SCOTT SHARES VOICES
THE PRACTITIONER BEHIND THE PRACTITIONER
Julie Scott reflects on the emotional labour behind clinical composure, exploring why caring for patients also means protecting the person behind the practitioner.
A couple of months ago, Kezia published an interview about me in this magazine, and I found myself doing something I rarely do: reading it several times. Not out of vanity, but because something in it unsettled me in a way I wanted to understand. In that article, Kezia described my presence, my calm and my assured way of communicating complex ideas, and what struck me, sitting with those words in the quiet of my own home, was how little of what she described felt like the person I experience from the inside. Reading it brought back a sentence I have carried with me from the very beginning of my clinical career, long before aesthetics, long before my own clinic, back when I was a nurse in plastic surgery working with patients who had experienced serious trauma. A comment a colleague said to me after a particularly difficult shift: “You have to be the calm one in the room.”
I have never forgotten that comment, because I already knew it was true, and I had already started to understand the cost of it. The calm the interview described is real, but it is not simply who I am. It is something I choose, deliberately and sometimes with considerable effort, every single day. My mind runs fast. I feel things deeply and I care, sometimes perhaps too much, about whether I have done right by the people in my care. What reads as composure from the outside is, more often than not, a practised and ongoing act of self-regulation, something
I have been refining for over two decades without ever quite naming it as such. Last month I wrote about what staying human asks of us in the room with our patients. This month I want to turn that lens inward, to the person behind the practitioner, and to the question we rarely ask ourselves with any real honesty: who takes care of the one who does all the caring?
EMPATHY IS A CLINICAL SKILL, NOT A PERSONALITY TRAIT
We do empathy a disservice when we treat it purely as a character trait, as though some practitioners are simply born more attuned, and others are not. Empathy in practice is active and intentional. It is a choice made dozens of times throughout a working day, in how you listen, how you frame a question, how you hold a silence rather than rushing to fill it with reassurance or clinical direction. Empathy, in that sense, is diagnostic. It helps me see the whole person, not just the presenting concern.
That same quality of attentiveness, the openness to other people’s emotional worlds that makes us genuinely good at this work, is also what makes it tiring. If we do not acknowledge that honestly, it tends to find another way to make itself known: in shortened consultations, in reduced curiosity, in the subtle flattening of our responses that we tell ourselves is professionalism but which is, more honestly, the beginning of a quiet withdrawal. Empathy is a muscle, and like any muscle it requires recovery as well as exercise.
THE DIFFERENCE BETWEEN FEELING AND CARRYING
There is a line between feeling with someone and carrying them home with you, and most of us who care deeply about our patients have crossed it more times than we would care to admit, often without noticing until the accumulated weight becomes impossible to ignore. I have sat with patients whose stories have stayed with me long after they left my clinic room. I have lain awake replaying consultations, wondering whether I said the right thing or whether someone is truly all right. I have felt the particular and difficult sadness of a patient who arrived hoping that a treatment might ease something that no treatment can reach, and I have carried that sadness for longer than was useful to either of us.
For a long time, I confused this with professionalism, thinking that caring deeply meant carrying everything, and setting anything down felt like a betrayal of the trust someone had placed in me. What I have learned, slowly, is that the opposite is closer to the truth. The practitioners who absorb the most are not always the most effective; they are frequently the most depleted, and a practitioner who is emotionally exhausted brings less to the room, however skilled they are technically. The patient in the chair deserves the fullest version of us, not the remainder.
I want to be clear that none of this means the work itself is a burden. After more than twenty years, I still walk into my clinic with a genuine sense of privilege. Acknowledging the cost is not a complaint about the role; it is what allows me to keep loving it.
WHY WE DO NOT TALK ABOUT IT
In aesthetics, as in much of medicine, there is an unspoken and largely unexamined expectation that practitioners should be able to absorb the emotional weight of their work without making too much of it. Caring for others is simply the job, and admitting that caring costs you something risks being read as weakness, particularly in a field where confidence and visible composure carry such professional currency.
