Leadership Listens 1 – The importance of compassion in medicine and the importance of self-compassion

This recording is a conversation between Michael and Dr. Alison Sykes, consultant in Emergency Medicine at Lancashire Teaching Hospitals and the conversation focuses on the importance of compassion in medicine and the importance of self-compassion.


Paul O’Neil [00:00:02] Hello and welcome to leadership listens, curated podcasts for leaders in health care. My name is Paul O’Neill, Head of Strategy, Research and Development at the NHS Leadership Academy, part of the People Directorate of NHS England and Improvement. This mini series of podcasts as part of Leadership Listens, is a series all about compassionate leadership. It’s a collection of conversations between Professor Michael West and a leader from the health and care sector. This recording is a conversation between Michael and Dr. Allison Sykes, consultant in emergency medicine at Lancashire Teaching Hospitals, and the conversation focuses on the importance of compassion in medicine and the importance of self-compassion. 

Michael West [00:00:54] Welcome everybody, my name is Michael West, and I’m delighted today to be joined by Dr. Allison Sykes. Allison is consultant in emergency medicine at Lancashire Teaching Hospitals, and the foundation programme director at Lancashire Teaching Hospitals for the North West of England School of Foundation Training and Physician Associates. Welcome, Alison. 

Allison Sykes [00:01:17] Thank you, Michael. 

Michael West [00:01:18] We’re going to be talking today about compassion and kindness in health care and the centrality of self-compassion and self-compassion in leadership. And so to begin. Allison, let me just say a little bit more about you. You started working I know as a consultant in emergency medicine in 2010, and your role as a foundation programme director at Lancashire Teaching Hospitals, is very much focussed on how to bring about change and improvement in placements for doctors in training; and also helping other doctors find a way to make it all work in these really challenging circumstances we face. And I think what’s particularly relevant to people is also, that you’ve pioneered the development and implementation of a compassionate leadership programme for trainees, and I know that you’re extending that to others. So I want to ask you obviously some questions about that pioneering work. But really, the first question is it’s a kind of an obvious question, but I think it’s important to explore it. Why is compassion important in healthcare and in medicine? 

Allison Sykes [00:02:27] It’s tremendously important for us as doctors because I think it is the essence of what we set out to be. It is why we went to medical school all those years ago for some of us, was to look after people, to care for people, and to help others. And that is what we are. We are compassionate beings and we know if you just look at the research, we know that children show compassionate behaviours at the age of 14 months. It’s what makes us human that desire to want to care for one another. And so when people set out on their journey in medicine, that is fundamentally why they went to medical school. It’s very important right now because I think at this stage that we’re at, we’ve lost sight of that. We have in some way become connected with what is a core value to be human. And there’s many reasons for that, in terms of the pressures of work, the current situation we find ourselves in. The lack of staff, but it’s about reconnecting with that core value of being compassionate, and we know it has hugely beneficial effects for patients, for staff and for us as individuals when we do reconnect with our core, which is compassion, which is to help and to serve others. 

Michael West [00:03:51] So you were saying that when people go through medical training, the evidence suggests that compassion in many cases declines. Is that because in a way we’re so concerned with developing technical skills, and memorising all of the information we need, and going through processes, that we we become focussed on doing rather than being in the relationship? Is it something around those sorts of difficulties that overlay our way of being? 

