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Hi, my name's beck Woodbine and welcome to Tenderness for Nurses.
I'm grateful for the person that I have the opportunity to be, so I hit it and parked it for Nelly four years. We always have free will, We always get to choose. We are autonomous.
Hi everyone, thank you for tuning into Tenderness for Nurses. Today we have the lovely doctor Lilli Burteck again who is becoming a regular on the podcast. We all can't get enough of her information, so thanks Lily for coming and joining me.
Thanks bec It's a worry when you become a frequent flyer, isn't it. I tell my patients that all the time. Don't become a frequent flyer.
Well, the feedback of your information that you disseminate has been very popular, so people have been asking to hear from you again, which is why I keep us send your back on and also it's just an opportunity for us to catch up, so of course I love that. Also, a big congratulations on taking over the presidency of ACEPS.
Thank you.
Another feather in the cap.
I think I think there's so much we can do with that, and I'm actually quite excited about the things that we can achieve with our apps.
So can you just explain to our listeners what ACEPS is.
Yeah, So as is an Australasian Society of Ascetic Plastic Surgeons.
So it is a Australian New Zealand group which is looking after our plastic surgeons who does ascetic surgery, which is cosmetic surgery, and our ethos is really actually promoting public safety in cosmetic surgery and also making sure that the standards required for plastic surgery or plastic cosmetic surgery is well made aware in the public and that people know that about the risks and they make the right decisions about their decision to go ahead with cosmetic plastic
surgery and they know who they should be looking for.
So it's all about patient safety and promoting patient safety but also promoting who are the right people to see for cosmetic procedures.
Yeah, it's very much about a few things. It's about advocacy to advocacy for public safety, advocacy for good safe cosmetic surgery and good regulations. It's also about education. As APPS is huge on education. Major component of as APPS is about educating, upskilling and keeping cosmetic plastic surgeons well informed and up to date. So one of our things that we talk about is that you know you have
the qualifications. It takes you up to ten years through medical school specialist training to become a qualified and registered spaceless plastic surgeon. But that's ten years to get your qualification, but there is like ongoing in thirty five plus years of ongoing education that's required to keep you in the most safest standards and the most up to date standards of practice. So that's what we're all about. We're about supporting the specialist plastic surgeons in their ongoing education.
As a plastic and reconstructive surgeon. Do all plastic surgeons do reconstructive work or is it some just do cosmetics, some just do reconstructive or you do a combination of both.
Yeah, so it's interesting. I guess it depends on where your interest lies. However, what is important is that we
are trained in both. And part of plastic surgery is about reconstructive surgery, which is, you know, reconstructing defects resulting from either trauma, cancer, or congenital Also, people are born with certain defects and the skills recontracting those and also skills of cancer surgery and trauma surgery actually helps us and it's also a part of the cosmetic surgery training because if you think about porotodectomy, so a perotidectomy is
surgery that we do for cancer. We'll remove the cancer in the parotid gland which lies underneath the facial skin over your cheek. The surgery that we do for porotodectomy is actually lifting the skin, taking the porotecic gland out, and putting everything back down. And that's pretty much a face left. The only difference is that you don't take the parotid out, but the surgery to expose the parotid to do the cancer surgery is very similar to a
face left. And obviously there's other components of a facelift that's in a face left surgery that's not in the product surgery, but it is, you know, everything that we do there is a component which we use in cosmetic surgery, such as you know, we harvest the abdominal flap for breast reconstruction, but the harvesting of abdominal flap part of that operation is actually a tummy tuck. So people talk about, oh, I'm getting a tummy tuck and a new boob at
the same time. And that's because part of that reconstructive procedure is a tummy tuck, So a lot of our training is inclusive for both cosmetic and reconstruct surgery. And the other thing is that because we know how to deal with difficult defects and problems, we also know how to look after complications. So if things do go wrong, then we are equipped because we know how we don't know. You know, we're not just trained in doing the simple
operation or creating something. We're also taught in how to reconstruct difficult defects and also deal with difficult problems. And when things do go wrong, we know what we're supposed to do and what the potential outcome could be, so we can try and prevent it.
We actually discussed some of that with doctor Samya last week when I was chatting with him, and that was one of the things and I'll bring it up again because I think it's really important. Is that you have hospital visiting rights, that's right. And if you go to a cosmetic surgeon, can you say surgeon.
