People Make Bad Choices If They’re Mad Or Scared Or Stressed

All over the UK, newly graduated medical students are starting to look ahead to the first Wednesday in August and their first day as Actual Proper Doctors.

If they are anything like I was, they’ll be having increasingly terrifying nightmares about holding the cardiac arrest bleep on their first night. And getting lost. And they’re the only one on the arrest team. And they can’t remember how to do CPR. And there’s a dragon in the corridor. No? Just me? OK.

A couple of years ago, I wrote a long piece that contained practical advice for new doctors. If you are a new doctor and you are looking for bullet points on where to get help, how to ePortfolio, the unsettling but central role that half-coloured in ticky boxes will come to play in your life, and other things, that piece is here and still contains the best advice I have to give. Over on Twitter, search the #tipsfornewdocs hashtag, and remember that we all remember this and that almost none of us bite.

Today, I want to talk about something a little bit different. I want to take a bit of time to think about resilience and self care.

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The idea of ‘resilience’ is a psychological one that has to do with the capacity of the collective and of the individual for what I’ll call ‘coping’. It was defined by Andrea Ovans in the Harvard Business Review as “the ability to recover from setbacks, adapt well to change, and keep going in the face of adversity”. In the last few years, it’s developed into a buzzword in the language used to talk about and to public sector workers. The first time I became aware of it as a thing that was being said to doctors was during the junior doctor contract negotiations in 2015.

Now, the first thing to say is that I’ve never met a junior doctor who didn’t possess resilience. It is a requirement of the job. It is a requirement of getting the job. So, the second thing to say is that when the government talks about junior doctors not having resilience, they are lying.

But if what they mean is that junior doctors have proven increasingly unwilling to be actual martyrs — well, yes, that might be true, and that might also not be a bad thing.

As a teenager, I wanted to be John Carter from ER. I wanted to live all the hours in the day for my job. There is a picture of a recruitment poster for Emergency Medicine going around at the moment that invites applicants to “choose surviving on coffee and adrenaline”. It is a terrible message to send, but half my life ago it was absolutely what I wanted for myself. And even as a 31-year-old medical SHO, there are days when that kind of thinking still has its seductive qualities. On the seventh day in a row of thirteen hour days, I can enter a mental state that is some sort of meld of beautifully Zen and utterly psychotic. I know all my patients inside out and back to front, and half the patients of the other teams, too, and I am completely on it and, look, I just live here now and I’m pretty sure that’s actually fine. (I have a bad-coffee-and-sleep-deprivation-fuelled memory of this precise thought process going through my brain, about eighteen months ago, and also I think I was skipping down a corridor at the time.)

It is perfectly possible to live like this for short periods of time. I clearly do and so do lots of other people, not all of whom are doctors. It is not sustainable. A period of work like that has to be punctuated by a period of rest and rejuvenation, or else the whole thing falls apart. I love my job, but my capacity to do it for thirteen hours a day without a day off is not infinite. I believe that that is true of any human in any job, no matter how much they might love it.

It is partly because no one has an infinite mental or physical capacity. In this job, that part of it is a patient safety issue as much as it’s anything.

It is also partly because you do eventually go home from your job, and it is at that point that you remember there is no food in the fridge and that you have no clean pants.

And that’s the part we don’t hear about enough when we hear about resilience. We don’t hear about self care: about how to keep ourselves alive and fed and sane and happy. In fact, we too often hear the opposite of that: that to do the things we need to do to take care of ourselves is selfish or lazy or uncommitted or in some way not being a team player. That is a perception that I want to challenge.

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First, put on your own oxygen mask.

Maslow's Hierarchy of Needs

Maslow’s Hierarchy of Needs. (Wikimedia Commons)

There are lots of ways to look after yourself well, and I can only talk about what works for me and what hasn’t worked for me. This is the part that is non-negotiable. You need to eat. You need to drink. You need to sleep. You need to put on your own oxygen mask first. You need to remember to go to the toilet.

I am pretty sure that if anyone had said any of that to me in the week before I started FY1, I would have rolled my eyes too. I was worried I might accidentally kill someone, not that I might forget to pee. Trust me, you will forget to pee.

