DR MAX PEMBERTON: Why some of us cope so well with this crisis while others really struggle

One of the things I find fascinating about my job is how people can surprise you.

Most of the time, human beings follow fairly predictable patterns of behaviour.

We like to think we are unique but, actually, most of us have similar motivations, fears, worries, preoccupations and needs.

Sometimes, however, people act out of character. A timid person finds their voice. A self-obsessed person acts selflessly. A shy person thrusts themselves into the spotlight.

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The rhythm and routine that our jobs provide give our lives a reassuring structure, and the truth is that some people are much better equipped to adapt to change than others. This applies to people in all walks of life, not just those in frontline roles within the NHS [File photo]

This phenomenon is particularly noticeable at times of stress or upheaval because you can never quite predict how people will cope in a crisis.

I’ve seen this over the past few weeks with doctors and nurses who, despite having the same training and the same level of competence and experience, have responded very differently to the pressures that the Covid-19 crisis has placed upon them.

One friend I know from medical school, who is quite a homely type of GP, has found reserves of resourcefulness I never imagined she had.

While undoubtedly well loved by her patients, she is not one to seek out excitement in life. Indeed, she left London as soon as she qualified to pursue a quiet existence in the suburbs.

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When confronted by change, most of us look back, retrace our steps and hold on to how good things once were. But harbouring a desire to return to a place that no longer exists is stressfu [File photo]

Yet she astonished us all when she announced that she was volunteering to work on a Covid-19 ward.

This unassuming medic is now at the coal face of the deadliest pandemic in living memory, working all hours without appearing to bat an eyelid.

But another GP friend, who has worked all over the world — sometimes living in huts in remote parts — has nearly gone to pieces.

He just can’t handle the uncertainty and unpredictability of the coronavirus pandemic.

I’ve taken calls from him several times and, on each occasion, I’ve been quite taken aback by how upset he is. 

When I raised this with him, he explained that, when he accepted an overseas posting, he always knew there was a stable existence back home that he could fall back on, and this enabled him to be daring and adventurous when he was abroad.

Now that stability has gone, he finds it unimaginably scary. ‘I just want it to go back to how it was,’ he kept saying.

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We like to think we are unique but, actually, most of us have similar motivations, fears, worries, preoccupations and needs. Sometimes, however, people act out of character. A timid person finds their voice. A self-obsessed person acts selflessly [File photo]

His anxiety isn’t simply down to the stress of dealing with a highly infectious virus. It’s also attributable — at least in part — to the upheaval it has caused to his working week.

The rhythm and routine that our jobs provide give our lives a reassuring structure, and the truth is that some people are much better equipped to adapt to change than others.

This applies to people in all walks of life, not just those in frontline roles within the NHS. While many of us have adjusted well to home-working, for instance, others find it tremendously difficult.

This does not make them snowflakes, or weak — they just have a different mindset.

Quite why some people find hidden reserves at times of crisis, and others don’t, is unclear.

However, research carried out in the 1970s and 1980s by the psychologist Salvatore Maddi offers some clues.

He produced a case study focused on the restructuring of a company, which led to half of the employees being fired.

While many of those who lost their jobs misused substances, suffered emotional difficulties or experienced a relationship breakdown in the aftermath, about a third not only survived but thrived.

What was surprising was how ordinary those in the adaptive third were.

They weren’t wealthy, hadn’t had a better upbringing and didn’t have happier home lives.

On paper they were completely unremarkable. But Maddi found that the key to their success was the way they dealt with their altered circumstances.

When confronted by change, most of us look back, retrace our steps and hold on to how good things once were.

But harbouring a desire to return to a place that no longer exists is stressful.

The adaptive third didn’t do this. Maddi concluded that, instead of wondering why bad things happen to good people, they asked: ‘What can good people do when bad things happen?’

The answer is: they accept the change and try to focus their attention on how they will adapt to it.

It’s an interesting lesson for these uncertain times.

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A pause for thought on breast screening

There has been at least one surprising health benefit from the Covid-19 crisis, according to a women’s health expert.

In a piece for the British Medical Journal this week, Professor Susan Bewley — a leading obstetrician and chair of the UK charity HealthWatch, which promotes science and integrity in healthcare — noted how the pandemic has resulted in the NHS’s routine mammographic breast cancer screening programme being quietly suspended.

This, she argues, is a good thing. You might be surprised to hear this as it’s often assumed that mammogram screening is a vital aid in the battle against cancer.

In fact, screening women without breast cancer symptoms has become increasingly controversial because it risks ‘over-diagnosis’ — picking up non-cancerous lumps which are treated unnecessarily.

Countries, such as Canada, Italy, Australia and Scotland, have also quietly dropped their screening programmes during the crisis. 

‘This recognition that breast cancer screening is non-necessary must be applauded, and the public reassured,’ wrote Professor Bewley. ‘Anyone with a lump, skin dimpling or other symptoms, should call their GP as usual, as the urgent pathways remain open.’

Perhaps we can take advantage of this hiatus by evaluating the benefits of screening.