Will Niven, Emergency Medicine (A&E) Consultant
“Midway upon the journey of our life I found myself within a forest dark, for the straightforward pathway had been lost.’ These are the opening lines of Dante’s ‘Inferno’ and they aptly described my feelings when I was diagnosed aged 39, with bowel cancer.
My name is Will Niven, I was born in Oxford in 1980 but moved to Zimbabwe with my parents in 1982, where I grew up on the grounds of a large private school called Peterhouse. My father was an English teacher and a housemaster for one of the boy’s boarding houses. My early years were an eclectic mix of roaming the African savannah, close encounters with snakes, Shakespeare productions and egg-on-toast Sunday evenings, watching Match of the Day!
Aged 15, we moved to a university town in South Africa where I finished my schooling and went on to study medicine in Cape Town. I worked for a few years in South Africa then moved to the Republic of Ireland. One weekend in July 2012, I came to the UK to see Paul Simon in concert and was introduced, through a friend, to my future wife. I moved over to UK a year later to work at a hospital in East London and it was at this hospital that this story begins.
In January 2020 I was working as an emergency medicine (A&E) consultant. That time of year is particularly difficult with long delays and overcrowding in emergency departments around the country. We normally begin to catch a break as spring arrives, but within a few short weeks of being diagnosed with the cancer, COVID arrived and lockdown was initiated. I was receiving chemotherapy during this time and could no longer come to work at the hospital. The whole of my working life, I had been on the frontline and would have been first out of the blocks to deal with a crisis such as this. Now, all of a sudden, I was stranded at home, staring at a computer screen and contemplating my own mortality. Unable to exercise and eating badly, I put on weight and was out of shape.
The summer did not relinquish much of a let up from the isolation, because I switched to radiotherapy and was still taking chemo when lockdown was lifted and everyone started congregating in the various parks. When I passed large parties I experienced a mix of envy and frustration. Frustration that the clapping for carers did not appear to extend to observing the COVID rules. Envy, that I was not among those enjoying friendship and sunshine. I felt lonely so to cope, I went for long runs on my own, going further and faster than I’d ever run before. The weight fell off me and a day before the cancer-removing surgery on 7th September 2020, I ran 20 miles before getting stuck in a biblical downpour!
The surgery went well and this gave my wife and I the breathing space to evaluate our options as to where we wanted to live. Cancer, COVID and the children made the house in London feel very small. We saw a house for sale in Ewhurst and knew from the moment we walked in, that this was it. The surrounding forest and hills only added to the charm. One of my father’s friends quipped, on hearing that we had bought the house, that in no time we would be organising litter picks and moaning about London Day trippers…
I started a new job at the Royal Surrey A&E in the peak of the second wave of COVID. After 6 months in the job, the time came for a second surgery. My original operation had removed the cancer by cutting out a part of the large bowel and re-joining it. In the meantime, my surgeon had brought out a loop of the ileum (small bowel) and created a stoma that now needed to be closed. Ironically, the second operation despite being a lot simpler, was more of a physical adjustment than I had anticipated.
The whole experience was invaluable to me as a doctor because I got to be a patient in my own hospital. It was not fun waiting, noting the inefficiencies and an overwhelming sense of wanting to be in my own bed. We like to believe we are the masters of our own destiny, but being sick serves to remind us that there are many things over which we have no control. That sense of not being in charge of one’s destiny or worse, at the mercy of someone else’s schedule, is disquieting for any human. My response to the stress of life events was to work harder in a bid to stay busy and not have to face reality in too much detail.
Luckily for me though, I met a guy at a kid’s birthday party – as you do! He looked oddly familiar so we started chatting and soon realised that we had grown up in the same part of Zimbabwe, 30 years ago. Duncan was a couple of years below me at school, but I remembered his brother Rory well. We exchanged numbers and later that day, he invited me to join an early morning fitness group in Cranleigh. As a night owl, this did not sound like something I would be in to, but I agreed to go along.
My reservations were not allayed when I was given a cinder block to lug around Snoxhall Park at 5.30am, with commands being called out loudly by one guy in the group. ‘What kind of crazy, quasi-military boot camp have I landed myself in?!’ I thought. However, I noticed almost immediately that this was different. There was structure and repetition in the calls that created synergy. Whilst there was competition and banter, I could see grit everywhere I looked. Contrary to what one often sees in men’s sport where machismo and winning are prioritised, these guys encouraged each other and took joy in getting everyone over the line.
