Interview with Amicus Associate, Dr Charlie Tweed

Welcome Charlie, can you give us a bit of background on your career history and what has led to what you do now?

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I first joined the military as a reservist private soldier during my late teens. I underwent survival and endurance training and found I thrived in some difficult training scenarios. I also took up Ultra Marathon running and was part of the Army Windsurfing Team. Unsure what to do after my first degree in history and with no science A-levels, I chanced an application to a relatively new postgraduate course in medicine at Newcastle, where you needed a 2:1 to apply. I wasn’t that convinced I would get in, but somehow managed it. My path changed quite quickly and along with continued military reserve service, I spent time preparing for life on the wards, keen to become a Surgeon. In my fourth year I chose placements in War Surgery and Psychiatry, doing some training with emergency medical teams before they deployed to Afghanistan. I then spent some time in the Middle East working with surgical teams of the Jordanian Red Crescent and Médecins Sans Frontières. We treated casualties from the conflicts in the Gaza Strip, West Bank, and Iraq, performing long and complex operations on civilians, many of whom were children. This was an experience I will not forget. After one of several operations helping try to repair a young man with a gunshot wound to his face, I left the Middle East for the UK convinced I wanted to be an Oral and Maxillo-Facial Surgeon, a speciality where you need both a medical and a dental degree, and I began to start preparing for this.

On qualifying as a doctor in 2011, I worked in London and Chichester in a variety of medical and surgical specialties, including head and neck surgery, and Maxillo-Facial Surgery. The operations in the UK, were generally more mundane to those of the Middle East, and I realised that life as a UK surgeon would be quite different. After time working in A & E and a GP surgery, I took up a post as assisting surgeon in Orthopaedic Surgery at Epsom Hospital. During this post, whilst I learned a lot and liked the team, I realised that surgery probably wasn’t for me as much as I thought it was, so I started to explore other options.

I naturally looked at the military, and the Royal Navy had space to work with Royal Marines as a medical officer, (the royal marines don’t have doctors, you join the navy and become attached). When the hatch shut to the nuclear submarine I was posted to and we dived, I think it felt like it had all gone terribly wrong somewhere.

Alas I settled in and was the medical officer for two Nuclear Submarines over a two-year period, going for long periods of time underwater without the ability to call for assistance or to evacuate casualties when they occurred. I also managed to get out to Sierra Leone between patrols for the Ebola Epidemic. Time on submarines tested me, my nerve, and my medical skills a lot and hoping for some more sunlight, I volunteered to work in Counter Terrorism. I deployed with three Royal Marine teams to the Middle East and Africa, and as a natural career progression started to think about taking up specialist training, where I looked hard at becoming a Military GP. I was lucky enough at that time to do some work for my part time master’s dissertation in ‘Peritraumatic Dissociation in PTSD’ with one of the chief Military Psychiatrists, who very kindly said to me, “you have far too reflective a mind to become a GP”. He encouraged me to apply for the one military psychiatry post that year, and I was successful.

During Military Psychiatry specialist training you work both in Military and civilian NHS settings. I realised I enjoyed the deeper psychological and psychotherapeutic work a lot more than much of what you do in the military, which tends to be quite occupationally focused making decisions as to whether people can function in their roles or not, and eventually I made the difficult decision to leave.

I work in a variety of roles now as well as being an Associate Consultant with Amicus. I work as a Trauma informed Psychotherapist treating veterans for the Royal Marines Charity, and as a psychiatrist for a Crisis Team based at the Bethlem Royal Hospital, treating people in the community and on home visits across South London. I also have a company called Resolute aimed at building Psychological resilience, and run a range of courses and training packages for groups such as sportsmen and women.

Why Psychiatry?

Whilst I found many of the complex surgical operations very interesting and exhilarating to start with, I found myself realising that one person’s jaw, knee, hip, appendix, liver, guts-is very similar to another person’s. I grew tired of spending long periods standing in operating theatres, and realised that if I was really honest with myself I liked the idea of being a surgeon, more than the reality of it.

