There are four lines from a Mary Oliver poem that give me
goosebumps every time I hear them.
In the poem, Wild Geese, she says, you do not have to be good.
You do not have to walk on your knees for a hundred miles
through the desert repenting.
You only have to let the soft animal of your body love what it loves.
And this really resonates with me, and I've been wondering why, why does
that line you do not have to be good?
Feel so hard for me?
And why do those extra lines feel like such a relief?
And I've been thinking about it, and I think it's not because they give
me permission to be careless or to be bad, but because they really release
something much, much older and heavier.
And when I unpicked what I was gonna say for this quick dip
episode, it's not really about my favorite poem by Mary Oliver.
It's about what being good has come to mean for me, has come to
mean for doctors and other senior healthcare professionals, and people
in high stress, high stakes jobs.
And what is the cost of that belief?
Because doctors, senior healthcare professionals, they care deeply
about doing good in the world.
And that's probably why you came into this profession.
You wanted to help, you wanted to make a difference, and you wanted to matter
in a way that really reduced suffering.
And yes, there's all the other stuff about the interest and the science
and doing something exciting, But somewhere along the way, all that
stuff, especially the doing good, it got tangled up with being good.
In fact, I was chatting the other day to a friend whose sister is a gp and she
said that she realized quite recently that her sister genuinely believes that
she is good because she is a doctor.
And this is all tied up as part of her identity.
And I think for us, being good has come to mean something very specific.
It's not reacting, not judging, not misspeaking or speaking out of turn.
Not swearing, not letting off steam, not being selfish or self-indulgent
and not needing too much.
Being good looks like being very measured, contained, and incredibly selfless.
And once that becomes standard and normalize inside us, then
your normal human reactions don't just feel inconvenient.
They feel like wrongdoing.
They feel like evidence that you are bad and you are not who you should be.
And so maybe it's not so much that we want to be good, but we are
actually trying to avoid the shame of feeling that we are not good.
And I think there's an important distinction here that we often miss.
It's this, being good is not the same as being safe or being wise.
Now wise.
Looks like noticing a risk, asking for help.
Acting within your limits, correcting your course early, admitting when you
are wrong, repairing relationships, giving honest feedback, acting
within what you know to be true.
Being good.
Often.
It's like absorbing all that extra pressure without complaining, staying
really pleasant and not let anything show, and certainly not being weak.
And these two distinctions are distinctions between wise and good,
they get blurred very, very easily in medicine, and when they do, denying
yourself and your very human needs starts to look like professionalism.
And I think part of the reason why those lines from that Mary
Oliver poem land so hard for me is that it feels really personal.
This is a You Are Not a Frog quick dip, a tiny taster of the kinds of things we
talk about on our full podcast episodes.
I've chosen today's topic to give you a helpful boost in the time it
takes to have a cup of tea so you can return to whatever else you're
up to feeling energized and inspired.
For more tools, tips, and insights to help you thrive at work, don't
forget to subscribe to You Are Not a Frog wherever you get your podcasts.
From a very young age, I was taught that being crossed was wrong, watching
certain things on the TV was wrong, having certain normal human urges was wrong.
And at the same time, I learned that you were judged by your output, by how well
you did, how much you helped people, how successful you were, how much you
achieved, and how nice you could be.
The problem was I was a child with ADHD, didn't know that at the time,
and so I was often told I was just tactless, that I upset people, which
was awful, that I was naughty, not nice.
And the problem is because being loving and kind are two of my deepest values.
I didn't hear all that feedback as feedback about my behavior.
I heard it all as a verdict on who I was, that I was not good.
I was not a nice person.
And so I, I tried to work my way out that by being good in other
ways, so getting really good grades, achieving a lot, and making sure that
I always was doing the right thing.
And also part of the problem was I challenged beliefs and ways of doing
things rather than blindly accepting them.
That was a bit dangerous because that then was framed as a problem with me.
I was told I was upsetting people, that I wasn't being loving or kind.
And if you've grown up in a controlling cultural or religious system, you'll
know exactly what I'm talking about.
And please believe me when I say there was nothing wrong with you.
Your intuition was spot on.
But the only way to control you and to maintain the status quo was to
turn it into a problem with you.
So again, the tables were turned.
The verdict was the same for me.
I wasn't good.
And that belief has followed me into medicine, has followed me all my life.
