Dr Sukumaran is a consultant child and adolescent psychiatrist at South West London and St George’s Mental Health NHS Trust. She is one of 25 women to be highlighted as part of a special project that celebrates the stories of 25 amazing women psychiatrists.
Dr Sukumaran's story: Becoming Special(ist)
Cardiology. Anaesthetics. Orthopaedics. While many classmates went for the cut-and-thrust of acute specialties, I got a buzz from psychiatry, developmental paediatrics and neurology, and working in multidisciplinary teams to meet the physical, psychological and social challenges of chronic conditions. So, after a stint in adult medicine, I became a paediatric trainee.
This was the 80s and 90s, with 80-hour weeks and 1-in-3 on-call rotas - we were a long way away from the European Working Time Directive1. As junior doctors, we survived and thrived thanks to bonds forged by living together in hospital accommodation, and the camaraderie of the doctors’ mess. We also had the benefit of ‘firms’ – teams comprising a consultant and two or three middle-grade doctors to whom you were attached for six months, with whom you followed patients from admission to discharge to outpatient care and, if necessary, to re-admission. This allowed us to get to know not just our patients, but their families and lives, and the real impact of the treatments we prescribed.
Then I had a stroke and my world turned upside down.
I decided that I could not complete the acute paediatric training required, as I could not safely carry out procedures such as intubation. I switched to psychiatry, eventually finding my niche in child psychiatry.
Yet I have been lucky in so many ways: I was able to ‘diagnose’ myself and phone for help, and was admitted without delay to a brilliant neurosurgical unit. I have had exceptional care from the NHS throughout, from life-saving surgery to cutting-edge rehab treatments.
Becoming a psychiatric referral myself was also instructive: “Seems withdrawn, not sleeping. Appears low in mood.“ Luckily the liaison psychiatrist agreed with me that I was not depressed, just angry. Yet I appreciated that a busy neurosurgical team had considered my psychological health and referred appropriately. It was a lesson in holistic practice which later spurred me, as a psychiatrist, to keep my basic medical skills up to date.
Although my stroke has affected my movement, I don't have any cognitive, sensory or communication impairments, and I am independent in daily living. This direct experience has ultimately enabled me to be an effective advocate for my young patients with complex disabilities. I am open about my own limitations and encourage colleagues to be curious, rather than make assumptions – in this, humour and an enthusiasm for coffee and for assistive technology have been helpful.
The biggest inconvenience is that everything takes longer even with help, and I’ve had to develop pig-headed persistence to do everything I want. Being able to drive has a special significance, as it’s the only time I’m as fast as other people.
I was also very fortunate to have studied in Liverpool: a city which was still recovering from the Toxteth riots when I lived there, but which still retained its openness and inclusivity; where the first question you were asked when you arrived was whether you were Red or Blue; and where a strong sense of ‘family’ meant that ex-colleagues telephoned around London hospitals to track me down upon hearing I was ill, travelled from abroad to visit, or offered a place to stay while I recovered.
In contrast, when I visited the part of Asia I come from, the concept of karma and retribution for sins in a past life mean there was low status for disabled people, even in educated communities. However, if becoming disabled was a just punishment for past sins, was refusing to accept it, and trying to get better, also a sin? No one could tell me.
Learning to walk again was a huge milestone - people often didn't make eye contact with someone in a wheelchair. In fact, well-meaning people suggested all sorts of ‘curative’ complementary therapies, even when I was independent and practising medicine again; anything less than a total recovery seemed not to be good enough. When I got married, my husband was called ‘a saint’.
- I am a dedicated child psychiatrist who has worked in several London Trusts and the independent sector.
- I helped set up one of the first neurodevelopmental teams in a community CAMHS, drawing on the expertise and creativity of a diverse multidisciplinary team, and the backing of pioneering women managers.
- I led my current team through several turbulent years of exceptional demand and scrutiny on the service. We came together as a team to communicate concerns about risks to patients and staff, and thus create positive change in the service. This cohesion has enabled us to survive the challenges of COVID over the past year. I believe that resilience, flexibility and communication skills, and building good relationships and trust are key to success as a doctor.
- I have a warm, inclusive and positive style as consultant and senior clinician, supporting and recognising positives in others before criticising their mistakes.
- I have strong relationships with my colleagues at all levels, many of whom have remained friends long after we stopped working together.
As one of my psychiatric trainers said, “Medicine should only ever be the second most important thing in your life”. Family, friends, social life and hobbies are therefore what keep me sane. I believe in trying new things whenever possible.
Hence, I have found great pleasure in volunteering - in charities for the homeless and for children, as a London 2012 Paralympics Gamesmaker, and in my local Labour Party, sometimes using my professional skills, but often doing other things. I have helped support potentially isolated neighbours, and organised meetings to talk about COVID in BME communities.
When my husband’s job took us to Hong Kong and I could not practise psychiatry, I returned to university to do an LLM in Human Rights, meeting people from all over Asia who were trying to improve human rights in their countries. This informs my daily practice and helped me in a Named Doctor for Safeguarding Children role. I have since served on the College’s Special Committee on Human Rights and in the Child Rights Alliance of England.
- Visionary medical leaders who supported part-time working, or staff wellbeing, or new approaches to care, that presaged what we take for granted today.
- My patients’ heroic parents who fight tirelessly to get the help their children need.
- The paediatrician who was one of the first Black women to qualify as a doctor in South Africa.
- The porters who always had a brew and a joke ready when I turned up in Casualty in the early hours to see a patient.
- The hospital chaplains who showed me how to sit with grieving families and offered succour when I was a patient myself.
- The A & E staff who looked out for me when I had to assess potentially violent patients.
- The ward sisters who would order extra Christmas lunches so our lonely patients who turned up in A&E could simply spend a day on the ward with friends and go home without being admitted.
- The ex-Forces hospital volunteers who drove me to hospital appointments, joking about ‘war wounds’.
- Even the tiny octagenarians who helped me after I’d fallen on a busy street outside Sainsbury’s: one brandished her umbrella to stop the traffic while the other rescued my shopping.
These are just some of the countless people who have helped, inspired, taught, or just encouraged me along the way.
- The EWTD placed legal limits on the hours worked by junior medical staff.