On the other hand I have always found people’s stories interesting. One person’s mind is astronomically different to that of someone else’s. Being able to hear people’s stories, to really hear the conscious and unconscious content they bring to you with some of their deepest and darkest thoughts and desires, whilst challenging, is also quite a privilege. There is something that transcends meaning or time about it, for me anyway. I think that humans are meant to tell each other their stories and I find Psychiatry to be the perfect blend of science, philosophy and art.

What’s the best part of your job?

In my trauma and crisis work I do know that there are several people alive today because of me, and the work we did together. That is a feeling that is difficult to put into words.

You facilitate the Amicus’ Leadership for Emotional Wellbeing Workshop alongside Peter and Jennifer and are involved in Amicus client projects focused on this topic, what elements do you cover and how does it help individuals and businesses as leaders?

We cover a lot in a short amount of time on the emotional wellbeing course. I think it blends together crucial leadership ingredients and expertise from Peter’s and Jennifer’s on the ground know how, with scientific explanations and techniques for why these ingredients matter, offering concrete tips and tricks as well as helping delegates think about themselves and their team in a different way. I think people often leave the workshop looking ‘lighter’ than they did before they arrived, and hopefully it steers people in the right direction to start having a happier and healthier work and home life, and as a by-product of that, a much more productive one financially.

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You recently covered a workshop ‘Looking After Yourself as a Leader’ in our Amicus Leadership Conference which went down very well. What would be some quick wins that individuals could adopt to look after themselves and their team?

There are many things one can do to have a more wholesome life emotionally. I try to separate gains into quick ‘hacks’ and more longer-term routines and insights. There’s a lot out there on wellbeing and managing yourself, and I’d suggest looking at everything in moderation.

A big one that has both short and long term factors involved is trying to sort out your sleep hygiene, as best as you can. One way to do this is by limiting your phone and social media use, especially close to sleep times. Try to leave your phone out of the room you sleep in- our minds are much more attached to them than you might think, even when we aren’t directly using them. Get a basic alarm clock for £10 and leave your phone somewhere else.

I remember reading some advice in the Oxford Handbook of Clinical Medicine as I was starting my junior doctor years, bracing for some of the arduous night shifts that has always stuck with me, and I think applies to us all no matter what your trade.

“Do not voluntarily deny yourself the restorative power of sleep, for it is our natural state in which we were first created, and we only wake to feed our dreams.”

Why is looking after your own and your teams’ emotional wellbeing so important as a leader?

You are already in some way looking after your own and your team’s emotional well-being, you just may not have consciously realised it yet. Emotions are contagious and most of our emotional communication isn’t done through speaking, It’s impossible for teams not to be affected by how you feel, and vice versa. 

Taking charge of your own, and your team’s emotional wellbeing will allow you to harness something that will make your work life smoother, win you more clients, and help make others more productive. It’s just plain common sense.

In your day to day job working as a psychiatrist, you must come across a variety of different stressful environments and certainly in the military. What do you do to relax at the end of a heavy day in psychiatry?

I have an energetic cocker spaniel who I try to hang around with outside of work. I also try to write fiction for teenagers, as well as the usual things we all do to chill out.

Can you share significant setbacks you faced as a leader in the military and how you overcame them?

I have made a couple of decisions under pressure that in hindsight, were not the right decisions. Summoning the humility to admit to the rest of the team I made a mistake was very hard, especially when the consequences might endanger them and our mission objectives. To move on from this whilst bringing them with me was important; a team sees through you if you try to cover something up or 'blag' it. On the flip side being honest with them allows them to adjust, (probably after rolling their eyes),but once accepting the initial changes to the situation, connect with you and your humility as a leader. I actually believe the teams ended up respecting me more and ultimately, we overcame the operational challenges much stronger, and with better outcomes overall.

Mistakes are inevitable both for you and your team; if people don’t feel they can make them, they will be covered up or driven underground. Don’t shy away from the fact that we are all fallible; that’s fine. By making a mistake yourself, you allow your team to be able to do the same. It’s when mistakes aren’t learned from and keep getting repeated, that you need to worry.

If your team aren’t making any mistakes at all, the question I would ask you is:

What aren’t they telling you?