The silence itself becomes part of the cost; I have spoken and written openly in recent years about imposter syndrome and sensitivity, about the fact that I feel things strongly and that I always get back up when I am knocked down. What I have come to understand more fully is that the sensitivity and the resilience are not in tension with each other; they are the same quality expressed differently. The capacity that makes me genuinely feel a patient’s distress is precisely the capacity that makes me fight hard for their safety and advocate loudly for their well-being. The answer is not to feel less; it is to feel with greater intention, and to become genuinely honest with yourself about what you do with what you feel.
THE PERSON THE INTERVIEW DID NOT QUITE CAPTURE
When Kezia interviewed me, she described a presence that she said made you feel your own energy soften and settle simply by being in the same room. I am genuinely grateful for those words, and I also want to be honest about what they do not show, because I think that honesty is more useful to the people reading this than the polished version alone. The steadiness she described is not effortless. There are clinic days that cost me considerably more than the patient in the chair ever sees, and there are evenings when the composure I maintained throughout the working day quietly unravels once I close the door behind the last appointment. There are mornings when I have to choose, quite deliberately, to bring my energy back down before the first patient arrives, because the mind that is always running fast has been running particularly fast since before I got out of bed.
I do not share this to diminish the composure, because it is real and it serves my patients genuinely well. I share it because I know there are practitioners reading this who present a similar steadiness to the world and who wonder privately whether the gap between how they appear and how they actually feel is a sign that something is wrong with them. It is not. It is a sign that you are doing the work, and that the work is demanding, and that you are human enough to feel that demand even when your professional self is holding the room together beautifully.
WHAT IT LOOKS LIKE IN PRACTICE
I want to share three things that have genuinely helped me, offered not as a framework but as honest reflections from someone who has had to learn them the hard way rather than being taught them.
The first is transition. When a patient leaves my clinic, I take a deliberate moment before the next person arrives, sometimes less than a minute, but enough to consciously acknowledge what just happened and set it down. Over time, I have come to regard it as a clinical standard I hold myself to, because the patient who walks in next deserves my full attention, not what remains of it.
The second is a distinction that sounds deceptively simple but took me years to genuinely internalise rather than merely intellectually accept: a patient’s pain, fear or sadness deserves my complete attention while they are with me, but it is theirs to carry, not mine to keep
The third is having people around me who I trust enough to be genuinely honest with, not people who will debrief every consultation with me, but people who can see when I am taking on more than I should and who will say so without judgement, and who remind me, when I need reminding, that I am a person as well as a practitioner. That distinction matters more than the profession usually acknowledges.
CLOSING REFLECTION
If you are reading this and recognising yourself in any of it, I want to say something directly: the fact that your work moves you is not a problem to be managed or a vulnerability to be hidden. It is the reason your patients trust you, the reason you pause when something does not feel right and listen when someone needs more than a treatment plan.
That quality is worth protecting, which means that protecting yourself is not an act of self-indulgence but an act of professional responsibility.
Empathy held carefully, with honest boundaries and the right people around you, is not a compromise. It is what makes this profession, at its very best, extraordinary.
Scott Shares.
Reflections for practitioners who care deeply.
JULIE SCOTT
Julie Scott RGN, NIP, PGDip(Aes) is an independent nurse prescriber, Level 7 qualified aesthetic injector and trainer with more than 30 years of experience in the field of plastics and skin rejuvenation. She is an aesthetic mentor and international speaker, who has won the Aesthetics Awards ‘Aesthetic Nurse Practitioner of the Year’ in both 2022 & 2024, and ‘Best Clinic South of England’ 2023 awards. She also sits on the Aesthetics Reviewing Panel for the Aesthetics Journal, is a Board member for DANAI and is an ambassador and KOL for the JCCP and several leading aesthetic brands.