Pear shaped - responding to adversity

A poem by Andrea Clay. 

I went home from my study group and I thought I’d write a song
A light hearted little anecdote to carry us along
A humorous look at training and the eportfolio
Just how do we get our trainees to learn all the things we know?
But events that followed after came and stopped me in my tracks
And our talks of authenticity had me thinking back
Life isn’t always funny when we’re in the here and now
And when it all goes pear shaped just what is the way to go?

The morning calm was broken by some news I had to share
I knew it should be spoken but I felt it so unfair
As I walked down the long corridor which wasn’t far enough
I rather felt like running than perform a task so tough
I reached my trainee’s room and I pushed the door ajar
She looked up with a cheerful smile, completely unaware
The calm before the storm, the news that only could upset
I sat down in the patient chair and took a big deep breath

Is it ok if we chat about a patient you saw on Monday?
I’m really sorry to have to tell you that he committed suicide on Tuesday

The long and painful silence was expected and I waited
There’s no easy way to say it, it’s a task that I just hated
Then we talked for ages thinking of the right or wrong
We analysed the details, thought what else might have been done
And though she’d done her job well, still I knew it would be hard
I suspected doubts and worry might be feelings that would last
And in the weeks that followed we discussed the hurt and pain
We reflected on our learning and we sought to make some change

The event has shaped our training as we walked through those few weeks
And I had to think quite carefully of what our course should be
About what would best support her, but allow her to mature
Could resilience assist us, courage help us to endure? [1]
Did she have the tools to learn and to move on to greater things?
Did I have the tools to help her, would I find myself wanting?
But I learned a few good pointers that I’d like to share today
And some hints so help me next time, if… when more trouble comes my way

Be prepared

We learn when we are students how to break the news that’s hard [2]
We follow all the guidelines and we walk the chosen path
There is time for preparation, we consider what to say
We can tell the painful story and then choose to run away
But when news is for a colleague it’s much harder to escape
If we need to be authentic we’re affected by the pain [3]
How should we give the feedback, what makes it best to take? [4]
As I’d asked this question earlier I told it to her straight

I gave her space for crying, options for the work that day
I asked for help from others to support her on the way
We talked through what might happen, to prepare for what could come

I encouraged self-reflection – to write down all that was done
There would be good and bad days for a while, but that would end
And I wasn’t asking miracles or suggesting she pretend
We could talk it out as much or little as she felt the need
She would come through feeling stronger if I could help her to succeed

Be real

We are bred as high achievers, because excellence is good [5]
And the top is where we aim for as all ‘clever people’ should
But does education fail us by pretending life’s not tough?
We should understand the concept that with smooth will come the rough
So when trouble comes we have the tools to make a better choice
To reflect, and learn, and change and speak out with a stronger voice
It’s ok to find things hard, to have our moments of distress
If we know how we can get back up it makes the pain hurt less

I could drive to seek perfection if I follow my own way
But that doesn’t help my trainee if she’s having a bad day
Is there space for contemplation – to admit we might be wrong?
And seek to do things better, as friends carry us along
We should ask for help from others – we’re not meant to walk alone
The task seems much less daunting when we have a friend to phone
Our response to circumstances helps to forge who we will be [6]
And in rising from the ashes we defeat adversity [7]

Be flexible

Our tutorials have altered, as I look its plain to see
That we had to change the pattern (which offends my OCD)
But it isn’t my agenda that should drive the learning plan
And her needs have been specific so we changed it as we can
And we gave it time to talk it through, to reflect on what it’s done
To think how we communicate, to look how to move on
To see how it affected her consultation style
And to work at ways to better this we sat and analysed

And it may mean I don’t get to do my ‘Diabetes talk’
But the time we spent has helped us both to walk this harder walk
To know how we react and to look at our support
To find ways of moving forward as we use what we’ve been taught
And this change is for a season so I can look ahead
For in the grander scheme of things my talk can stay unsaid
Events like this will shape the way we face our daily job
And I needed to respond to help bring good from what was not

Be encouraging

The traits of failing trainees are of those who won’t reflect [8]
So they never learn to look at things and what could happen next
Insight and a willingness to grow is what they need
Because brave determination may assist them to succeed [1]
So a few congratulations have been said along the way
As she sets her vision forward at the start of each new day
And though there may be stumbles, she will keep on standing tall
With encouragement at every step we learn to climb the Wall

And some public affirmation makes the journey seem less long
So I’ve often told my colleagues what a sterling job she’s done
For though we all agreed that there was no question of blame
She set her mind to look at things and to consider change
And for me the help of others made the difficulty less
We are all in it together and together we progress
And the openness of talking –‘what to do if this were me’
Has provoked wider reflection which is positive to see

Be forward looking

But there’s a time to draw some lines now and to think of what’s in store
And though she will remember now we need to close the door
It is time for more deep breathing as we put the past behind
And to say we’ve learned a lesson which was hard but not unkind
For there are things we wouldn’t know now if we hadn’t walked this way
But we’re stronger and we’re wiser as we face another day [9]
When she says ‘next time’ and smiles I know she’s started to move on
And resilience is growing for she battled through the storm

So I walked the journey with her and reflected on my role
To support and help her through it – so we both came out as whole
And there’ve been some painful lessons with some tears along the way
But I hope that she’ll be glad when she looks back at this some day
So my rhyme is shortly ending and I’m sorry there’s no tune
But I needed to be honest and the process wasn’t fun
If you’d like to hear some singing you can try out my CDs [10,11]
‘Cause some shameless advertising is always good to see!

So the moral of my story is that life is sometimes hard
But with tools to help improve us, we can keep moving forward
And it doesn’t have to end with ‘pear shaped’ being our life design
We can come out with some roses which smell better every time


This poem appeared in Education for Primary Care, 2016 http://dx.doi.org/10.1080/14739879.2016.1218797