What are you reading at the moment?

I am reading a young adult fiction novel by Neil Gaiman called, ‘The Graveyard Book’. It’s about a young orphan who is raised in a graveyard by friendly ghosts. It has a great opening and will change your mind about graveyards, so clever is Gaiman’s writing.

A fascinating fact about you?

This is perhaps more random than fascinating, but I can play the bagpipes. I learned with a London Scottish Regiment Army unit when I was 17.

In your opinion, what are some common misconceptions about psychiatry that you’d like to dispel?

Whilst psychiatric settings often make for great films such as ‘Shutter Island’, ‘One who Flew over the Cuckoos Nest,’ and ‘A Beautiful Mind’, they are often not great depictions of what it is really like to work in mental health. Generally, I find psychiatry is about one group of people, trying to help another group of people, who are in some sort of pain. It really isn’t like what you see in the movies, and often the common misconception that ‘patients don’t get better’ is just plain wrong. More than any other medical field I have worked in, I find I make the most tangible difference helping someone lead a happier and more content life.

Can you share a memorable success story where your leadership skills made a significant impact on a situation?

Some years ago myself and a colleague were deep in the jungle of West Africa, in a particularly remote area near the Sierra Leone and Guinea border. Travelling by motorbike between villages along tiny tracks through the bush, we were aware there were poachers and other criminal networks operating in the area. On the way out to a remote village, we came across an illegal roadblock. Five men holding machetes walked out from the bush and surrounded the bike.

We had a quick decision to make. Try to fight? Try to flee? Try to- what? Run?

In a situation like this, your heart and gut tell you all sorts of things in a very short space of time. One of them, is that you should fight. Following several quick assessments of their numbers, their weapons, as well as other more vague estimates one makes such as, ‘How well trained are they? How well motivated are they really?” The question I believe I was unconsciously faced with was; ‘should I allow the adrenaline response I am having, govern my next action?’ My colleague, was I believe moving in this direction, when he smashed through some of their makeshift roadblock. For a moment, when they grabbed the bike, I didn’t believe things were going to end well.

The right decision here whilst outnumbered and outgunned, was to calm things down and confidently negotiate. So that’s what I did.

For the price of the equivalent of around 5 pence in Sterling, we continued on our journey- alive and unharmed, with a call from the ringleader wishing us a ‘bright day.’ This felt like quite a success, though I was annoyed to lose the money which was worth a lot out there.

Sometimes, as much as it may dent our pride, or feel plain unfair- the best thing to do is be left feeling a little irritated and hard done by. Much better to feel that way than several of the alternatives, particularly in situations like this one. Trying to put a fire out with more fire, doesn’t often work. Especially if there isn’t lots of support around you.

As Alfred North Whitehead says, “the purpose of thinking is to let our thoughts die, instead of us.”

In your opinion, what are the key qualities that differentiate effective leaders from average ones?

Leaders that have the humility to be a human being, that don’t treat someone different because of some perceived difference in ‘rank’ or power always stand out for me- the leaders that bring people with them rather than dictate what to do. If someone has to pull rank, I believe they have already failed as a leader. Leaders who have humility will always stand out in my mind because it’s such a difficult trait to maintain, especially when you climb to the top and all those great temptations that come with senior and more powerful positions start to become seductive.

What advice do you have for individuals aspiring to become better leaders in their organisations?

Have the humility to gain some self-insight into how you work as a person. Never think your sh*t doesn’t stink. Have the confidence to stand up to things you don’t agree with. Know when to follow and when to lead; too many cooks definitely spoil the broth. Don’t say ‘how high’ when someone says jump. Say ‘how high’ with your eyes fully open if the person asking you to jump, is a formidable leader and you trust them. Think as wisely as you can before you start barking orders. If in doubt, the serenity prayer is always a good place to start in leadership, and I’m not saying you need to become religious:

“God, grant me the serenity to accept the things I cannot change, 
the courage to change the things I can, 
and the wisdom to know the difference.”

Do remember that lots of things we think we can’t change, we can. There is such a word as ‘can’t’ but it’s true much more rarely than we think. If in doubt, go for it.

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