Well depends you can. So the difference, I guess is a cosmetic plastic surgeon is a registered specialist. Plastic surgeon who does cosmetic surgery is you know, we do both. A cosmetic surgeon is a surgeon, so they have the fellowship or real Australasian College of Surgeons, but they could be a general surgeon, n T surgeon, vascular surgeon, any type of surgeon, so they can call themselves surgeons, but
they can also do cosmetic surgery. So they are called cosmetic surgeons because the word cosmetic is not a protected title, Okay, the word surgeon is.
So what about the people that GPS that have gone and done some extra a little bit of extra study and then then performing surgical.
Well, they can't call themselves surgeons. They call themselves cosmetic doctors, cosmetic physicians. Okay, yes, cosurgeons are protected time, Yes, yes you can. I think they call themselves also cosmetic practitioners. But surgeon became a protected title earlier this year and I think w A was the last state to pass that legislation. But that's all through and now so throughout
the whole of Australia. Yeah, that's a protected title. So yeah, cosmetic plastic surgeon is somebody who is a specialist plastic surgeon registered to such with OPRAH who performs cosmetic surgery.
Okay, and you have hospital visitation rights yes, cosmetic physicians may not.
No. Yeah, So it's all about admitting rights. So if things do go wrong, such as you have bad bleeding and required go back to return to operating theater in your blood transfusion, or your quite over nice stay and things like that, you know, to have hospital visiting and admitting rights is important because you want to be able to look after your patients in the hospital where you have all the support that you require.
At the conference, did you talk or touch on wellness and wellness of self and looking after yourself? Is it something that you think people are becoming more aware of.
Yeah, I think I think we are. I think we're recognizing that support for each other is really important. And that's one of the things I you know, spoke about in my speech about my acceptance of the position. My vision is to build and you know, an ethical and supportive aesthetic community.
Absolutely, yeah, for.
Everybody concerned, for the surgeons, for their staff, for the nurses, for the non surgical for the non surgical community, and also the industries because I think if the ethos of being ethical and supportive instead of just being concentrating on being competitive. I think if we can keep the supportive and ethical environment in this industry, patient safety I think will naturally come because people will do the right thing.
It also creates a much better space for people to share ideas and also listen to each other, and that in itself produces the environment that fosters good relationships. You know, supportive environment, good mental health, and good practices. I think they're all just feeding each other.
I agree, I totally agree.
One of the I think what I found was extraordinary is about these conferences is every year we have a women in Plastic Surgery dinner. And you know, when I first started training, there want a lot of us at all, and this was back in the early two thousand and The women Plastic Surgery Dinner is that something that has grown over time or started by doctor Jillian Farrell, and
now it's become quite a big group. We have about twenty four to twenty five people attending the dinner each year and there are more than that of plastic surgeons female plastic surgeons Australia. But what I love about that
environment is that females are naturally very competitive. Yeah, it is just one of those things because and also like if you think about female in plastic surgery or in any surgical specialty, more competitive simply because we have to be to survive, because it's a very male dominating environment.
I remember one emergency physician one said to me, which is rather nasty, I thought, He said to me, goes, So is it that people females will do surgery are just naturally nasty or is it and competitive and bitchy or is it the specialty that makes them competitive? And vicci?
Wow?
Yeah, I thought that was a bit nasty, wasn't it? And I thought, well, you know what, that's another here or there isn't it's it's actually about us feeling like we have to keep fighting to survive in the specialty, and we don't. I don't think people mean to be such that way, but it's almost it is a competition. It's a constant competition of trying to get ahead, and
we always have to do things twice as good. We have to work twice as hard to prove ourselves to be heard sometimes even and that just makes us a little bit more that as certain, a little bit more you know, I guess in your face sometimes maybe.
But if a man behaved that way that way, they would just say they're.
Competent or oh, that's just being a boy.
Yeah, Like, why do we as women have to always justify ourselves ourselves?
Yeah, yeah, I don't know. I don't know. To be honest, I'm always puzzled by the way women behave, especially in positions or leadership. And sometimes even my husband tells me this. He says that, you know, sometimes you sound like a man, And I say, well, what exactly do you mean by that?