The need to eat and drink and sleep is about more than keeping yourself alive. It is about that, too, of course, but it’s also because everything seems so much worse when you haven’t.

This is a crap job, sometimes — for all sorts of reasons. A tip of the hat to @DrTonyGilbert on Twitter who aptly described this as “those nights where you’ve been punched and your shoes are full of ascites and you think, ‘I could’ve worked in a bank'”. The world will be much more manageable on the other side of a good meal and eight solid hours of sleep. I’m not saying those things will fix everything, but they will make most things look a lot less dire.

So:

  • FY1s cannot live on coffee and Mars bars alone.
  • Eat breakfast. You don’t know when you’ll next get a chance to eat.
  • But do eat lunch. There are really very few things that can’t wait until you’ve eaten a sandwich and had a drink.
  • If you can get off the ward for a break to eat lunch, do that. The days when you eat with a sandwich in one hand while writing a discharge letter with the other hand will come, but they should be the exception rather than the rule.
  • Drink. If your patients’ kidneys need fluid, so do yours. The correct response to, “Doctor, Mrs Jones has only passed 30 mls of urine in the last 3 hours,” should not be, “Well, that’s more than I have.” Get a reusable water bottle and use it.
  • Meal plan. If you can make food with leftovers, you can come home from an on call shift and have a home-cooked meal in the time it takes to transfer a plate from the fridge to the microwave. This is a wonderful thing. It also means that you’re less likely to collapse on your bed and fall asleep without eating.
  • The existence of supermarkets that will provide you with ready-prepared food and people who will bring delivery food to your house is evidence of the kingdom of heaven on Earth. It isn’t sensible to live off them, perhaps, but they have their uses.
  • Comfy shoes. Get some.
  • Take care of your physical health. Register with a GP. If you are a doctor with a chronic illness or a physical disability, take the time you need to take care of that. A friend of mine, Dr Beth (no, we are not the same person), wrote a blog post recently about this which was aimed particularly at doctors who have diabetes but which I think is worth reading for everyone.

Learn how to say no.

Take your days off. Take your annual leave. If your work emails are connected to your phone, learn how to unsync them.

There will always be situations where someone needs a shift to be covered on short notice. People get sick. People have family emergencies. Rota coordinators fail to take into account the fact that the staff grade’s contract was only for six months and ended last week. You will end up being the person who covers these shifts some of the time. You do not have to be the person who covers these shifts all of the time.

At some point, you will be asked to participate in rota monitoring, where you fill in a form for a couple of weeks with your rota hours compared with your actual hours. Your Trust is supposed to use this to ensure that your rota is legal, that your department is staffed appropriately, and that you are being paid correctly. If you are asked to work differently to your usual practice or you are asked to lie about your hours, say no to this too. (However, do not expect the person from the rota monitoring department to understand your job. I gave up fighting that battle on the day one of them tried to insist that I should be leaving the cardiac arrest bleep behind when I went to eat lunch.)

Likewise, there will always be work that needs to be done outside of normal work time. This will sometimes be valuable, and sometimes not. Like the online induction module that even as I type I am side-eyeing in my learnPro account, which will take time that I could instead have spent learning something about cardiology before I commence my six month cardiology rotation. The point is, there are exams, and ePortfolio, and quality improvement projects, and things to read and learn. This isn’t entirely a bad thing. It is part of what being a professional is. But develop some sort of system to deal with it so that it doesn’t end up taking over your whole life, because it absolutely will if you allow it to.

Don’t forget to look after your mental health, too.

There are lots and lots of doctors who have mental illness. It is not a shameful thing. It is not an unusual thing. Don’t ever let anyone tell you otherwise. You will not be the only doctor who takes medication to maintain your mental health, or sees a counsellor or a psychiatrist or goes to therapy. Do what you need to do to keep well, just the way you do for your physical health.

If the above does not apply to you, don’t presume it never could and don’t ever be ashamed to ask for help.

My sanity has been saved — so many times and in so many ways — by having brilliant friends.

If you are struggling, please talk to someone.

If you think you aren’t struggling, please talk to someone anyway.