Allison Sykes [00:04:21] I think that’s part of it, Michael. I think we go through your medical training and you come out the other side as a doctor and the next thing that you’re looking to is. Which speciality am I going to go in? Which set of exams am I going to do? What of those skills and knowledge I need to achieve those things? And so you have this sense of forever being on the hamster wheel, there’s always another hurdle, after the first round of exams is inevitably more. And then there’s jobs to think of. Where do I need to locate myself to get the best CV for what will hopefully lead me to the right post for me as an individual? And in amongst that you do lose part of that connection of why we are truly there. But I also think there’s more to it than that. I don’t just think it’s about pursuing knowledge and skills. I think it’s also the sense of time, of what time we have available when we’re working. And as you’ve mentioned, I work in emergency medicine, so for me, if I see one patient, there are still probably another 10 waiting to be seen, at least. And not just for me. That’s the same for all of us. There is a huge time pressure to see a large number of patients in the shortest time possible. And you can end up just rolling from one to the other without pausing, without stopping to draw breath and even just reflect on what you’ve just seen and done. So you become hardened to it, I think. I think that’s definitely what happens. I was I was aware I was losing touch with my humanity. I felt like I was, I was just leaking my humanity out because I was always running from one thing to another. And obviously, people watch television programmes about doctors and casualty and things like that. But the reality is that you do have shifts where there’s one patient after another that’s coming through the resuscitation rooms are our sickest patients. They deserve and need our attention immediately. And you just have to go, you have to do it. And that’s right and proper that we do, so when we don’t have enough staff there is no opportunity to pause, to breathe and go phew, that was tough. And so I think you become a little bit hard and I don’t just think it’s about the the focus on skills and knowledge, although that is definitely some of it. We don’t draw attention to this as an area in the same way that we would talk about managing heart disease. And yet we know this is just as important. 

Michael West [00:07:00] So I think these are hugely important observations. I’ve been really impressed. Amazed actually by a review of the research on compassion in health care published by Trzeciak and Mazzarelli  in their book Compassionomics a few years ago, which basically showed us, I think, from the hundreds of randomised controlled trials and metanalysis that compassion across the board is the most important intervention in health care, probably. And you know, some of the studies showing visits by anaesthetists to patients prior to surgery, where anaesthetists are extra compassionate, much lower requirement for painkillers, post surgically and much shorter length of hospital stay. The randomised controlled trials of patients with an early diagnosis of lung cancer, who are given early palliative care, if you like extra compassionate care, living significantly longer, 30 percent longer and studies of the treatment of long term conditions like diabetes and HIV, where clinicians are compassionate, much better outcomes, much better adherence to treatment protocols. And in the treatment, of course, of mental health problems, therapies, compassion being associated with much better outcomes. And also, I suppose that well, a couple of things, one is the research showing that being compassionate has an impact on clinicians own well-being, lower levels of anxiety, stress and depression, but also that compassion doesn’t need to take any longer. That in some of these interventions, the protocols used scripts that involve compassionate statements that only took about 20 seconds. But the other point that you make, it seems to me hugely important, is the issue of staffing and workload. And I mean, that’s just a huge point in the current work context. And actually, it has been four years from before the pandemic, with hundreds of thousands of vacancies across both health and social care and very large numbers of staff intending to quit and the problems of chronic work overload, leading people to be absent, to be sick at work. And as you say, that that is having an enormous impact on clinician wellbeing, and that’s partly why we’re losing so many clinicians. So, you’ve also seen the impact of the pandemic, and can you say a little bit about what that’s been like in terms of the experience of you and your colleagues working in emergency medicine? 