He goes, well, you're just more aggressive, you know, you don't talk like you do at home with me, and really, yes, yes, And you know I catch myself that, I catch myself do that, And to be very brutally honest, I actually am a little bit ashamed that sometimes I do put on that front, because that is not who I am. It's who I feel like I have to be.
I've never seen that side of you.
I mean, you obviously haven't said yet, you obviously haven't sat in the board meeting.
But I don't have an issue with that. I mean, it probably was an idiot that said something stupid. Yes, you know, I mean, I should probably say that, but you know, sometimes you just go, oh my god, did you just say that, like seriously if I said that as a female.
Yeah, yeah, I know, I know. But what was was lovely about the whole women Plastic Surgery dinner is to see a group of women together and we're all like incredible right in our own right, we're all leaders in our own right, and we were just sitting there having a really nice dinner, having a fantastic talk about, you know, what we're all up to, and being supportive of each other.
I mean it was amazing because so there they were like council members, vice presidents to vice presidents, do you know, And it was just a really nice thing.
I think it's great.
Yeah. So I find that that's the most rewarding, the most rewarding experience, and you walk away thinking, wow, you know, I can do anything. Well.
Women are really great at holding space for other women, and I think when you find your right tribe, women uphold women.
I think being a female is actually a fantastic advantage. And the reason is because I think we see things differently and we just by nature more caring. Do you know, we do it? Actually we worry about other people think. You know, we worry about you know, how people are going. You know, we naturally will ask questions like you know, even with patients, we naturally ask questions, go, so who's going to look after your WIFEI are you in hospital?
Do you know? Things like that that I think as women, we just kind of consider because we understand, I guess we see a more lot more of a person, more than just a person, but also the life around them, not just the individual, but the whole you know, the
whole village that they have a community around them. And you know, I find that to be advantage sometimes also because I have male colleagues that come up to me and talk to me about, you know, their concerns or they're having issues, and they probably I would not think comfortable talking to their own male colleagues. And I find that to be a real privilege. It is a privilege because they obviously feel comfortable enough to talk to me, but they kind of go, well, what do you think?
You know, what are your thoughts? And I have male colleagues coming up to talk to me about their family, so, you know, about their daughters, about their wives, even something as simple as oh you know, my daughter's about turned sixteen. What do you think will be a good present? You know, you're like, oh, okay, so what is she like? They're trying to think back when I was sixteen, which is a long time ago. It's very thick up for me. But I think part of that is also mentally, women
are a lot more in tune with people's emotions. I think we read situations, we have a more more situation awareness, and we're able to sort of have better perception what people need. I think it's a real intuitive yes, this intuitive thing, isn't it?
Thing as well without a doubt? I mean, how many times has your husband told you that you know a friend of theirs has just had a baby, and the first thing you do is how much.
Did it weighs?
The warrior? Is it a girl? How's mum?
Da?
Da da? And they look at you blank and go, surely he would have asked that question. Now if had it been you and I that had found out about we would know maybe how mummy is, did you have an episiotomy?
You know exactly exactly, and how long? What's name?
We would have all that information, But they just it just doesn't enter the because it's not it's not that it's not important to them. They just don't think about asking those questions.
No, no, But you know, there's things about women's psyche which are also not great sometimes, you know, things like we tend to internalize things. You worry, worry, We worry. If something goes wrong, we think it's our fault. So we internalize everything that happens outside. We don't know how to let go. Sometimes.
Do you think women are more praying to burn out than men?
I think so, And I think part of that is that compassion fatigue, do you know, I don't know. I mean I have met men who are amazingly compassionate and amazingly in tuned with their emotions and also in tunes with their patients' emotions, and they get quite significant compassion fatigue. Are they probably not as good as us in expressing it?
I think so we forget sometimes that men can all also get quite severe compassion fatigue and burnout, And a lot of it is also they place a lot of pressure on themselves like we do, but their pressure is slightly different, you know about I think their pressure is a lot on themselves, you know, on wanting to bearing a burden of I'm responsible for this, and that our pressure on ourselves is more I think expectations or the imposter syndrome where we think we're not good enough.
Imposter syndromes.
