What can I say? By that I mean some combination of, what is meaningful for me to say? What is interesting to say? — And, importantly, what am I allowed to say?
”Allowed by whom”, you might ask. [a long pause] ”I am not sure”, I’d say, while inside my head a voice says: ”allowed by the regime”.
”What regime?!”, you ask, with some incredulity now. And now I really don’t know what to say for I don’t really even know what a regime means!
Wikipedia to the rescue. It defines a regime as ”sets of protocols and norms embedded either in institutions or institutionalized practices”, where these can be formal (e.g. states, universities, NHS trusts) or informal (e.g. a community of clinical academic leaders).
So I reply, ”Allowed by the norms and relationships that surround us, in the institutions and groups we represent – and serve. For I do take my agreement to serve as willingly given, and so I do feel committed not just to my own view but to the views we have agreed as a community.”
You look long and hard. Say nothing. Not sure if I see it in you, or if it’s just my own voice. My inner voice makes a mental reply: ”yes, I know it looks like I’m just a puppet. But it’s not like that.”Outwards I say nothing. Saying is futile. Silence is better. And anyway, I know by now that it’s enough that I know what I am – am confident my judgement is solid.
Yet, a very rapid internal cycle of sense check. Just as a safety mechanisms. Yes, I’ve had to adapt, and yes it’s often a narrow path. But no I don’t feel it has made us conformist. I firmly feel I remain always honest. So I tick that box. Continue the safety check. Yes, I do still believe the best option is to work from within. Check that box too. End the cycle with a mental note to repeat the check again, in not too distant future. Just in case.
Cabinet responsibility. Support the motion. Or resing. Important to always be willing to walk away, give it all up. This seem (impossibly?) hard at times. But. It is also incredibly helpful. It makes speaking truth to power easy. For it’s that or to walk away. It’s acting conciously. Much consideration.
Important to be very clear on values. And how to enact them in everyday decisions and behaviours. To retain integrity. Fortunately, millions of small situations of practice over the years. How to keep thoughts straight, and to listen to feelings as well as the reason.
”What in the earth is all this?” you may eventually ask. A pause. Then, just to say something, I reply with one of many possible thoughts. Just to illustrate the internal struggle. ”No senior NMAHP has agreed to write on this blog, ever (if you are reading and willing – msg me!). Even when I’ve offered to keep them unidentifiable.” I shrug.
I’ve begun to realise how it can be really hard to find the thing to say. Yet, I’m leaning towards a view that we must continue to try.
Clinician Academic 