Men & Doctors - getting the best from your GP
By Christopher Banks (aka Bipolar Bear)
Dr George Forgan-Smith isn’t your average-looking GP. It’s hard to imagine him in a white coat, actually, with his casual dress, tattoos covering most of his body, and two abnormally-large German shepherds (they’re not that large, but when you’re not a dog person, anything large and slobbery becomes magnified).
He originally hails from Brisbane, then moved onto the hippy community of Byron Bay, and finally to Melbourne, where he works at a busy practice and runs his own blog, The Healthy Bear.
“I grew up in a very medical family,” he says. “When I was in Cubs and Scouts, the first badges I got were the first aid ones.”
Many of us have had bad experiences with doctors and psychiatrists – myself included – and a lot of this stems from the fact that we don’t think they get it.
Dr George has had two experiences with depression, the first related to his experiences with growing up as a young gay man, which he has blogged about eloquently already.
The second was during his time as an “infallible” medical professional.
“I was studying medicine, and I was sleeping a lot – finding it difficult to get out of bed, low mood, no energy,” he remembers. “I don’t know why, but the one lecture I managed to drag myself was on depression. There was a list on the screen, and I thought – fuck, they’ve listed ten things that are common in depression and I’ve got about seven of them. I’d better do something about it.”
He went and saw a GP, got some pills and life went on. A few meltdowns, a few trips on the medication merry-go-round, but recovery mainly went in the right direction. Eventually, he decided to come off the pills.
Then came Armageddon Day.
It was during his first year as a doctor, working in a practice with a high turnover of people, many of whom were acutely unwell. He had a supervisor that was unsupportive, and seemed “equally as lost in his role as well”.
“When you’re a junior doctor, you have this belief that you have to fix everything, and if you can’t fix it…
“I was muddling along, and then there came one day when everything went wrong. It was just abysmal. I had two pages of patients – I was freaking out. How the hell am I going to get all this work done today?
“I didn’t have the skill set of time management, or knowing what was important and what wasn’t important, so I was getting behind – which meant that the nurses would constantly page me to tell me I was getting behind.
“You have to stop everything you’re doing, phone them up, and be told, ‘you haven’t done X’, and it’s just this little reminder in the back of your head that you’re incompetent, you’re stupid, you don’t know what the hell you’re doing. I had a full day of that.
“And to make it even better, I got pulled out for the afternoon, for some workplace health and safety.”
Swiss cheese model of disaster theory
George found himself sitting in a room having the Swiss cheese model of disaster theory explained to him, which according to Wikipedia “describes accident causation as a series of events which must occur in a specific order and manner for an accident to occur, which it compares to the holes of several unique pieces of Swiss cheese lining up.”
The memory of that day is still raw with George. “I’m sitting there thinking, my swiss cheese has been lined up all week. Give me a goddamn break, you’re taking three hours of my time that I should be able to do some work. And it just built up.”
At the end of the seminar, he turned to his boss – the man above his unsupportive supervisor – and said he needed to talk. Half an hour later, the boss turned up in George’s office.
“‘Look I’m quite busy,” he said, ‘can what we need to talk about wait till Monday?’ And I said, ‘no, we need to talk NOW.’
George went to his boss’s office and broke down.
“I just cried and cried and cried. And to his merit, the poor bastard didn’t know what to do, he had this crying mess in front of him. I said – ‘look, I need a week off. I need to see my psychiatrist, I need to get back onto my medicines, because I’m not coping.’
“He listened, and he said, ‘ do you need a glass of water?’”
George got his week off, but he should have asked for help earlier.
“All doctors feel this – if you take time off as a doctor, then someone else has to pay and that’s usually your patients. Or your colleague. If you’re not there, then someone else has to do their work and yours. There’s a big guilt within the medical community about that.
“And for that reason, I’m very big in making sure that doctors understand, if you’re sick, you don’t go to work. If you’re grumpy or tired, then you’re probably better off not going to work, because your grumpiness is going to come across to the patients as anger towards them and that’s really counterproductive.”
At this point, George started to learn more about how his brain worked. He learnt that, like all of us, the brain has a limited channel or band to deal with stress. This incident had taught him what size band he could comfortably operate within.
“If my channel of stress gets bigger, then my capacity to deal with that becomes thinner – my sleep goes bad, I become angry, etc. That was a big learning experience for me as a doctor, learning what was good for me and what wasn’t.”
One more lesson to learn
But the story wasn’t over yet. George had one lesson still left to learn.
“When I came down to Melbourne, it was a bit of a stressful time for me, and I wasn’t sleeping. I went onto a medication, got referred to a psychiatrist who I only found out when I saw him was a talk therapist, and I didn’t want that.
“I wanted a medicine that’s going to fix me NOW – I don’t want to deal with yucky feelings, I don’t want to deal with pain or anything like that.
“But something about him piqued my interest, and more out of morbid curiosity than anything else, I became involved in a nine-month period of talk therapy.
“I’d rock up every week, we’d talk about stuff, sometimes we’d laugh, sometimes I’d feel uncomfortable, and sometimes it’d be embarrassing, but he taught me to become more understanding of what makes me feel good, what makes me feel sad, and if I’m having feelings of anger or frustration, being able to identify that and make a decision as to what I want to do.”
Part of that learning curve included being taught about self-care.
“When you’re a GP, you’re seeing 32 people in a day and you have to zone your attention onto them, and that can be really tiring. So I had to learn skills to deal with that, and that could be riding a bike, or going for a walk. It’s a good way to just reduce the level of chatter in the mind that can slow it down.
“To have some time to myself is very important – every week, I have sanctioned times where I have my own personal space, personal time that I can do stuff I really enjoy that brings me happiness and makes me feel good, and that’s part of my mental health care.
“I love to have a sleep in on my days off. Going out and having dinner with people that I enjoy, that’s a really good thing for me. Understanding that there are things that you need to do to care for yourself, and make sure that they get done.
“Don’t ever delay self-care. It’s a priority if you’re going to stay happy.”