Yeah, yeah, so it's a slightly different kind of I think pressure on ourselves and our burnout is slightly different. But as a female, I do have to keep reminding myself that, you know, I don't need to prove anything to anybody, and that my best is good enough because I can't do anything further than what I can do my best, and if that's not good enough for them, then I'm sorry. That's all I can give. So it's not my problem, is their problem, you know.
So and if you know, if you know you've done your best and there's nothing else, I mean, there's nothing else to give, is there?
No, there isn't. And that's the thing. As long as I know I've done my best, and at least I can say, well, I've done my best and I'm proud of myself. And if that's not good enough for them, too bad, So sad, I'll move on.
It's interesting today a client of mine came in and she travels down from Rockhampton to see me, and she's just delightful and she's just finishing her two more assignments to do. And she's a registered nurse and she's a mature age becoming a mature agearin she's one on a million. She's amazing. And she was talking about imposter syndrome, how even though she was really high up in the government and decided to go do nursing, she is so nervous
and anxious about becoming a registered nurse. And she said, I really feel like I've got imposter syndrome. She said, I just don't feel like I'm prepared enough to actually go into the ward. And I said, no, one's prepared enough in that first six months. I said, that's you know why you're supported and you've got other RNs around you. And I said, you know, when I became a nurse practitioner,
I really had imposter syndrome. I was, well, I'm trained with all these alcohol and other drug nurses, eating nurses, cancer care, palliative care. Now, those nurses were remarkable, absolutely remarkable, and all I could do was compare myself to them and go, I don't know any of the stuff they know. Yes, you know, so how can I be a nurse practitioner, And there really was.
This yeah inadequacy, absolutely absolutely, and you know I learned from that experience. You know, my husband always laughs and jokes that my master's in health law is a very expensive band aid for my imposter syndrome, because he was expensive. But I think the importance is that imposter syndrome is in everybody, isn't it. You have that feeling of inadequacy, but it's about how much you believe in yourself as well.
And nobody can actually make you believe in yourself. I mean, you can have all the pep talks in the world, you know, people can boost you up with you know, great messages and all that stuff, but unless you actually believe in it, you are never going to surpass it.
No, No, it is something. It is something I actually really had to work on. Yes, that I was adequate enough and I knew enough and in my area and my specialty, I was okay.
Yeah, And I mean the fact that I guess some of the fact will be that because you are a nurse practitioner in cosmetic and dermatology and dermatology, right, and you probably don't feel that that is as important as cancer care and stuff like that. Right, It's just like, you know, I get told every day that he saves lives and I make the world pretty. I do remind him that ugly people do sue a lot. But it's a horrible thing to say, but you know, it is
one of those things. And that's another thing that I find that it's really hard when you say you're a plastic surgeon. People kind of give you that look. It's really funny and just an example. Right. So a few years ago I was in anzac day dawn surfers in Melbourne and the man standing next to me this five o'clock in the morning collapse next to me, this old gentleman,
and he just collapsed next to me. And then I went down on the grass and I saw how he was, and I think he was having a heart attack because he was obvious having very heavy chest pain and things. And I said, what do you have your GT and spray? He goes, yes, I do. I said, where is it?
So I took it out for him, put two sprays under his tongue and then just lie him there and just sat with him, tried to calm him down and check his polls and then the ambos arrived because somebody obviously called when they got the ambulance officers, and the ambulance officer goes, oh, what's happened here? I said, oh, I think he's just having angina. I've given him two sprays with GT and under his tongue. He goes, oh, you're a doctor, and I said, yes, I'm a doctor.
And then Mber goes, so what type of doctor are you? And I said, oh, I'm a plastic surgeon. And thember goes, oh, well, that's that's all right, will take it over from him, So you know, like why yes, And it's interesting. That's not just one of the examples. Interesting. The other thing is that when I was doing my Masters of Health law and we all had to write a thesis on regulations and things like that, and then I said, I said to my lord professor, as he goes, oh, what's
your topic? You know, what are you going to talk? What are you going to a thesis about, you know, in ethics, in bioethics, And I said, oh, I don't know, I'm just I'm thinking about my topic. Goes, well are you talking? Are you going to write about genetic testing? And the ethics of genetic testing of because we were talking about topics like, you know, being able to select your genes in embryo before you have the baby, so they call it eugenics, and that was the topic of
discussion at the time. And I just said, well, no, actually no, I'm not really my field. I said, I'm thinking about doing an ethics piece on cosmetic surgery. And the look I got like, why would you do that? That's not important?
