Delivering excellence in an imperfect world

Delivering excellence in an imperfect world

“Delivering excellence in an imperfect world” was the theme of this year’s British Gynaecological Cancer Society conference. Driving home from Bristol, I realised it also describes how it can feel to teach in healthcare.

I had 20 minutes: 20 minutes to contribute something useful to a room full of clinicians working in systems that rarely give us enough time, enough training or enough services to meet all of our patients’ needs.

Carrying stories into the room

Whenever I speak about sexuality after cancer, I feel as though I carry the women I have met in workshops and clinics with me. Their stories shape what I choose to say. I cannot speak for them, but I feel a responsibility to advocate for what they have said they needed and did not receive: information, acknowledgement, practical support, permission to ask difficult questions and someone willing to stay in the conversation.

What do you do with 20 minutes?

Do you focus on practical interventions that clinicians can begin using tomorrow? Or do you spend the time talking about trauma, bodily autonomy and why feeling safe in healthcare matters as much as getting treatment right? I still do not know.

Avoidance rarely comes from a lack of compassion. More often, it comes from knowing how important something is while also knowing there may not be enough time, training or somewhere meaningful to refer someone afterwards. There is a particular kind of shame that grows in that gap — not because we do not care, but because we do.

Keeping the door open

Every time I finish one of these talks, I think about what I did not say and whether I chose the right 20 minutes. Perhaps delivering excellence in an imperfect world is less about having the perfect answer, and more about continuing to ask difficult questions. Each conversation shifts things a little. None of us can close this gap alone, but if we all do our little bit, we can make it smaller.