Somewhere over the rainbow

Peter Aird is a GP in Bridgwater, Somerset.

Judy Garland’s was not a happy life.

Last weekend I went to see Renée Zellweger in ‘Judy’. It’s a remarkable performance in a film that portrays Judy Garland towards the end of her tragically short life whilst visiting England in 1969. It reveals the effect on her of having been driven to succeed for the benefit of others, compelled to be what she may not have chosen for herself, and controlled by others to the extent of even of being told when she could and could not eat and sleep.

The mental breakdown that followed was surely inevitable. At one point she was asked had she ever taken anything for her “depression”. She replies “Four husbands –  it didn’t work”. It’s not all she took – alcohol and a combination of the uppers and downers she was first plied with as a child fared no better in relieving her unhappiness. The only time she did seem to be happy was, paradoxically perhaps, when she was where her success had taken her, on stage, in front of the audiences that loved her.

But such happiness was only ever short lived. After the success of her opening night’s performance at London’s ‘The Talk of the Town’, Rosalyn Wilder, her personal assistant on her visit to England, congratulated her and tried to reassure her that she was going to be alright. Garland replied, “But what if I can’t do it again?” In a life where she had been shown little love, she needed the love of her audience but knew that this was always dependent on her constantly delivering what those who came to see her wanted. She was right to be anxious. One night, arriving on stage late and the worse for too much alcohol, the crowd turned hostile and pelted her with bread rolls. Their love was not the unconditional love she needed.

The unconditional love we all need.

There were those who seemed to truly care about her. A couple of ordinary folk seem perhaps an unlikely pair for an international star to be drawn too, but her fondness for them becomes wholly understandable when their genuine affection for her allows her to be her true self. Interestingly, it is when she breaks down in public, revealing that true self on stage, exposing how she really feels, that real compassion flows to her from her audience. Only then, as the star becomes an individual, does the barrier between her and her audience come down.

Boarding the conveyer belt of medical training at an impressionable age, we have been controlled by the system much of our lives.

I’m not sure that Judy Garland really knew how she ended up where she did, or that where she ended up was where she ever really wanted to be. So manipulated was she by the world she found herself in as a child that, once she had entered it, she ceased to be who she really was. Some of us may feel similarly. Boarding the conveyer belt of medical training at an impressionable age, we have been controlled by the system much of our lives, even to the extent of being dictated to by the demands of the job as to when we can eat and sleep. Whilst many have survived this ordeal, and have found satisfaction and happiness in medicine, too many have not but and are left struggling on to their detriment.

How, I wonder, do we cope with not being the person others demand that we are?

More importantly perhaps, how do we cope with not being the person we demand that we are ourselves? Not being able to be the person we long to be, how many of us find ourselves asking, with Judy Garland, “Why, O why can’t I?”.

The answer may reveal why we respond the way we do to complaints, however trivial. Might our self esteem be so easily shattered because that self esteem is already so fragile, too dependent after a lifetime of pleasing others, on having to please everyone? Likewise, might not the anxiety we feel as our appraisal approaches result from our being driven to perform at ever greater levels? The need for us each year to show improvement comes with the inherent implication that last year we were still not good enough. We must, we are told, do better.

And so we strive all the more to satisfy those who demand from us, drive ourselves on in the vain hope that if we could only be the better people we ought to be, all would be well.

Over the summer, in an attempt to concentrate on all things cricket as the Ashes series drew to a close and Somerset CCC still had hopes of the county championship, I watched ‘The Edge’, the film that chronicles England’s climb to the top of the world Test rankings. What became apparent was both how hollow the team’s success felt when it was eventually achieved and how costly, in terms of the adverse effect on the mental health of a number of players, that success was when winning became mandatory.

We live in a world which encourages us to follow our heart and promises that our dreams will come true if only we want them to enough. This is a dangerous philosophy to follow since it simply is not the case. We need to wake up to the fact that our dreams will not necessarily come true and that, as for Judy Garland and a number of the England cricket team, too often they turn into a nightmare.

And when all that fails, it leaves too many of us crying and, what’s more, crying alone.

The emotional well-being of medical professionals is no more important that that of patients, but neither is it any less. And just as patients will not be helped by being burdened with the unrealistic goal of being responsible for their dreams coming true, neither will those in health care be helped by increasing demands being put upon them to be perfect. An insistence that we should merely increase our resilience to cope with what is unreasonably asked of us is tantamount to being told to ‘come on and just get happy’. The justification for this, that ‘when we’re smiling, the whole world smiles with us’ may well be true, but thinking like this results in too many of us putting up with a situation we long to escape, imprisoned by our desire to be seen to succeed and be needed, all the while medicating ourselves to get ourselves through the day. And when all that fails, it leaves too many of us crying and, what’s more, crying alone.

None of us are unaffected by our past. Many of our patients come to us struggling as a consequence of hugely adverse circumstances in their childhood and subsequent lives. Some do not understand how they come to be in the situation that they find themselves to be in and need help to escape. Some of us in medicine are no different. We too need to be able to drop the facade of our professional image and be honest about who we are so that we too can receive the same compassion and understanding as our patients.

We all need a little grace. Grace that does not demand that we be what we are not but frees us to become what we truly really are.

But does such a world exist? Is that place just like that elusive pot of gold we merely can dream about, only found somewhere over the rainbow? Let’s hope not.


Featured photo by Steve Johnson on Unsplash

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