So important?
Yes, And I just and I said, well, no, that's important because why do people think cosmetic medicine, cosmetic surgery is unethical? Why do people think it's not important? It is so important it is because it's been so ignored. That's how the public safety of cosmetic surgery and the standards fallen behind. Because cosmetic surgery is ethical. It is part of medicine. And the reason it is is because
you are helping people. You know, people goes, oh, well you don't have a disease, so therefore it's not real medicine. That's not true. That's not true. There's this whole concept of lucism, right, So leucism is the biggest type of discrimination that has not actually been put out there so things like sexism racism right, where people are disadvantaged because of their sex or their race, but people are also disadvantage because of the way they look. So it's a
real issue. There's been a lot of stuggies to show that if you are good looking, you get ahead in life. Absolutely, you get better jobs, you get better pays. Right, So if you extrapolate lucism right, and then you think about what cosmetic surgery does for people, not just you know they can get a better job, that's not the point of it. Is that they get they feel better about themselves so that they have the confidence to go out and get better jobs, better pay, better life, better relationships.
There's even been papers showing that people who think they're attractive get better relationships. So cosmetic surgery itself is part of medicine because we are making a difference in people, even though it's not a disease, but it is something that is affecting their overall general health and well being and their mental status.
Absolutely, it impacts strongly on their mental status.
So there's a lot of bio ethics and cosmetics and how it should be practiced and how that space should be regulated.
Without a doubt there when all the forms came in and everyone was just discussing about body dysmorphic disorder. Now I do have a couple of patients that definitely do. The whole conversation has been done, We've gone through the questionnaire.
They are very aware that they do. But they've now chosen to be with me and managed by me because of the conversations and because of them doing the forms, and they had been elsewhere and they've come back and it was like, well, I'm not going to treat you again. If you keep going elsewhere, you have to choose to provide otherwise we're going to have to refer once A psychologists or CEU GP that sort of thing. I have been able to really carefully manage those patients that haven't
gone elsewhere. They've followed what the plans that I have written, and their well being has improved, yeah, dramatically, because they weren't being gas lit at other places. Me being able to manage them now has this amazing continuity of care. If that's not managed its people can get really sick.
It's about the ethical decision to help people because without taking advantage of them, because these people are really easy to be taken advantage, absolutely, because you know they already have a vulnerability that which you know, you know which triggers to pull.
So it's just about making For some people, it's just about making.
Money, yes, And it's about the interests of the patient rather than the surgeon or the practitioner or the injector, right, And that's where the ethics of cosmetic surgery comes from, because cosmetic surgery is verging on commercial without a doubt, and commercial is about interest of the business owner, whereas medicine is about the interest of the patient. So it's a very fine balance. And at the end of the day, you were a health care worker foremost, right, so the
patient interest you come first. And you know, in the world of cosmetic, aesthetic medicine and surgery, it is one of the things that we need to keep reminding ourselves that what we are doing, who's interest isn't in and what we're doing is it the right thing to do for that particular individual, because not everybody. And that's the thing about the other thing about aesthetic medicine surgery is that there's usually no one no right answer. One right answer,
isn't it. There's usually ways of approaching it. And it's also a lot of human management, like human holistic management. We're not just managing their so called physical deficits or deformities or problems. We're actually managing their psychological wellbeing.
I agree absolutely what you're saying. I suppose that's why we focus on skin first and foremost, and then we like, if someone's got hips of sun damage, we'll refer them on to a lease. There's no way I'm going to do any ipl or any laser work unless it's been assessed by alist who's our nurse practitioner for.
Skin cancers and skin damage.
