What I've Learnt… With Laura Hipple

This is an edited and abridged transcript of the TOG podcast episode ‘What I've Learnt… with Laura Hipple’, available on RCOG Learning. Jo Morrison (JM) spoke to Laura Hipple (LH). Laura lives and has worked most of her career in North Cumbria as a proud Specialty, Associate Specialist and Specialist (SAS) doctor and recently stepped down from her role as Vice President (VP) of Membership and Workforce at the RCOG after being the first SAS VP of any Royal College. JM Why did you choose obstetrics and gynaecology? LH I loved it as an undergraduate. I trained back in the 80s and we did quite a lot of hands-on O&G then, so I got to deliver a number of babies, stitch episiotomies, things that probably wouldn't be allowed now, but I absolutely loved it. I managed to get a surgical house job with 2 months gynae in it and again, really, really enjoyed it. I applied for and got a 6-month post in O&G as my first post-house job with the idea that it would help me decide whether to go down the general practitioner or the hospital O&G route. Two months into that post, after a 24-h shift, I was asked if I wanted to do an abdominal hysterectomy. Having recovered from the shock, and rather nervously, I—heavily supervised, I would add—did my first abdominal hysterectomy. From that point, I was hooked. I hadn't a clue what I was letting myself in for, I'll be honest. I went to a comprehensive school. I was the only person in my year to do medicine. Neither of my parents had been to university. No one in the family was medical. I really was very naive as to what a medical career was about and was following my heart as much as my head, I guess. And it was only years later I realised this lack of knowledge about medical careers and hierarchy perhaps played a role in my decision to become a SAS doctor. JM You've recently retired, but when you were working clinically, what did you still find hard? LH I think in terms of what was hard right up to the very end of my career, particularly with early pregnancy clinic work and fertility work, was breaking bad news. One of the hardest times was during COVID when people were wearing masks. I remember having to break bad news to a partner who was sat outside in his car in the car park, and hearing this man sobbing down the phone was just awful. Equally, if that awful situation could be handled in such a way that people leave the room saying thank you, I think that's incredibly humbling. If you can make an awful situation even marginally less awful, that is incredibly rewarding. But I don't think it ever gets easier. JM Who were your role models and mentors during your career? LH When I was training, there were very few female consultants, so I remember distinctly being very aware of any women I came across who were juggling family and careers in O&G, and I was fascinated to know how they did it and delighted to know it was possible to manage both. I had one colleague who organised the first early pregnancy clinic in Carlisle, and she had worked part time, juggled work and four children, taken a very alternative route to her consultant post and was an absolutely brilliant clinical director. She retired from the NHS early to work in Ethiopia and ended up working with the WHO. A long time after she left, I found myself thinking, ‘What would she have done in various situations?’ When you find yourself thinking that, it makes you realise how good that person was. Of course, at the College, two particular female colleagues who mentored me were Lesley Regan, who first raised the idea that I might consider VP role—I nearly fell off my chair at the time, because that was the last thing on my mind—and Ranee Thakar, our immediate past president, who again was very encouraging and supportive of me taking on this role, which was huge and scary. JM I think it's a great example of ‘you need to see it to be it’, now you've been that role model for other people. LH It was never on my radar at all. My whole career, I sometimes feel, has been a sort of a happy accident with me just sort of bumbling along and opportunities arising. The first time it was mentioned, I thought, ‘I couldn't possibly’. It was only when it was re-mentioned 3 years later, I suddenly thought, ‘well, if these two women who I respect hugely are both suggesting it, maybe they can see something I can't’. And I was absolutely terrified and definitely had ‘imposter’ printed over my forehead firmly. I think it's easy to have this belief sometimes that only consultants can do this, that and the other. And actually, it is about ability, not job title. It is about being given opportunities and support. We all have something unique to bring. And I think I feel very lucky to have had the opportunity to do this. JM Can you share some of your setbacks? LH At one point it was suggested by our associate medical director that I applied for a clinical director role in our department. Again, I nearly fell off my chair with shock. With some huge trepidation, I applied for the job, and I didn't get it. I was slightly relieved, I have to say, because I think clinical director job is a really tough one. But actually, that setback ended up opening another door for me because at the same time, the SAS lead role at the College was being advertised. When I didn't get the CD post, it turned out that the application