A few days ago, while covering a four-day stretch of on-call shifts, I was asked to step down from my usual role as a psychiatry registrar to cover a vacancy in the senior house officer rota. I have been in the United Kingdom for almost two years now, but during that time I have worked almost exclusively in community psychiatry. Although I had previously worked in inpatient psychiatry in Malaysia, including at two of the country’s largest psychiatric hospitals, I had very little experience of how an inpatient service functioned here. In fact, this was only the second time I had ever stepped down to cover the junior rota. I arrived at work more anxious than I cared to admit.
The handover book contained a long list of jobs waiting to be done. It soon became apparent that my biggest challenge was not clinical decision-making but navigating unfamiliar systems. I realized I did not even know where to find the admission clerking form on the electronic medical record, having never needed it before. So I did something many doctors find surprisingly difficult.
I asked for help.
I texted two colleagues. One was someone I had only met a week earlier during an educational event. The other was someone I worked alongside but rarely saw in person. Both replied as soon as they were able. One message simply read, “I’m glad you reached out.” They patiently answered every question I had over text. The following day, both checked in separately to ask how the shift had gone and whether I had made it through the night.
At around three o’clock the following morning, I found myself defeated once again, this time by the electronic prescribing system. Having not used it for months, I had forgotten how it worked. I telephoned the other house officer covering a neighboring patch. We had never met before. We had never even spoken. I explained my predicament. He laughed, not at me but with me, talked me through the prescribing system step by step, and before hanging up simply said, “Call me back if you need anything else.”
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It struck me afterwards that none of these colleagues would probably remember those interactions. To them, they had answered a few questions, taken a telephone call, and sent a couple of text messages. To me, they transformed an intimidating shift into one I knew I could safely get through.
Medicine often celebrates competence. We admire doctors who appear calm under pressure and who always seem to know the answer. Yet the longer I practice, the more I wonder whether one of the most important skills in medicine is not knowing everything, but creating an environment where people feel safe admitting they do not.
As doctors, we frequently encourage our patients to ask for help before they reach crisis point. We remind them that seeking support is a sign of insight rather than weakness. Perhaps we should remember the same lesson ourselves.
Asking for help requires vulnerability. Responding well to that request requires kindness. One without the other is not enough.
If people fear ridicule, impatience or embarrassment, they will eventually stop asking. In medicine, that is not simply a problem for the individual doctor. It is a patient safety issue.
Looking back, I realized that what sustained me that night was not simply my own training or experience. It was colleagues who quietly made it safe to ask questions without ever making me feel inadequate for asking them.
Those conversations lasted only a few minutes. They will never appear in my training portfolio, contribute towards my appraisal or be mentioned during my annual review. Yet I suspect I will remember them for a very long time.
Sometimes what sustains us in medicine is not a grand gesture or an inspirational speech. Sometimes it is simply another doctor answering a text message and saying, “I’m glad you reached out.”
Loshi Rajen is a psychiatrist in the United Kingdom.
