Friday, August 31, 2018

Language Matters…Universally

As a healthcare professional, there is no question about the issue of Language Matters- or indeed my personal belief in it. Started by the indomitable Renza along with Jane Speight - the further dedication to the theme by Jane Dickinson bears no debate about its relevance - and research as funded by NHS England and expertly marshalled by Cathy Young and Anthea Wilson has shown its importance in patient care too. Personally, my staunch support to it is well documented and a subtle, yet important difference between the Australian and American work on this and the UK one is the relevance of the national body leading on this with patient organisations- rather than the organisations leading it. We are proud of the work done, the steer given and the collaborative work across all sectors which has got us here. 

However, something has started to gradually come sharper into focus. It started as gentle conversations with fellow HCPs about the pressures they face, the language sometimes they face and what impact it had on them too. Recent forays into some patient social media groups has been interesting- no question about the educational element to it but also the realisation of the sharp context of some words and how that would land with me- if I knew that particular point was about me as a clinician. There's also the issue of conversations amongst those living with diabetes and it has left me intrigued, maybe a bit chastened to realise that the whole issue of "language we use" is perhaps not just about HCPs, but about all of us. 

Let me give you three examples. The first one was about the PM, Theresa May. Whether you agree with her politics is a personal issue for us all in a democracy but that shouldn't extend - in my opinion- to " I wouldn't wish anyone a DKA, but with her, I wish she does". It made me wince given that it was from another person with type 1 diabetes- where indeed does the language stand in this situation? Our political allegiance wants someone to go into ketoacidosis? Imagine a healthcare professional saying that...quite rightly, they should be censured for that. What about those who aren't? It's an intriguing space - mixed in with the lethal way as to how social media sometimes functions- but adjoin it with "Language Matters"...and we suddenly have a conundrum.

The second one was about a nurse colleague. Words used to describe here were "fat", "ignorant", a use of the "c" word and a follow up from others joining in to laugh at this particular HCP who should eat "less carbs", "wish she gets diabetes"...and some other interesting comments. All from those living with diabetes. Perhaps a reflection of a frustrating consultation or indeed the person concerned not feeling being listened to- but how does that translate to those sort of language in a public forum? After all, flip it around...unless you live in a parallel universe, the pressure on HCPs in the NHS is huge, the staffing issues are paramount- and in the main, most are going above and beyond what their designated jobs are. How would that HCP feel if she read those? What impact could it have on her well being, her motivation etc? Intriguing space indeed- and I do tend to see a fair bit of how it was the HCPs to blame for X,Y and Z. If we want to move to a culture of no blame, then as much as we don't castigate a person living with diabetes for anything, the reverse also perhaps needs to be true. HCPs are human beings too- and words matter. To many? It's not just a job, it's much more than is indeed their vocation.

The final example was which I saw recently- the Gary Mabutt story about rats- and I must admit to raising an eyebrow. On one hand, it could have been a misquote and media looking for a sensational headline ( on this case, it wasn't); on the other it is his story to tell anyway he wants. His view perhaps would be to use this as an example to raise awareness of the issue...the question I had where that leaves a HCP. I have never practiced shroud waving to any patient of mine- neither am I to start- and frankly I don't think it works. Chris Aldred work on this strikes the right chord and is something to explore more indeed for HCPs- but given Gary said his story like that, how does it pan out for others? How would a 6 year old child read that? Or their parents? 

How would it work if HCPs use that as an example? Can they? Should they? I must admit to having no idea whatsoever. It also opened up a new avenue for me- seeing the view from Gavin Griffiths on it- and the subsequent response from others within the #gbdoc community and wider. Was this a case of stopping folks voicing their opinion in a democratic society or wasn't it? Some of the comments against him made me wince and have a wry smile- as frankly Gavin's commitment to improve care or raise profile of Type 1 diabetes is above any doubt in my book. He was voicing his opinion- but the response? Fascinating indeed.

So to be honest? I don't know much about what is the right answer to this- and I suspect I will always be a Muggle in the #doc - and rightly too- I don't live with diabetes- and there are aspects I will never get. But if there is a gentle request from someone who tries his best to bridge the 2 worlds, my appeal to all is simply this. Language matters all the time. Whether it's from HCP to person living with diabetes- or between folks living with diabetes- or indeed the other way around.

In a nutshell? Words matter. However resilient we all are, we all have a breaking point, we all have chink in the armour which breaks the barriers. In today's world, asking for kindness to each other is perhaps due to fall on deaf ears but maybe a moments pause before hitting the "post" or "tweet" button won't do any of us, including me, any harm.


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