Abstract
Forgive yourself!
I recently witnessed a doctor discussing a mistake he had made, with a close friend. After a long explanation, deliberation and much self-deprecation, his friend said, rather bluntly, ‘You need to forgive yourself’. A most helpful and thoughtful remark, and on reflection this made me think how we, particularly as clinicians, can carry guilt and shame on our shoulders despite the best of intentions, for far too long. Guilt and shame can be particularly damaging to ones sense of well-being, an attribute that is needed for the demanding care of patients. So why can this negative force plague our minds when we work so tirelessly for the benefit of others? Medicine, like life itself, is a challenge and we are not always fully prepared for the turmoil when things go wrong. Time for self-reflection in this busy world doesn't always bring about the cure one needs from the distress aroused by ones error. Life can change in an instant and we can never be fully prepared for what the future may hold.
In this example, only with the help of a loyal and compassionate friend could this clinician move forwards. Perhaps sometimes we reflect too much? Is this possible? This doctor was clearly baffled by what had happened, how and why, and was desperately searching for a reason or something to learn. In the end there was little to learn apart from the acceptance that he was human, had made a mistake and needed to forgive himself. Not every error in life has a reason or a moral lesson, and your actions may simply be entwined in the entropy of misfortune. Some say forgiving oneself is a more arduous journey than forgiving others. The great Martin Luther King Jr. said: ‘Forgiveness is not an occasional act, it is a constant attitude’. This touches on the need to forgive the little things and not just the huge mistakes; simple things such as running late in surgery or arriving to work late. We must learn to counteract the negativity in our day, as caring for patients brings its own challenges that we need the stamina to face.
Self-praise, yet another virtue, is something one must find time to do now and again. The marathon challenge of learning to love and respect yourself is a mountain worth at least beginning to climb. I always thought narcissism was a negative character trait, yet my partner recently told me that a small dose is essential to function and be successful; why do we go to the gym and dress nicely? Together with the art of reflection and sharing of learning, these are great skills to enhance your personal and professional life.
Humility, the opposite of arrogance, is a further attribute that adds to the journey of success and is not always so easy to master. Life’s challenges, and often mistakes, make you stronger, but only when the power of meaningful reflection is embraced to learn the wisdom for a better path. People deliberate about the forces of fate or self-determination, but either way, discussing your frustration with a friend can be a problem halved. A colleague recently taught me the saying ‘It is what it is’. This brings a sense of mindfulness and is a phrase I now say to myself frequently when my situation is not as desired as I would like.
Patients too bring shame and guilt into the consultation. Issues such as obesity, smoking, alcohol, and in fact any lifestyle behaviour that may give them a sense of blame for their presentation, can be a burden inside them. So can we, as their GP, help them to forgive themselves? Could this be a useful prerequisite to behaviour change and a better mood? And how can our consultation skills master this? Does the COT marking scheme or the Clinical Skills Assessment examination need an ‘addressing guilt, blame or shame’ score?
So when you feel baffled by a mistake that troubles you for too long, stop and think. You may find yourself wandering in circles in your beautiful garden of reflection. Share your concern with a friend and ask yourself what you can learn. But never forget also to ‘forgive yourself’.