I first developed a stammer at the age of three. Apparently, my speech disappeared altogether for several weeks and, when it returned, I found it very difficult to speak and get a word out.
This remained the case throughout a lot of my childhood, particularly when at school and feeling under pressure to ‘perform’ according to others’ expectations.
Even buying a bus ticket felt an impossible task and I would often walk an extra mile just to be able to select a ticket price I could ask for more easily.
I’ve been desperate for ‘fluency’ so many times, and not being able to say what I’ve wanted to say has really affected my self-confidence and esteem through the years. I’ve felt great embarrassment and frustration at times, depression at my inability to express myself, feeling unheard and ‘inarticulate’.
Despite this, I’ve written this to encourage anyone with a stammer (or those connected to them) to go for your dreams however hard or impossible it may seem from the outset!
After completing a PhD in music psychology, I retrained in my early 30s and qualified as a medical doctor at Barts and The London Medical School (University of London).
I can’t pretend that studying to be a doctor is easy when communication is key to becoming a good clinician, but training and working in medicine has taught me that there is far more to communication than spoken words, and that being a ‘good doctor’ is dependent on a whole host of other factors unrelated to fluency.
The job can be challenging enough without a stammer; there is the obvious pressure to manage life-and-death and other emergency situations when the ability to communicate to others is paramount.
However, I have found that my focusing on the specific task in hand to ensure the patient receives the treatment and care they need at that point in time, in addition to attending to the person themselves rather than my inability to be perfectly fluent, has been instrumental to success, in addition to the faithful support and understanding from others.
It helps me to remember that even though I may not be able to ‘hold forth’ as confidently as my colleagues, this doesn’t necessarily mean that I lack a good understanding of a particular area of medicine or psychiatry (working now as a qualified psychiatrist).
Arguably, there are positive aspects to having a stammer as a doctor for which I’m even grateful. I seem more attuned to patients and relatives with their own speech difficulties in a number of clinical situations.
I’ve seen patients in emergency departments and on the wards finding it very difficult to speak after a stroke; frustrated, scared or even embarrassed at their lack of verbal communication.
I’ve seen patients who have a stammer of their own or talked with parents whose children have had their own speech difficulties and are finding it hard to understand and support them.
I’ve sat by the bedside of patients who are mute with severe depression. My own hesitations and blocks have often brought me nearer to a shared understanding and emotional reciprocity and lessened a tension between us.
My stammer has often served as a leveller; swiftly getting rid of any power imbalance or barrier that may be otherwise perceived.
In child and adolescent psychiatry, working with young people with selective mutism does not seem as challenging as it may do otherwise.
It’s certainly helped my being quite open about my stammer from the outset. I adopted this strategy early on in my training after finding levels of stress rising if a ward sister or my clinical consultant supervisor didn’t know about my stammer and I was caught in a block in a handover, or stumbling over giving a case presentation; trying to hide the difficulty from the start only made things worse.
I also took this approach when applying for my Royal College of Psychiatrists’ final practical clinical membership examinations last year; deciding to register my ‘disability’ from the outset.
I thought there would be little chance of my communicating ‘fluently’ throughout the all-day practical examination of 18 clinical scenarios played by actors. I’m thrilled to say that I passed all 18 stations and did stammer, sometimes significantly, but felt that I was judged very fairly for my communication and relational skills as a whole in a context of focusing on safety and risk.
Overall, I continue to see working as a doctor as a great privilege and calling. Without a doubt I would prefer to be fluent quite simply because it is a huge added effort to have to think about my speech all the time, but nevertheless I am hugely thankful that I can work as a doctor with a stammer in child and adolescent mental health.
Over and above everything else, working in this field means that I can give hope to others by demonstrating to my young patients at a very practical level that it’s possible to have dreams and obtain them after years of effort even if at the beginning it all seems an impossible struggle.
Sophia Williams is a specialty trainee 4 in child and adolescent psychiatry in London