Some of our tests take seconds and some take weeks. IT and technology is a big part of our day. Every sample comes from a patient and everything we do is driven toward providing a better service that helps make better and quicker decisions. We are a fascinating workforce; the diversity of pathology is incredible. We are comprised of 17 different disciplines looking at every aspect of the human (and animal) body, and whether it is working and doing what it is meant to do. The tests you have heard of; glucose, urine pregnancy tests, iron, biopsies, smear tests, Covid-19 PCRs…..and 1000s more that you haven’t.

We have so many different entry points from national training programmes like the Scientist Training Programme, local trainee Biomedical Scientist trainee positions and all the support roles we require for pathology services to run; administration, stores, transport and reception support. There is a role for so many; not just the young generation I refer to earlier, but those looking for a change, a swerve in career or even a few shifts working as part of a team.

There is no denying, we need to grow more healthcare scientists. Our numbers are small, it takes time to gain experience and knowledge, and our workloads expand year on year. 1000s of students do Biomedical science degrees but not enough of these come to pathology for their career. If you are a student considering a career in pathology; consider attending the IBMS Student congress event https://congress.ibms.org/student-congress.html for talks on careers, CV writing, placements and meet the staff working in our services.

What did I do about it?

Well that Sunday morning cuppa sparked a group of us working in pathology to recognise our common goal – the desire to roar about pathology and express how much we value lab staff. We wanted that message to get out there; to students, to influencers, to anyone looking for a career change. And we wanted to do so with real-life examples of those who work in pathology to showcase the passion for their work.

On Wednesday 9th February at 8pm we will be showcasing our #IValueLabStaff videos of real pathology staff; wearing their real-life lab coat or at their desk, talking about what they love about their jobs. Join us for the #PathologyROAR and celebrate with us.

All opinion on this blog are my own

Time for Some Real Talk: I have the best job in the world & even I don’t know how much more I can take

Let me start with the positive and please bear this is mind as you read this post. I adore my job, I can’t imagine doing anything else. In a way that is probably a little unhealthy, it is a lot of what defines me. I found my place and my calling and I’m not going anywhere. That said the last 2 years have been filled with extremely long days and unpaid weekends leading me to be more exhausted and broken than either a PhD or FRCPath exams achieved, partly because for both of those you knew when it would end. So I want to shine a light on how I feel in order for others to feel less alone if they are feeling the same way, and to remind us all that, despite how it feels right now, it has not always been like this and that this too shall pass.

Last night in a press conference our Prime Minster uttered the words ‘extraordinary effort’. It wasn’t in praise, it was a request for all of us in healthcare to make one more effort, to step up to the plate yet again and give it our all for the sake of the country. The thing is, phrasing a request like this doesn’t feel like a call to action to me anymore, it feels more like an insult. Although I acknowledge people’s experiences of the pandemic have been vastly variable, for most healthcare workers we’ve been making an ‘extraordinary effort’ for almost 2 years. Two years of changing guidance, 2 years of practically no down time and in recent times, experiencing both abuse and bad temper, alongside belittling of the things we are doing to find a way out of this i.e. requests to wear masks and to get vaccinated.

Given it is undoubtedly hard right now what can we do to get each other through this (other than make press conference statements – yes I may be a little bitter). This post isn’t based on evidence, I’m just going to talk here from personal experience. I know this is what I tell others off for as anecdotes aren’t facts. However as this is about feelings I can only truly tell it from my perspective.

Acknowledge all burdens are not equal and any single solution won’t fix everything

As a lot of people have pointed out, we may be in the same storm but we are all in very different boats, our experience and well as stressors throughout this aren’t the same. As leaders, colleagues and friends it therefore crucial that we take time to understand the things that are adding to stress levels and impacting our colleagues. For instance, because of my health it is easier for me if I can work from home a couple of days a week. It saves me a 3 hour return commute and gives me space to mentally focus on tasks without interruption. For someone else however, they might find working from home in itself a stressor, they may wish to have distinct work and home separation, they may have a lack of space or family reasons why this makes it harder for them not easier. We need to work on how to check in with our colleagues about what it is that they find difficult and then, where possible, customise our approaches to support them. It takes longer and requires more resource, but if we’re serious about helping each other through this than that is what it is going to take. I believe we should be finding equity rather than equality in our solutions, although fairness is important:

  • Equality is providing the same level of opportunity and assistance to all
  • Equity is providing various levels of support and assistance depending on specific needs

A little respect goes a long way

At times of stress and challenge it is really easy to close down in terms of empathy and compassion. I hold up my hands to raising my voice in a meeting last week. I did immediately apologise, but it is really difficult with the cognitive and emotional load everyone is experiencing, coupled with me being so tired to always remember to think of others. Every little moment like that if not addressed chips away at the others in the room and adds an unnecessary additional burden. At the moment, in those moments where we may not feel like it, it is even more important enough to be kind to each other.

