S02E04 – Becoming a Joyful Doctor with Dr Caroline Walker

Psychiatrist and GP mentor Dr Caroline Walker delves into why we’re great at looking after other people, but often struggle to take care of ourselves as healthcare professionals.

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Transcript

Speaker 1:

Welcome to Heart-Based Medicine’s Heart of Healthcare podcast, featuring Dr. Caroline Walker, founder of the Joyful Doctor: How to Move Towards a Happier, Healthier, More Fulfilled Life and Career as a Healthcare Professional.

Jan:

Okay. Hello everybody. Welcome to this episode of Heart of Healthcare live. And this is our podcast today with Carolyn Walker. Really pleased that you are with us today. Hi Carolyn.

Carolyn Walker:

Hi Jan, thank you so much for having me.

Jan:

Well, it’s wonderful. And it’s really … It’s a particular joy to have you here for many reasons. First of all, Carolyn you’re the psychiatrist, you’re a therapist, speaker, you’re a trainer, a coach, and you have founded the Joyful Doctor. And I was just so touched by this effort, by this initiative. I thought this is just so much of roots of what healthcare professionals really need right now, and what patients then get to benefit from. Tell us a little bit more about yourself and the Joyful Doctor and how you got your start.

Carolyn Walker:

Sure. Yeah, so I’m one of those people that always wanted to be a doctor since I was, I don’t know, five, six years old. I’d watch doctors on TV and think that was the most amazing thing in the world to do. They healed sick people, they seem like really great people seemed interesting. And so that was me. I was set on that conveyor belt all the way up to medical school and beyond. And then when I came out onto the boards in my mid twenties, I got a really, really terrible shock that actually the art of practicing medicine is really quite tough. And within weeks I was struggling, and throughout all my early years as a doctor, I really struggled with my mental health particularly. I had lots of episodes of depression, burnout, and through struggling as a doctor, I got interested in helping other doctors and other healthcare professionals with their wellbeing. I noticed that somehow we’re really great at looking after other people, but we really struggle to look after ourselves.

Carolyn Walker:

And gradually, I just specialized more and more and more in helping other doctors. And through that, the Joyful Doctor was born. And we’re an organization. We run like a not for profit. And we basically try to improve the wellbeing of doctors and other healthcare professionals through one-to-one coaching, wellbeing based trainings, webinars and workshops and events. And we have a fairly strong social media presence as well, trying to break down that stigma of what it means to struggle a bit as a healthcare professional. To let people know it’s okay. It’s alright struggle and it’s okay to get help.

Jan:

Yeah. That is such an important message to send. When we consider the burnout rate and the suicide rate among our colleagues, it is frightening.

Carolyn Walker:

Yes. Well we know that doctors have higher rates of mental health care problems, higher rates of suicide than the general population. And I certainly really struggled, when I was struggling back in those days I really felt I was the only one, and I thought it was the end. I just thought, “I can’t be a doctor if I’m struggling myself.” Many, many times I thought, “God, I’m going to have to give up this job,” or, “I’m not good enough.” And that just isn’t true. In fact, some of the most incredible doctors I know are people who have struggled themselves with their own journeys.

Jan:

Yeah. And through your work and the work of so many people who are in the same position and have started to raise the issue and voice the issue, actually now we know that this is such a huge number of colleagues that are actually involved. Yeah. So thank you for taking a stand and for speaking up. And isn’t it amazing that in our trainings, where … Wouldn’t we expect that a healthcare professional should primarily be trained in their own health, and really kind of understand their own health?

Carolyn Walker:

You would think, wouldn’t you. But I certainly … I don’t remember any of my medical training doing that. We spent thousands of hours focused on the health of human beings, but not a single hour that I remember or recall on my own health as a human being. And that for me is another big thing that I talk about. We are human beings before we are doctors. And we forget that. I think through medical training, we become so zeroed in on diagnosis and treatment and avoiding risk at all costs and all of this stuff. And it all becomes … We just lose sight of the heart of it, which is two human beings, one who is sick, and one who is trying to help.