Your most readily available resource is your colleagues. You may not have met your fellow new FY1s, yet, but you will become each others’ most reliable support. (The thing about getting off the ward for lunch if you can? It’s even better if you can get lunch together.) There is no one who understands this weird job like the people who are going through it with you. Use your seniors. Your educational supervisor is there to support you, not just to tick boxes on your ePortfolio. If they aren’t supportive or you think they’d be difficult to talk to, there are other consultants. If that seems too intimidating, your regs and SHOs did this not too long ago and I promise most of us are nice. The administrative staff, too. In my FY1 year, it was known that our postgraduate administrator’s office door was always open for a cup of tea and a biscuit and a bit of a cry and I think we all took her up on that at least once.

You won’t be the first person to have cried in a sluice; that’s what sluices are there for. If you cry in the sluice every day, that’s not okay and please talk to someone.

It is okay to not be okay, but people won’t know you need help unless you tell them.

Do the things that make you happy.

I suppose there is a professional bit to this, about finding your niche and finding your people and not worrying when you don’t like every single rotation you do as an FY1 or even FY2. I’m pretty sure that I grew up thinking it was all “being a doctor” and I know that I have friends and family who pretty much still think it’s all “being a doctor”, but one of the brilliant things about medicine is that it’s all so very different. I think that’s all true, and you’ll do that.

But what I really wanted to say was, remember that you’re still a person as well as a doctor.

I can’t tell you what it is that makes you happy.

The things that make me happy include but are not limited to:

  • Real books
  • Sunday dinner with people I love
  • Running around the parks of Glasgow or along the Clyde with music or a podcast and the sound of my feet on the tarmac
  • The work I do in “my” cathedral
  • Taking the extra five minutes in the morning to make real coffee
  • Cats who like to give me Eskimo kisses
  • A knotty bit of Beethoven and the adrenaline rush from singing it on stage
  • Netflix and Yarn

Your list will not look like that. You will have your own list. But remember to find the time and space to do the things that make you happy.

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Listen, I am not good at all of this and some weeks I am not good at any of it.

You are about to do a thing that is real and hard and that you can never be properly prepared for, not really. For the first few months, you will be more tired than you have ever been in your life. You are going to do a job that is brilliant and terrible, and that will give you unsurpassable highs and will also completely break your heart. You owe it to yourself to look after yourself while you are doing it.

And for when absolutely everything else fails, I always keep emergency ice cream in the freezer. It’s a start.

This Is What’s Next

You all already know how this story ends.

The endings are rarely the interesting parts. Did you read the first six and a half Harry Potter books to find out that the good guys win in the end? (Uh: Spoilers.) You did not.

It started on a hotel balcony in Madeira. I had deactivated my NHS email account in the baggage check queue at Glasgow Airport, but the second last thing I’d done before flying away for a week to a warmer, sunnier annual leave than was offered by February in Scotland had been to submit my application to higher specialist training in Acute Medicine. And because I am paranoid, I had submitted the application under my personal email address. Under a cloudless Portuguese sky, my phone buzzed. I had been long listed and I would hear about an interview in due course.

Or it started in the medical receiving unit of a Glasgow hospital that no longer exists. At quarter to eleven on a Saturday night a few summers ago when I hadn’t sat down all day and had clearly not yet made it home to my rapidly cooling pizza and I realised that this, this, was what I wanted to do with the rest of my life.

Or it started in the medical receiving unit of a dozen other hospitals scattered hither and thither across the West of Scotland where through my years at medical school and in the Foundation Programme they had welcomed me in and given me work to do and shown me the nuts and bolts of how to be a doctor for real, and, where I had learned that, if you wanted, this was what you could do with the rest of your life.

And then it was spring and I was back under a Scottish sky, the April version of which is every little bit as steely-grey and rain-saturated as the February one. I had spent the previous two weekends printing out and putting together the required portfolio of evidence, a folder that might have served well as a blunt weapon if I’d run into a riot on my way to the East. I had spent evenings pacing my living room floor, trying to formulate an answer to the question, “Why do you want to do Acute Medicine?” Ideally, one that wouldn’t make me sound deranged. I had spent the previous evening as the SHO on call for oncology, replacing venflons and trying not to pull out all of my hair.

