The Virgin Money London Marathon of 2017. I reached the finish line! My time was 4.29.06 (4 hours, 29 minutes, and 6 seconds). I am elated, triumphant, glorious.
My victory rests on 6 months of hard slog: miles of running, hours of strength training, money spent on new kit, physiotherapy, and food. And the endpoint? Four and a half hours of running. A similar amount of time to my Monday morning on-call session at Moss Valley … which gets me thinking.
The marathon was a huge personal challenge for me. I wanted to see what I could achieve if I pushed my body enough, and I resolved to do my best. Being a GP is a huge challenge and I want to be the best that I can be; indeed, I want to always do my best. But what were the things that helped me pass that finish line? And are any of these transferable to my work as a GP?
RUNNING DAYS AND REST DAYS
For my marathon, I followed a clear training plan. This plan had running days and rest days. The rest days, I am told, are as important as the running days because they allow my muscles time to rest, recover, and to grow stronger. Too much running without enough rest leads to exhaustion and a decrease in performance. Roger Neighbour has done a thorough job in instilling in us the need for ‘housekeeping’ to enable us to function at our best.1 Too much work without rest also leads to a decrease in performance, a well-recognised phenomenon.
Each week I was pushing my body harder and harder. I felt exhausted and was at risk of injury. At these points I was advised to cross-train — try something different: swimming, cycling. This increased my ability to work out and train, but didn’t push me too far. In the same way, variety in our workplaces can extend our ability to function.
AFFIRMATION AND ENCOURAGEMENT
When I ponder on what really got me through, to mile 23 where my legs were heavy and my body tired, it was the crowd and my support crew who gave me the motivation to continue. Along the whole 26.2 miles there was not a viewing point unfilled. The crowd cheered and whooped, yelling good wishes and showing respect to the runners. I crossed the line, having given it my all, and was greeted by affirmation and encouragement; I had done my best and the support acknowledged this. Within general practice I also do my best. However, I am rarely greeted with affirmation or encouragement. Currently, the work I do just seems like it’s not good enough. I could not have run the marathon any faster but many other people did! There were 20 000 people who finished ahead of me. I was average, but I had done the very best I could with the body, time, and energy available to me. And I was greeted with such affirmation I felt like royalty.
Now I’m clearly not saying that I need this amount of affirmation to complete my day job. But, currently, I am greeted with grumbles and dissatisfaction. Is it possible for me to engage my practice population in the challenges of a Monday morning surgery? Is it possible for me to communicate the challenges to them and encourage them to also play their part? Their part lies in a commitment to self-care or a recognition that we are doing our best.
AVOIDING BURNOUT
Not all the runners made it over that finish line. Too many people had pushed themselves too hard and had to stop due to injury or exhaustion. In general practice this feels like an apt analogy and many are nearing burnout. I wonder if more rest, variety, encouragement, and acknowledgement that we are doing our best, and can do no more, would help us to reach our goals and maintain our peak performance as GPs?
I for one am going to use the lessons learned in marathon training in my working life as a GP. Better to cross that finish line smiling at a slightly slower pace, than to fizzle out halfway round.
- © British Journal of General Practice 2017
REFERENCE
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