Allison Sykes [00:09:29] I think it varied between the waves. I think it’s quite important to make that distinction, because the first wave there was a lot of fear. There was a lot of uncertainty and unknown for all of us. And there was also a very different message being sent to us about what we were going to do. There was a lot of reference to almost military terms about going into battle to a to an enemy you can’t see or hear or touch. And the first wave we, in our emergency department at Lancashire Teaching Hospitals, we actually retained our staff, so none of our staff moved on. So we kept everybody that we started with at the beginning of December, stayed with us for about eight months. And that was hugely beneficial and protective because we all knew one another and there was that herd sense. We, you know, we looked after one another and we looked out for one another. And certainly for us in the Northwest, the first wave was not as severe as it was in London, and we had time to sit with one another to debrief at the end of shift. So at the end of every shift, we would make sure that the outgoing team were able to talk about their experiences and to share that load. So the first wave was quite different to the next wave that we then got. So we got our second wave in June in the Northwest, and that was different. And then the third wave, which was the national second wave. Again, there was then the pressure that we had to catch up, we had to hurry up. There was work that hadn’t been done. There were long waiting lists. We were asked to commit to high levels of workload as an organisation, 120 percent. And that felt really different because suddenly you weren’t just coping with the devastation that COVID was causing to individuals, to families, to communities. You were also trying to cope with additional workload on top of that and catch up. And I think that was a far more damaging situation to be in for individuals, for people’s health and their wellbeing. And also, we were back on track. We were trying to do all the things that were normal. So our trainees were moving on. They were rotating back, which was right and proper for them. It’s right and proper. That training was developed and I want to make sure that I stress that point. But that meant that they were back to moving between different departments so that lengthy attachment was lost. We still instituted the same things, but when you lose team members and get new team members and then obviously it changes the dynamics and when you with somebody for a longer term, you have a deeper connection with each other. So, I think we’ve seen more damaging effects from those second and third waves than we did from the first wave. I think the first wave was hard for us in terms of adjusting to the environment that everybody found themselves in. You know, it wasn’t just health care workers that were struggling, it was everybody was struggling. As a friend of mine says the quiet pandemic, the mental health pandemic that’s going on as a result of the COVID pandemic. So that was hard for everybody. The second and third wave were hugely damaging, I think, for individuals, for staff because they’d got through the first wave. And if you’d had troops in some country or other fighting, then you would have rested them and there was no rest for NHS staff. There was no pause, there was no break. And in fact, it was worse than that. It was right. Come on, get on. We’ve got work to catch up on. We’ve got to deliver 120 percent. And you could almost see it in people. There was a – really you want more? And so that was more damaging and. And it’s sad, really, because it’s sad for those individuals that suffered, and it’s sad for the NHS, but it’s sad for communities because the result of that is that we lost the highest number of staff in December 2021 than at any other time. So more staff have chosen to leave the NHS now. And I do feel that if we done things differently, that wouldn’t have happened. But it has. We’ve lost people and that speaks volumes about where staff are at in terms of their health and wellbeing, levels of burnout and what they actually think they can now do what they feel they’ve got to give left inside. 

Michael West [00:13:53] And so what could have been done differently, Allison? 

Allison Sykes [00:13:56] For me, it would be about recognising where individuals were and acknowledging that, and I don’t think that there was never going to be a cavalry coming over the hill for the NHS. We all knew that. But we did need something else. We did need hope. We needed some way to, to find a way through. To not be asked to give more, but to be honest, to give what we could perhaps, and then to support staff and look after staff and that support and looking after staff needed to be timely. People shouldn’t have waited the length of time people have waited to get help when they’ve needed help for PTSD, depression, anxiety. It needed to be faster than that. It almost needed to be there at the same time as people were going through this so that they didn’t leave a shift having experienced moral injury and then take that home with them to then come back in eight o’clock the next day and go through it all again. But that didn’t happen. People came into work day in, day out. They delivered, they cared. They did what they could, and then they were burnt out. And it’s no surprise we are where we are. 

Michael West [00:15:03] I’m impressed, and I think it’s really important that in your department you have these end of shift huddles, if you like, where people could talk about what they had experienced and what they were feeling on a daily basis, that feels important. And I think the deeper point, an important point is that I think there is a real danger. There has been a danger traditionally, but I think there is a real danger still, even with the pandemic, that people are often reluctant to talk about workforce shortages and chronic excessive workload, partly because they’re anxious that they don’t have solutions for these things. In the middle of all of this Allison, you made the decision to introduce a Compassionate Leadership course for foundation doctors and physician associates. How did that come about? What was the motivation for that? I mean it’s a pioneering course in the country. 

Allison Sykes [00:15:54] Thank you for that, too. That’s that’s lovely. So it came about because I worked very closely with Professor Paul Baker at the Northwest of England School of Foundation and, and his view, what he said to me was, we are two steps away from compassionate leadership at foundation level. I want you to talk to Professor West about it. And that was how it started. And then we had our conversation, and I think it became apparent that if we accept that foundation doctors are more compassionate than at any other time in their future careers, they are the fertile ground to which we should apply this knowledge, these skills, this information to help them go on and lead the rest of us in being compassionate, almost a bottom up approach. So that to me, struck a chord that we should really be doing this for our foundation doctors. And then I looked more into where they’re at in terms of their health and wellbeing. I was quite surprised to hear that they also suffer higher levels of burnout than any of the training grade. So it seemed to me a perfect match. We’ve got high levels of burnout and we know they are probably the most receptive to this type of information. And so then with yourself, with Professor Baker and with the University of Lancaster, we started to develop the compassionate leadership course for foundation trainees, and we were able to start delivering that in May 21, which was great. And we developed an eight week course looking at several aspects of compassionate leadership, but also providing a reflective space where the trainees could talk to one another. They could exchange their experiences, their views, their solutions as well, because, as you know, I love my bees, I’m all for a hive mind of sharing information, and they were able to sort of explore the material to look at compassion as a state of being as a way of living their lives. And I think when we’ve looked back at the information that we’ve received in terms of feedback in the interviews, I’ve been absolutely amazed by what has come out from that, for them as individuals. And for me, I think it was the right thing to do, obviously. I still think it’s the right thing to be doing because I think they are our future. They’re the doctors that’s going to be looking after all of us. So, you know. 