So they all get referre to her. Then they come back, we treat the skin and honestly, probably six times out of ten they're happy with that result. They've got a lovely glow, the collagen has, you know, started to kick back in. Their skin tone is lovely and even and they go, oh, I quite like this. So it's not just about shoving product in your face. So I suppose what I feel in my area is that dermatology and
cosmetics asthetics go hand in glove. You've got to have great skin, yes, and then you know, we can then look at doing you know other bits and pieces and a bit as jugie as I call it, and it's never a huge amount, but when you treat the skin. And a good example is a client came in today. Couldn't treat her because she'd gone to see the specialist after this spot i'd seen on a brow and I said, I don't like it. She's covered in freckles. She went,
and it's well you should. I think she needs to have it revised because honestly, it's a heavy dex it's done, is left this massive creator. It was huge. So but then we've noticed in a couple of other spots, so I've referred it back to see her dermatologists again. And that's when I think things that's the ethical way of our industry is behaving in that way. I suppose. Another
example is we don't do the pdo threads anymore. There's too much downtime, It costs too much money, there was too much bruising, too many complications, too much hand resets, and the results really are so minimal for what the downtime, it's just not worth it. So we don't offer that anymore. But that came from feedback from what i'd seen and I suppose we're doing our own research constantly, aren't we
in our own clinics. It wasn't the information that was given to me from the provider, like from the company. It was what we saw in clinic, and it was not doing that. And I suppose there are things you see and do that you've got no not doing that anymore?
Yeah, I mean, I say, spend more time saying no to patients than saying yes. You know, when I feel the patient's not suitable for surgery or the surgery is not the right thing for them. I actually it takes longer to say no that does to say yes, absolutely, isn't it, Because what you're trying to do is not
just telling them that they're not suitable. You need to explain to them why they're not suitable and why the surgery is not suitable for them, and also you know why it is in their best interest sometimes not to have the surgery, and so that they don't just leave thinking that number one, you've insulted them, number two, you've belittled them, and number three you haven't listened to them.
But number four, they will just go to the the highest bidder who will actually do anything for money and they end up getting their surgery done that it's not right for them and getting a bad result or you know, doing some harm. So at the end of the day, what I want the patient to understand is that when I'm saying I always tell them this. This is my usual cliche talk, is that I'm a surgeon, right, so
I don't get paid unless unless I cut somebody. So if I tell you that I don't want to cut you, it must mean something absolutely right, So you can go and see anybody that you like, and that there will be somebody will be willing to cut you for a price, so you know. So I have a think about it, have a listen to what I have to say, and then you can make your own decision.
Do you go home from certain days consulting exhausted?
Yeah, I get emotionally exhausted. The breast clinics I find extremely exhausting. So the breast clinics are usual, my usual reconstructive or implant clinics. So there can be a bit
mixed of cosmetic and reconstructive surgery. But because a lot of my cosmetic practice is revisions rather than primary So these are ladies who've had implants before and they've had issues with them, you know, other you know, within a couple of years or we're talking about years down the track, and these patients carry emotional baggage with them about their implants usually and they're not ready to not have the implants or they're not ready to lose the look they've got.
And then you have the breast cancer patients who are come in from reconstruction, and some of them are just being diagnosed with breast cancer, and some of them are people who've diagnosed with the genetic propensity to have breast cancer, which is a huge implication to their lives. And some of them are finished with their cancer journey and they are coming back for reconstruction. So they're always different phases
of their cancer treatment. And it's motional exhausting because I've got to constantly adjust myself to where they're at and what they're prepared to hear. There's a lot of things that we tell patients that they're not quite in the right headspace to hear just yet. Or if you say it in the wrong way, they will take it in the wrong way. You know, they will take it almost like a personal in to a personal transgression to their emotions.
So it's really important with these clinics that I kind of constantly watch their reactions, constantly just what I say, and constantly trying to work out where they are and what they actually understand what they don't, and then get a sense of are they suitable so surgery, because it's not just where they're physically suitable. Are they in the
right headspace for surgery? And are their expectations realistic? Because if their expectation is not realistic, then I've got to spend another fifty minutes telling them why their expectations are not realistic and what I can actually deliver for them and what, you know, what they're actually going to get
at the end of the day. I'm a firm believer in undersell and overdeliver because I think expectation is one of those one of the biggest things that can really bring you down afterwards, like consent right with expectation, It's like whatever you tell the patients prior to the surgery is called consent right and informed consent, but whatever you
tell them after the surgery is called an excuse. So it is so important, and that's that's why with these breast clinics I am just emotionally exhausted afterwards.
So how do you look after yourself?
Well, one of the things I do is I go home and we sit down at dinner and tell my husband I've used up all my words for the day.
Don't talk to me. No, I don't silence.
