LIFE DOCTOR

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IN THE film Parenthood, Steve Martin tells his boss that he needs more time at home with his problem son. So naturally the boss promotes a "tougher" rival over him. "I don't even know if he has children," explains the caring employer. "If this guy's dick fell off, he'd still show up for work." What isn't mentioned is that the dickless guy is probably kept afloat by a daily course of anti-depressants and a bottle of vodka.

Modern employment encourages us to compete against each other. To be more resilient, put in longer hours, to be more macho and uncomplainingly more "professional". The result: stress and isolation potentially leading to ill-health, physical and mental.

The severity of the problem among doctors has prompted a conference this month, Doctors Under Stress, organised jointly by the Royal Society of Medicine and Royal Society of Psychiatrists. The aim is to discuss ways of helping doctors to deal with and admit stress before it becomes a problem.

One speaker is Dr Elizabeth Armstrong, who suffers from manic depression. She has been well for the past five years but when she first fell ill, aged 30, her life was very different. "I was stuck up in Edinburgh, under pressure, in a job I didn't like. I had no social network. This was the trigger for my illness," she says. "One day, I just didn't turn up for work. Nobody rang to find out why, they just appointed a locum. They still paid me even though I didn't turn up for four months. Nobody said anything. The policy was `if she can't do the job, we'll get someone else'."

After a spell in hospital, recovery, and switching from neurology to less prestigious general practice, Dr Armstrong helped to set up the Doctor's Support Network. She believes it could be a model for other professions. The network is open to any doctor suffering from mental illness - including depression and eating disorders. There are now 200 members. A pounds 15-a-year subscription covers admin costs and the production of a monthly newspaper.

Members meet once a month and talk about their situations. There are normally between 10 and 20 people per meeting. "It's not a therapy group," Dr Armstrong emphasises. "People should be on the road to recovery. If someone is obviously not well enough to deal with the group situation, someone will talk to them alone. A lot of friendships build up. It is rebuilding the social networks that modern work culture is breaking down."

The key to the group's success is trust, knowing that they are not risking their jobs by talking. "One of the most important things with any self- help group is knowing that you're not alone," says Dr Armstrong. "Many doctors with mental illness do not join the group but say that just knowing it exists makes them feel better."

It's a way of stopping the free-fall. Instead of cutting yourself off, which is what happens so often with people who are afraid of losing everything if they admit to "weakness", you have a lifeline. "Talking in a group shows you that other people with similar problems have survived. You have space to think. You remember what's really important."

You can still pretend to be invincible during the day. Nobody need know. In fact you will be more able to convince your colleagues that losing your genitals would not make you late for work.

So, this week's homework: lawyers, engineers, hairdressers, start a support group. And when the journalists' group is going, give me the phone number.

Doctors wishing to contact the Doctors Support Network can e-mail: lizzie.miller@talk21.com

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