Michael West [00:18:28] What’s the structure of the course then that you’ve developed, Allison? So thank you. 

Allison Sykes [00:18:34] We start with about an afternoon just looking at what compassionate leadership is. And in doing so, we’re looking at the principles of compassionate leadership, attending, understanding, empathising and helping. And we use a very reflective space so that they can try those things out, see how they work for them and experiment with them. We then move into self-compassion and we’ve found that that’s particularly difficult and challenging. So we’ve spent longer on self-compassion than actually we planned to do, but we’ve seen the benefits from doing so. So it was the right course of action. We then move into compassionate leadership in teams and across teams looking at our relationships with one another, not thinking of the I and the you, but actually about the we, and how we can move forward together to serve the common purpose, which is to care for those in our community that need our help. And then we look at compassionate leadership in difficult or challenging situations, and try to find ways to make that easier to cope with because those situations are not just damaging for patients, but they’re damaging for us as individuals. So actually, it’s hugely important that we find ways people can manage that situation and cope with it better. Ideally not end up there. But if it happens, then we look at that as well. And then we close by looking to the future, by how we can implement these principles in the way we go about our work. But as we’ve mentioned, it’s not just about our work, it’s about the way we interact with everybody, with our colleagues, with our friends, with our family. 

Michael West [00:20:14] So, so there’s a couple of questions, I guess, that arise from what you’ve said. I mean, it’s pioneering. You have done something really at the moment, quite unique in terms of the training of doctors. And yet it seems utterly obvious that we should be developing compassionate leadership for doctors. What were their reactions in the middle of this intense training that they’re going through in the middle of a pandemic? What were their reactions? What maybe was difficult for them and what was most important to them in the content of the training? 

Allison Sykes [00:20:44] It landed on many different levels for them all in different ways. We obviously held a very reflective space for them, which was. Very different to how a lot of medical education is delivered at this stage to trainees. So there was a little period of adjustment, didn’t take long, just a tiny period of adjustment for them to actually engage with that space. And then they flourished in it. And in terms of individual things landing for them, it was humbling to read one of our doctors attributing her staying in medicine as a result of the course. I had no idea that that was going on for her, that she was considering leaving. Yet the course gave her confidence and it gave her courage, and it gave her a different approach to how she would progress further in medicine. And she’s still working in medicine. And so we have that extreme. And then I have wonderful stories of trainees talking about working and seeing a patient unable to butter their toast, and him stopping and pausing and seeing this and going over and buttering this lady’s toast for her because she couldn’t do it herself. That’s just a wonderful connection between two people and acknowledging that we can do those things for one another. And that rippled out further. Just that little interaction between the foundation trainee and the patient was observed by a nurse, and the nurse said, I’ve never seen a doctor do that before, you know, and that then made him feel emboldened to try other things. So he went off and did different experiments. So when he was quiet, one of our sister departments is Chorley District Hospital, and they only open at 8:00 in the morning. And when there was no patients in at 8am, he helped the nursing staff do the nursing checks and really was sort of swept along on a tide of teamwork in a compassionate leadership way that was hugely beneficial, not just to him but to the team he was with. And of course, that then had an effect on the way that day went, which then impacted on the way the patients received the care. And we know that don’t we, from all the evidence that we read how just these small things can actually have massive effects and ripple outwards, which is it’s a wonderful idea, isn’t it? 

