Masks: are you wearing one?

It’s 2020. The Year of the Mask. Whether you are a medical professional or not, you will have been asked to wear them, discern their worth, determine which type is best for you, consider their real purpose and deliberate on where you stand with respect to the health benefits they may offer you personally or the population as a whole.

This article is not so much an examination of the physical benefits of wearing masks and the pros and cons of this or that type of mask or even the risks and benefits of wearing them at all. Instead, let’s go deeper and examine the masks we all wear every day at work, at home, out and about, on-line and even when we think we’re alone. These are symbolic masks: the mask of the ‘good’ doctor, the mask of the empathetic nurse, the mask of  ‘fitting in’ with your hospital or clinic mainstream narrative, the mask of people-pleasing and for me, the Daddy of all masks – ‘niceness’.

In Truth, metaphorical mask wearing is not new to Medicine, or indeed to life. It is an old, entrenched and normalised expectation that expertly moulds us, if we choose to go along with it. Long before surgeons ever donned face coverings as protective barriers, we doctors have been covering our authentic, true selves with protective barriers of intellectual superiority, medical-speak and invulnerability. Our masks become so comfortable we forget they are there, or that they deeply hurt us, which is ironic, as we have taken them on to try and protect ourselves from further hurt.

So – what are we protecting ourselves from?

All masks, actual or symbolic, are intended to protect from perceived, not necessarily real, danger. And that they may offer, for a time, but they sabotage our connection with that ‘dangerous’ other because our true expression is not ever given its full reign. So we remain isolated and apparently secure behind the barrier, the smiley demeanour, or the script we have accepted – free from the call to deeper connection with our patients, colleagues and ultimately from ourselves. The truth is that our protective masks are double-edged swords; promising security from hurt, rejection or ‘being the outsider’ whilst guarding us in a comfortable prison of invisible isolation. Could it be that the untold pandemic of ill mental health and suicide within Medicine and our societies at large is the end-result of these ubiquitous prisons?

Doctors are told that speaking up, from the heart, can incur serious retaliation, particularly if it goes against the almost religious tenets of evidence-based medicine. Nurses and social workers discover that questioning institutionalised corruption or abuse can incur a wrath that jeopardises jobs and livelihoods. This is what happens to those who realise they are in a prison, steal the prison keys, free themselves and try to free others who are in there with them. Our invisible security masks may protect, yes, but they also stifle our true expression, building a tension in our bodies that has its inevitable release in illness and disease, be it mental, emotional or physical. That is no basis for a truly caring health ‘care’ system.

Nice – the iron-clad mask

So many of us, particularly women, have been trained to be nice, at all costs, and to think that it is something we have to be. ‘Nice’ is impeccable, good, accommodating, dutiful, polite, respectable (not respectful) and above all, beyond reproach. It is all the qualities we are groomed to aspire to as healthcare professionals. Nice is now the scaffolding of our modern society, a bullet-proof mask that asks you to conform quietly like the rest or you will be judged, ousted, deprived of your social position, reputation or just ignored. Nice rejects truth in favour of expediency.

Looking back on my medical career, it is those times when I have emulated the poster-boys and girls of the ‘nice’ brigade that have been the most harmful to my self-worth. Those moments when I failed to speak from my body, my heart, about incidents or policies that were obviously harming and imposing on patients or staff, just to keep the ‘nice’ or ‘good’ alive. That time everyone in the multi-disciplinary team agreed (except me) with forcing a patient down a particular pathway (for their own good) whilst paying lip-service to shared decision making. That heartless, scripted and accusing email that was so soaked in ‘nice’ I barely knew what I did or how to respond. That time I turned a blind eye to our colleague’s bullying behaviour to keep the team ‘together’. Nice is the unspoken compromise we face when corrupt social ideals and beliefs clash with the instant knowing and truth in our heart. We all know when we are being sliced and ‘niced’ by someone who is choosing to outsource their expression of truth for the comfort, protection and social acceptance that ‘nice’ promises.

Can’t I just take my mask off, when it suits?

Well yes you can, if it’s just a cloth or paper one and the ever-changing regulations permit. It may be a bit trickier with the invisible variety. With daily repeated wear, that mask can own us. Stepping away from the comfort of security, job-safety, and social acceptance that wearing a mask offers is a big trade for true freedom. Not a choice most medical workers are willing or feel able to make.

What are the benefits of taking off my mask?

Living in a genuine connected way, going off-script, is a true freedom that is real and tangible and felt in your whole body. It is the cure for your ‘normalised’ anxiety, the lasting joy that far outweighs any temporary sense of ‘happiness’. It is the knowing that you are aligning to what is inside you, your inner heart, and not looking to others for approval. Is it easy? Not always. But it is simple. And that simplicity reflects to others that they can do the same.

Imagine if one of the (actual) criteria for entry into medical or nursing school was the lived and observed ability to be genuine in one’s interactions with others, free of masks, niceness, expected medical narratives, social traditions and scripts. What would the knock-on effects be for our health care system? Perhaps an absence of carelessness, of institutionalised arrogance, and instead an ease of expression, a unity of true purpose for staff wellbeing and subsequently true patient care, with simple and uncomplicated standards (not complex regulations) that support that aim. As a profession we have flirted with taking off our masks – usually during catastrophic events such as earthquakes – or during ‘crazy socks’ medical mental health awareness days. However thus far, most of us have never just taken our masks off permanently. If the majority of us did, the prison of isolation and stunted expression that underlies the medical suicide epidemic may be deconstructed.

Consider that mask-wearing, actual and symbolic, has been a human characteristic for aeons.
They have been used in various cultures to create mystery (deception), disguise and power differentials, whether in tribal settings or childhood play. The freedom of transparency is something we talk about but rarely live, and yet that is what most of us crave with another. Who will take off their mask first and for how long? Perhaps this game is the way it is because it keeps us firmly locked in our golden prison of comfort and security.

There is inspiration to be had from doctors who are showing us what is possible when we unite, masks off, against the imposition of ‘nice’ that is peddled by the mainstream media and our current corrupt medical models. The moment has come to be inspired, en masse, to take off our masks and show our true faces and expressions, uncovered and rediscovered.