Jan:

That is so true. And this is so amazing. It’s so beautiful where the Joyful Doctor and heart-based medicine that are completely aligned. When I saw your messages on the website I was so touched. It’s like, yay. I guess, in a way, what you experienced as an individual and then kind of started to actually take care of others and see how much larger the issue is than you had thought initially, now in a similar way, there’s now these different organizations coming together. And it’d be wonderful to see that we’re building a network of organizations globally. Really teaming up to address this issue and to, in a way … The way I see this is this is going to change the paradigm in the medical profession.

Carolyn Walker:

Absolutely.

Jan:

Yeah. And you have such a fantastic take on this. You have a magic word here. It’s called permission.

Carolyn Walker:

Yes.

Jan:

And I love that. It is such a caring term. Can you explain to us how you see permission?

Carolyn Walker:

Yeah, well this is basically a theme that just kept coming up time and time and time and time again when I was working with doctors who are struggling, and people who are struggling in the healthcare system. We just give ourselves permission enough to take breaks, to say no to things, to look after ourselves as well as we look after our patients. And it got me thinking, what is going on here? And I got thinking about how when we’re children, we tend to grow up in the world, and we learn our permissions from the people around us, don’t we? We kind of soak them up without really realizing it. We learn that walking on the pavement is okay, but we’ll come down the middle of the road is not okay. That’s really dangerous. We don’t have permission to do that because otherwise we’re going to get squished.
Carolyn Walker:
And that got me thinking how that carries on throughout our lives, that we look to those around us to see what is and isn’t okay. And when we go to medical school, as doctors, or nursing school as nurses, or whichever healthcare profession you’re in, you look to all those people around you, you look to your senior colleagues, you look to your peers and you see what are they doing? And we give ourselves permission based on that. So I might turn up to my job and I’ll see that everybody at lunchtime is sitting there, hunched over their computer keyboards, doing their emails with a sandwich in one hand. And that’s their lunch break, and I think-

Jan:
That’s so true.

Carolyn Walker:

Oh okay, that’s how I should have my lunch break. Whereas I go to my next job and everybody at lunchtime, everybody gets up and they will go to the canteen and they sit and they laugh and they talk and they … I think, “Oh, I can do that. Great.” So we often just take these permissions from other people about what we can and can’t do in our medical practice, in our personal lives, in every area of our life. And for me, if we can become aware of that, then we have a choice. We can say, “Okay, actually am I going to give myself permission here to say no or not?” Am I going to give myself permission to stop for lunch, go for a walk, get some sun on my face. Then everything changes. We can give ourselves permission to do what we need as human beings in medicine, everything changes. We become much better practitioners, our patients benefit, everybody benefits.

Jan:

Isn’t it amazing. When we’re actually … When we wake up in the morning, by chance as it feels like. It so happens I wake up in the morning and I feel great. Everybody’s smiling that day. Everything’s in the groove, everything’s right. And if it so happens to me that I wake up a little grumpy and letting my … I’m not feeling in myself, everybody’s kind of … The world looks kind of gray and everybody’s miserable and we start complaining.

Carolyn Walker:

Yeah.

Jan:

What if we actually had the freedom to question normal, and what if we actually recognized that this is not by chance how we wake up. We can actually take control, we can actually take responsibility to do this and drive our inner state.

Carolyn Walker:

Absolutely. Yeah. I love … I don’t know if you know Brene Brown’s work at all, but I absolutely love her. She talks about … She’s a shame researcher from the US, and she talks about the stories we tell ourselves in our head. And that has changed my life completely now because when I have a thought, I think, “Oh …” So this morning I was getting ready for this podcast, and I went to get something off a shelter, and I knocked over a whole load of books, and I [crosstalk 00:09:12] postcards and all these posters went flying all over the floor. And immediately my head was full of stories. It was like, “Oh, it’s going to be one of those days. Oh, I’m being so clumsy. Oh, it was just story after story and I thought, “Hang on a minute. Maybe not. Maybe today’s going to be a great day.”

