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Change



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Somebody once advised me in my 20s that destiny is when luck meets preparation.

When I was younger, I used to think that you could prepare yourself out of any situation. But wisdom and events proved me wrong. I soon discovered that what you did yesterday though can affect today, and what can affect today can affect tomorrow. The only thing you can predict pretty comfortably, apart from death and taxes, is change. When I was younger, I used to think I could live forever. All this changed when I woke up newly physically disabled, after a six week coma on a life support machine on the Royal Free Hampstead. The National Health Service saved my life. Indeed, the on call Doctor who led the crash team the day of my admission, when I had a cardiac arrest and epileptic seizure was in fact a senior house officer with me at a different NHS trust in London.

This feeling of solidarity has never left me. I do also happen to believe that anything can happen to anybody at any time. I studied change academically in my MBA in the usual context of change management and change leadership. It’s how I came to know of Helen Bevan’s work. I’ve thought a lot about that and the highly influential Sirkin paper. But I don’t think I honestly ‘got‘ change until this year. In 2007, I was forced to change, giving up alcohol for life. I realised that if I were to have another drink ever I would never press the off switch; I would either end up in a police cell or A&E, and die. This is no time for hyperbole. It was this forced change, knowing that I had an intolerance of alcohol as serious as a serious anaphylactic shock on eating peanuts, that heralded my life in recovery. I later came to describe this to both the legal regulator and the medical regulator as the powerful driver of my abstinence and recovery, rather than a ‘fear based recovery‘ from either professional regulator.

But I feel in retrospect my interpretation of this change, as due totally to an externality, is incorrect. As I used to attend my weekly ‘after care’ sessions with other people newly in abstinence from alcohol or other toxins, or from gambling, or sex, I discovered that the only person who can overcome the addiction is THAT person; and yet it is impossible to read about this path of recovery from a book, i.e. you can’t do it on your own. So ‘command and control’ is not the answer after all. Becoming physically disabled, and a forced change of career and professional discipline, and a personal life which had become obsessed by alcohol, meant I had no other choice. I had to ‘unclutch’ myself gear-wise from the gear that I was in, and move into a different gear. But I did find my new life, living with mum, and just getting on with my academic and practitioner legal and business management training intensely rewarding.

In 2014, I attended a day in a hotel close to where I live, in Swiss Cottage. One of the speakers was Prof Terence Stephenson. After his speech, I went up to thank him. I found his talk very moving. He was later to become the Chair of the General Medical Council (GMC). I was later to become regulated once again by the GMC. Two lines of his has kept going through my mind repeatedly since then. The subject of the day was how sick doctors might get salvation despite the necessary professional regulation process. Stephenson claimed: “If you’re not happy about things, I strongly urge you to be part of the change. You being part of the change will be much more effective than hectoring on the sidelines.” This was not meant as any threat. And as I came to think more and more about this I came to think of how much distress my behaviour had caused from my illness, how I wish I had got help sooner, and how looking for someone to something to blame was no longer a useful use of my energies. I am now physically disabled. I get on with pursuing a passion of mine, which is promoting living better with dementia. But if there are any people who are worthy of retribution I later decided then their karma might see them implode with time. Not my problem anyway.

I now try to encourage others where possible if they feel that they have hit rock bottom; I strongly believe that it’s never too late for an addict to break out of the nasty cycle. If you think life is bad, it unbelievably could be much worse. I think businesses like persons get comfortable with their own existence and their own culture, but need to adapt if their environment needs it. I think no-one would wish to encourage actively social care on its knees such that NHS patients cannot be discharged to care, if necessary, in a timely fashion. I don’t think anyone designing the health and care systems would like them to be so far apart deliberately, with such bad communication between patients, persons and professionals. Above all, I feel any change has to be authentic, and driven by people who really desperately want that change. I think change is like producing a work of cuisine; you can follow the recipe religiously in the right order, but you can recognise whether the end result has had any passion put behind it. ¬†For me, I don’t need to ‘work hard’ at my recovery, any more. I haven’t hit the ‘pink cloud‘ of nirvana, but I am not complacent either. Change was about getting from A to B such that I didn’t miss A, I was in a better place, and I didn’t notice the journey. If I had super-analysed the change which was required to see my recovery hit the seven year mark this year, I doubt I would have achieved it.

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