In this episode, I speak with Dr Nicoletta Fossati, consultant anaesthetist at St. George's hospital, and honorary reader in clinical education and anaesthesia at St. George's University of London. We chat about navigating one's 'new' identity after becoming suddenly disabled later in life, and the grieving process that accompanies this process. Nicoletta tells us about the perks of being a 'reformed perfectionist' as a disabled clinician and academic.
In this episode, I speak with Dr Nicoletta Fossati, consultant anaesthetist at St. George's hospital, and honorary reader in clinical education and anaesthesia at St. George's University of London. We chat about navigating one's 'new' identity after becoming suddenly disabled later in life, and the grieving process that accompanies this process. Nicoletta tells us about the perks of being a 'reformed perfectionist' as a disabled clinician and academic.
Welcome to Enable the Academia! My name is Lienkie Diedericks, your host creator, and hopefully not the only listener of this podcast about how to survive and thrive in academia as a disabled, chronically ill, and old neurodiverse individual. Here with me today I've got a very special guest, Dr. Nicoletta Fossati. She's a consultant aneathetist at St. George's hospital, and honorary reader in clinical education and anesthesia at St. George's University of London. And joining her, we have Sammy, the 13 year - old yellow Labrador, a lovely boy, that might make an appearance somewhere in this podcast. So please, guys to give a shout out to Sammy the lab, Nicoletta, it's lovely to have you here today.
Nicolette Fossati:Actually, I'm liking you for having me. It's a great opportunity to be part of this project.
Lienkie Diedericks:Nicholetta, I was wondering if we could start off by you telling the listeners a little bit about your story.
Nicolette Fossati:Yeah, it just, it could be very long story. But to cut it really short. I moved to the UK in 2004, after working for more than 17 years in Italy as an anesthetist. And I came to London to become a consultant and his job at St. George's is still where I work. But 14 months into my consulting job. I had a subarachnoid hemorrhage, which is a bit of a mouthful, meaning that essentially I had a brain on bleed mean. So there was a hemorrhage or bleeding on the surface, largely on the surface, but part you know, into the matter of my brain. So that caused me to fall into a coma. It was a bit difficult days for my family. Of course, I was completely unaware of what was going on. I woke up 12 days later, in neurointensive care, and I learned that I had been operated on en de fi to remove completely unbeknown to me, congenital arteriovenous malformation, it was a long way to recovery. And I am now physically disabled, my problems go all through the right side of my body, but they concentrate on my lower leg and foot. So I need a tutor on my leg. We call it an ankle foot orthosis in order to be able to walk and to support myself outside to manage slopes and curbs. I use walking stick, there's a little bit of weakness in my right shoulder. But probably an onlooker wouldn't notice that again, and I'm back to doing what I used to.
Lienkie Diedericks:That's fantastic, Nicoletta, and amazing that you were able to get back to work after such an unexpected a major setback. I remember when we were speaking earlier that you said one of the big things that was well, I wouldn't know if it's a challenge. But something that that really popped up after your incident is this issue about perceived changes in one's identity and mental functioning by others. And you noticed that your internal narrative of yourself remains the same. But for others, you're seen as "a completely different entity".
Nicolette Fossati:Yes, unfortunately, that's what happened to me. And I have to say that at the time, I started visiting some websites and given blogs, people who had gone through a very similar experience to mine on it was very much the same for them. And I remember the sky mentioning the ward round go in, in reaching his bed at some point. So I started chit chatting with him. And, you know, people speaking to him very loud and spelling out as in how are you today? I'm dismantles? Like, fine, thank you. I'm not sure why you speak into me like that. And then he mentioned something about Will I be able to fly again, after this operation I've had on my brain and everybody went quiet. And they looked at each other. And like, what exactly do you mean? Because, you know, could be difficult for you to fly a plane. And this guy went No, I mean, commercial airplane travel, but I'd be able to go places. So you know, it's like, people look at you so differently. You ask the question, and people start wondering, you know, what is this person thinking? It's what it I mean, no one would even dream of reacting that way to a different question or will I be able to fly says yes, you probably can, you know, perhaps you have to be careful for a couple of months, you know, something like that you would expect that kind of interaction. Instead now, this guy had had something To his brain happened to his brain. So everybody's assumption was that, you know, he wasn't cognitively the same person as before. Of course, we know that these problems happen after brain injuries or, you know, like myself or brain hemorrhages. But the assumption is that you're not the same as before. And again, just to compound the job, he said, in this blog, and I thought I was the brain damaged one, so. So that's, you have to deal with these assumptions from others.