An early morning train to Edinburgh. A heavy wodge of paperwork. My good suit, and my lucky socks, and my very best terrified face, and a pressing concern that I shouldn’t vomit all over myself.

The most significant days of my life seem to begin thus.

It is five years since I graduated from medical school. I have just about persuaded myself that I really am a real doctor. I mostly don’t have the urge to giggle anymore when I introduce myself as one of the doctors, and most days these days I don’t actively expect to be stopped in a corridor by someone there to tell me that my finals results were all a terrible mistake. But as a brand shiny new junior doctor, I remember believing that the registrars were really the real doctors. They were proper adults and were very organised, and they knew everything. If it all went wrong and I needed to call someone (or maybe just scream really loud), the med reg would come. I still believe all that, and because I still believe all that I do not in any true sense believe that I am qualified to be one.

This is an awkward thing to not believe when you are on your way to a job interview.

But there is a little bit of point of no return to this kind of thing, and on I went through the door of the Radisson on the Royal Mile, my black suit and green-tinged face incongruous amongst the gaggle of short-and-T-shirted and frostbitten-looking Americans, and my imposter syndrome out in force.

An interview for a medical training post begins with an administrator who checks through all the documentation, and there is a lot of documentation. There is proof of identity and proof of registration with the General Medical Council, and, even though being on the GMC register in the first place depends upon your having one, your original medical degree. My original medical degree is A3 sized and entirely in Latin. And then there’s that blunt weapon of a portfolio, which contains proof of everything you have ever claimed to have done including things which are wholly unrelated to medicine. Two years ago in my interview for Core Medical Training, they asked what I was proudest of that was unrelated to being a doctor and I had to decide to talk about changing the world because I suspected no one would have believed me if I’d said, “being Ginger Rogers except with a thurible”.

My fellow interviewees and I took our places outside closed doors, waiting for the knocks that would signal the beginning of our half hour of torture.

“Why do you want to do Acute Medicine?” asked a consultant who I’d not met before.

I did sound deranged. But as the Cat said, we’re all mad here: we must be, or we wouldn’t have come here. I decided to go with it.

After ten minutes — and I think that at some point in those ten minutes I flapped my arms around and tried to design an ambulatory care service out loud — there came another knock. I gabbled out a run-on sentence about — oh, who am I kidding, like I have any memory of it. And ran.

The same corridor, another door. Andrew Lloyd Webber probably wrote a song about that. This time, I had a card to read about the clinical scenario that I would be presented with when I entered the room. An elderly man presenting with collapse, ?cause. This was more straightforward than any of the scenarios I had been trying to revise, which immediately sent me into a sort of flailing tailspin. My panic did not improve when I entered the room to be greeted by a man who used to be my boss and the information that he would be playing my 75 year old patient. I wish I could tell you what I said. I really do. I remember that I mustn’t have taken any time to organise my thoughts, because I vividly remember that I got a good third of the way through before I stopped and apologised and announced that I was going back to the beginning and starting again. I also vividly remember that the interviewer who wasn’t doing the roleplay looked thoroughly relieved after I had made this announcement.

Back in the corridor, waiting for the signal to enter the last room. Footsteps. A bang.

“Housekeeping!” a voice shouted.

We three candidates abruptly tried not to meet one another’s eyes, lest we giggle. That answered the question that had been niggling at the back of my mind ever since I’d arrived earlier that morning — been directed away from the business centre, been surprised when guest-looking people stepped out of the lift with me, noted empty trays and copies of the Times lying on the carpet outside rooms that were right next to the rooms we were all going in and out of. It seemed that we were indeed having our job interviews conducted in what were usually hotel bedrooms.

Not quite so weird as that one time I sat a postgraduate exam in a football stadium, but quite weird enough.

And then I ended with five minutes to conduct a “driving advice” conversation with a twentysomething professional HGV driver who had been newly diagnosed with diabetes, or so my card said. But when I made the mistake of asking an open question, he turned out not to yet know that he had diabetes at all. “This is a conversation that I’d normally take longer than five minutes to have but I’m on a timer here,” I tried frantically to project with my eyes to the consultant playing my HGV driver as I talked at speed.