Michael West [00:22:55] So there’s a really uplifting examples, Allison. And actually what might be useful is if you just very briefly say what the content of the course covered and what do you think the most powerful part of the course was for the doctors? 

Allison Sykes [00:23:08] So it was really about the how and the what have compassionate leadership was what we set out to achieve over an eight week course, and we met with the trainees for an afternoon every week. That was partly to give them that space for reflection as well, so that when we talked about various aspects of compassionate leadership, they had a week to reflect on it, to think about it and to experiment as well. We encourage them to try things out, see how it felt, see what it meant to them and to others in terms of the actual subject matter that we looked at. So we initially spent the first session looking at what is compassionate leadership, what the aspects of it are, why it’s important not just for individuals but for themselves, not just for patients, but for staff as well. 

Michael West [00:23:53] So you covered those four behaviours of attending to the other understanding that challenges empathising and then helping. 

Allison Sykes [00:24:01] Absolutely. That was how we started. So bringing in what we term the principles of compassionate leadership with the attending, understanding, empathising and helping, and then we moved along into self-compassion again using the same principles. And, you asked me which was the most difficult and this was the most difficult for people. It was the most challenging to accept, to think about themselves compassionately, that that was definitely the hardest part for them. And I’m going to be honest and say for me and for all of us, that will leading in on the course, we are all still learning. I’m no expert on this material at all and very much a work in progress. So, um, so the self-compassion was the most challenging for everybody. 

Michael West [00:24:50] Why do you think that was? 

Allison Sykes [00:24:52] I think that as doctors, you come in to serve, you come in to focus on other people. You come in to care for the people. So to turn you direction towards yourself seems unnatural. And, there’s also the hidden curriculum around being heroic and stoic. We see it on television programmes. You hear it if you’re on the wards about how, you know, I’ve just worked the last 48 hours non-stop and I’ve done this and I’ve done that, the underpants on the outside, sometimes term that kind of behaviour. So there’s this whole heroic and stoic the hidden curriculum really about being a doctor, about how you can cope with all these things and survive them and keep going and see the next 400 patients, whatever. So there is that mentality around medicine, too. So a strong sense of altruism, the heroic and stoic behaviours that we have been immersed in. You know, from early days of graduation, if not before graduation, that affects the way people behave. So to turn compassion onto oneself is really going against the tide. That’s difficult stuff. And actually, that was born out by us recognising we needed to spend longer on that, perhaps than any of the other material we wanted to cover. And for me, it was fundamental to have a good bedrock in self-compassion because if you don’t have that, then trying to empathise without being overwhelmed will be incredibly difficult and perhaps damaging. So for me, you have to be moving in the direction of self-compassion to then be able to be compassionate to others, to then be able to be that compassionate being that is what you are at your core. It’s a wonderful thing, isn’t it? Because as a leader and I’m now thinking about when I’m working clinically, as a leader, if I show my self compassion, it’s enabling for everybody else to do the same. It sends a very powerful message and that helps other people see this as important for themselves. See it as something that they should be doing. 

Michael West [00:27:09] And I guess what feels really powerful in what you’re saying is that compassion is a way of being isn’t siloed in the sense. It’s not just about being compassionate to others who are providing care for. It’s also about compassion being my orientation to the others that I work with. And that compassion is also about my relationship with who I am with myself, and that in a way to develop our ability to be compassionate. It means that all relationships with others and with ourselves are characterised by that compassion of paying attention to ourselves, being self-aware and in the moment. And seeking to understand how I’m feeling and why. And accepting the feelings rather than rejecting them and then bringing a nurturing, loving attitude to ourselves. I suppose I think that that notion of having a loving attitude towards myself, a caring, nurturing attitude towards myself is quite a hard one for people because as you say, it goes against the norm that we would be loving towards ourselves. And yet each of us is as deserving of love as every other human being. And so I think when we are loving towards ourselves, then we’re more likely to take the actions that help us to be the best we can be. 