Whether you are in a formal or informal leadership position, it is also really important right now to acknowledge the work of those around you. It’s easy to have tunnel vision and revert to task thinking when we are all so overwhelmed but people are doing A LOT based on good will. If we want people to go above and beyond then we need to acknowledge it and respect the fact that it is not a given that it will always happen. Saying thank you is still a powerful tool.

The system isn’t set up to support us so lets change it

Two years into the pandemic the system is still not set up to support the work demands that are being placed on the workforce. I have colleagues who have not had a full day off in two years. I do weekends on-call without any acknowledgement in terms of pay or returned time. From conversations I’ve had most IPC teams do not have systems in place to support on-call working, despite the fact that we have just about all had to do it over the last 2 years. We’ve all been doing this because we focus on the needs of the patient and the service, but at some point the service and the system that it sits within needs to be fixed. Services shouldn’t constantly rely on good will and changes need to me made so the system is empowered to support those who work within it. When emergencies and major incidents first happen it takes a while for the infrastructure and the system as a whole to respond, at this point however we need to be looking to the future and working to fix the system we work within. This won’t be the last time we have to face these kind of challenges, although hopefully not over such a protracted period, lets learn the lessons and get measures in place to make it better for everyone moving forward.

The workforce issues are going to get worse before they get better

As I said, I’m not going anywhere, but it would be naïve to say that this is the wider attitude amongst healthcare workers. A number of my colleagues who could retire have done so, more have moved either into non operational roles or out of healthcare all together. I don’t feel we have reached the peak of this yet. I think a lot of people will stay until they feel this aspect is over and then make decisions about what is best for them moving forward, burn out is a real thing right now. This will place even more pressure on those of us who remain. Its takes ~11 years to train a me, there aren’t a lot of people waiting in the wings to swoop in and support. My guess is also that a fair amount of trainees will be included in the numbers who are considering alternative choices. Those of us who remain need to know what the plan is? How are the exhausted workforce who remain going to be supported so they don’t have to then do the work of the 2 people who have left as well as their own? Are we, as we all predict, going to be hit my massive catch up targets when the pandemic is finally over which means there will be no respite to support recovery. The focus of the system seems to (understandably) be on right now but to give people hope for the future we need to know that there is a plan on how we will make it through not just today, but tomorrow and next year.

This isn’t a war, no matter how much our politicians language make it sound like it is

A lot of the language people have utilised linked to the pandemic has very deliberately utilised language reflective of going to war. In some ways this creates a nice psychological short cut in terms of significance and in peoples minds. The problem with it is that most healthcare professionals didn’t enlist to be part of a war, they are not obligated to stay and fight it out. The support systems are not part of the existing infrastructure to enable them to deal with the stress and emotional load we have put upon them. Most of them have given extra hours and supported extra job roles as part of good will, a gift if you like from them to wider society. However, like all gifts these can and should not be taken for granted, they are under no obligation to just keep on giving. We have moved from an emergency situation to a state of life, as much as we don’t want to acknowledge it. It’s a state of life that will not last forever but we cannot expect people to continuously act like they are in emergency response anymore. Plans and language aimed at healthcare workers need to acknowledge this otherwise we are not recognising the reality of most of their lives.

Wellness programmes are not going to fix this

I’ve already come out as not being the biggest fan of wellness programmes, although I know what they are trying to achieve. I’ve talked before about the fact that I think the NHS system has to address the issues and not continuously put the responsibility on individuals to fix. That said I don’t think the system is going to ‘White Knight’ for me anytime soon. I have come up with a strategy for me that means when I reach the point that all I want to do is walk out or walk away I have a bathroom disco. For those of you who don’t know I have a converted bathroom cubicle as my office, hence bathroom disco. I frequently fail to make time for food or even a couple of tea, back in the day I used to have a walk around the block or settle down for a cup of tea, I drink my tea black it takes 20 minutes to cool, when things became too much. There’s no time for any of that right now. When it becomes overwhelming I’ve decided I will allow myself a ~3minute bathroom disco break. I lock the door, put on an energising track and dance like a loon. It not only brings me joy but stops me spiralling and wakes me up enough to re-set myself for the challenge ahead. If we have going to survive this we all need to find a bathroom disco equivalent to get us through the next 5 minutes some days, let alone the next 5 months.