Even this far on this side of knowing what the outcome was, my strongest memories are of all the spaces where I forgot to say things.

The end of the story is that I was disgorged back onto the Royal Mile, befuddled and blinking in the sun that had finally come out.

The beginning of the story is that in a little under three weeks, I’ll be a specialist registrar in Acute Medicine in the West of Scotland, spending the first year of my training in a district general hospital and my first six months trying to learn something about cardiology.

The end is where we start from.

Changing The World

It was good to be back home on Sunday.

It felt good to walk back into my cathedral, into a place that has become very much my home, and to be asked the questions that I have always been asked when I’ve returned to it from Synods and for my answer, this time, to be, “Yes.”

The Provost, the Vice Provost, and I held a Forum conversation after the Eucharist on Sunday morning, to try to explain what precisely it was that happened in Edinburgh last week, and a large number of the congregation were interested in hearing about that. The short answer is, something more complex and with a great deal more nuance than you’ll find in the newspaper headlines. The longer answers are contained in the following video:

I suspect I have not yet said my last word on the subject. I have a lot to reflect on, about the journey the Church has been on, the extraordinary journey that I’ve been on and the extraordinary people I’ve been on it with. This campaign has changed me in ways that I can’t yet begin to explain. In time, there will be more work to do, a new chapter — the business of changing the world goes on and it is business that I intend to be part of for a very long time indeed.

It will take time to reflect on all that. For now, I’m taking a little bit of time. To unpack. To let all the emotions of the last week and indeed all the emotions of the last eight or nine years settle. To allow the significance of this enormous thing that we did to sink in.

And to think about what’s next.

Because at the end of everything that had happened, Jesus said to his disciples, go, go and change the world.

The video content of this post is copyright St Mary’s Cathedral, Glasgow: http://thecathedral.org.uk.

Into This World, Morning Is Breaking

I woke up this morning with a melody running through my head, the melody from the hymn that we sing at the beginning of our Easter Vigil every year. The hymn that we sing as a people who have gathered in the darkness that comes before dawn and who find that the light has broken back into the world.

Into this world, morning is breaking,
All of God’s people, lift up your voice.
Cry out with joy, tell out the story,
All of the world rejoice!

Yesterday, the Scottish Episcopal Church did an astonishing thing. A loving thing. A generous thing. A thing that has taken years of work and prayer and soul-searching.

A thing that I have dreamed of for so long that when I did get out of bed this morning, I had to check the news to make sure I hadn’t actually dreamt it.

The moment I think I will remember from yesterday afternoon was not one that took place in front of the cameras and microphones. I made my way back from the podium, having made a speech in which I told the great and good of the Church that love is love and that love will turn the world upside down, and having also given a heads up to my cathedral Director of Music that one day I am probably going to be asking him for the trumpets from the Verdi Requiem as a wedding processional. The ecumenical delegate who has been sitting next to me during this Synod removed my speech from my hands, turned the paper over, and wrote on the back, “You can’t have the Verdi trumpets, they’re too scary.” And after it was all over, leaned over and said, “You can have the Grand March from Aida instead.”

There was no questioning that I as a gay woman was going to someday walk down a church aisle to something operatic and over-the-top — but, perhaps not the Verdi, she said.

It’s just marriage now.

It is now the policy of this church that same-sex couples who choose to be married can be married in the eyes not only of the law but in the eyes of God and in the presence of his congregation.

It is the policy of this church that priests whose conscience and commitment to equality has meant that they felt unable to perform marriages in church for as long as they were constrained from performing them on an equal basis for all couples, whether gay or straight, can now say to everyone, yes, yes, we do do weddings here.

It is the policy of this church that anyone who is called by God to ordained or lay ministry can explore their vocation certain in the knowledge that it will not be denied on the grounds of their sexuality or marital status.

And it is also now the explicit policy of this church — always true, before never written — that the conscience of any priest who does not wish to marry anyone for any reason will be protected. And any attempt to circumvent or disparage the clergy for whom that is their decision, they will be defended as passionately as all the rest of this was fought for in the first place. A decision to respect religious freedom does not, after all, count for much unless our commitment is to respect all religious freedom.