Jan:

Well done.

Carolyn Walker:

“Maybe I’m not going to be super clumsy all day today. Maybe I am, maybe I’m not, who knows.” But the point is we’re telling ourselves these stories all the time, and if we think they’re fact, then we’re stuck with them and we behave in different ways because of them. So if we can challenge that and go, “Actually, maybe it’s just a story. Maybe today could be a good day,” I’m much more likely than to have a good day.

Jan:

Amazing. So you practice this for yourself, very clearly. You develop this awareness recognizing, “Oops, I’m now going into my automated robot mode, getting swamped away with my thoughts.” How do you integrate this in your work as a psychiatrist or as a coach when you work with colleagues?

Carolyn Walker:

All the time, I mean, I’m just … We’re full of stories, aren’t we? All day long. I think what I’m learning more and more as I work with human beings is the number of assumptions I make actually, based on what people tell me. So I like to think I’m a good listener, and people would say something like, “Oh, I’m feeling really annoyed,” and I make an assumption about what that means. Immediately I think I know what annoyed means for me. I think I know why they’re annoyed. I’ve got all of these stories going on and actually what I’m having to learn more and more is just ask. Be curious, stay with that person, see what it means for them. Annoyed like what? What does that mean? Or what’s that mean for you? Because we do just make constant assumptions about that.

Jan:

Yeah. Isn’t that true?

Carolyn Walker:

Yeah.

Jan:

So when you … Here’s our thought pattern. So we’re realizing we’re kind of going into kind of jingles and the radio. We’re going into recurring patterns of thought forms and beliefs, and then we share them with others. And as you said, in the hospital canteen, we go together into sandwich and coffee eating. We go together to the vending machines, so we share the habits even. So those thoughts then turn into actions.

Carolyn Walker:

Yeah.

Jan:

And and when we try and reverse this, when it’s the first step of taking responsibility, it’s kind of saying, “Okay, now I’m not going to think this anymore. Okay now let’s change thought framework.” Or let us change action. Okay, now I’m actually going to do something nice to me, or I’m going to care for me or somebody else. Then we perceive this as a loving act. And it seems like these loving acts emerge from something we say or do. As a psychiatrist, how do you … What is your take on this? Is love something that is the result of actual and speak, or is the result … Is love something that is actually available already, and we can kind of open ourselves up to this, if we can make ourselves available to this, or we can surrender into what already exists.

Carolyn Walker:

Yeah. What a fantastic question. My goodness. I think it’s both. So I’m a recovering addict. So I’m an alcoholic. I just celebrated six years sobriety.

Jan:

Yay.

Carolyn Walker:

My journey with that has really led me to discover that I think there really is an energy of love around that we can tap into if we choose to. I do think it’s there. I think it exists between human beings. I think it exists within us, around us. It’s everywhere. But I also think that we are animals and we are we’re behavioral. And I really believe that we can do things, we can think in ways and act in ways that then encourage that love within us and between us. So I can choose to have … To think a loving thought about somebody. Somebody shouts at me, I can think, “Oh, that’s really unfair. Can’t believe they just did that.” Or I can think, “God, I wonder what’s going on for them today that’s made them so angry.” So I think it’s both, personally. And as a psychiatrist, I see it in people’s lives. I see when people are profoundly depressed, for example, the love is still there in their life. They just can’t quite access it. They just can’t quite feel it or be in connection with it until that depression lifts. So I think it’s both. I think it’s there, but I think we also can behave in ways to encourage it.

