Microaggressions case study: Graeme

Graeme Watson is the director of Kilmalcolm Physiotherapy, which he runs with his wife Nicola. As a dyslexic person with a band 8A clinical role, Graeme battled in vain for years for reasonable support from the NHS. 

Graeme Watson, director of Kilmalcolm Physiotherapy
Graeme Watson [Murdo MacLeod]

I had some time off work because of the stress caused by working without dyslexia-related reasonable adjustments.

On my first day back, a colleague said to me in earshot of senior colleagues, 'Get your uniform on Graeme, you’re five minutes late for our meeting.' I was in fact early for the meeting only to find my locker had been cleared – including of my uniforms.  

This microaggression, which may not have intended to make me feel uncomfortable, spiked my anxiety about the return to work meeting. It cemented my realisation I could no longer work in that team.  

My experience with peers in the CSP’s DisAbility Network showed me that managers often do not possess the knowledge and skills to support staff with neurodiversity. 

In one of my NHS roles, a colleague came into my clinic asking if it would be possible to harmonise my diary with the new one being implemented in the department. This appeared to be a poorly veiled way of asking why I was not working to the standard work plan of my senior role.

Instead of having an open and honest conversation about how my dyslexia was affecting my ability to work without reasonable adjustments, the colleague dismissed my explanation and said, 'Oh, well, I guess dyslexia is dyslexia'. It made me feel angry, embarrassed and anxious that I was being judged for not being able to work to the levels expected by my colleagues. 

Microaggressions are unfortunately not limited to between colleagues. I have occasionally observed microaggressions by physiotherapists to their patients when asking if they’ve done their exercises. Colleagues have sometimes been quick to criticise, making statements like, 'You’re wasting my time if you don’t engage with my treatment.'

Thankfully they are in a minority, and the good practice of emotional intelligence and empathy over exercise prescription is the norm. However, we must always be mindful of how we manage our own frustrations in the interests of the best clinical outcomes for our patients. 

We must also be mindful when applying our own lived experience to our patients, as it can lead to microaggressions. For example, I’d taken over the care of a patient who had emergency surgery. He was scared and upset and confused because he’d been struggling to walk without crutches.

The physiotherapist, who’d previously had different elective surgery, had told him, 'You need to get rid of those crutches. I didn’t need them at this stage - I was back playing rugby after eight weeks.' The patient said this made him feel small.

Worse, by the time he had come to see me for his care, he was walking with a significant antalgic gait and pain without his crutches, negatively impacting his recovery. 

I hope everyone reading this reflects on these examples of microaggressions and, if needed, educates themselves to better manage colleagues and patients presenting with these difficulties.

This will improve their staff’s ability to optimise the effects of their disabilities in order to thrive in the workplace.

And if we are mindful when managing our patients to avoid microaggressions, we will maximise clinical outcomes from our care. 

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