Being the midwives of care in a pandemic: reflections on authentic leadership

The history of any battle is often the narrative of those who are victorious and those who are the powerful. As a result, most of the history which has been written and taught has been at the cost of remembering and recognising those who have really led the struggle and achieved the victory.

The remembrance and story of Coronavirus in Scotland in the last few months should be one about leadership – but not the leadership of the loud and visible, not the narrative of the strident and self-advocating, not even with respect about the decisions of politicians and scientists, but of those who have rolled up their sleeves to do the work of care, those who have sat with the dying and those who have spent themselves in the giving of life and love to stranger and friend alike. They have been the real leaders of this hour.

There has been true and remarkable leadership during Covid19 in Scotland and in my blog this week I want to reflect on that leadership both to recognise it and treasure it.

A long time ago I used to teach theories of leadership in a vain and I fear forlorn attempt to try to teach people about how to better manage group dynamics and inter-personal relationships. I have forgotten most of what I taught – as doubtless my listeners have – but one or two things have stuck with me. One was the concept of maieutic leadership.

Maieutic comes from “maieutikos,” the Greek word for “of midwifery.” It is a style of leadership which strikes me as entirely apposite for the current times.

A midwife is someone who is immensely important during a birth. S/he is someone who provides support, comfort and assurance. Through encouraging word, by physical presence of a holding hand or wept brow, she enables the mother to bring her baby to birth. Despite all the advances in the technology of birthing it is still this essential human accompanying that is the midwife’s greatest gift and capacity. It is not she who does the work, but she who enables life to happen. She is present at all times, like the support of a bridge that enables you to cross from one side of a river to the other, she is the enabler of fulfilment, the supporter of new beginnings, but she leaves the work and autonomy to the individual mother.

A maieutic leader is someone who is such an enabler. She is present to provide structure and support. The task to be achieved is not one that she as a leader needs to do for personal fulfilment but she creates the conditions, through word, action and presence to enable it to happen. Her knowledge rests quietly, her creativity sits silently, her intervention only necessary if it is needed, but throughout she gives assurance by presence and skill.

Who have been the leaders in these past few months?

The women and men who get up every day and leave their families to go to a care home or to work in the homes of others during this pandemic have surely been the real leaders of these times. They may not recognise themselves as such, they may indeed be uncomfortable both with the concept and the recognition, but it is true, nevertheless. I hope we have all of us come to a better sense of appreciation of the human skills, technical abilities and personal humanity of the thousands who work in social care. Before all this they were described as ‘low-skilled’. This demeans their abilities and capacities and it equates knowledge with that which is possessed through academia alone, rather than affirming the emotional intelligence and human capacity of thousands. The work of care is not easy and should not be romanticised. It is raw, dirty, physical and often upsetting. But these women and men have been in the forefront of the struggle against the pernicious virus we have all faced. That is true leadership, often working autonomously, beyond personal energy and frequently without appropriate recognition. They deserve to be known as the true frontline leaders against Covid19.

There is another group of people whose story might often be forgotten, and they are the managers and supervisors of our health and care services. This last week I received messages from quite a few managers which made me aware of the sheer exhaustion these individuals have been working under, especially in care homes. They have been there from the beginning. At the start they dealt with the upset of starting lockdown, they have struggled with the issues of PPE, of infection control, of testing, of staff absence. They have met head on the need to reassure, encourage and enable others despite all the challenges including in many instances the real grief of dealing with multiple deaths. They have worked long hours with colleagues to keep morale up and to ensure that despite the inhumanity of what was expected, that residents were kept positive and as healthy as they could be. They have dealt with the increasing and at times overwhelming demands put upon them by the system through scrutiny, from constant reporting and increased paperwork, from multiple sets of guidance and new requirements. In recent days they have had to manage the very real desire and pain of families to reconnect and to start the preparations for the restoration of visits and contact. These women and men have been amazing and deserve to be seen as leaders against Covid19.

And my last group of people who have been leaders at this time and who might be too easily forgotten are the residents in care homes and people living in their own home, the families and relatives of all who have had to be isolated and sheltered. This has been hell on earth for so many because no matter how we dress it up the response to the virus has effectively meant that people have been shut away from those they love the most. This is changing for many outside our care homes, but the threat and prevalence of the virus has still not led to the decision to formally open up visiting. Every day I speak to someone or read messages from someone who is enduring the agony of separation and becoming more and more frightened about what they might find when they see their relative again.  This is achingly hard but the strength of character and resolve, the determination of those families to see change which is safe and speedy, the advocacy of family to uphold the human rights and dignity of their loved ones at a time when policy appears cold and disinterested in the personal, is and has been an act of courageous leadership. This is not an easy time and it has and is taking astonishing strength of resolve and character for residents and families to keep going. I only hope that the end of that particular pain is coming very close. This has been real leadership.

So the true leaders in the fight against coronavirus are not those keyboard warriors who use words to show superiority or to prove a point; they are not those who seek personal advance or popular esteem; not those who score political points but are distant from decision-making; not those who point fingers at those who really are out there fighting. The true leaders over the last few weeks are the same folks who are still today fighting the presence of this virus. They are the frontline workers who are bringing compassion and solace, comfort and assurance, doing their hardest despite all that is hurtful and hard. They are the managers and supervisors  encouraging yet more from a drained group of staff and showing their own willingness to muck in and show the way. They are the families and residents who are pulling us all to that point in the horizon of hope which we want to reach soon.

I hope that when the story of this virus is told in months and years to come that we will remember the maieutic leadership of those who care and are cared for. It has been and is leadership of true authenticity, nothing false but completely real. Not loud and brash, but strong and tender; not talking but doing, not draining but affirming.

I hope we can shape leadership in the rest of society and in all our relationships. It will be a future worth living in and working towards if it is one where those who uphold others, who wipe tears away in aloneness, who use a word of quiet to encourage, an arm to uphold a weakened spirit, where their maieutic skills become the norm.

To all who lead today. Thank you

Donald Macaskill