Lienkie Diedericks:How did this affect your journey going back to work, and especially the the decision, you know, to move into academia as well.
Nicolette Fossati:On the one hand, I was really between a rock and a hard place because of the particular circumstances my family and I found ourselves in. At the time, I was still the main breadwinner, and I very honestly put, was desperate to get back some some kind of paid work. Of course, this wasn't possible immediately, I was out of work for recovering on long sick leave for 10 months. But in the meantime, I was assessed in a number of different ways. There were a plan a plan B for my return. And as my neurological recovery, continued development, there was a glimmer of hope that I could actually go back to anesthesia. But that was a phased return. Because clearly the concern, which was easily dispelled, in the beginning, it was about my cognitive activities, I was tested. And everybody was satisfied that I had my cognitive abilities intact. But then there was the physical aspect, which was further tested. And eventually, after, probably something like 16 months, I go back and full capacity as a consultant to nice statistics that required some negotiation, also on my part, and I remember these sessions in theater with very nice kind colleagues who were present in theater with me, I mean, the operating theatre, they let me do they will let me do all the things of my professional but obviously, they weren't there ready to support me, should I need to be supported? Interestingly, I had had months before this happened a session on the simulator to test exactly, we have an advanced simulators. And George's were very lucky in that respect. And I had a full day to myself with a facilitator to explore three typical difficult scenarios that an institute can experience with patients on the operating table. And so had an opportunity to test myself. And it was very interesting, because it shed a light on things that I thought would be difficult. They weren't. And also there was some things are never thought about, I learned that I had to negotiate around those. So it was a very interesting journey. Back to my anaesthetic activities, you will also asking me about academia, this was something that had always had in mind, even when I was an Italian doctor, and I had had achieved a PhD and I was working in a university hospital. So everything seemed to be lined up. But obviously, after an event like this, and just having just arrived in this country for a while, I just put my academic dreams on the back burner. And obviously getting back to work, as I described, took up some time adapting to new circumstances. But then this academia dream again resurface on the found a very open and welcoming environment at St. George's University of London. So that's why I then became a step by step anomaly reader in clinical education dynasties. Yeah,
Lienkie Diedericks:It's fantastic. And it's really heartening to hear that there are also cases where academia can be a very accommodating and fulfilling place for someone who's gone through a disabling event. Like let's I think something that struck me, while we were speaking is this whole process from having such a major health events. And you know, I not I didn't have something similar to you, but I was having major health events, is moving through this process, not only of getting to a point where you can get back to some of the activities and dreams and things that you have in life, but also learning to live with a sort of grief of a loss of one's old identity and parts of oneself. And then I remember you saying you in some ways you felt like your life was a broken base, and going through this process of putting it back together really quite difficult, and that you actually have two birthdays, one birthday of, you know, your actual birthday and one birthday of the events when this happened to you. I was wondering if we could speak a little bit more about this process of grief.
