Dr Hannah Barham-Brown on campaigning, disabled doctoring, and medical ableism

In the run up to my book launching in September, I am running a series of interviews with fabulous disabled women. Today: the fantastic Hannah on what it's like to be a disabled GP

Feb 16

Hello,

Let’s start with some exciting news: my book has a publication date! The View From Down Here: Life as a young disabled woman will be in all good bookshops (I hope) on 7 September 2023. I’ll let you know as soon as I can when pre-orders open!

The book, being a memoir, is incredibly personal. But I am not the only person who experiences life at the intersection of disability and womanhood. There are so many diverse stories to be told about disabled women!

So, from now until publication day, I’m going to be running an occasional series of interviews with some of the disabled women I admire (and am lucky enough to know). Make sure you’re subscribed so you can get these warm, funny, wise voices in your inbox!

Today, I am chuffed to be starting the series with an interview with my lovely friend, Dr Hannah Barham-Brown. I’ve long admired Hannah for her activism - and her indefatigability - so it was an absolute pleasure to speak to her.

Our conversation was as wide-ranging as Hannah’s seriously impressive CV, so I have split it in two! Today, we’re looking at her career as an activist and doctor. Next week, we’ll be talking body image, dating and all things intersectional!

Enjoy.

LW: Hi Hannah, lovely to see you. I’m such a long-time fan, but for readers who don’t know you, can you introduce yourself and what you do?

HBB: Yeah, I can try! Tt's always a bit complicated when people ask me to introduce myself because I never quite know what I do. I'm a GP registrar - I should fully qualify as GP, hopefully, in the next six months. We'll see; I'm taking my sweet time. But alongside that, as a wheelchair user and someone with ADHD, I do a lot of disability campaigning. I also do a lot of campaigning around gender and LGBTQ stuff as a queer woman. And until about a month ago, I was one of the deputy leaders of the Women's Equality Party in the UK. I did a lot of work around feminism and stuff, which went through the pandemic.

And now I'm doing speaking so I now travel around the world. I'm off to Singapore in March to talk about disability and employment. I've done two TED talks on disability and employment so I work with various companies around the world on how they can be better at employing and supporting disabled people as businesses. And I'm also doing a bit of political commentary type media stuff. So last week, I got in a fight with Ann Widdecombe on Times Radio. And that's kind of my crazy life in a nutshell. I guess.

LW: Well I think my first question has to be: how do you do it all?

HBB: Well, I'm not very good at sleep. I have a very patient partner, and a neurodivergent brain. So I'm constantly bouncing between things and I think, you know, I'm incredibly privileged in many ways. My clinical work keeps me financially solvent enough - just about - that I can spend my non-clinical time doing other stuff. And physically, I can't work clinically more than three days a week; I tried and I broke myself. So I figure if I've got that kind of non working time, rather than kind of sitting, twiddling my thumbs, I'd rather make the most of the experiences and the skills and the privilege I have to try and make the world a bit better for people. And that excites me and it doesn't really feel like a job most of the time, which is good because very little of it pays!

LW: Did you set out to do campaigning work or did it just kind of happen?

HBB: No, not at all! I took a weird route into medicine anyway, in that I did two degrees before I went to medicine, and I only kind of really became disabled during my medical degree was when my legs started really misbehaving. And I got my wheelchair while I was at med school. So, prior to that I had not really been an activist. I’d kind of dabbled a bit in party politics, but been left cold by all of the parties really. And then I think when I kind of got to medicine, a few things kind of all happened at once and that yeah, I became disabled. And I realised quite how crap so much stuff was for disabled people! The postcode lottery around wheelchairs was probably the first thing I really kicked off about, because I was suddenly on the receiving end of it, going: ”This isn't fair. This doesn't work.” And being a doctor at that point, when I made a fuss about it, people listened.

So, I started with that, but at the same time, the junior doctors contract dispute was kicking off - the first time around - and I got really involved in some of the media stuff that and got involved in the British Medical Association. I ended up being one of the deputy chairs of the junior doctors committee and on the council of the BMA. And so I kind of ended up in this trade unionist role from a medical perspective, which led me to do work around the gender pay gap and women's unmet health needs. But also it gave me a platform to kind of go: “Wait, medical profession, we're really letting down disabled people here. What can we do as a profession to fix that and talk about things like access to cervical screening when there aren't hoists and GP surgeries and all of these things?”

LW: That’s definitely one of the things I wanted to ask you about. My personal experience of medicine is that it can be unbelievably ableist. What’s your experience, as a disabled patient who’s also a GP?