date for the college SAS lead role had been extended, so I still had the opportunity to apply for that and got it, which was absolutely fantastic. And from there, that gradually led to the opportunity to become a Vice President. It just goes to show how one door closes and another door can open. JM I think one thing that comes across is how successful you have been at seeing a glimmer of light through a door and just walking through it. LH Also accepting that life has seasons. The nice thing about a SAS career is you're not having to jump through hoops on an annual basis in quite the same way. I've seen many SAS doctors who are combining parenthood and careers. And then when the kids get older, they can become full time, take up senior educational roles, leadership roles, and they have loads of experience to give back—when the time is right. So, it's important to learn not to worry when you have seasons where your life takes priority. JM What lessons have you learnt from your juniors? LH When I was in a district general hospital, often the SHO I was on call with when I was doing the registrar-level on call would be a GP trainee. I was hugely respectful and in awe of all their medical knowledge, which was much more up to date than mine. Many of them now are senior GPs in practices in North Cumbria. And that is hugely helpful when you're co-managing patients across primary and secondary care—that you know these people so very well. In terms of our specialty trainees, during COVID I found myself flung into developing our local guidelines and working with the resident doctors trying to get local pathways set up. I was hugely relying on the feedback from the floor, and I was so impressed with these young doctors coming up with ideas, helping to change things. JM What would your advice be to your younger self? LH Probably to believe in yourself more. I think we're taught very well at medical school how to listen to and work with patients, but really badly how to work with colleagues. And that's where a lot of problems arise. Nowadays, young people generally know themselves a lot better, and people are much more aware of personality types and different drivers. I was quite old before I went on a formal leadership course and suddenly realised other people didn't always see the world the same way as me. So, I think, learn how to work well in a team and with colleagues as well as dealing with the patients. JM What would you like to be remembered for? LH Probably raising the profile of SAS doctors as a positive career choice. Those of us with the ability and the inclination, when the time is right, should be given the opportunities and support to develop—to me that's been through teaching, research, appraisal; these are all things I've done and really enjoyed, as well as leadership roles. People should be valued for who they are, rather than just the job label they've got. I would love for people to never use the term ‘middle grade’ again. We should all be ‘top grade’ doctors, whatever the grade of work, and not labelled as something that can sound not quite good enough. I would love to be remembered for getting rid of that term, wherever possible. JM If you could change one thing about yourself, what would it be? LH Oh, I'd love to be tidier. I'm forever losing car keys, papers, glasses, chargers, you name it. I once managed to get on the train to London, discovered I remembered the charger, but forgot the laptop. I hoped when I retired, I might get on top of it. But somehow there's always something more interesting to do than decluttering, isn't there?! JM And if you could find it in the clutter, what would be your most prized possession? LH This is a difficult one, actually. There are things like my wedding and engagement rings. But I think in terms of something that I'd miss the most if I didn't have it anymore, it would have to be my home. I think not only the bricks and mortar, but the sense of security, feeling at home in your place. My husband and I are hosting our second Ukrainian guest at the minute, and it literally brings home how privileged we are to be in a country that isn't currently at war or undergoing horrendous problems because of climate change - yet. And I think we're very, very lucky if we have a home somewhere we love, where we feel safe. Another of the delights for me about a SAS career is you get that sense of place and stability a bit earlier in your career than you do as a consultant. JM So, your motto for life? LH Am I allowed a couple of things? The first one I've learned over the years is that learning medicine is a science, but practising medicine is still very much an art. This is one of the things that attracted me to it, and it links in with my other motto, which is basically never stop learning. I trained in the day of textbooks, but your patients will teach you far more at the end of the day than you'll learn from a textbook. JM Yes - John Ledingham, who I had the real privilege of working for, would say, ‘listen to your patient, they're telling you what's wrong with them.’ It can be so easy to organise tests now that we sometimes look at the numbers and not the person. LH Oh yes, treat the patient, not the scan. That's one of my very oft-said quotes in the clinic. So maybe that should be my motto: treat the patient, not the scan. The authors have nothing to report.