Judy Garland’s was not a happy life.
Last week I went to see Renée Zellweger in ‘Judy’. It’s a remarkable performance in a film that portrays Judy Garland during the visit she made to England in 1969. This was towards the end of her short life which ended tragically early as a result of her taking an accidental barbiturate overdose when she was just 47 years old. It reveals the effect on her of having been driven to succeed for the benefit of others, compelled to be what she may not have chosen for herself, and controlled by some to such an extent that they even decided for her when she was allowed to eat and sleep.
The mental breakdown that followed was surely inevitable. At one point she was asked whether she had ever taken anything for her ‘depression’. She replies ‘Four husbands – it didn’t work’. It’s not all she took – alcohol and a combination of the uppers and downers she was first plied with as a child fared no better in relieving her unhappiness. Paradoxically perhaps, the only place she seemed to be happy was the place where her success had taken her, on stage, in front of the audiences that loved her.
But such happiness was only ever short lived. After the success of her opening night’s performance at London’s ‘The Talk of the Town’, Rosalyn Wilder, her personal assistant at the time, congratulated her and tried to reassure her that she was going to be alright. Garland replied, ‘But what if I can’t do it again?’ In a life where she had been shown little love, she needed the love of her audience but knew that this was always dependent on her constantly delivering what those who came to see her wanted. She was right to be anxious. One night, arriving on stage late and the worse for too much alcohol, the crowd turned hostile and pelted her with bread rolls. Their love was not the unconditional love that she yearned for and needed.
The unconditional love that we all yearn for and need.
There were, however, those who did seem to truly care about her. A couple of ordinary fans might seem an unlikely pair for an international star to have been drawn to, but her fondness for them becomes wholly understandable when it is seen how their genuine affection for her allowed her to be her true self. Interestingly, it was only when she broke down on stage, revealing that true self and exposing how she was really feeling, that real compassion flowed to her from her audience. Only then, as the star became an individual, did the barrier between her and her audience finally come down.
I’m not sure that Judy Garland really knew how she ended up where she did, or that where she ended up was where she ever really wanted to be. So manipulated was she by the world she found herself in as a child that, once she had entered it, she ceased to be who she really was. Some of us may feel similarly. Boarding the conveyer belt of medical training at an impressionable age, we have been controlled by the system much of our lives, even to the extent of being dictated to by the demands of the job as to when we can eat and sleep. Whilst many have survived this ordeal, and have found satisfaction and happiness in medicine, too many have not and, to their detriment, have been left to struggle on, disillusioned and unhappy.
In such circumstances, I wonder, how we cope with not being the person others demand that we are? More importantly perhaps, how do we cope with not being the person we demand that we are ourselves? Not being able to be the person we long to be, how many of us, like Judy Garland, find ourselves asking, ‘Why, O why can’t I?’.
The answer may reveal why we respond the way we do to complaints, however trivial. Might our self esteem be so easily shattered because that self esteem has become too fragile, too dependent, after a lifetime of having to please others, on having to please everyone? Likewise, might not the anxiety we feel as our appraisal approaches result from our having constantly been driven to perform at ever greater levels? The need for us each year to show improvement comes with the inherent implication that last year we were still not good enough. We must, we are told, do better.
And so we strive all the more to satisfy those who demand from us, driving ourselves on in the vain hope that if we could only be the better people we are told we ought to be, all would be well.
Over the summer, as the Ashes series drew to a close, I watched ‘The Edge’, a film that chronicles the England cricket team’s climb to the top of the world Test rankings. What became apparent was not only how hollow the team’s success felt to many members of the squad when it was eventually achieved, but also how costly it was, in terms of the adverse effect on the mental health of a number of the players, when winning became mandatory.
We live in a world which encourages us to follow our heart and promises us that, if we want them to enough, our dreams will be fulfilled. This is a dangerous philosophy to follow since it is simply not the case. We need to wake up to the fact that our dreams will not necessarily come true and that, as for Judy Garland and a number of the England cricket team, too often those dreams become a nightmare.
The emotional well-being of medical professionals is no more important that that of patients, but neither is it any less. And just as patients will not be helped by being burdened with the unrealistic goal of being responsible for their dreams coming true, neither will those in health care be helped by increasing demands being put upon them to be perfect. An insistence that we should merely increase our resilience to cope with what is unreasonably asked of us is tantamount to being told to ‘come on and just get happy’. The justification for this, that ‘when we’re smiling, the whole world smiles with us’ may well be true, but thinking like this results in too many of us putting up with a situation we long to escape, imprisoned by a desire to be needed and seen to succeed, whilst having to resort to medicating ourselves just so as to get ourselves through the day. And when that fails, too many of us are left crying and, what’s more, crying alone.
None of us are unaffected by our past. Many of our patients come to us struggling as a consequence of hugely adverse circumstances in their childhood and subsequent lives. Some do not understand how they got themselves into the situation that they now find themselves and look to us for help to escape. Some of us in medicine are no different. We too need to be able to drop the facade of our professional image and be honest about who we are so that we too can receive the same compassion and understanding as our patients.
Patients and medical professionals alike, we all need be shown, and show, a little kindness, a little understanding, a little grace – grace that accepts the limitations that we all need to be honest enough to acknowledge that we have, grace that does not demand from us now what we can never hope to give, and grace that frees us to grow into the people we were truly meant to become.
But does such a gracious world exist? Or is it, like the elusive pot of gold that is always just out of reach, only to be found somewhere over the rainbow?
Let’s hope not.
Two further posts which to my mind form a trilogy on the subject of burn out follow:
For some related thoughts on the film ‘Joker’, click here.
For some thoughts on when responsibility for poor outcomes lies with us, click here.
Other related posts:
To read ‘Wither tomorrow?’, click here
To read ‘The NHS Emporium’, click here
To read ‘On Approaching One’s Sell By Date’, click here
To read ‘General Practice – is time running out?’, click here
To read ‘Friday, Bloody Friday’, click here
To read ‘On being overwhelmed’, click here
To read ‘On Not Remotely Caring’, click here
To read ‘Contactless’, click here
To read ‘An Audience for Grief’, click here
To read ‘Vaccinating to remain susceptible’, click here
To read ‘Eleanor Rigby is not at all fine’, click here
To read ‘The Abolition of General Practice’, click here
To read ‘General Practice – still a sweet sorrow’, click here
To read ‘The Life I Lead’, click here
To read ‘When “Good enough” isn’t good enough’ click here
To read ‘Something to reflect on – are we too narcissistic?’, click here
To read ‘Too busy to be happy?’, click here
To read ‘The NHS – the ‘S’ is for service, not slave’, click here
To read ‘On keeping what we dare not lose’, click here
To read ‘Bagpuss and the NHS’, click here
To read ‘Health – it’ll be the death of us. Is there institutional arrogance in the NHS?’, click here
To read ‘On being crazy busy – a ticklish problem’, click here
To read ‘From A Distance’, click here
To read ‘I’ll miss this when we’re gone’, click here
To read ‘Don’t forget to be ordinary, if you want to be happy’, click here
Some musings 
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