Allison Sykes [00:28:34] Hmm. I think that’s true. And I think when we started working with your material, Michael, we realised very early on that, that this wasn’t just a set of skills and knowledge. This was a way of being, and being not just at work, but in every aspect of our lives that it would ripple through and the self-compassion again. Absolutely, I agree with you. I think turning compassion on to ourselves is, it’s incredibly difficult, but it’s so important to do because if you’re not compassionate with yourself, then what other people see is not authentic. It doesn’t make sense. You become a paradox, don’t you, in that you are wanting to to be compassionate to everybody else, but you cannot give yourself that compassion. And it’s difficult. It’s not an easy thing to do. I’m not saying that this is something that I’ve got right. I definitely haven’t. This challenging time still for me to be compassionate myself. 

Michael West [00:29:32] And so how does self-compassion manifest for you? What do you do to be self compassionate? 

Allison Sykes [00:29:38] I think it’s important to make the distinction between self-care and self-compassion. I think there are things I do to look after myself regularly, which which will involve sort of exercise and diet and things like that. And and hobbies obviously are important. So as you know, I keep bees, so I in the summer will go and spend time out with my bees looking at them and and I find I can draw a lot from the world around me to the nature that I live amongst. But we have quite a wild garden and so we have quite unusual visitors. And I also like to be up mountains quite as often as I can. 

Michael West [00:30:17] What you’ve just said chimes wonderfully with all the research. Professor Sabina Sonnentag University of Mannheim, has done over the last 20 years on recovery from work, showing that people who have stressful work need to be able to recover. And the activities that enable recovery are things like engaging in activities that help you psychologically disengage. So you’re not just thinking about work all the time you’re thinking about other things the bees or a Netflix series that you’re watching, but also that it’s quite helpful to do tasks that give you a sense of effectiveness, some sense of achievement in doing something a little bit challenging, maybe the bees or cooking a nice meal or whatever. And of course, relaxation, meditation, those sorts of activities. And I was struck by her research showing as well that people need to be able to, outside of work, not just have another huge raft of tasks they’ve got to do, but they’ve got some choice about what they do in non-work time. And that work breaks are important not only for recovery, but also for safe patient care and obviously exercise. Her work shows that spending time in nature is astonishingly powerful for recovery, and there’s a kind of hierarchy of natural environments, with blue being at the very top lakes, rivers, sea, closely followed by green environments, mountains, hills and then a little way down urban green environments. But even being outside at all can be beneficial. So what you’re doing in terms of you’re taking care of yourself is very much mirrored in her work. And of course, we know that probably the most important factor in terms of human wellbeing is spending good quality time with the people we love and who love us, and that has a huge effect. And it’s also why compassion is so important. You were going to talk about a second area that you focus on in terms of self-compassion. 

Allison Sykes [00:32:19] So I get a lot of comfort out of those aspects that we’ve just talked about. But for me, the self-compassion starts by recognising that I need to do something. I need to change something or listening to myself to where I’m at. And so for me, there’s that first step of recognition, of knowing that my stressors, my anxieties are perhaps just on the boundary of what I can tolerate. To cope with that, I need to do something just to move away from that boundary or reinforce it a little bit. And quite often, I think for us in many different aspects of our lives. It’s not just applicable to doctors, but obviously that’s all I know about. But for us in healthcare, you do feel quite often that you can’t change some of the things. So you’ve mentioned chronic excessive workload and where we are at the moment, there’s nothing I as an individual can do to change that. So for me, recognising when that is too much, and knowing when I need to step back from it, and not spend the time coming home sorting out the washing and the ironing, but coming home and saying, I’ve got to go off the mountain today or I’ve, you know, there’s something else for me as an individual that I need, that I need filling up in some way. For me, that’s the first step is recognising that and accepting where I’m at with it, that there are things I can’t change, but I can change the way I feel about them so that I can choose how I cope with it, 

Michael West [00:33:55] Rather than just being impelled forward to working harder and harder, not having any respite. Mm-Hmm. 

Allison Sykes [00:34:02] Yeah. So I can choose what I do. So accepting it and stepping away and and taking that time to look after myself in whichever way that is, but not feeling guilty either. I don’t have to feel guilty about a day out up in the hills, so I have agency I think is what I’m saying. If Mike Perset, that was with me, one of my co facilitators, he would say, You’ve got agency. You can choose how you do this. 

