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Energy-giving vs Energy-depleting – Nishma Manek

Energy-giving vs Energy-depleting

Nishma Manek

Your inspiration and motivation are clearly off the scale and contagious! How do you cultivate these?

Thank you! I’ve not really thought about it before, but I suppose it comes from 2 choices.

I think most things we choose to do fall on a spectrum from energy-giving, to energy-depleting (think Dobby vs Dementor, if you like a Harry Potter analogy!).

I choose to do things that give me the most energy. For me, it’s those things that I wholeheartedly believe will make a difference. I’ve always been struck by the quote: ‘we do not inherit the earth from our ancestors, we borrow it from our children’. That might sound a bit trite, but it really makes me think about what I can do to leave things in a better state for those to come, however small. That’s where I focus my time…so staying inspired and motivated a lot of the time doesn’t feel that hard.

Secondly, I purposefully surround myself with people who are also contagious in their inspiration and motivation! I think we are a product of the people we choose to spend most of our time with (and the things we listen to, read, watch…). It’s a bit like choosing your radio station- you can be aware of other channels of fake news and negativity, but it’s up to you to decide what background noise you tune into every day. And that can have a huge influence on your energy and inspiration.

What’s the big excitement about general practice? I sometimes wish I’d done it – can you sell it to my 24-year-old former self?

I could talk for hours about this!

So, a GP once said to me: ‘In the hospital, diseases stay, and people come and go, and in general practice people stay, and diseases come and go’. That really sums up the essence of general practice for me. What I love most about GP is being a part of people’s stories, even if it’s just listening to them. It’s a total privilege.

General practice also feels like one of the last bastions of clinical medicine.  That challenge of dealing with uncertainty, having few tools at your disposal, formulating a plan- that feels like real medicine to me.

Finally, the degree of flexibility to shape your own career and control your own destiny in general practice is virtually unparalleled. I’m not sure I appreciated that when I started out, but I’m much more grateful for it now- and that’s something I’d point out to my own 24-year-old former self.

Tell us a bit about the leadership programme you run. What is Next Generation GP?

In 2016/17 I was a Clinical Fellow to the National Medical Director at NHS England.  A couple of months into the role, I had a sense that this was going to change things for me and my leadership aspirations in a way I couldn’t even articulate at the time. I knew I had to find a way to bottle the best bits and share it with more young leaders. That’s how Next Generation GP was born.

In short, it’s a free leadership programme aimed at trainees and new GPs. Each programme consists of a series of evening events over 5 or 6 months. The first half is a workshop about a topic about leadership or the wider system (e.g. the structure of the NHS, influencing skills), and the second part is an interview with a senior leader.

It’s grown at a pace that I could never have predicted, which I think proves there is a real appetite amongst my generation to improve things and contribute to the future of primary care. Our team has expanded to over 50 young GPs who are doing a fantastic job in helping me to lead it across the country. The programme is now in 20 cities with more than 1200 participants, and we’re still growing.

I’m seriously overwhelmed as I travel through London daily with the plight of the homeless. You are clearly committed to caring for and advocacy for the homeless. Why? Any suggestions of what we should do as individuals?

I spent a long time feeling overwhelmed and helpless like you when I walked past a homeless person.

A few years ago, it got to a point where it would hit me so heavily that I had to stop. People on our doorstep have life expectancies in the mid-40s. In a country like ours, how can that be right? I realised that I had to do something, anything. Even having a conversation with a homeless person was a start. Surely that was in my power to do? Trying to think about tackling the complexity of homelessness paralysed me- but one conversation I could manage.

There are some things in life you do because you know you will look back one day and regret not taking that first step. For me, this was one of them. I’ve spent the last few years volunteering for a few different homeless charities. Mostly this means spending time in homeless shelters just listening to guests.

Some days I think I’m not even scratching the surface in terms of tackling such a big problem. But every now and then someone will tell me a story that adds another jigsaw piece to my understanding of homelessness, and how I might be able to help these patients as a GP. Or someone will say that it’s made a difference to speak to another person who cares. And I’m reminded that even just bearing witness to a person’s story, without passing judgement, can be a small gift in itself.

I’m impressed by your cycling/running and other commitments on top of everything else you do. How do you prioritise your own fitness and wellbeing when you get so busy? Any suggestions to those of us who are trying to redress the work/life balance?

Something I’ve learnt from hearing senior leaders speak at Next Generation GP is that there is no such thing as a work life balance. The word balance implies there is a sweet spot where everything is suspended perfectly. But that’s virtually impossible to achieve all the time… so I’ve stopped aiming for it, which in a way has been liberating. It’s more of a blend, or a juggle, that looks a little different with every chapter of your life.

On a more practical note, at the end of every week I take some time out to reflect on how that week has felt, and whether I’ve given enough attention to the things that matter to me. Sometimes I can see where I need to readjust a bit for the week ahead…and doing that often helps me to check in with myself regularly and keep perspective. I may not get a great work life balance day to day, but over weeks and months it seems to even out.

As for the running and cycling- my husband will tell you that I’m intolerable when I’ve not been able to exercise for a few days, so I must fit that in to preserve both his sanity and mine! Commuting by bike or running first thing before work makes it easier to squeeze in, and I just love the headspace and energy being alone outdoors gives me. The rest of my day is always better after this. So, days when I feel like I don’t have time for it, or it feels a bit self-indulgent, I remember that my patients, my team and my husband are going to get a better side of me if I do it!


Nishma Manek is a GP registrar in Cambridge and ST4 Leadership Fellow for Health Education England. She has worked for companies like KPMG and NHS England. Outside of medicine, Nish is an avid collector of half marathon medals (raising money for the Butterfly Thyroid Cancer Trust), blogs about her experiences as a trainee for The Guardian and Pulse magazine, and is a devout Liverpool FC supporter. 



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