So there it is. I’m going to put on my big girl pants and prepare again for my ‘extraordinary effort’. Those making these requests however should remember that I am so fortunate to know that I will eventually get back to a job I love. Others were not so fortunate prior to this and so they are right now making different choices in response to your plea. Lets follow our words with actions that also enable them to stay!

All opinions on this blog are my own

Saturday Morning Zombies: how infection is portrayed in the genre

As it’s Halloween and National Pathology Week 2021 is coming up I thought I’d re-share my love of zombie movies plus a little activity if anyone is looking for a fun outbreak to run with colleagues or as part of outreach.

It’s Saturday morning and I’m spending my day watching zombie movies. There is a reason that I watch in the morning… I’m a complete scaredy-cat and so I don’t want to watch these before I go to sleep. Also, I don’t really like horror movies. Correction: I only like horror movies with plot, i.e. Get Out.

So, why am I spending Saturday exploring the world of zombie horror?

Three reasons:

  • Despite not liking horror movies as such, I’m intellectually obsessed with how infection is portrayed in them and debating whether the infectious cause would result in different types of zombies.
  • Nicola Baldwin and I, because of our shared obsession with the genre (albeit for different reasons), are going to create a new piece of work on zombies and infection for the Rise of the Resistance Festival (online 7th and 8th May 2021). I therefore need to do some homework.
  • My husband really really likes zombie movies: he is super-stoked that this is my weekend homework, rather than writing papers or analysing data

My friends and I talk about this so much as part of our ‘pub conversations’ that we honestly do have a zombie survival plan. So much so that one of my best friends included saving her husband ‘during the zombie apocalypse’ as part of her wedding vows. This may sound silly and, believe me, it is; But there is some interesting and philosophical stuff in here:

  • Where is the best place to run to (cities vs country)?
  • What would you do in the 1st 24 hours, 1st week, 1st month?
  • Who would you get to join your party? Why? What skills do you need?
  • Do you take people along for the ride because you like them, or does everyone have to have purpose?
  • What rules of society might you abandon for the sake of saving the human race, i.e. monogamy, patriarchy?
  • How much aid would you offer to strangers ‘Good of the Many’?
  • Would you opt to die as you or turn if infected? ‘Survival at any cost and in any form?’
  • What would your ‘rules’ be?

These questions are all about how we, as humans, would react to a zombie outbreak. However, the thing that really fascinates me is how the zombie might change based on the cause of the zombie infection.

There are real life instances where infection can result in behaviour change. As part of my interest in this, I created the activity at the bottom of the page called ‘Zombie Island’. It was one of the first public engagement activities I designed and ended up being turned into a live action takeover event in the city centre of Toronto, where visitors had to solve different clues and challenges in order to cure themselves before they became zombies. The activity in Toronto was called Zombie Rendezvous and the link to the booklet is below:


Zombie Island – How Will You Save your Tropical Island Home?

The first thing you need to do is design your zombie. Will it be due to:

  • A virus?
  • A bacteria
  • A fungus?

This decision will affect not only how your zombie transmits infection, but also how fast and easy/hard to kill it is.

How do infectious causes affect zombie characteristics?

Slide taken from Design You Zombie Activity (see downloads below)

Once you have your zombies designed you can then play the scenario. Each different type of zombie requires different infection control and public health decisions/prioritisation. Make the wrong choices and the zombies will reach the port or airport and get off your island to infect the outside world. They can also infect your food supply, take down your military, or cause mass point-source outbreaks if you fail to shut down public events. All decisions aren’t equal, so make your choice…+

More on all of this later when I’ve watched some movies. Remember – aim for the head!

All opinions on this blog are my own.

Some Days All We Control Is Ourselves: How to respond when things don’t go to plan

Earlier this week I made a post about wellness programmes and the problems I have engaging with them. I did say however, that I don’t discount the fact that sometimes we need to take some personal action to manage the situation we are in, even if that is to just to survive to the next encounter.