Silence is golden. I let him talk. Actually, I just listened to him. But what do I do for myself? Well, I tend to think about things that make me feel good about myself, or tend to do things that makes me good about myself. And sometimes the music is great. Play music, and I don't know whether people wear, but I'm actually musicians. So I played the piano and the flute, and so I like music some. I also dance as well. I'm not dancing as much now because I got that
very old a three technee. So but you know, I love exercise because exercise is a great way. Walking on the treadmill really clears my mind. Sometimes I walk on the treadmill just to think through all the things, all the things that I've done for the day, or about things that are coming up and trying to clarify in my head. And because all I need to do is walk my head kind of can go on it's own pace, so it's very therapeutic. I like to bake.
Oh you baker.
I'm a baker. Yeah, yeah, So I love baking, and I love the fact of sitting. I'm one of those terrible bakers or like, I don't just put the oven in and put the cake in the oven and then walk away and do something else and one of those people comes and back and check it every five minutes. But I love the fact that I can just like relax for five minutes, do something else, you know, go on my phone, look at a few things, or read bits of the book, or watch a little bit of TV,
and then come back and check my cake. But it's great because it's just like, so, my husband loves iron right.
What I know right in military?
No, No, no, he loves ironing because he even to the point where he actually cut down the hours of my housekeeper, of our housekeeper who does cleaning, washing, ironing and stuff like that, so he's actually half her time so that he could do the washing and ironing.
Right.
I know it's crazy. You're welcome to hire him, by the way, but I'm asking why do you like he irons? Bed sheets. So asking why do you like ironing, he goes, well, because it's nothing better than crisp, smooth fabric. Once you've done it, it's a sense of achievement and you know why you're doing it. You can't kill somebody. Yeah, fair enough, because he does lung surgery, right, So everything when he
does lung surgy stressful. But he's worried about doing having the wrong move and that can potentially be fatal in lung heart and lung surgery. But ironing like he gets a result, He gets a sense of achievement without the risk. He loves it.
So does he come home from surgery and that's his relax You just get out of the ironing board.
And no, he does that. He does that on his days off. Yeah, he just spends a whole day ironing. And he listened to a podcast while he's ironing. And I always know when he's been ironing because when I get home he's usually very relaxed. True, but he cooks. He cooks for after work after he's been operating. I think he finds that also another sort of achievement. Sense of achievement. The worst thing that can happens is that everything goes to pair shape with the cooking and we
just have to call in foot with eats. But you know, to him, that's doing something without catastrophic risk.
Being a cardiothoracic surgeon, I've never really thought about because it was never anything. It wasn't my interest. And to be fair, back in the day when it took hours, that would be my worst nightmare to spend that amount of time in a theater. I liked fast, quick theater, fast turnovers. I loved plastics. I loved guy and he loved loved it. So I liked getting that vergo with me. I loved having a list run on time well and keeps moving. It keeps moving, and that would rock my world.
The thought of standing in a theater orthopedics or cardiac or thoracic.
Where the case goes over hours and hours.
The worst nightmare. So I've never really put thought into the stress levels of those surgeons.
Yeah, yeah, it's a phenomenal amount of stress. And you know, and stresses is interesting is actually a perception of relativity, right, I remember, I remember when I took a little bit of time off when I was training, about three to six months. Actually, I took a research time off. I wasn't really researching, I was just being a housewife.
But it's okay.
But I remember standing in front of a food counter at the supermarket stressing, stressing over the type of sugar I should use in a certain cake, and it was so stressful. It's the same stress as me standing in front of the patient trying to decide what margin to take for a certain cancer. Because the scaly stuff around the cancer, part of the cancer, is not part of the cancer. Is that interesting. It is relative because it depends on what's in your life. And so this is
where gaslighting happens. Right. So patient's coming and they tell you, or you know your friend's coming and they tell you how stressed they are over a certain thing, and you're like, going, seriously, was your stressed about that? That's so minute, that's minutia. But to them it is the same caliber of decision as you make absolutely every day. So so I think I think sometimes, you know, we lose perspective.
It's limitations we put on ourselves.