Jan:

Yeah. Clearly there can be a synergism. You can be cross fertilizing the … Looking at physics, the particle perspective, and the wave perspective can both be that they kind of co-exist and interact in some way that we still need to understand better. So I’m totally with you here. So what is in the way? So that part that everybody knows, that it’s actually this is who we are fundamentally, but something is in the way. We can’t really allow ourselves. I feel this is at the root cause of what you call permission.

Carolyn Walker:

Yeah. So I was going to say that brings us back to permission, doesn’t it.

Jan:

Yeah.

Carolyn Walker:

Are we giving ourselves permission to stop and actually feel it? And I think what was interesting about COVID and the coronavirus pandemic is that it actually did give us all a bit of a chance to stop and rethink things. Didn’t it? Kind of shook us up. It kind of stopped us in our tracks and we all went, “Oh my goodness. Oh, we might not have that long on this earth.” And, “Oh, things can change really suddenly.” And this experience that a few people amongst us in the population had already had, they’d already had major life changing events happen to them, but not the whole population. Whereas coronavirus came along and it was like, bang. We were all shaken to our core a little bit. And I think it gave us permission to stop and think, “What’s important? [crosstalk 00:15:36] What matters?”

Carolyn Walker:

When we can’t do this and we can’t do that and we can’t do this, and we’re worried about this and we’re scared about that. What actually really fundamentally matters to us? How do we want to spend our time on this planet? So I think it’s about permission, and it’s giving ourselves that permission. I think that’s the key. And giving each other that permission. So in medicine, we often look to our colleagues and peers for what’s okay and what isn’t. So if I see a colleague over there saying no to somebody, I’m much more likely to be able to say no to somebody as well.

Jan:

Yeah.

Carolyn Walker:

But I think we need to give ourselves and each other that permission to start to connect with what’s really important and to practice medicine in a way that that really matters to us. I see a lot of doctors at the moment really distressed, really down, de-motivated because they can no longer practice medicine in the way they want to. They’re doing … So a lot of general practitioners in this country, or family doctors, who love seeing patients face to face all day long. And now seeing them more and more online or by telephone, and they’re losing that really interpersonal, lovely human to human contact and they’re missing it. It’s taken the heart out of their practice for them in many ways.

Jan:

Isn’t that saddening?

Carolyn Walker:

Yeah.

Jan:

That’s saddening. So some people … You’re really well connected with I think the NHS GP group, I think. I think you mentioned that there’s a group of GPs actually meeting on it. There’s an NHS platform where GPs can meet and exchange and share ideas and needs and try and see whether they can promote ideas and see to big change.

Carolyn Walker:

Yeah, it’s actually not just GPs. All NHS workers across all disciplines actually came together throughout COVID to talk about wellbeing, to talk about what can we do here, to learn from each other from all that … Because what was happening was wellbeing was starting to be recognized as an important thing to focus on. On our staff wellbeing. But COVID kind of just accelerated that, and it kind of brought people together so they could learn from each other. And things that were happening in little pockets around the country were kind of joined up so that we could all start to learn from it. It has been wonderful. Really.

Jan:

This is just one of those things where the NHS, the UK and the NHS, it’s just light years ahead of so many other healthcare systems where there’s like … Within no time, there’s platforms available in spirit of actually [inaudible 00:18:09] together.

Carolyn Walker:

Yeah. It comes to the spirit of it.

Jan:

Yeah.

Carolyn Walker:

I think perhaps sometimes we let ourselves down a little bit, but the spirit of it is definitely there. This kind of … A call to … Not call to arms. A call to … It’s not like a choosey, a human imperative that we must help each other [crosstalk 00:18:27] when people are suffering. And I think there’s been a growing recognition that we are the ones that were suffering. We were the ones that were burning out, that were overwhelmed, that we’re anxious, and then COVID comes along and suddenly we’re like, “How are we going to cope with this?” If we were struggling already, how are we going to manage with this extra load? So there’s been a lot of people trying to think about how we can help people through that.