What kind of situation am I talking about? Well this post was prompted by something that happened a couple of weeks ago. I gave a talk, it was supposed to be inspiring, but I felt it didn’t land. I followed a really amazing speaker who everyone really engaged with and so it felt really clear to me that I didn’t get a similar response. It was my second talk of the day, in the middle of a week where I was running conferences on the Monday and the Friday. Needless to say I was feeling more than a little tired.

Why is the fact that I was tired important? What kind of impact does that have on my perceptions? Was the outcome, in terms of talk impact, a real failure or just a perceived one? Also it was just a talk so does it really matter?

The truth is that maybe the circumstances in this case didn’t have significant outcomes. However I think this is just an example of how fatigue and tiredness can alter our perceptions of performance. In some cases this altered perception can lead to more consequences for us as individuals, in terms of stress etc, and also change the way we do our jobs, therefore impacting on others.

So, I was curious whether it is just me that feels this way. Are others more likely to feel like a failure, or that they have failed, when they are tired. So I ran a poll on twitter and I was pretty surprised by the results:

I’ve always felt really alone in this and that my response to tiredness, increasing levels of self criticism and feelings of failure, was a ‘me thing’ and probably a weakness/fault. I don’t know therefore whether I was pleased or saddened by the results. It seems like most of us feel this way at least some of the time, so why don’t we talk about it more? In a world where the focus is being placed on us to to find ways forward and when, I suspect, many of us are feeling broken, stressed and tired, what can we do to support ourselves and others through these periods where we are feeling like our own harshest critics?

So having said that wellness sessions don’t really work for me what can we do? Some of the lovely people who responded on twitter gave some great advice, which I’ve combined with some my random thoughts to try and help us all in finding a way through when everything feels too much. All things won’t work for all people but hopefully there is something that could work for everyone as a piece of support or way forward.

Try to be self aware and remind yourself of the cause

By identify the route cause you can start to distance yourself from it, you’ll also hopefully be able to find an intervention that might help. Tired, try and find a window to sleep. Stressed, try and be kind to yourself and find some time to do something you enjoy. Know that you can re-evaluate once you’ve given yourself some time/space/sleep. It’s worth considering what your interventions in different scenarios might be when you are in a good place so you have a plan for when you need it in order to alleviate how you feel.

Try to not make decisions and react when aware you are in a hyper reactive mind set

Leading on from being aware of how you are feeling, a key suggestion was knowing what not to do when you’re not feeling quite yourself. Don’t send emails, make decisions or react during a time when you’re judgement may not be truly reflective of your normal thought processes. In these periods I tend towards being overly apologetic, submissive etc, others I know will tend to be the opposite and come across as less collaborative. Wait until you can find your way back to the middle ground.

Try to change your inner dialogue

If you find yourself spiralling (see my previous shame spiral post) do something to put yourself in a different mindset, read a book, go for a run, make a to do list with some things that are easy to tick off. I find shame spiralling slightly different as it’s linked to a specific event rather than a general feeling (which my mind can sometimes hook onto things). Often when I shame spiral it’s because I’ve actually failed, rather than just perceiving I have, but the response is similar. For most things in life, tomorrow offers a re-do. If what has happened is non critical, or even if it is critical but is fixable then tomorrow will arrive and with it some level of distance to support reflection plus hopefully with the benefit of sleep and relaxation.

Reach out to trusted advisors and get a reality check

Try to be kind with yourself by thinking how you would respond to someone else in your situation and use that as a benchmark. I often find this impossible to do by myself and so that’s where checking in with my friends really helps. I’m lucky enough to have wonderful colleagues who I also count as friends, who are always willing to have tea, catch up via WhatsApp or provide support via twitter. Know who your trusted people are and be open and honest with where you are at. As the poll showed me you will be surprised at how many people have experience of what you’re going through and how they can support you through it.

Know tomorrow is another day

This doesn’t help everyone, but one thing helps me quite a lot. When the going gets tough, the tough get planning. To tide me over to the point where I can make actual decisions or feel more like me, I find daydreaming about plans for that future helpful. I start to plan holidays or pleasant experiences, anything that draws my mind from the present. I try to consciously be aware of the fact that the way I feel now won’t last and think about what could happen when I’m refreshed.