I think. So I think we think that we have no how do you say, no choices? You know, we think that something catastrophic is going to happen when that's not the case. If you step back and think about it, what's the worst thing that could happen? And that's what I actually ask myself all the time, what's the worst thing that could happen? That's one thing. Number two is what's your plan B. It's always to know that you've got to plan be. And number three is hoo can
I call? Because I think that's really important to have somebody that you know around you that can support you behen you need them the most. And I think all those three things essential for you know, really good mental health support about the way you think about things right, because I get told this right. So you have two choices, two things in life that you must do right. So one you must die, everybody dies. But two you must
choose Okay, So you have the choice. You have the choice to go around and mop and see all the bad things, see all the bad choices, see all the bad options, or feel bad about things. Or you have the choice to see things in the different light or to just stand up and deal with it, or be excited about stuff. You can be you can be moppy about stuff, or you can be excited about things. Right, And it just changes your frame of mind.
And it changes the neural pathways of your brain as well. If you choose positive that is now being researched. It's really quite remarkable.
And do you know what else it changes? It changes the people around you. Absolutely try I mean, and it's almost like a positive feedback loop. Right. So you turn up to work grumpy. You choose to be grumpy, basically, you do. You choose to think that the coffee is crapy instead of Oh I got a.
Cup of coffee today, How blessed am I?
How clessed am I? So you know, it's it's one of the things that rather people and and you know, I don't know whether you're weare, but I used I had a really severe depression when I was a medical student, and there were a few things that stopped me from getting better. So Number one, I didn't recognize I had a problem because my father just my parents actually my parents just all told me, goes, you're not depressed, You're just weak, right, you need to be stronger and to
deal with problems and just get over yourself. So I didn't recognize I had a problem. So obviously I didn't seek help. And when I seek help help. I wasn't convinced I had a problem, and that's you know, all I did. All I needed to do was take drugs. Then I had a terrible psychiatrist because one of my best friend actually trying to commit suicide. And my psychiatrist told me that was my fault, that she tried to commit suicide. Yeah, horrific. So I fell down deeper into
a ditch. And then I met a really good psychiatrist who just realized that whatever was happening wasn't getting through to me. And then so he goes, okay, so you want to do surgery. I say yes, I do. And this time, at this time, I was a junior doctor. He goes, so you're applying for surgery. I say yes, I am. He goes, okay, well you will understand this. So having depression is that having a broken arm? Right, what do you do when you have a broken arm? Okay,
we'll fix it. He goes, yeah, but before you fix it, what do you have to do before? I said, well, you have to go to ED, get an emergent, get a next ray. And he goes, yes, so you got to recognize you got a broken up and get a next ray. To diagnose your broken out, right, and then you got to accept the treatment to fix it. So what do you do to fix it? I said, we'll put it in a plasta cast, will put plates and screws in them. I go yeah. He goes yeah. So
you put plays and screesing them. What does that do to your arm? I said, well makes it strong enough. He goes good, and it makes it stronger because it got work in it, right, I go yeah yeah. And then he's like going, well, that's what you do with depression. You got to recognize it, diagnose it, you got to treat it. You've got to be willing to accept the treatment that's required, and then you become stronger because of it.
And so what happens when you hit it again? I said, it was less likely to break because he's got a plate on it. He goes, yes, that's what happens. So that's how he got through to me and make me acknowledge the fact that, you know, I needed to do
something for myself. It's not just the drugs. I got to accept the treatments, and that's not just drugs, but I accept to change the way as I was thinking and actually do the psychotherapy and should be engaged my phsychotherapy to be able to get better, and he goes. What you're building is your mental resilience so that in the future something similar happens, or something that triggers you to go back into depression, you pick yourself up before
you get that bad and you'll recognize it. Yeah, you're recognize it and you go and get help before it gets bad. I think that's so important, do you know, And that's part of insight, I think.
Yes, and insight it's one of those things that the first time I think you have quite significant depression.
You lack a lot of money.
Oh yes, I think then if you work on yourself and you spend the time in the f and surround yourself with the right people, that insight develops and you start to I recognize now when I'm starting.
To yeahel, don't you Yeah, you know.
I know I don't want to go out and you know, just little there are little things, but I wouldn't have recognized that initially. So Lily, we have to wrap this. That's her right, Thank you so much.
That's okay, pleasure.
I'll be booking the next time you come back. Thank you. And thanks guys for listening and I'll see you all next week.
Thank you, thanks for having me, M