Stories from the Spectrum: Harri Wilson

Harri Wilson is an autistic junior doctor on the front line of the NHS treating patients with coronavirus (Covid-19).

Harri tells us about their experiences working as a doctor who is autistic during the coronavirus (Covid-19) outbreak and shares their advice for how hospitals and non-autistic NHS staff members can support their autistic colleagues during this difficult and unprecedented time.

How has your work as a junior doctor changed since the coronavirus (Covid-19) pandemic began?

There has been a huge amount of uncertainty. The hospital emails out an updated plan every day, often two or three times per day, and guidance also changes daily. Our rotas have changed three times in two weeks, and may well change again soon. Juniors were supposed to rotate to new jobs on 1 April, but this has been cancelled. Instead, we are being redeployed at very short notice to parts of the hospital that need more doctors – areas we’ve never been to before. It’s been so stressful not even knowing a timetable for the next few days, never mind the next few weeks, as like lots of autistic people, I struggle to cope with unexpected change and need time to prepare for a change to happen.

Patients and families are more stressed and anxious too, which means they are more likely to get angry with staff members. We in turn feel guilty because it can feel like we must be at fault. Having said that, all the staff have really pulled together. Everyone is determined to do their best, and the way everyone is so generous in helping each other out all the time makes me really proud to be a part of the NHS.

What are the challenges you face as a doctor who is autistic?

Perhaps surprisingly to some people, I don’t struggle with patient communication. I worked really hard and attended lots of simulations through university to improve my communication skills, and now, although I have my own style, communication is the aspect of work where I get the best feedback.

Something I do struggle with is the noisy environment of the workplace. I am supposed to get a separate quiet space as part of my reasonable adjustments for breaks to help me cope, but I have never actually had this provided, despite contact with occupational health. As an autistic person, having the structure of your day upended can be really difficult. You sometimes get pulled to another team or another part of the hospital midway through the morning with no warning. This is fairly unusual though.

What advantages do you feel being autistic gives you in your job as a junior doctor?

The support I received around the time of my diagnosis helped me realise lots of things I take for granted are because of what being autistic is like for me. For example, I always notice lots of details other people miss and this can be really important in making the right diagnosis or picking up that a patient is deteriorating. I also have an excellent memory, which really helps in my job. I can’t really recognise or remember faces though – this can make things tricky when many of my colleagues wear the same uniforms!

What is being autistic like for you?

I have worked very hard for a long time to learn social ‘rules’ when interacting, which can be a common experience for lots of autistic people. I still make mistakes with this, particularly as interpersonal relationships progress beyond the initial conversation. My friends are very forgiving, but historically, I have not managed to keep friends very long and this used to really upset me. Apart from socialising, I am also sensitive to noise, busy visual environments, and textures. I struggle with 'sensory overload' and can have big meltdowns if I am 'overloaded' for long periods of time.

How can hospitals and non-autistic NHS staff members support autistic colleagues?

NHS teams are already used to looking out for strengths as well as the challenges facing their colleagues. I feel doctors do this especially well. A focus on clear allocation of roles and tasks, as well as allowing people to take a few minutes away when needed, is helpful for everyone in stressful situations.

For autistic colleagues, I think it’s important to give as much notice of any changes as possible to allow them to prepare, and even a rough timetable if feasible, as these are things that help me work at my best. I wish people understood when plans change, a lot of my brain is taken up by coping with the change, and so I can’t process other tasks the way I usually can. Unfortunately, some information simply isn’t available, as it isn’t known, so I understand there is no perfect solution. I hope we will settle into a new routine as time goes on.

What do you enjoy most about your work as a junior doctor for the NHS?

I really love when you get to solve something vitally important to the patient. As a junior, you are the 'middle person’ and responsible for finding out what matters to each patient and making sure the team knows about it, as well as ensuring the patient understands what is happening. This can mean little things like organising a trip out for a long-term patient or tracking down the one type of food a child will eat, or big things like controlling someone’s pain or helping them understand their treatment.