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And what a powerful word it is too. It provoked a huge range of memories – from the patients and colleagues they felt had been wronged, to the way ‘sorry’ can be a habitual statement for life’s inevitable shortcomings.
For the winner, Clackmannanshire GP Gyda Meeten, ‘sorry’ was not just a way of defusing a very difficult consultation but of finding out the real story behind her patient’s anger. Her skilful building up of the tension and atmosphere, and raw honesty about her feelings and misgivings, was what led the judges to award her entry first place in what was a very strong and competitive field.
Dr Meeten will receive £250 in John Lewis vouchers as her prize, as well as a framed copy of the specially commissioned illustration by the renowned illustrator Paul Blow.
Five runners-up will each receive £100 in John Lewis vouchers, plus a framed copy of their illustration. They are: London GP Alice Bell, former GP and freelance medical writer Louise Wiseman, South-east Scotland ST5 in anaesthesia and intensive care medicine Claire Adams, London clinical fellow in respiratory medicine Revati Naran, and NHS Practitioner Health Programme clinician and therapist Caroline Walker.
Their work will be published in the weeks ahead.
The judges – most of them doctors with a strong interest in medical writing – would like to thank all entrants for another excellent competition.
A GP consultation was spiralling angrily out of control, until one little word changed the temperature. By Gyda Meeten, the winner of this year’s BMA writing competition
Merely five minutes in, the consultation had gone seriously awry. Her words rushed towards me, a wildfire of rage. Every inch of her, from expensive-looking black high-heeled boots to honey-coloured highlights, was making it clear I was the worst GP she had ever come across. I began mentally drafting the complaint response.
I had challenged her alcohol intake, suggested this was contributing to her mood swings. I had ostentatiously totted up her red wine on my laminated unit calculator and turned it to show her the bad news. Technically I was absolutely right, but I couldn’t have predicted the frightening turn things had just taken.
How had I misread the situation so significantly? After all, was I not the ‘nice new GP’, rapidly building a reputation for being ‘good at mental health’?
Taking a ragged breath, I struggled to control my fight or flight impulse. Just moments earlier, thinking we were establishing a pleasing rapport, I had been doggedly moving down my tick list of items constituting a ‘good consultation’, diligently addressing lifestyle issues that might be contributing to her psychiatric distress. Now suddenly I was free falling. Failing. [GP communication expert] Roger Neighbour hadn’t prepared me for this.
There was a choice facing me, and like most decisions in a 10-minute GP consultation, a split second to deliberate.
Taking a ragged breath, I struggled to control my fight or flight impulseGyda Meeten
Should I stay calm and address the ranting? Or should I square up to her, given that I was at least four inches taller, had the big chair, the letters after my name? Even if my grey roots were showing and my boots were more scuffed than stylish, I had the moral authority. No one was checking how much red wine I got through in a week. I could demand she stop using that tone with me, hand her a copy of the practice leaflet detailing our response to aggression towards staff and usher her out of the door.
The words were out, before I could phrase them more elegantly.
The fiery tirade stopped. She looked me full in the face.
‘Sorry’ hung like a weight in the still air between us.
But then, in that moment, the dynamic between us shifted. We were no longer doctor and patient. We became merely two women, having a conversation.
That blurted, instinctive 'sorry' turned me from authority figure to human beingGyda Meeten
She began telling the story of a small, shy girl who loved books, who watched her father drown sadness in vodka, losing him for days, drunk or hungover. And then she cried, remembering how she had held her father’s hand in a white hospital room as he drowned in the blood pouring out of oesophageal varices into his lungs.
I’d had no perception of what pain lay beneath the ‘too much red wine’ I had so confidently, carelessly diagnosed; no comprehension of her terrible, latent fear that she would end the same way. All I saw was rage, all I had felt was hostility.
But that blurted, instinctive ‘sorry’ turned me from authority figure to human being. By acknowledging that I had got something wrong I had unwittingly opened a door for her to walk through.
That one unremarkable word became the key to working together to support the fragile mental health hidden by the glossy exterior.
In the years that followed, I was privileged to walk alongside her as she navigated the long shadows of that early trauma.
I have regrets about many consultations since those days of being the ‘nice new GP’. I’m sure I’ve missed many hidden stories over the years and sometimes dealt badly with conflict but I have never regretted saying sorry that morning or the years of connection which were unlocked by that small, simple word.
Gyda Meeten is a GP in Clackmannanshire