HBB: So, it's really challenging. I'm generally quite open about the fact that I am myself a doctor when I see health professionals. And part of that because I think it just makes life a lot easier. If I'm seeing a patient and they're a doctor, I like to know about it, because I think it just makes the whole thing feel a bit less combative. But also, I want to undo some of the unconscious bias they may have about me when they see me rolling in in a wheelchair; having ‘doctor’ on my notes does really help with that. And we can't shy away from that. It is difficult, I think, to be honest, as a patient, I haven't had too many awful experiences. I think because I became disabled when I was already at med school. So I had that language and that experience, that knowledge to really push back and go “nope”. I had that confidence. I was within the system anyway; and I know how to use the systems and who's secretary to contact and all that kind of stuff. So, as a patient, it hasn't been as bad for me.

But I think as a doctor with a disability, that's been quite challenging. More when I first started out, because most people I came into contact with at work hadn't ever seen a doctor in a wheelchair before. So I was brand new, and there was a lot of anxiety of: “How is he going to do this job? Can Hannah do this job?” It took a lot of negotiating, working out different tricks and tips for what I needed in terms of reasonable adjustments. I think one of the challenges is that the health service is so overstretched. I think when the workload is that big you want to know that the people on your team will keep up and they won't put extra work on you. I think a lot of my colleagues, when they first saw that they were working with me, saw it as “Oh gosh, I've got to carry her as well.” Rather than seeing how I potentially work differently and having those conversations with me, because I think they just didn't know how to. So I think that's been the biggest challenge I've experienced personally; explaining to my colleagues that I'm perfectly capable. In fact, I'm probably better at some things. But I just work differently and that doesn't mean that they're going to have to pick up any slack for me - because they're not.

LW: Having to do that all the time must be emotionally draining?

HBB: Yeah. Yeah, it's exhausting. And I'm very lucky now that being in general practice, I'm with a small team who know me really well. I've been there over a year. And so they've always been incredibly open to write. Let's just see how we make this work for you. And very much celebrate me as an asset with my disability rather than, you know, a pain in the bum, which I am sometimes!

LW: There must be some patients who are immensely glad to see a disabled doctor?

HBB: Yes, I think it does make a big difference, particularly when you've got someone who's newly disabled. I get, you know, a fair few people who come in with a new life changing diagnosis. They've had a life with family, kids, jobs, all of this sort of stuff - and suddenly everything's changed. And I can sit there and go: “Actually, I do know exactly how this feels. And here's some resources. Here's what I found helpful. Here's another way of thinking it.”

I introduce a lot of people to the social model of disability. It's really helpful to think about things in those ways. I think just I know the systems. I'm a governor of Motability. So I know everything there is to know now about getting Motability vehicles. When I have people come in who are clearly struggling with a disability and who might not know about the scheme, I can go: “You know, this might be an option for you. Do you want more information about it?” and actually see it in that more holistic way. So I think that's really helpful and just negotiating those systems and knowing how can make a big difference for my patients, definitely.

LW: Yeah, I’ve been disabled all my life and there are still some services I don’t know about, because they’ve never been signposted. Do you think doctors could help with that?

HBB: You know, doctors aren’t told either! We aren’t trained in this. We meet so few disabled people who are training, at least in the context of them being disabled people and the kind of long term impacts of that, that you just don't have that knowledge. I think as a profession, we are terrified of not knowing the answers. Because it's drilled into us from day one that you must know the answer to everything and you will be grilled on the ward round. And if you don't know , you're a failure to the medical profession. And it's really hard to kind of come out of a training system like that and then be able to say: “Actually, I don't know but I'll go away and find out.” And that's what doctors have to do a lot more with disabled people.

LW: Do you think that’s why there’s such a problem with the diagnosing of quote-unquote rare conditions?

HBB: Yeah, and that happens all the time. I saw my GP multiple times with joint problems, before I got my diagnosis. And, you know, they tried everything “normal”, but at the same time, it was only because I had a lecturer in rheumatology, who saw me in a teaching session at med school. She was the one that picked me up and went “I think you need to go and see my friend because I think you might have this.” And if I hadn't been in that med school setting, I probably wouldn't have got my diagnosis when I did. And I think it's just important as professionals, we acknowledge we don't have all the answers, but are happy to kind of go away and find out and feedback. And as GPs that's something that we have the opportunity to do far more of that and the opportunity is there to say: “I don't know, but let me text you some information later,” or whatever it might be. So yeah, I think those conversations are really important. And they are ones we struggle to have.

Stay tuned for part two of my conversation with Hannah where we get stuck right into the thorny issues of body image, dating as a disabled queer woman, and intersectionality. You’re in for a real treat.

See you then,
Lucy

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