Nicolette Fossati:Yeah, that's absolutely correct. And I stick I want to set the idea of grief, contrary to what I would have thought, at the beginning, this grief comes and goes, it's not as if the grief is greater at the beginning and then time helps out to soothe the pain and the loss. That's not my experience. It's it comes and goes away. At the beginning, I was, I guess, essentially very happy to discover that I was alive. And I could have another girl, although from restricted view seats, so to speak, I could have, you know, I could take part in that, I could watch the show again. So I was very, very excited about that. And even if daunting, I was feeling like I was raring to go and build up my life and our family life, again, around the new self, so to speak. But again, this is not a linear process, there are moments where all of a sudden, you know, you wake up on a morning and you, you're angry. And you think to yourself, Why am I so angry? Why should I be and of course, you with a little bit of reflection, you start realizing, I started realizing that he was angry about what happened to me and to us as a family. So again, it comes and goes, and it's something I've had to learn to live with. And it's something that has encouraged me to be a bit kinder to myself, to accept that we'll have some of those days, on occasion. And again, to accept that this thing will always we bear with me, and most of the time, it'll be under the radar. But once in a while, it will resurface. And I'll just have to deal with it, look it in the face, and have a nice chat to myself and try to just survive and wait for a better day.
Lienkie Diedericks:Absolutely. And that's why it's so important, I think to have support networks, you know, a supportive colleagues and supportive place where you work. Because those are all anchors that help you deal with that grief, isn't it, we don't have that, then sometimes I know with myself, it can feel very untethering. And you can feel like it's sort of being thrown into this really big ocean of grief and loss. And it's very difficult to to navigate the storm in the ocean. But then of course, I have wonderful partner, wonderful family, and some wonderful friends and colleagues. And those relationships in the end are the things that really bring me back to myself. And back to celebrating myself as I am right now.
Nicolette Fossati:I have to say, You're completely right. It's so over evolved over the these 15 years, since the bleed, it's all been about rebuilding myself, with the help and support of other people. A lot of people have told me over the years, that was amazing. That was extraordinary. And I'm like, I don't think so I've always thought that the the strength and the potential of the human spirit is really untapped most of the time. And we should be grateful for that. Because we don't want to be tested. You know, like, I have certainly other people much less lucky than I was have been. But when the time comes for the human spirit to be tested, there's a lot of untapped potential. I never felt that was special, or particularly brave. Again, another word that people have used in the past, I never felt it was been particularly brave, I was just getting on with it. And I felt like I had no alternative really many times I've, I've used this kind of metaphor, this kind of analogy, you know, it was like being in you know, traveling through a tunnel. And all of a sudden there's a landslide behind you. And the only thing you can do, even if you can't see anything is just to try out, continue to travel ahead, hoping to see the famous light at the end of the tunnel, but you can't go back. So I'm like, there's no other option really. And of course having your family support in your hand your friends and calling supporting you, you know, people who make you feel loved and valued in spite of what happened to you. It's a great great booster for for anyone who finds themselves in a difficult situation and they have to live that kind of work day routine, which is all of a sudden become more difficult than it was before in all those lanes that I was taking for granted and had to be rebuilt again from scratch. So yes, the people around me, even people I would never have predicted It would have been on my site, I've had people who barely knew me, who were absolutely pivotal, crucial in helping me getting back on track at work. So I've got loads of people to say thank you two and a half done. So over the years, and so these relationships with all these people have been strengthened, although I would offer a word of caution on that. And, you know, it is said that a war doesn't kill you makes you stronger. But I, for one know how much they sit situations can put a huge strain on relationship or relationships. So it's not a surprise, and I actually feel a lot of empathy for, for instance, those couples that break up when there's a health problem is not necessarily because there's not enough love in that relationship is the strain, the strain of support on the relationship can't really be too much. Yeah, absolutely.
Lienkie Diedericks:And I think, you know, there, it's so important that when something like this has happened to, to you to be really honest with yourself and to check in all the time, you know, and that communication is it has to start with yourself, doesn't it?
Nicolette Fossati:Absolutely.