We have changed the world.

We have changed the world by being a Church that has chosen to stay together over the issues of sexuality and same-sex marriage.

And we will do it again — the decades of squabbles over sexuality will surely still rage across other denominations and provinces, but we are a church that can change the world because we can start talking now about all the other things that are imperative to the world in which we live. I woke up this morning to news of political chaos, but, more significantly, to news that the tide of the alt-right is finally turning and that the values of social justice and radical common sense seem finally be making their way back to the Britain. It is time for the Church to start making its voice heard in areas of economic justice, climate change, and global peace; the protection of education, healthcare, and social care; the protection of the poor, the vulnerable, and those who come to these lands seeking refuge; and the business of building the city of heaven here on Earth.

We changed the world yesterday, and surely, surely, that means we can do it again.

On my way into Synod yesterday morning, wearing a badge that displays the Scottish Episcopal Church’s pub sign on the background of a Pride flag, someone said to me, “If this happens, what will we do if busloads of gay couples start arriving who want to get married?” Well, if busloads of gay couples want to start making their way to Scotland to make their marriage vows, they may come and with gladness in their hearts, and there I will be, waiting with the confetti and an open door, for in the Scottish Episcopal Church all are welcome at Christ’s table.

Christ be our light,
Shine in our hearts, shine through the darkness,
Christ be our light,
Shine in your Church gathered today.

Marriage in the Scottish Episcopal Church – Turning The World Upside Down

This is what I said to General Synod today:

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Chair, Members of Synod.

Gosh, aren’t there a lot of people interested in what we have to say today.

You would think we were about to turn the world upside down.

For all the talking I seem to have done about it over the last few years, my love life truly isn’t that interesting. I’d like to believe that when I leave here today, it will return to being a matter for my parents, asking why I haven’t yet provided them with a daughter-in-law; my friends, nudging me towards the terrifying prospect of Internet dating; and, maybe, someday, when I’ve found the perfect woman, for the Director of Music at my cathedral as he tries to persuade me that the trumpets from the Verdi Requiem do not a wedding processional make.

But today — maybe we are trying to turn the world upside down.

And if we want to build the kingdom of heaven here on Earth, maybe that is what the world needs.

The question of our place in the world — our responsibility to the Anglican Communion — is one that has come up over and over again, the whole way through this process. The question of repercussions that any decision we might make today might have on our sister provinces.

Synod, the Anglican Communion is a very broad church indeed and it works in a very wide world.

As hands are wrung over the fate of the Anglican Communion, we so often forget that there are many people beyond these borders who cheering us on, praying for us to shine a light into places on Earth where our LGBT brethren and their allies too live and, often, die under the darkness of systems that oppress and persecute.

We do a disservice to our brothers and sisters around the Anglican Communion when we presume that they are of one mind any more than we are of one mind, and we do them a disservice when we presume that by keeping our mouths shut we are keeping them safe.

We can surely do better than that.

I want to be part of a Church where everyone can flourish. I want to be part of a world where everyone can flourish, too.

My learned friend from Aberdeen and Orkney feels that what we are doing today has broken the Church, but, with the greatest of respect, I feel that the amended Canon 31 can make the Church more whole than it has ever been.

Today, we have the opportunity to say that this is a church where there is room for everyone, where all are welcome, and where there is enough and more than enough love to encircle all of God’s children.

To get here — it’s been a long road.

I am so proud to have walked it with so many of you.

To have walked it with my brothers and sisters who agree with me. To have walked it with my sisters and brothers who profoundly disagree with me. This has been a journey. In the words of our marriage liturgy, a journey in which we have grown and been transformed. I believe that is true for every single one of us. And I believe that in the wording of this Canon, there is room for us all to flourish.

The thing I am most proud of today is that at this moment, here we are, all of us, hand in hand, walking together.

If we do this, the Church will become a more welcoming and more inclusive place for people like me. I can go to my cathedral on Sunday and say to members of my congregation, “Yes.” And should I find that perfect person, I will be able to say to her, “Yes.” I want you to not understimate the importance of that.

But today is about so much more than that.

Because today is also a chance to show all of this to all the world.

