From burning out to burning in
When we started out, I felt like Penny – lost in a land without hope, burned out having been overburdened with mindless, misdirected work trapped within a system that increasingly cared for numbers rather than valuing care, in a climate of endless reorganisation, under relentless pressure from top-down initiatives.
I have found hope again by tending to the soil and working from the grassroots. I found myself ‘burning in’ to a more stable but energised place where my work regained coherence, meaning and purpose. The hours may be similar but the emphasis has shifted from the mechanistic pursuit of efficiency and outcomes, to a focus on real compassionate patient care. My joy has been restored. In the greatest book ever written about general practice, A Fortunate Man (1967), John Berger describes his friend John Sassall, a country doctor in the 1960s as ‘… a fortunate man because his work occupies and fulfils him; his work and his life are not separate’.
Our project has grown, literally and figuratively. It expanded from our early gardening groups, into organised and impromptu gatherings and waiting room ‘crafternoons’, then came a poetry pharmacy and story- walking. At the outbreak of the pandemic, galvanised by our knowledge of how to work as a good team, we were able to quickly set up a pop-up social kitchen, to feed staff and patients in need. The role of the clinician has been to facilitate participation, to invite civility in conversation across diversity, to provide support and navigate difficulties when there is distress, or if inevitable tensions arise in group situations. Our social prescriber Jo, who facilitates and supports the various groups that have developed, acts as a true link-worker, a warm and welcoming connector between all of us in the practice. In this way our work can remain expansive. We focus on working with our relationships and less transactionally, always aiming for more equal partnership with our patients, other community organisations, individuals and businesses. Through this participatory approach and by ensuring our activities are fun, inclusive and positive at their heart, we are growing the community we imagined, rather than building an army. As each participant finds their place we are learning to work supportively and to grow our resilience and ability to rise to the challenges we will all face.
A tree can be only as strong as the forest that surrounds it.
Peter Wohlleben, 2016
Penny’s story (2)
So, what of Penny? As I listened to her tale unfold and her self-diagnosis of depression, I gently suggested that perhaps in her situation, sadness was understandable. And sadness requires mainly gentle observant company and community. We talked of what once had nourished her, her love of nature, of gardening and of her teaching. With our expanded outdoor ‘consulting room’ we were able to offer an alternative prescription. That evening, Penny and I met, wandered among the flowers, the herbs and the productive beds of The Listening Space. We spoke of other gardens, the power of nature to ground and to heal; and imagined together a different future path.
Penny joined us the following day for a distanced, intergenerational gathering and walk between The Listening Space in Kentish Town and The Story Garden in King’s Cross. I spoke to her in a follow-up appointment two weeks on from our more despairing conversation.
‘I can’t believe how different life looks. I didn’t think at this point in my life, there could be anything else. But I know where I am now and what I want to do with whatever time remains for me.’ Penny is now volunteering with us, a valued, worldly-wise elder in our community already sharing English conversational skills with those from other lands who are also growing roots in our re-generating and re-membering community.
What if GP surgeries became catalysts for Transition?
So how do we weave a stronger social fabric; how do we learn to mend, remake, grow it and sew it? I was fortunate enough to be in conversation with Rob and Michael as part of Rob’s podcast series ‘From What If to What Next’ (Hopkins, 2020), where we were given generous space to reimagine healthcare for the future and had carte blanche to suggest policies as ministers of the imagination. Perhaps you will listen and join us?