Familiarity: The Double Edged Sword to Our Growth

Familiarity is quite simply knowledge of something. That can of course be for better or for worse. I mean, I am familiar with how I feel with my 6am alarm but that doesn’t mean I like it. On the other hand, I am familiar with that wonderful feeling that I have when I take my first sip of morning tea to start the day. The thing is, in order to be familiar with something, you have to experience it repeatedly. What I want to talk about is that sensation of unfamiliarity and how we need to stick with it so that it does become familiar.

Now being a doctor definitely has its downsides. One of those big downsides for me is unfamiliarity. I, along with all the other doctors that go through their medical school placements and then their speciality training rotations will encounter this. For me, it is made all the worse because I am always, unequivocally lacking in my confidence as I start a new training post. So there I am, every 4 months – starting a new unfamiliar training post with no confidence. It is such a pain in the arse and very much a ground hog day experience until I fully quality as a general practitioner – and then, onto Sports and Exercise Medicine!

So let me give you an example; at the end of July, I would walk onto the gastroenterology every ward – a familiar ward, my medical stomping ground, knowing ever little corner of it, the staff, where I can hide my coffee without my being told off my the ward sister (aka the boss). I was comfortable. I was confident and that translated into how I felt about the medicine I practiced. Fast forward into August and I can’t even find my way to the paediatric ward. I don’t know the staff. I don’t know the expectations of me in paediatrics. In fact, I can’t remember the last time I spoke to a child. I don’t even try and hide my coffee because I’ve spilt half of it down my trousers. So, when I do finally arrive for my first day I am not only late but appear to be incontinent. In short, I was in unfamiliar territory.

As type this I have just finished a week working my 9th week in paediatrics. I can now navigate a babygrow effortlessly having conquered this, the rubix cube of the garment world, I have resuscitated babies and I have dealt with unwell children as part of the paediatric team. I no long wear my coffee on my trousers but in a mug – with its own hiding space. In essence, I am now familiar – and happier for it.

So why am I am talking about familiarity? Well, it’s something that affects us all. It’s also something that grows and evolves with time – and as it does, so often does our confidence, knowledge and application. And that is why we need it! We need unfamiliarity to stretch and unceremoniously push us out of our comfort zone. That, afterall is where we grow. Stay in familiar territory for too long and we stagnate. Nobody wants to stagnate!

My worry however is the period before we feel this confidence and the risk that many of us let our heads drop, let our motivation wain and we quit. I have definitely been there with my career in medicine – constantly taken out of my comfort zone, constantly questioning my ability, and constantly considering leaving medicine. But you know what, every time, and I mean EVERY time, I get through that period of unfamiliarity – and in its wake is familiarity, more confidence and more application. Now of course, yes, like I said in the beginning, it’s not always ‘nice’ familiarity. But you know what, even then I learn how to deal with it – and soon It is no longer a surprise and is an opportunity to adapt and evolve. Afterall if you cant change the situation, change the way you well about it.

I hope that if you are reading this, you to decide to stick with it, to get past that period of unfamiliarity and know that you will get into that familiar zone with progression, knoweldge and application at your fingertips.

And don’t forget – after a while, dip your toe into more unfamiliarity. It’s how we all grow….



Recovery: Don’t let it be in your blind spot

This week I wanted to talk about recovery. Now recovery is a word that is used in all sorts of contexts isn’t it – from recovery after exercise to a tough day at work to a horrible psychological event or even a break up. I even recover from a tense episode of X-factor from time to time…

The fact remains however that recovery is incredibly to us. It is about preparing the body and mind for the next iteration, the next stage of being or action. And it is bloody important for without it we can significantly disadvantage ourself.

Of course it’s not just important because we all enjoy some time off from that event, job, task (or person!) – but because in order to perform well – whether that be physically or mentally – we need to have that period of time to heal, reflect, digest and learn from the event. 

And I bet you know what I mean it I say that we fail to do that – when we fail to allow recovery to take place – we may find we begin to struggle to perform as well as during the previous event. As an added factor, stress levels can too build as performance drops, so compounding the effects of what was already inadequate recovery.

For me, I’m going the end of two weeks off from a long stretch of busy paediatric accident and emergency shifts followed by a set of night shifts in paediatrics. I was both physically and mentally exhausted. Due to the workload I doubt that my recovery between shifts was probably enough to fully ‘recover’. And so I crawled to the start of my two weeks off. My period of recovery.

And for the first 3 days I slept. Then ate. Then sleep. I was in desperate need of recovery!

I was, in essence, trying to refuel the body and rest the body and the mind. Perhaps it’s because I’m a scientist by background before I became a doctor but to me this was an incredibly important process – not least to have some time away from baby vomit and screaming children – but to allow me to process all that I had done, seen and learned in that stretch of paediatric shifts. To put it in another context, just like when going to the gym and lifting weights, it is the during recovery days afterwards (not the days you lift weights) that the muscle recovers, repairs and grows.

So there we go; Recovery has been a huge focus for me during the past two weeks (and of course yes, I didn’t need that long and indeed I had a little holiday within that and got tasked with plenty of DIY jobs!). Now though I am ready to return to the frenzy of paediatrics, get my hands dirty, learn, experience and keeping moving forward with, for now, a refreshed body and mind. How do I know this? Well because I miss it, I’ve had enough lying around and now I want to start growing as a doctor again.

So I guess my message to you is this – yes, recovery in our busy modern lives can often get left in our blind spot of life – but please try and make sure you ask yourself from time to time – am I giving myself enough recovery? And if the answer is no, then find a way to weave some more into your days. Every little counts. 

Have a great week. 


The Junior Doctor Contract: Beware the Iron Fist in a Velvet Glove

I have just sat here for the last 45 minutes thinking about what to write about the junior doctor contract debate. My tea next to me has now run cold, the apple nicely oxidised and I’ve clearly neglected to pay attention to the programme on television as “Beth has a big decision to make….” though I’m not sure who Beth is nor the decision she’s making.

I am a calm man and it takes a lot to make me shift from that baseline. I would also like to think that I am a reasonably educated man, despite occasionally having the mentality to rival my current paediatric patients. The new junior doctor contract is circling us, the junior doctors, like a hungry vulture smelling fresh meat for the taking. All the while however, we, the men and women who have worked so tirelessly to earn the privilege to become doctors stand in formation, ready and willing to slip our hands out of our velvet gloves of calm and professionalism and show that yes, while gentle, we too possess an iron first.

I have my opinion of the contract. I also have my opinion on the precarious and risky nature of industrial action and its repercussions both within our ranks and on our relationship with the public and our patients (Mind you, I count myself lucky that most of my patients are under the age of 10 years – I doubt I’ll get much stick from them). With that said, the American novelist and social critic, James Baldwin sums up the position we, as doctors, are in when he once said, “not everything that is faced can be changed but nothing can be changed until it is faced”. Therefore, we have no choice but to face up and be counted.

While my emotions on this matter are quite simply a melting-pot, my support will be quietly unwavering – not through standing at a picket fence but my unceremoniously slipping off my velvet glove ready to show my iron fist. But until then, I will digress into a mere breath of immaturity and say thank you, Junior Doctor Contract, your timing is perfect – I just run out of toilet paper…

….it seems you will have your uses.

Loo roll

Dr Nick Knight