To say, you can do it like this. You can find enough room for everyone. You can do anything, just as long as you remember to love one another.

And love is love is love is love is love.

And God is love.

And love will turn the world upside down.

Open, Inclusive, Welcoming, and Proud: Scottish Episcopal Church Approves Canon 31

General Synod has approved amendments to Canon 31 with a greater than two thirds majority in each of the houses of Bishops, Clergy, and Laity.

The Scottish Episcopal Church is open for business in all its glorious diversity, and our business is professing the Gospel truth that God loves everyone. I am proud to have been part of this process and will be proud to see gay couples walk down our church aisles. I am relieved that we can move on from long years of squabbling over sexuality, and delighted that have done it in a debate that was so generous and diverse.

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How To Follow Along With General Synod

This is the key information for those who are hoping to follow along with the General Synod of the Scottish Episcopal Church.

There will be items on the Today programme and BBC Breakfast this morning.

The discussions on Canon 31 are this afternoon (Thursday 8th June). The debate on Motion 6, which would pass the proposed Canon, is is expected to start at about 2.45pm. An hour has been scheduled for the debate. There will be a break for refreshment and the vote to be counted, and we expect to have a result at about 4.20pm.

The papers are available to read here. They include the text of all the motions, the text of the proposed amendments to Canon 31, and a draft guideline from the House of Bishops on how various practical aspects of the new Canon 31 would be dealt with if it passes.

General Synod is held at St Paul’s and St George’s Church on York Place, Edinburgh. The meeting is open, and the gallery is open to the public. It is likely to be busy today. There are security measures in place, so please allow a little extra time to get in.

If you wish to follow along at home, the live video stream of the proceedings is available here.

The conversation on Twitter can be followed and joined in with at #pisky.

The Primus is making himself available for interview immediately following the day’s proceedings, which we expect to be complete at around 5pm.

On The Eve of General Synod, Some Thoughts on Love and Marriage

Tonight, I am preparing myself for the General Synod of the Scottish Episcopal Church which begins tomorrow in Edinburgh.

This is the long awaited Synod in which we may well make equal marriage a reality for those in the Church who choose it, but it is also the Synod in which the Church may equally well choose not to do that. If we were to believe the headlines in the mainstream and Christian press over the last week, we would be forgiven for thinking that it is hardly even up for debate. This is not true. A two thirds majority is a high bar to clear, and the debate in our last two Synods has been robust and thorough, and I am certain that this Synod will be no exception.

But there are things that I am certain of.

There was a time — and it wasn’t that long ago — that to be a gay person in the Scottish Episcopal Church meant listening to other people talk about issues of LGBT equality as if there were no gay people in the room. There was a time when I struggled to believe that the wider Scottish Episcopal Church would ever wrap its head around equal personhood for LGBT people, let alone equal marriage. And the idea that I would ever hear straight people making speeches in favour of marriage equality in the Church did not exist even in my wildest dreams.

I am certain that those things are not true anymore.

This is a campaign that has changed the Scottish Episcopal Church for the better.

I will believe that, no matter what happens tomorrow.

The headlines are not saying that either. No doubt it doesn’t make such a good story as the one that says we’re on the point of schism, but the version that is being printed simply isn’t the case.

I have made no secret of where my allegiances lie. You know how I want this to go.

I’ve said a lot of things over the last five years, and I have mostly talked about the bigger issues. I’ve said a lot about why I believe this is important for the world and why it is important for the Church, and those things are all true and no doubt I’ll say them again before we’re done here.

Tonight, I want to put my cards on the table and talk about why it’s important to me.

The presumption is that if you are campaigning for marriage equality, you must have someone who you actually intend to marry once you are able to do so.

I have a job that lends itself to odd hours and strange dinner conversation, a cathedral that lends itself to more odd hours and even stranger dinner conversation, and a rather wonderful life that is no less wonderful simply because it does not happen to feature a partner.

And yet — this is something that is important to me anyway.

I already know that God loves me.

I know it because I happened to stumble into a cathedral that would become home, and a few weeks later I happened to hear a sermon that would change my life and change my faith. A sermon that told of the Gospel truth of a God who loves everyone.

