The Untold Story: Being the change you wish to create in the world.

Francis Report

I recall reading the Francis report (2013) for the first time and trying to take in the shocking realisation that many people had died unnecessarily at the hands of our so called ‘caring professionals’ in an inquiry into Mid Staffordshire hospitals. How could this be? How can the caring professions be so careless and at worst potentially abusive? The evidence was here, but how did this happen? Questioning the basis of the Francis report is one thing, but when your own father becomes such a statistic is another.

Conflict only breeds conflict

My father died in hospital under strange circumstances at the age of 91. We were not clear how my father had died and had reason to be concerned and suspicious. As you can imagine, I and my family, were enraged at a time of facing the trauma of my fathers’ loss. My first reaction to these events, was to take on ‘the system’, to find ‘the culprits’ and to lay blame against the so called health ‘Carers’. Ranks began to close before me and I quickly realised that fighting this case would bring only one thing – more fighting. Conflict only breeds conflict, in my own mind and would I want this to be my father’s’ legacy, despite wrongdoing? So what do I do? What difference could I, one person, make in these of most difficult circumstances?

A role model

I remember turning to the wiser part of me in this moment and recalling a saying that the greatest act of the warrior is to know when to lay down his sword. It was then I wondered how might the tragic loss of my dear father bring about some meaningful change? I recalled the work of Gandhi and how he was inspired to become the change he wished to create in the world. What change would that be? If I could channel my anger and distress into something meaningful in the memory and respect for my fathers’ life?

Working with healthcare professionals

I began over the days that followed to share this thinking with my life long partner Dr Gwil Roberts. Together we sought to unravel and answer the question how committed carers in health care roles may become uncaring and even abusive in their practice? I recall stating a wish to Gwil, that I would really like to work healthcare professionals, newly entering the healthcare system as carers. This work would essentially examine how we as carers can revert at times to uncaring and at worst abusive practice and how, only through this knowledge and awareness, we can better inform and sustain a compassionate healthcare practice. Remarkably an opportunity presented itself not long afterwards where Gwil and I worked together with groups of healthcare practitioners at Cardiff University. Our attendees were occupational therapists, physiotherapists and nurses and potential doctors, all destined to enter the healthcare service in Wales.

Compassion begins with self

This work continued over 4 years. In these workshops, we essentially explored how healthcare workers with a great intent to do good can, if caught by the pressures of work and a growing anxiety, revert and default.  In contrast to optimal functioning, the self to which we default has characteristic behaviours associated with self survival – the carer becomes detached non-empathic, non-relational and non-collaborative and when on autopilot sees the other more as a threat more than someone to be cared for. The self to which we default, in keeping us safe and wishing to survive, does so at a cost of uncaring and at an extreme, abusive behaviour. Because we revert to autopilot, we take no or very little responsibility for our actions and therefore go unconscious to our responsibility of care. Only in seeing and owning how we all as carers can quite unconsciously slip into uncaring even abusive behaviour, do we begin to find the compassion that is missing from our caring professions and key clues to how we can maintain and sustain a compassionate person centred healthcare practice. Compassion begins with self, translates to others and the wider system – a sort of positive/appreciative contagion. Only in recognising how we can potentially miss care, do we find the means to sustain a caring approach despite organisational challenge. I recall after one workshop of maybe 50 healthcare students many came forward to thank us for the experience and learning we had shared together. I recall at that point looking up to the heavens and saying “Dad, we did good”. I was moved to hear how young future professionals were valuing this expanded self awareness.

The untold story

I thought our work was complete at this stage. But unknown to me, Gwils had secretly written a book proposal and we were commissioned to write a book on this topic. After a further year the book was published under the title of: ‘Appreciative Healthcare Practice – A Guide to Compassionate Person Centred Care’. The day it was published, I once more looked towards the heavens again and had another chat with Dad. Nothing can take the loss of a father away. You can however be the change that you want to create in the world, for yourself and mindful of those you love. In retrospect I realised, when the book was published, that I did not put my own story in it. Only in my recent teaching work in Positive Psychology did I decide to tell my untold story and to courageously complete my own circle. If my few words inspire a similar act in one other person reading this blog to ‘be the change that you most wish to create’ then our work is truly complete – don’t you think so Dad?


About the author: Andrew Machon A PhD is an ICF Master Certified Coach. This article refers to the book, co-written with Dr Gwilym Wyn Roberts Appreciative Healthcare Practice: A guide to compassionate, person-centred care’ 



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