End of the school term just before Christmas- guarantees several teachers will make an appointment at the surgery. Common symptoms are excessive tiredness, poor sleep, general aches, and respiratory infections. In teachers hoarseness is a frequent feature. This is called laryngitis and the treatment is simple; rest, paracetamol and no talking-or singing for that matter in the school choir.
However it is worth enquiring a bit deeper as the symptoms may be a sign of stress.
Jane consulted me this week with hoarseness. She had been a primary school teacher for 10 years. Routine questioning confirmed a viral laryngitis. But when I added a simple additional question, ‘How are you coping?’ it resulted in floods of tears. The truth was she had not been coping for a long time. She was stressed and exhausted. She is worried about her job, is lacking in self confidence and sleeping poorly. When she started her job as a teacher she loved it. However recent changes has altered the job beyond recognition. There is more paperwork, target setting and expectations of her are much higher. Many children seemed out of control.
This made her angry, depressed, and frustrated all at the same time. But most of all she was mentally and physically exhausted and now did not really care anymore.
This sounded like burnout and it is quite common in the medical profession too.
So what advise to give her? She needs to begin first to care for herself. Do the things she enjoys doing, and do more of it- walking, meeting friends, listening to music, relaxing. The Christmas holdiday may not be long enough. She needs help and support at work and at home.
I have asked Jane to come back and see me before she goes back to school to discuss what else we can do, and decide if she is fit to return to work. It my experience she will need counselling, support and perhaps anti-depressants over the next few months. It would be sad to see her leave the teaching profession -I hope it does not come to that.
An article in the BMJ in November showed how counselling helped doctors with burnout.
Interestingly, in homeopathy, this lady would be likely to be prescribed Causticum: one of the key remedies for exhaustion in over-caring or sympathetic people, and the classic remedy for hoarseness in those who use their voice a lot - called 'clergymen's throat' in the old texts. Causticum is also a great homeopathic remedy for depression generally, especially if stemming from a feeling of powerlessness, or 'it's not fair'.
ReplyDeleteBut it doesn't matter whether the therapy is homeopathy or something else - this lady is fortunate indeed to have a GP who understands that her hoarseness is simply the tip of the iceberg, and a focal point for all those emotions.
As soon as you enquired about her hoarseness, she 'spoke her truth' and told you all about the upset that lay beneath. Hopefully, now that she has had a chance to be heard, the discomfort in her throat centre will start to heal!
Great blog, Craig. Wish my GP had such a holistic approach.