Lienkie Diedericks:I know, you said that. You know, this honesty, you you were speaking about it before, it was a kind of radical honesty and what happened to you, you brought what you said your inner perfection to the front and took away the pressure of hiding your imperfections. I don't know if you want to speak a bit more about that the fearlessness in the end that your health events gave you, this is something that
Nicolette Fossati:I really wouldn't have expected. But I consider this probably the biggest, one of the biggest, positive, there aren't very many of what happened to me, it's, you know, when something like that happens to you, and I accept that a lot of people have to live with invisible disabilities. And that, you know, when other people can't perceive your disability, it could be very difficult, because those people may be like, what, what's wrong with you. So it's a very difficult conversation at that point. But again, my disability is physical, so presents me with different problems. The still, there are still people who turn when a walk, you know, down the street, and to look up me, because a walk with a visible limp. And some days, I don't care, some days, it's still a little bit raw somewhere down deep. But this is to say that if you have a visible physical disability, you've got nowhere to hide. And it's very difficult to pretend that you are the same person you were before. I mean, we've been talking about your internal narrative. And of course, you feel like you're still yourself, although you're evolving into someone different as we all do, through our entire life. But again, the fact is that it's very difficult to pretend you can't do certain physical activities as you used to, you can't wear certain shoes anymore, you and I could go on forever, even again, silly things like the one I just mentioned, you know, just being able just to wear sensible shoes. So there's no way you're going to be able to hide behind some kind of thing, although, a time some people may well try to hide, but it's a very difficult process. So also because of my personality, I've always liked to look at problems head head on head first. So I was like, Okay, I'm very clearly not the same. I used to be I used to be a runner sprinter. None of this anymore, ever. So I'm like, fine. I'll make it work for me. I've always been a perfectionist. And I consider myself a reformed perfectionist. And I've always mentioned this to my students during my my talks, you know, you can see that a walk with a limp. You can say that I, you know, I'm clearly not able to cope with certain physical situations. I need help. But you know what? I'm not afraid to say, I don't know something. There's no such thing for me as Q & A, terror. Q & A. The idea of Q&A after a talk or a presentation as an anti scientific meeting has always been a bit of a kind of monster, but not anymore. I'm not afraid of admitting to not knowing something. I'm not afraid to engage in a conversation with the public. Because I'm like thinking to myself, look, you can see very clearly I'm not perfect. No one is really, we may entertain this illusion delusion that we're perfect no one really is. And my disabilities, as you pointed out, simply brought up to the fore in made it more evident to others. But most importantly to me that all my attempt at trying to be perfect and to do things well, 100% of the times, it's just not possible. So, a bit like I was saying, before, I had to learn to be a bit Kinder with myself, I have to admit that times 80% is okay is good enough, at times, even 70% is okay, depending on what you're doing. So it's the kind of acceptance and clarity of mind when you have to tackle an obstacle. And this is something that I would really gave us a if there's such thing as a message to others. And don't be afraid of that. Don't be afraid of that. Be kind to yourself, accept your imperfections, don't be indulgent. With those are I am not. But again, Be kind, be kind to yourself and be kind to others when they don't understand what's going on inside you. Because they may have their own problems with their own imperfections, they may have their own struggles. And it's difficult for everyone to deal with those. So let's be kind to each other.
Lienkie Diedericks:I think that's such a lovely in a powerful way to conclude our interview today. I think it's very difficult, isn't it? Because I think the same way that grief comes in waves, the expectations that we put on ourselves come in waves to some days, it's easier to accept that, you know, you won't be able to go at 100% and other days, it can be incredibly hard. And I think that those two things, the grief and realizing your own limits, and being honest with yourself are actually intimately related. Nicoletta, thank you for making the time today and sharing your story and for being so honest with us. And I really hope our listeners can take to heart the kindness that you shared with us today.
Nicolette Fossati:Thank you very much for having me and for giving me the opportunity to share my story.
Lienkie Diedericks:Thanks for listening to today's episode of Enabled in Academia. Please do like, share and support this podcast on Twitter by following us as at @EnabledInAca. If you have any questions, suggestions or impressions, please tweet at us or send me an email at enabledinacademia@gmail.com. T e music for this podcast, A Roo for Two. is composed by D n Lebowitz and is available o the YouTube Audio music library As always, access isn't optiona for us to be enabled i academia. Yep, I'm making that thing