Jan:

That’s beautiful. And there’s a new quality. You mentioned the call to arms and that’s such a … There’s so often a healthcare language, we have to have the fight begins and [inaudible 00:19:04]. And in a way, it is a bit of a Dunkirk mentality. So let’s stick together and help each other, but this time it’s not war. This time it is actually a paradigm shift about … It is still the motivation to actually care, the fundamental ethical parenting of call to care.

Carolyn Walker:

Yeah, yeah.

Jan:

But this time it is about health care. And some people say that in a way, humanity, policy regulations, insecurity, ignorance has actually trumped medicine. Yeah?

Carolyn Walker:

Yeah, yeah, absolutely. Well, and the stories … I don’t know about you, but the stories that stay with me are the ones of the families that were separated at the time, and their loved ones died, or those moments where a health care worker stayed at the bedside of somebody holding their hand and reading them their favorite poem because their loved one couldn’t get there. It was those moments that are going to matter to people more than which dose of which drug they got, or which intervention was given. And those things are absolutely important, of course they are, but you’re right. I don’t think … They can’t possibly trump that human connection.

Jan:

Yeah.

Carolyn Walker:

It’s interesting. You bring up … We touched on this idea of the war metaphor, and I’m a bit in two camps on this one, I think, to use another war metaphor. I think there are pros and cons, because if we look at what’s happening in war and amongst comrades in arms, amongst soldiers, amongst … Yes, there are some potentially negative and unhelpful things like fighting or being defensive. These … But there’s also some incredibly helpful concepts like connection, togetherness, unity, strength. And I think if we can sometimes use those metaphors, but just be mindful of how they impact on us. And yeah, I agree. I think there is a paradigm shift at the moment. I feel it. I think it started possibly a decade or two ago, very slowly. It feels like coronavirus has sped it up a little bit. Yeah.

Jan:

Yeah. It’s amazing. So how clear this becomes to everybody, both the healthcare professionals, and you outline this beautifully, how the health care professionals are increasingly drained. The work that has been done at the front lines is just heroic. It’s incredible. The continuity, the relentlessness, and just the availability and the flexibility to constantly shift, change shifts, and switch and swap and replace and help each other and stay in a team and stay together. Unbelievable the burden on the healthcare system globally, whether you’re in a hotspot or not.

Carolyn Walker:

And of course, behind each of those individuals is another family who perhaps isn’t seeing their loved one, or an individual who is there in that moment, fully present with the team and to help their patients who then goes home at the end of the day utterly broken and exhausted. And I think for me it’s about finding that balance between how do we pull together and keep going, but also at the same time, look after ourselves and stay well. And allow ourselves the permission to still live our own lives. To still have time with our families, to still have time off, to still take care of our own needs as well as our patients and our clients.

Jan:

Yeah. Thank you. And it’s interesting you mentioning your family. This a particular moment for me is that when I’m in hospital and as an infectious disease person, and hospital hygiene and all the good things, I have this role to also ensure that those things are actually happening according to the way that they should. So yes, in the children’s hospital there’s only one parent per child, so least we have one parent a child. That’s good. So there’s some rules and regulations minimizing it. And I can totally see the value of those. And then my 88 year old mother is right now in a geriatric hospital, and so the rule there is nobody can see her.

Carolyn Walker:

Yeah.

Jan:

So here’s an 88 year old, completely in dementia with very heavy dementia, completely disoriented, and the family can’t see them.

Carolyn Walker:

Without perhaps one of the few things that might anchor them into a feeling of safety and security. Yeah. Yeah.

Jan:

It’s amazing.

Carolyn Walker:

It’s heartbreaking. It’s absolutely heartbreaking. We saw that in this country, of course, with the care homes being shut to visitors, families not being able to see their loved ones for months, sometimes nearly up to a year now [crosstalk 00:23:47] been separated. Yeah. It’s absolutely heartbreaking. And I think it misses the point that yes, of course there’s a threat to human life, but there is as equally a bigger threat from a lack of connection, lack of humanity, a lack of heart, a lack of … Because that ultimately is what matters most to us.

