I can be there for my patients regardless of my blocks
14th April 2021
Becoming a medical doctor seemed an unrealistic dream to Sophia Williams. Here she tells us about deciding to go for it and stop hiding her stammer, and how her speech gives her an advantage with patients.
I was told I stopped talking for a time when I was three. When my speech eventually came back, I stammered. All I remember are the struggles of early dysfluency which stayed with me throughout my childhood and beyond.
If anyone had told me then that I would end up working as a doctor, a job where verbal communication is key, I would have looked at them in utter disbelief. So I'm writing this to encourage you to aim for your dreams, as I have — irrespective of the challenges ahead.
As a young person, I would have done anything to avoid using the phone or buying a bus ticket; walking an extra mile to escape a particular fare I couldn't say.
If anyone had told me then that I would end up working as a doctor, a job where verbal communication is key, I would have looked at them in utter disbelief.
I remember having to read in a class assembly in front of the whole school; hundreds of eyes upon me as I squirmed and shook, standing up at the front trying desperately to push out each word as I alternated between blocking and repeating first syllables, with tears running onto the soaked piece of paper in my hands.
- 'Most of the time I forget my stammer even exists, as the patients come first' Read nurse Abbey's story
Or the time when I phoned up a friend and her father answered, and asked if I was still 'chewing my breakfast', as I made unfamiliar noises while blocking on my name. I remember feeling so ashamed. But there was also thankfulness for my best friend when she answered the register for me from behind our open desk lids. There was always lots of speech avoidance along with a mix of intense guilt and shame.
My stammer now
My stammer's reduced over the years. It waxes and wanes with the pressures, strains and even excitement that comes from life in general. I've tracked patterns of dysfluency linking them to tiredness, stress and hormones; and every time I change my medical 'rotation'.
Most of the time I can sound fairly fluent or I just avoid if it gets too much. I admit, at times, stammering has led me to feel depressed. It can feel unreliable. Untrainable. Out of control. It had always been hard living up to the expectations of others to be fluent; the added pressure impacting upon my speech. As a result, getting words out can feel like wading through treacle.
Going for my dream career
In my early thirties, I decided to go for a career in medicine. I had a PhD in music psychology but felt an ache from deep inside, wanting to be a medical doctor. My dream seemed tantalising; unrealistic at best, ridiculous at worst. Thankfully, I had supporters who were encouraging.
When I started my medical training at St. Bartholomew's Hospital (Barts) there seemed little to gain from hiding my stammer anymore. It was a better strategy to let my colleagues and seniors know so that when I stammered in a ward round or at a handover, no one wondered what was going on. As a result, my endless word switching lessened and I started to own my stammer rather than apologise for it. It became more about confronting it rather than hiding away from it, but it wasn’t easy.
My endless word switching lessened and I started to own my stammer rather than apologise for it.
Even now, when I have a day with more blocks than others, it's easy to start asking myself whether I'm up to it, and I don’t think that doubt will ever leave me. Strangely enough though, I have found that the more I concentrate on the job and less about my speech, the more workable it all becomes. I've had to learn to live with it in order to move forward.
The support and understanding from others has been paramount. And without a doubt, the increasing climate of inclusion in the workplace has helped this.
Advantages of stammering
Despite the difficulties, my stammer has some advantage. I'm attuned more than most to both patients and relatives with their own speech difficulties. I've seen patients in emergency departments and on the wards finding it very hard to speak after a stroke; frustrated, scared or even embarrassed at their lack of verbal communication. I've sat at the bedsides of patients mute with severe depression, my own blocks and hesitations bringing me nearer to a shared understanding and emotional reciprocity between us.
Similarly, I've supported parents whose own children are finding it hard to speak, for instance like the child with selective mutism. It acts as a leveller; redressing any power imbalance and getting rid of any barriers between us as I expose my more vulnerable side.
I'm attuned more than most to both patients and relatives with their own speech difficulties...I am able to understand, listen and be there for my patients regardless of my blocks and hesitancies.
Yet total communication is so much more than just words. I am able to understand, listen and be there for my patients regardless of my blocks and hesitancies. The realisation of this is remarkably freeing. There is far more to being a 'good doctor' than getting the words out at the right time. I'm aware I'm not as able to 'hold forth' confidently with colleagues on topics in medicine and now psychiatry, but nevertheless I can still share their good level of understanding.
So when I applied for my final examination for membership of The Royal College of Psychiatrists, I felt it was essential to declare my disability. I would never have been able to sustain my fluency during sixteen 7-minute practical scenarios played by actors lasting all day. I'm thrilled to say that I ended up passing even though I stammered, sometimes significantly. Overall, I felt I was judged fairly for both my communication and relational skills as a whole.
Now I have the privilege of working as a doctor in child and adolescent mental health and I see it as both a great privilege and calling. I would prefer not to have to think about my fluency all the time due to the huge added effort, but nevertheless I am very thankful. It means that I can both inspire and give hope to the young people I see in a practical way, by demonstrating to them that with effort and determination it is possible to have dreams and obtain them, even if you stammer.
If you work in the NHS, you can join the new NHS Stammering Network. See our Professional Networks page for more details.