Looking after myself

Ajay Verma, consultant gastroenterologist at Kettering General Hospital, shares his experience of looking after his mental health and offers tips for new consultants.

I have always been a controlled person – organised, tidy, and efficient. I don’t like outstanding items on my to-do list, my work schedule is on a shared electronic calendar which is visible to my secretary, and my family schedule is on a shared calendar with my wife! I diligently file emails into folders and the only items in my inbox are emails relating to outstanding actions.

However, working in the NHS can be quite a chaotic existence for consultants. Patients can be allocated under your name even if you have never seen them. Sometimes the first time you’ll know about a patient is when a result appears on your desk.

I have always had the compulsion to not let admin sit on my desk for more than a day. I would utilise lunchtime or the end of the day to clear my desk. My rationale for this behaviour when describing it to others, is a fear of finding a disaster at the bottom of a pile of notes. However, the truth is I can’t explain why a pile of notes on my desk stresses me out.

The same can be said about emails. I find unread emails or a full inbox particularly stressful and I work hard to keep on top of this. This extends to having my work emails push to my smartphone, and I would check my emails even on annual leave just to ensure that my inbox remained manageable.

2018 for me was a challenging year. Instead of looking forward to the year of my 40th birthday, it started with dread of an impending event. My best friend Tim – we were best men at one another’s weddings – had been diagnosed with terminal bowel cancer 2 years ago and was likely to die within a few months. We were a similar age and met at university. He and his wife had a little boy who is a similar age to my young children. In the summer it became clear that he had a few weeks of life left and the final visit to see him at the hospice was particularly hard for all of us.

He eventually died. I had pictured speaking at his funeral for many months, yet on the day it was the hardest thing I’ve had to do in my life. In the following weeks and months, I muddled through as a way of dealing his death. I realised in December after nearly losing my temper at the hospital (which is not in my nature) that I was running on empty.

I decided that I had to make adjustments to the way I work to look after my own mental wellbeing. I thought I would start with little things. The fact that having notes on my desk really bothered me was something I needed to look at. I had a discussion with my secretary, and we agreed that she would email me every week with a list of patient details that needed results looking at instead of putting notes on my desk. I have found this helpful and it reduces my anxiety levels as I enter my office and glance at what is on my desk.

For the last two holidays I have spent with my family, I have realised that I needed a break completely from work and that checking my emails via push wasn’t conducive to relaxing – it wasn’t good for me, nor was it fair on my wife and children. For the first time, I switched off the push email alerts to my smartphone. I found this liberating and it helped me to switch off. A compromise for me was to check my work emails every few days. This allayed my fears of missing something important and also meant that on returning from leave I didn’t have to wade through an inbox with scores of unread emails.

I have also relented a little on ensuring my desk is clear at the end of every working day. If I am tired or it is late in the day I will generally try and leave my admin tasks to another time and go home. I now deal with the urgent tasks straight away and leave the non-urgent tasks for a convenient time.

These changes may appear minor, yet they have made a difference to me. On reflection I see it as part of growing into my role as a consultant as I approach 5 years since appointment.

I still have a way to go. I enjoy taking time off work, yet I have not managed to book the full allocation of my annual leave in any of my 4 years as a consultant; I carry over as much leave as I am allowed into the following year. My challenge is to ensure that I book all my leave in 2020 for the benefit of me and my family. I recently spoke at the RCP trainees conference, giving tips on being a new consultant. Ensuring you book your annual leave was one of those tips. I did declare a self-rating for this – giving myself a mediocre score of 5 out of 10. I’m aiming for 9 out of 10 in 2020.

Find out more

The RCP’s Mental health and wellbeing resource aims to support physicians to stay well and seek help when needed by opening up the conversation about mental health issues and their impact.