Remember the good times

Quite a few people have said that it is useful to keep a success/achievement list somewhere. It is all too easy when feeling this way to only focus on our failures, be they real or perceived, but keeping a list in a drawer/computer folder can be a useful prompt. This doesn’t have to be a work related list, it should cover the whole of your life and remind you that you are more than just a job/situation and of everything you have to offer. As Laura said ‘more roses, less thorns’

Do something you love

Sometimes it’s not about addressing the problem, sometimes it’s about treating yourself, or as my wellness colleagues would say ‘self care’. In my case I go back to movies/TV series as that bring me comfort or cook. I watched a Christmas movie a couple of weeks ago as they are a place of comfort and joy to me. Other people suggesting singing, going to the spa, reading a favourite book. My friends and I often talk about making our pit of despair comfortable if we’re going to be there for a while. This is what this is to me. I acknowledge that I may not just snap out of it, so how do I make myself feel better whilst I get through it.

Put your feelings into context

As stated at the start I tend to focus my feelings of failure, linked to tiredness, onto different scenarios. These are often for me perceived issues rather than actually knowing that something has happened i.e. thinking I gave a bad talk rather than receiving the evaluation that says I gave a bad talk. Similar I know, but I think the way out of it for me is different. If like me you start to obsess I sometimes try to make myself take a step back. If it didn’t go well, does it really matter. In my case this week the worst case scenario here is that I am not invited back to speak, and some people might feel slightly less of my skill set. Now this hurts as part of my sense of identity is that I’m not a bad public speaker and I quite enjoy it. That said, does it matter? I don’t believe I am the best public speaker in the world, so as part of that I have to acknowledge that there will be people who do a better job at it than I, it’s not going to cost me my career. If it is something that matters, then know that once you feel more yourself, that is the time to make plans about recovery. Definitely not whilst you are in the midst of it.

Stop fighting it

This may be the 90s goth in me but sometimes you just need to sit back, ride the wave and enjoy the rain:

One thing you have all taught me is that feeling this way is not a failure in itself, it’s not a weakness, it is life and so lets not beat ourselves up about it, lets watch a movie, bake a cake and know that it will end.

All opinions on this blog are my own

Lets Talk About Wellness: Is it just me whose struggling to engage with wellness programmes?

I’ve had a LOT of emails and messages this week linked to various Wellness Programmes and links and my emotional response to them has surprised me. I’m not normally a cynic, I’m usually someone who is keen to engage and see the benefit of things. I have, instead of wanting to engage with these items, been really irritated by them and so I wanted to explore why I feel this way and understand if I’m the only one.

Let me start by talking about what my currently day to day looks like, as I think my thoughts linked to this are very context specific. I’m just getting home at 19:30 after leaving the house at 6:30 this morning and working a 10hr day without lunch or tea break.  I have an hour and half to spend with my husband and eat before going to bed and starting the whole thing again tomorrow.  The sad thing is that this has actually been quite a reasonable day, 12+ hour days are frequent.

Last week I ran 2 conferences and so wasn’t tied to my desk, followed by a couple of days off sick post booster vaccine That meant going into last weekend I had over 2200 emails on my inbox and over 1100 unread. I needed to cover IPC over the weekend and so in order to try to get back on top of it I worked to get the email mountain down from 2200+ to 156 to action. As I’m also on clinical this week that action pile in one day is back up to 190.

What’s the point of me telling you this? I think my aim is show that I fight just to stand still. If I take my eye off the ball even for a day I sink into quick sand. No one covers my whole role if I’m off sick, there isn’t another Consultant Clinical Scientist in the department. My point is that I don’t get how wellness works when this is my life?

My Trust and the NHS has invested a lot in wellness programmes and resilience training. This post may sound like its having a go at the really lovely people who provide those programmes and put so much energy into getting them up and running, but it isn’t. This is a post that is expressing my tiredness and exhaustion at working in Infection Prevention and Control in a pandemic within a system that does not deliver the resource for lunchbreaks, let alone provision for me to be training up my successor so there would be cover.

So what is that doesn’t work for me about wellness and resilience programmes?

The programmes we’ve instituted are things like ‘Wellness Wednesdays’ which includes a lunch time seminar on a wellness topic. We’ve been given access to the headspace app to support meditation and promote sleeping and healthy eating. There are also things like yoga sessions run in the Trust and GOSH supported 5k Park runs to encourage an active life style. There’s also access to counselling.