Forty five minutes later, we circled up and the man who had been leading shared a personal story from his life and the insight it gave him. Physical strength on the field was mirrored in the bravery of one man allowing himself to be emotionally vulnerable: a power more subtle yet no less impactful.
Each member of F3 gets a nickname after their first work out and so it was my turn to get mine. I felt slightly embarrassed relating my potted biography as they proposed nicknames, but it was good natured. Eventually they named me ‘Scrubs’ based upon the hit medical TV show.
Perhaps it was the endorphins flowing, perhaps it was the calibre of man present, but during the coffee afterwards, I felt so happy. Chatting to guys that felt like old friends, this was an outfit which did not lack for warmth or authenticity.
The next few weeks, I came to understand why F3 works so well as an idea – aside from being authentic, it understood its ‘why’. Organisations, according to leadership guru Simon Sinek, often tell you what they do or how they do it, but are often pulled up short when it comes to the key aspects of why they are doing it. The founders of F3 in the United States realised that in order to be successful and reach men it needed to address an unmet need. In the iconic series ‘The Sopranos’, we hear the don, Tony, describe himself as the sad clown: ‘laughing on the outside but crying on the inside’. Tony’s unmet need is a creeping sense of isolation and purposelessness despite the fact that he is outwardly successful and does not want for money, sex or power.
Toxic masculinity or retreating from life and intimacy in a mirage of distractions and business are 2 potential responses to ‘Sad Clown Syndrome’. F3 for me has come to represent a third way. The 3 ‘F’s’ stand for fitness, fellowship and faith. The fitness is the magnet that attracts men tired of the dad belly and getting out of puff whilst chasing their kids around the park. The fellowship is what we find when meeting regularly, early in the morning with like-minded men. So many of our interactions nowadays are in the virtual world – abstract and easily prone to misinterpretation – even with our long-time friends. The relationships with other men in F3 are both embodied and tangible. Candid feedback and accountability to one another makes space for a common sense of purpose. It also increases the chance that you will lever yourself out of bed on a cold, wet morning! The fellowship extends to helping each other out, checking in when someone is going through a rough patch and ensuring that, as on the field or in the work out car park, no one is left behind.
Finally, there is the ‘faith’ – probably the bit that most people struggle with. F3 is not an explicitly religious organisation but we all share a belief in serving something bigger than ourselves. In truth what you do or how you live your life matters more than what you believe. Over the past 3 years, F3 has raised nearly £30,000 for various charities from Yellow Wellies – a great charity that is tackling poor mental health in young farmers – to the more established organisations of Cancer Research UK. In addition, we help out the Lions in Cranleigh, arrange litter picks, raise money for struggling families, teach CPR, clean around the cenotaph for Remembrance Day and remove your Christmas trees for a nominal fee. No one person organises these initiatives because we are a flat hierarchy. Rather, what we do is a happy by-product of men who, now fit and friended, can afford to look outwards…
The past couple of years have been transformative for me both at work and F3. Every man who comes regularly to F3 is expected to ‘Q’ or lead the session. Established Q’s give you feedback after the session and gradually you become more comfortable in taking the lead role. Learning the commands, shouting words of encouragement, pushing others to their limit whilst balancing intensity with humour and care for all were invaluable lessons when I took over as clinical director of the Royal Surrey A&E.
My new team was blessed with an incredible nursing matron and a number of enthusiastic managers. Together we emerged from a very challenging winter in 2022 with a clear plan to rebuild our service. Supported by our executive team, the results have been a steady and sustained improvement in our performance against the 4 hour target. Peaking in August this year, we out-performed all but 3 trusts in the country – having languished briefly in the lowest quartile at points in 2022. We have not fixed all the problems – long A&E waits are still a reality for some people, but we feel more cohesive and focused than I can remember. The pride in what we do is being restored and for the first time in many years, we had a summer without a single patient being cared for on a corridor.
Ultimately, I believe our success as a species is dependent on our capacity to cooperate. Truly no man is an island – our need to belong and build meaningful lives is innate. Whether we realise our potential both personally and as a village or community, depends on the extent to which we are prepared to put in the effort and commit. I feel incredibly lucky to have stumbled upon a group of guys who care deeply about each other, want one another to succeed and have a shared goal of uplifting the health and wellbeing of this wonderful area. I am 3 years cancer-free now and after going through hell and purgatory, I feel like I have found a paradise of sorts, in Surrey. Life is lived in the here, in the now, so if you are a man, over 18 and want to get your life in shape, don’t think, just do it!
For more information contact:
www.f3uk.net