That is the business of the Church. To proclaim that God loves everyone.

But here’s the thing:

You can’t just say it.

You have to live it.

My coming out story isn’t particularly unusual, nor did it go particularly badly, or, at least, not in the larger picture of what happens when people come out and it really does go badly, but I did grow up knowing that what I would come to understand was my sexuality was something that wasn’t quite okay, wasn’t quite normal, and put me on the outside.

This is why civil partnership and then equal marriage legislation has been so significant. The wave of equality and love that seemed to sweep across parts of the globe over the last decade. The day they passed equal marriage in England and Wales. The interns running across the steps of the Supreme Court. The day the parliament in New Zealand broke out into a Maori love song, a moment so profound that I still cry when I watch it. The day it passed in Holyrood and the man who was trying to sell me a car while I watched the vote on a cracked iPhone screen thought it was all wonderful but also utterly unremarkable, and that it was that, the fact that he thought it was unremarkable, that was absolutely astonishing to me and more than anything else made me realise how far we had come.

These things are important not only because they legitimise our relationships, but because they legitimise who we are.

Tomorrow, that’s what Synod will be saying to me if we pass this.

That you, and you, and you, and me, are exactly who God intended us to be.

That you, and you, and you, and me, are included in the circle of all that is holy.

That the Scottish Episcopal Church is open for business, and that that business is telling everyone that they are loved by God.

It’s Time – Marriage Equality and the Scottish Episcopal Church

In eight days time, I will be in Edinburgh at the General Synod of the Scottish Episcopal Church.

A significant piece of business that will be done at this Synod will be to vote on proposed changes to Canon 31, the law that governs marriage within the Church.

I am aware that I have been banging on about this for — well, for a very long time now. It is truly my great hope that I will return to the General Synod of 2018 and get up to make a speech about refugee welfare or clergy education or the budget or anything at all that isn’t about marriage, but this is what we’re doing next week.

There is a lot of detail that I could go into about what exactly it is that we’re doing. If your memory does need refreshing, I’d start with the equal marriage tag on this blog.

A few specific starting points:

The main thing to say about the proposed change is that this is the vote that, if passed, would make marriage equality a reality in the Scottish Episcopal Church.

The main thing you need to know, though, is that, if passed, this vote will enact something that is written in such a way as to be the thing that will enable the Scottish Episcopal Church to be kept together: all of us. Those of us who are straight and those of us who are LGBTQI. Those of us who are single and those of us who are married. The most conservative traditionalists and the most liberal progressives, together in a Church where we will be able to finally sing with truth that all are welcome in this place.  

We will need a two-thirds majority — 66.7% — in each of the houses of Bishops, Clergy, and Laity.

I am a child who grew up under Section 28. In the last thirteen years since the Civil Partnerships Act, I have seen the most astonishing seismic shifts in the way LGBTQI people are spoken of and viewed by society, and in the civil rights legislation that has followed, and never more so than in the way things have changed in my last four General Synods.

I am hopeful that we will do the same thing in eight days time in Edinburgh, but, make no mistake, I am taking nothing for granted.

Yes, I have been talking about this for a very long time and I will continue to talk about it and I will not minimise how important it is.

Because — it is important.

To me, on a personal level.

To the Church, because I truly believe this is something that will be good for the whole Church and the whole Communion.

To the world, because when I got into this in the first place it was because I wanted to be in the business of making a better world — and make no mistake, if we do this in our little corner of the globe, our little corner of the Church, then a better world is what we will have made.

I remember that day, that wonderful day in 2014, when marriage equality became the law of the land in Scotland, when an impossible dream came true, and surely, surely, we can do it again.

It’s time, I think, to give this one a dusting off:

What’s Next?

You may remember that not too long ago — it feels like forever ago —  I was being admonished by my emails to prepare properly for a job interview and spending evenings being grilled on clinical scenarios by long-suffering friends.

It is with something beyond joy and no small measure of disbelief that I tell you that this afternoon I was offered a job as an ST3 in Acute Medicine in the west of Scotland. I am a bit terrified, and a bit gobsmacked, and a bit weepy, but I am mostly just really bloody happy.