All of this looks amazing when written down and don’t get me wrong I think its great. However it only works if you’ve addressed the system issues that are driving some of the problems.

For example, I have never managed to attend a wellness seminar, despite having them in my diary, because I don’t have time to have lunch and usually spend my life in back to back ‘urgent’ work zooms. The biggest system change for me would be to enable me to have a lunch break and then I could choose whether to spend it on a wellness seminar OR I could step outside my windowless office and see sunlight!

The activity stuff is great. I used to run pre-pandemic. Now I work mostly 12 hours days with a 3 hour round trip commute. On a good day I get 2 hours at home in the evening during which time I might, for instance, have time to wash my hair and eat. On weekends I am either working or too broken to make food and catch up with all of the household tasks, such as food shopping, that are needed to get me through the next week. In terms of wellness, the better fix for me would be to enable me to actually have a homelife so I could choose what to do with it, if I don’t have time to eat I’m not going to be able to join in yoga.

One of the final things that I find really tricky about all the wellness stuff is that it seems to go on and on about being present in the moment. I have a meeting in a Tuesday where the first 5 minutes is a wellness meditation. I will give an honest confession here, if I have time I use that 5 minutes to actually make a cup of tea so I can have a drink. This doesn’t normally happen as I’m always running late from previous zooms, but that is the intervention that works for me. I find being in the present hard. I’m exhausted and physically pretty broken, spending 5 minutes noticing that is not helpful to me. I’m surviving this by planning and focusing on the future, which is how I always manage my stress and survive.

So where is the system letting me down?

Some of the problem with this is the way that Healthcare Science functions. We’re not like some other specialists, who effectively do the same job with different specialisms and therefore cover each other for sickness and holiday. We’re not like some other colleagues who work in a team of multiple similar roles and, although may not always truly cross cover, have someone to pick up their responsive role. We are usually lone individuals, as there’s never considered to be enough work to have more than one of us. That causes issues in terms of career progression and training up someone to eventually take over (as it can take 10+ years) but it also means that no one actually covers your work load. They may pick up the screaming urgent stuff that has to be managed but the rest just builds and builds.

All of this means taking holiday becomes a trial that becomes inherently stressful. You spend so much time trying to pin everything down before you go that you pull double hours and when I return I frequently have up to 3000 – 4000 emails and my diary is back to back as I’ve been unavailable for a week or 2.

It also means that when that workload becomes too much it very hard to get someone to help carry the load. Don’t get me wrong, I have great teams and we work really well together but I don’t have someone I’m training up to be the new me that I can hand bits off to, in the way my medical colleagues do with their registrars. It also means we’re not planning for the future

It’s not just Healthcare Scientists that are struggling however, so it’s not unique to us as a group. It is physically not possible to be on 8 hours of zoom calls, deal with 300 – 600 emails and a day and then actually do productive work that requires thinking on top of this. So how do we change the system to improve the way that we communicate? To determine whether the meetings we have are productive? To change expectations in terms of being available for 8am meetings and 6pm meetings when we only supposedly work 9 – 5? This is something we can start to tackle as individuals but requires changes in culture, which is in my opinion is something that organisations should be investing in as much as free yoga.

Instead the response is usually that we should find things that we can drop to create time and space. The sad thing about this response is that it means all drivers for work become focussed on core work and reduces both time and acceptance for tasks that require creativity and innovation, the kind of tasks that will actually permit changes to the system in which we are existing. For me it is these tasks that energise rather than drain me, these tasks that give me hope that I will make it out the other end and permit planning for a future where we do things better for both ourselves and our patients. I feel especially infuriated when I’m told I should discard the only things that are enabling me to continue, to do even more of all the things that are leaving me hollow and tired, even when these things are done on top of everything else. I know to many it seems like an easy fix but to me it would be the straw that broke my back.

So here’s my plea. Instead of placing the burden to fix burn out on individuals, lets also work with the systems that led us here. The pandemic is a once in a lifetime challenge, but what it’s done is expose problems that were already present in the system, not ones that only exist because of the pandemic. Personal responsibility is important, but making people feel responsible for their burnout as if its another of their failures is not the way forward. Support them, offer individual help, but also acknowledge the system wide issues that led them there.

Apologies for the rant, but I for one feel waaaaaaaaaaaay better for getting that off my chest. Now I’m off to watch a YouTube video on the importance of laughter yoga.

All opinions on this blog are my own.