Michael West [00:34:29] And that’s so important, isn’t it is the sense that we we have some control over all of this. I find the guidance that Tara Brock gets in her book on self-compassion really powerfully talks about an acronym of reign, and I think the first two steps are so powerful, so recognising what I’m feeling. Having the courage to be self-aware in the minute and to recognise feelings. Feeling overwhelmed, feeling guilty, feeling angry, feeling at the end of my tether. Feeling joyful, feeling happy. And then she talks about accepting the feelings, just just accepting it, rather than denying them or berating ourselves for having them or pushing them away. And those first two steps that involved the courage to be self-aware, recognising and accepting how I’m feeling, and then being able to enquire in the eye of reign into them so that I understand where’s this coming from? Why am I feeling like this this minute? To see it clearly and unpack it. Oh, I just had that difficult interaction with that person, which is left me feeling actually a bit hurt and then bringing a nurturing, loving, caring attitude to ourselves to say, you know, yes, this hurts. It’s hard and almost as it were, you know, metaphorically or physically even to hug ourselves. And then that makes it much more likely, as you say, that we’ll have agency and consciously take a choice to do something that helps us to be happier, the best we can be. Enable ourselves, as you say, by going up into the mountains for a day. So, Allison, what’s the one, maybe two things that you would recommend for leaders in healthcare? Doctors in health care? That they could do to embody, if you like or implement self-compassion, that would be most helpful for them. 

Allison Sykes [00:36:25] I think that was quite difficult because we’re all very different, aren’t we? For me, it was about connecting and, and recognising my connection with the world around me and and I live that through through beekeeping, that’s my hobby. But it’s more than a hobby. It is about connecting with the world. And if I can just explain what I mean by that connection by a lovely piece of science that I read last year about how a flower well hear and I put “hear” in inverted commas for me, and we’ll hear a be approaching and what it does that it releases, it increases its flow of nectar for the bee. What a beautiful picture of a connection of compassion, of help that we find in the world around us. To me, my bees are a hobby, but they’re also a connection with something far deeper, far greater than than just a high. 

Michael West [00:37:27] I was listening also about how daisies turned to the sun as soon as it’s there, they open up and turn to the sun and they get really warm temperatures in the middle of the flower so that when the bees come, they get warmed by the flowers as well makes it makes those daisies particularly attractive. But that lesson of interconnection I think of interbeing is in a way, the message at the heart of compassion that we are connected with each other and we are connected with the entire planet and universe, and that our growth, our happiness our fulfilment are all greater when we recognise and live that interconnection. 

Allison Sykes [00:38:10] I do agree. Absolutely. 

Michael West [00:38:13] Allison, I’ve got a question for you. How many hives have you got now? 

Allison Sykes [00:38:18] (laughs) I’ve got nine. 

Michael West [00:38:20] Okay, so my question is, what have you learnt from the bees that can help us human beings? 

Allison Sykes [00:38:26] Oh, absolutely loads. One day I’ll write a book about it. I’m compassion and bees. So for me, they’re a community. They are a perfect community in everything that they do is for one common good, and that’s to see them all through winter. So that is their primary purpose to care for everyone in the colony. And it is a magical thing to look inside a hive and to see them all working together. And when the bee comes in laden with pollen, just as an example, that the hairs on the bees legs are exactly spaced for dandelion pollen to sit one atom of dandelion pollen directly on. So when they come into the hive, they can’t get that off that off their legs. So think of the bees come in and they clear the pollen off and they put it into what we call bee bread, which then feeds the baby bees and life goes on and they all have a purpose. And that is to look after the whole, the whole colony of the community. So for me, that speaks volumes about, about how we could live our lives, thinking about one another and caring for one another. There are many other aspects, but I was aware I bore people after a while. 

Michael West [00:39:37] Not at all. Allison, it’s been just a joy and a delight to spend this time talking with you about the amazing work that you’re doing in the most difficult circumstances as well. So a huge thank you from me. 

Allison Sykes [00:39:52] Thank you very much for asking me. 

Paul O’Neil [00:39:57] I hope you enjoyed this conversation. Please look out for others in this mini series and subscribe to the Leadership Listeners’ Collection for more content like this. 

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