Because once you are a doctor or you have a very responsible job,
the standards feel even higher.
You're not just meant to behave well, but you are meant to be better than everybody
else and gooder than everybody else.
And when I found myself leading the professionalism curriculum
for medical students at Cambridge University, that pressure intensified.
My job was literally to teach future doctors how to be good.
At the same time, I was bringing up three children pretty much as a default parent,
holding down multiple roles as a GP, a medical educator amongst other stuff.
And my nervous system did what nervous systems do.
Under sustained pressure it reacted, it got overwhelmed, it got cross, and
it got resentful and every time that happened, I didn't think I'm exhausted.
I thought I've been bad.
And even when I left general practice and the job that I really hated,
I was flooded with guilt and shame because a good person would keep
seeing patients, would keep working in a role that just didn't suit them.
A good person would cope.
A good person would be selfless and a good person wouldn't leave.
And after eventually being diagnosed with ADHD a couple of years ago and
subsequently having some therapy, something's really shifted for me.
I look back at that little girl and I think you poor thing.
You were desperately trying to be good in a system that just wanted to control you.
Your reactions weren't sinful.
They weren't evidence that you were bad.
They were human responses to be highly controlled in an environment that didn't
tolerate difference or challenge, and that relied on no one speaking up.
And I realized that I'd spent my life trying to prove to the world
that I was good, even if I was a bit impulsive and irrational at times.
But I was living in constant fear of saying or doing the wrong thing.
And what I am slowly learning now is this, that I am human.
I have wisdom, I have integrity.
And yes, some things occasionally come out wrong or quite often come out wrong.
And sometimes I can say things impulsively or insensitively.
Sometimes I talk too much and I overwhelm people.
That behavior doesn't work.
Doesn't mean I'm bad.
It doesn't mean that I am unkind.
It just means I'm human.
And here's something I have really come to see is that good and bad are not
very useful categories for human beings.
They're just moral labels that we slap onto behavior, And then
we turn them into judgments about identity, about who you are, who I am.
It's like calling a cat a good cat or a bad cat.
A cat isn't good or bad, it's just a cat.
It behaves just like a cat behaves.
So if I was cooking some fish for our tea and I left a bowl of fish
on the side and the cat ate the fish, I might say, you bad cat.
But if I put that bowl of fish down and left it next to its food bowl and wanted
them to eat it and it doesn't eat it.
I'll go Well, what's wrong with that cat?
Right?
The judgment changes, but the cat doesn't.
It's still being a cat.
But with ourselves, we do this constantly.
We turn the fact that we are humans and have finite capacity,
we turn that into a character flaw.
We turn having limits into moral failure and we turn our normal human reactions
into something that needs correcting.
And here's where I want to say it's a very inconvenient truth and widen the lens a
bit because this belief that doctors must be good, it doesn't just live inside us.
It lives in society, doesn't it?
It lives in the system and it's very, very useful to the system.
Because in the short term.
Everybody benefits from doctors who over function, who stay late,
who fill the gaps in the rota, who absorb the risk so that everyone
else can breathe a sigh of relief.
And so a failing system just can keep going with under resourcing understaffing,
and unlimited demand, and patients never understanding that the healthcare system
cannot meet all of the things that they think they need from it, and a political
system that is unwilling to admit that.
So patients benefit from doctors who over function.
Organizations benefit, and even our colleagues benefit.
And it's just like children who benefit from parents who just do everything
for them, who absorb all the stress for them, but we know how that ends.
In the long term it creates dependence, resentment, and actual harm.
And yet doctors somehow keep waiting for permission from other people
and from the system to stop, for somebody else to say, it's okay.
Now you can rest.
You are never gonna get that permission because the system is
totally relying on you not stopping.
So that permission is not gonna come from anybody else.
It needs to come from yourself.
And even worse, this belief that we are morally defective.
If we can't just keep going and going and going.
And the belief that that doctors must be good.
The doctors have to keep going.
Otherwise it's a moral failing.
This belief just gets weaponized.
So if doctors step back or go off sick with burnout or,
or just say no to something.
It's not just practically a little bit difficult, but they meet moral judgment.
People saying to them, or whispering, yeah, you are not coping or
you're just not resilient enough.
That's resilience, victim blaming.
You are not a team player.
Uh, you are being selfish or greedy.
