Time to Change!

Nish Desai

The time has come; Striking the Balance our first ever WICM meeting on 27 September 2019, on a rather wet Friday at the Royal College of Anaesthetists. In all the excitement leading up to the event, I recall speaking to Lucy Rowan at the Faculty the day before to discuss the day and shared my rather nervous feelings about writing this blog.

What am I going to talk about? Am I really the right person? Is this imposter syndrome? Or perhaps I have the typical introvert archetype? Lucy reassuringly said “Just be yourself”.

For those who weren’t able to join us, I’ve summarised a few of my thoughts on the topics covered and wonderful people I met on the day below. Striking the Balance! What an inspirational, thought-provoking day; inclusivity and balance, two of the most important themes of the day.

I was in conversation with Segun Olusanya the day before the event. Having just finished a set of on calls and if I am honest, feeling pretty exhausted. Segun, rather joyously, was reflecting on the fact that he will have to branch off his long day at work to ironically talk about work-life balance and then promptly return to work… We both came to the realisation that we all need a conversation about work-life balance and what it all really means.

As Segun put it, perhaps what is truly important is that you are finding time and space for yourself and you are happy”

Carl Waldmann opened up the day as his last meeting before stepping down as Dean, he celebrated the success of the Faculty of Intensive Care Medicine (FICM), with the 10 year anniversary of its foundation approaching next year. However there is a gender imbalance in ICM, the statistics really do speak for themselves.

This imbalance is very much at the forefront of ICM society agendas internationally. With the launch of the first ever International Women in Intensive and Critical Care Medicine Network conference coming up in Italy in June 2020.

Roisin Haslett talked about her work on the many barriers to a career in ICM. Roisin has found there is a perceived gender bias in ICM however this bias is not real. There are many contributory factors and wider workforce issues, we need to strive to do better, to have a more collegiate working atmosphere and support the drive towards more portfolio careers.

Matt Morgan’s book “Critical”, is written in a beautifully humane way, it really emphasises the complexities of our practice in intensive care and the mountain of challenges we face as a profession.

When it comes to change, we need to be visible, and we should lead with authenticity and example. As Liz Thomas put it, often “Good leaders are followed because people want to, not because they need to”.

Nazir Lone‘s talk covered ways to be an effective ally. An ally is a person who works to understand the imbalance in opportunity and then strives to change it.

He summarised the five ways to be an effective ally:

1. Understanding your biases

2. Ensure others are heard

3. Mentor, support, and offer equal access

4. Promote to others

5. Advocate for change at work

ICM perhaps attracts the introvert archetype; as Jaqueline McCarthy put it ”introverts do not like to talk about a subject until they know everything about it”.  As doctors, we uphold ourselves to high standards and constantly fear failure and at times strive to display perfection to secure approval.

Ritoo Kapoor challenges the way we look at failure in a truly inspirational way. Her book “10 Pitfalls in intensive care”  delves deeper into perceptions, with a thoughtful analysis of evidence-based medicine and how we manage our patients. It is interesting how as a profession we constantly focus on failure, often perceiving failure in a negative derogatory way without context, whilst at the same time undervaluing success. As Ritoo put it “All the women who made it to the top felt like it was some kind of luck that got them there”.

Part of working and thriving in ICM as Lindsay Chadwick describes it, is “knowing yourself and your personality” and celebrating your story.

As a profession we need to get comfortable with being uncomfortable talking about failure, making it visible and normalising it, appreciate what is hidden underneath the iceberg. Sometimes you climb the ladder, get to the top, break the glass ceiling and then you are pushed off the cliff. It’s not about how you get to the top it’s about who will catch you when you fall and what will break your fall. 

How do we reach our full potential? At times we all need a mentor: during transition, for greater effectiveness, for personal growth or as a sounding board. Alison Wheatly’s mentor training workshop really enlightened the group to appreciate the power of peer mentoring.

A powerful end to the day was the final speaker, the new Dean of the Faculty, Alison Pittard, took to the podium. Whilst the audience prepared for a traditional lecture, Alison unexpectedly brought out a chair and sat in the front of the lecture theatre, facing the audience and opened a children’s storybook. She eloquently read us a story and took us through a very personal journey, her compartmentalised life – her story. Pin drop silence in the audience as everyone reflected and resonated with the themes and stories of the day.

Thoughts I took from the day

  • As women we need to be kinder and more inclusive of other women and their successes and choices.
  • Men can be very effective allies and help change behaviours.
  • Overall we all need to be more inclusive.

Let’s strive for a positive drive for change; for a more inclusive and balanced professional and personal life, where we are open about failures. Which at its core, starts with talking. Fundamentally, change requires visibility and being comfortable with being uncomfortable.

Thank you to Rosie Baruah, Sarah Marsh, Daniel Waeland, Susan Hall, Lucy Rowan and the rest of the WICM sub-committee for putting together such a fantastic motivational meeting.

Nish is a member of the Women in Intensive Care (WICM) Sub-committee. She is a Consultant in Intensive Care Medicine (ICM) at  Guy’s and St Thomas’ NHS Foundation Trust. She is a Critical Care Echocardiography enthusiast.