Jan:

Yeah. If you zoom forward five or 10 years, as a psychiatrist, when you look at the children that are now three, four, five years old, and they’re growing up in this kind of fully masked up environment, and the feeling that everybody else is a potential danger, and all of that. And you look at the elderly now in nursing homes or in elderly homes who are not allowed to see and actually meet and feel their beloved family, what do you think is going to be the greater pandemic? The virus pandemic or the fear pandemic? What is going to have a longer lasting impact and effect.

Carolyn Walker:

I don’t know. Part of me wants to go buy into that whole kind of doom and gloom scenario that, “Oh my goodness, we’re going to have an absolutely mental health overwhelm pandemic. We’re going to have a fear pandemic, we’re going to have …” But actually I think what we know from how humans adapt and change is that things do tend to resolve and go back to normal, eventually. Having said that, there’s no way that this isn’t going to have some sort of impact. We look back at major events like world wars, or … People carry those stories with them for their whole life. Don’t they? And this is what … If we go back to what we’re talking about in the beginning, if we can raise a generation of children who realize that they have some control over what they’re thinking and feeling, that they can at least acknowledge what they’re thinking and feeling, they can do something about that. And they don’t have to do it alone. They can talk about it with people, that it’s okay. That it’s the human condition, that we feel all these different feelings, and we struggle. We all get scared. We all get scared and that’s normal.

Carolyn Walker:

If we can raise a generation of children that can think and feel that way, feel empowered to have some sort of potential to change their own internal world in some way, then I think we’ll be okay. I think if we raise a generation of children that thinks, “Well, you’re scared, that’s it. There’s nothing you can do about that. You must just stay scared. You’re a scared person. You’re scared generation,” then we’re in trouble. But I think it’s … That’s the wonderful thing about being human, isn’t it? We have equal capacity to heal and grow and learn than we do to feel all of those other negative, bad emotions and things. So I think we’ll be okay. I’m quietly optimistic that however this pans out we’ll be okay because we’re in it together. And that’s the key for me. If we can stay in it together, stay talking about it, stay open about it, model to people that it’s okay, whatever it is you’re going through. It’s okay to be not okay and it’s okay to get help, and I think we’ll be okay.

Jan:

Beautiful Carolyn. Thank you so much. You’re really … You’ve shared a little bit your life story, and you’re just such a … Just an exceptional role model of actually moving from a state of despair and confusion to really find your inner balance, to find your trust, go through that route, and see that you can give yourself the permission to work in a different way, to not accept the status quo that you’re in and that your environment it is to question normal, to question what is going on around you, to be kind to yourself and to your patients, and first of all, to be a human before you are a doctor. And to kind of then see that you have the freedom to make that choice, that that choice is yours, and it’s not something that has happened randomly.

Carolyn Walker:

Yeah. And even when that choice is taken from us, even if we get an illness, like you described your mother struggling at the moment, even if I get unwell, if I become unwell with my bipolar disorder or my alcoholism again, I still have a choice. I still have a choice at that point, is what I do about that. I can still get help. It’s not easy, by no means joyful all the time. For me, being joyful means experiencing all of the human emotions and that being okay. But yeah, I do believe it’s really important that we share our stories, that we share our vulnerabilities, that we share when we struggle, because that’s the only thing that gives other people permission to do the same.

Jan:

Beautiful Carolyn. Thank you so much for your path, for being a warrior, for setting up the Joyful Doctor, we’re going to be in contact in exchange. Very, very beautiful. All the best to you. Have a great week, all the best of your family. Thank you so much for being with us today.

Carolyn Walker:

Thank you. Thank you so much for having me here, and all the best to you and your family.

Speaker 1:
This has been a Heart-Based Medicine Production. Thanks for listening.[/vc_column_text][/vc_column][/vc_row]