“I can be changed by what happens to me. But I refuse to be reduced by it.”Maya Angelou
I would like to consider myself a reasonably resilient person. On the Resilience Assessment Questionnaire (RAQ), I scored a 147 (/175), which should be a significant number to those of you who like snooker. That doesn’t for a second mean that I haven’t at least considered throwing in the towel on a number of occasions. Sometimes, things seem insurmountable, and I’ve had to take a step back, gather my thoughts, remembered why I was trying to achieve something, and who I was doing it for.
Here’s the thing. How do you speak about resilience without almost wishing that you had Baz Luhrmann’s “Wear Sunscreen” reassuringly playing in the background? Most of us think of it along the lines of the ability to bounce back, to bend but not break, and perhaps even to demonstrate personal growth in the presence of adversity. The American Psychological Association defines resilience as “the process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of stress…” These reactive analogies are useful, but they don’t reflect our own unique, complex, innate biology, nor do they explain the social, culture, and psychological determinants which influence our responses. Truth be told, resilience is an incredibly personal experience, and dynamic, and something you can’t really contemplate until you face these challenges.
Business attempts to distil resilience into actionable points. Companies use these then to develop long-lasting systems using terms such as redundancy, diversity, modularity, adaptability, prudence and embeddedness. They talk about investing in procurement as a protective factor. The Global Workplace Study (2020) of resilience against COVID-19 illustrated a couple of unexpected, but important findings:
- Resilience is a reactive state of mind created by exposure to suffering
- The more tangible the threat, the more resilient we become
From an industry perspective it all boils down to three things: Routines, Simple Rules, and Improvisation. One cannot predict geosocial or economic, or even pandemic-related upheavals. However, through simulation, altering routines, using heuristics, and improvisation, leaders can build organisational resilience, much like hospitals simulating trauma/infectious disease outbreak protocols, or military personnel preparing for missions.
I’m used to being told “no”. That’s generally what happens in the health service. I’m used to models of poor behaviour and leadership which set things up for failure, and I had always taken the approach to barriers as I would have on a rugby pitch: at top speed. However, the closest I had ever gotten to not being able to find a solution was in the first couple of weeks in Canada after bringing the entire family over for my fellowship. We were in a strange country famous for its bureaucracy, on our own and floundering, looking for some normality, and something to go right. It may seem strange, but a surgical fellowship is not arranged, it’s facilitated. You bear the full cost and hassle of moving, visas, accommodation, schooling, licensing, social security, insurance etc., of which only a tiny amount can actually be carried out before you emigrate. It was outside yet another unconstructive government office appointment, soaking in a thunderstorm with 3 crying kids, that I looked at my wife Sonia, and said, ‘I don’t think I can do this anymore.’ The consequences were enormous, but she looked at me and smiled and said she’d support me no matter what. That we were a team.
Long story short, we didn’t go home, and we made things work. Coming home to Ireland in 2020 from Toronto in the middle of COVID-19, we faced 8 cancelled sets of flights, having nowhere to live (our house still had tenants in it), and not even being sure if I had a job as I hadn’t formally signed a contract, and yet we knew that together through perseverance, grit, or just blind faith, something would just work itself out. Routines (Continue with work, and homeschooling. Keep looking for flights and animal transport. Keep in touch with friends, family and hospital back home). Simple Rules (Keep talking and communicating. Accept frustration . Don’t over-finance for potential flights. Don’t worry the kids. Don’t give up). Improvisation (Be willing to travel through any airport. Don’t need to necessarily travel with the dog. Might have to stay in Canada. Could potentially go to the US. Might need to split flights. May need to work in a random locum job as a non-consultant doctor if necessary).
I’d like to think that I’ve become more resilient as time has gone by, and I fervently believe resilience is something that you can learn. Only a couple of week ago, my middle son had to be rushed back to the operating room for a bleed 5 days following removal of his tonsils and adenoids. We were in the middle of the end of year exams during this unpredictable situation, and yet my experience, and knowledge of similar situations, allowed me to acknowledge the crisis, and a plan of how to work around it.
I would study and write in the hospital room, and do shift changes with my better half. I understood that emotion and concentration would both compete for my time, and that each would have to be (metaphorically) fed in order to allow me to function. Furthermore, I knew that I could afford to work at 70-80% and still be reasonably productive. Routines (Continue with non-movable items like the school run, kids’ dinner, bedtimes, work commitments). Simple Rules (Allow for emotion, understand and accept that productivity will temporarily decline, eat, spend time with the kids, respect deadlines). Improvisation (Work in the hospital rather than at home, relay shifts between home and hospital, have friends and family on standby [COVID-permitting], move non-urgent work meetings and clinics).
There have been many other moments, but again, it’s personal. How can I compare my experiences to others? For some resilience is based on chronic low levels of adversity and stress, for others it may be based on single life-altering events. I think I’ve had it easy compared to some of my friends–or is that just the resilience speaking?
At an individual level, resilience has been shown to positively influence workplace satisfaction and engagement, improve overall well-being, and reduce levels of depression. Importantly however, it is also positively affected through strong relationships and networks within our own lives. These can modulate our perception of the demands placed on us, and help us see a path forward to persist: much like my wife did in that stormy day in Ottawa.
Conflict, adversity, and failure are inevitable. They can appear to the unrehearsed mind like raging infernos. The crux is therefore how to manipulate those fires to ignite you, rather than consume you. You don’t need to carry that burden alone.
—Fardod O’Kelly, MD, EMBA Class of 2022