And when that judgment comes from colleagues, which it can do, even if it's
just inferred through a tone or alert or just silence, it can be really, really
devastating because it confirms what we're already thinking already, our deepest
fear that maybe I really am not good.
And that's why burnout can often hurt us in the way it does.
It's not just exhaustion.
It's a, a separate kind of moral injury.
So the things that we've been doing to be what the system calls
a good doctor and what we believe to be a good doctor, have actually
harmed us, pushed us into burnout.
And then on top of that, we think that because our bodies have reacted in a
normal human physiologically way to the stress of the overwhelm and the
burnout, that we are deficient, we are weak or selfish and not good enough.
So let me be very clear about what I am and what I am not saying.
I'm not saying that anything goes.
I'm not saying that it is okay to lie, to cheat, to steal, to
deceive people, to bully people.
Absolutely not.
But that's not what I'm talking about here.
But I'm also not saying that unfiltered emotional reactions are safe.
They're not, especially in an unforgiving system.
Being emotionally dysregulated at work doesn't work very well for you
or for anybody else, and it often disregulates others and then you
get this vicious spiral, don't you?
And it creates risk, but that doesn't make it bad or wrong.
It makes it information.
Your human reactions are information and they're pretty
automatic, so you can't help it.
That's the shift I want to offer from good to bad, to behavior that
works and behavior that doesn't work.
Because actually saying yes to everything, that doesn't work a lot of the time and
saying no isn't automatically selfish.
Sometimes saying yes is the least good thing you could do.
Certainly the least wise thing you can do, and certainly often
not in your own integrity.
And sometimes staying in a role that's not aligned with you, that doesn't suit
you, where you can't give your best, it's self punishment, dressed up as
professionalism and responsibility.
So here's a different definition of integrity i'd like to offer you.
Integrity is not about being good.
Integrity is about knowing your limits, telling the truth about your
actual capacity, not pretending you can do more than you can do, acting
in a way that you can stand behind, that means you can back yourself.
For me, integrity means saying what you mean and meaning what you say, and
repairing stuff when you accidentally muck up or something you've said lands badly.
And it's about not using moral judgment to beat yourself up for
being human being with normal human needs, urges and reactions.
Most doctors I know have thoughts they would never put in the notes
or never say in a meeting, let alone admit out loud to somebody else.
Now, that doesn't make you dangerous, it just makes you human.
And what matters most is what you do with those thoughts.
So when Mary Oliver says in that poem, you do not have to walk on your knees
for a hundred miles through the desert repenting, what I hear from that is this.
You don't have to overwork or sacrifice your own health and happiness
to make up for the fact that you feel that you are not good enough.
you don't need to overwork as a punishment.
You don't have to destroy yourself to prove that you care deeply about things.
And you don't have to suffer at work to earn your worth as a human being.
And side note, if you are suffering at work, You are not going to
be giving your best, are you?
It's only when we're really happy, we're thriving in our work that we are giving
our best, that we are actually then really able to do good in the world.
And you do not need to be perfect to do good.
And if we need a new definition of good, let me offer this one.
Good is being wise, it's acting with integrity, true to what you really
believe.. It's backing your wise self, and acknowledging your humanity and
your reactive amygdala reaction, and then working with it, not against it.
And that is not selfish.
That is how you stay in this work that you have to do without losing yourself.
And that's why these lines still give me goosebumps.
They don't let us off the hook.
They let us off the lie that being a good doctor is being good.
And maybe this is where You Are Not a Frog really comes in.
Because a frog relies on reflexes and instinct.
And it reacts 'cause it has to, it can't step back and
question it's froggy programming.
But you are not a frog.
You are a human being.
You can notice the beliefs that you absorbed in the programming that
was set from a very early age about goodness, sacrifice, and worth.
And you can decide, are these still true?
Are these still serving you?
So if this episode has resonated, you might want to share it with
someone else who's been living under that same pressure to be good.
And over the next week, when that familiar inner judgment starts to
show up, just see what happens.
And see what happens.
If you remind yourself of, I'm not here to prove I'm good.
I'm here to act with wisdom and integrity as a human.
And that's what matters.
Not how good you are, but how honestly and humanly you meet what's in front of you.
And you will find you know what to do.
You are not a frog.
And as Mary Oliver says, you do not need to be good.
You just need to let the soft animal of your body love what it loves to be human.