#1928 Just What The Doctor Ordered - Dr. Dinesh Palipana

have you done? Because I know you're a box ticker, you're a list doer, you love your very type A. You push the button before you finished wing? Or is that just me? What's been the what's been the pinnacle so far? Well, actually it's got to do with this episode, because you sent me a video earlier of our guests and it was fascinating. I did, Yeah, I watched the whole thing because it was so interesting. I normally do

I normally don't. I've never done that, in fact before, because you don't really need to do too much research on our guests, because you don't need to ask too many questions. But as I say, you can be as evolved or uninvolved as you want. But I watched so last night, I went, I'm going to have a look at this dude, and he's because Russ, one of our mutual friends, told me listen to the podcast and went, so I had to listen. That was great, and I went,

I'm going to have a look at it. He did a ted talk and then look at that, I'm like, well that was good. And then I'm just had a look at a few others. And then this morning I woke up at six ish and which is about nine hours after Dnash gets up, and I watched I don't know who produced it, he'll tell me in a moment, but it was about a half hour VID, which well will pass on to you folks. It is really, really fascinating.

And I knew that once because you're busy, like you've got no free time, and I sent this to you and I said, because it's thirty odd minutes, I said, just watch ten twelve minutes so you get a sense of who we're chatting with. And I knew that once you watched it, you wouldn't you wouldn't stop, and you watch the whole thing, didn't you. Yeah, you can't just watch ten twelve minutes of that, like imriguing You've got to watch the whole thing. I know. It's like, here,

just have a bite of this cheesecake. Just you don't have to have the whole piece. I'm like, God, give me the whole piece.

He's the first quadriplegic medical intern. He was in Queensland, second one in Australia, second person with quadriplegia to graduate as a doctor in Australia, and the first wispinal cord injury. There's just way too much stuff. He's been on the ABC Radio, ABC TV, BBC, The Today Show, Vice Magazine. He's got a Medal of the Order of Australia for Service to Medicine Junior Doctor of the Year at Gold Coast University. His actual do you know why? I know? Now?

Denesse Versusly, Hello, my friend, how are you?

five ISHU. You were midway through your medical degree. You were driving home to see your folks who lived too and two ish hours away, which was a regular thing for you. You hit a big patch of water in the road, Your car went out of control and flipped

end to end, and you ended up a quadriplegic. You ended up you're in hospital for seven months or so and spent another four years recovering and doing bits and pieces fill in the gaps for me and you all that while we're thinking about can I ever be a doctor? I'm halfway through my medical degree? Can I do it? Is it possible? And you ended up obviously going back qualifying as a doctor. A lot of speed bumps along the way, a lot of hurdles and barriers, probably ones

that we wouldn't think. But you did law before you did what you did the law, and then what happened with that? Did you go? Hang? What was that about? It was?

So when I was in law school and studying law, I think, you know, I think depression and whatever what, whatever our thought process are, there's there's an organic component to it, and there's a neuropsychological component to it, and there's a very scientific components to it, for sure. But I also think that certain life events and new path in life can lead you into that as well. I think the reasons for me choosing, or the reasons for me studying or then we're not, we're not. Something that

was close to my heart. I just finished school. I was trying to figure out what to do, and I thought, hey, you know, I'll get paid well, I have a well respected job, and this would be a nice thing to be doing, which really aren't which probably aren't that good reasons to be doing something in all honesty. But over a period of time, I just became really really depressed, like I was in the pits. I was anxious all the time, I had handic attacks, I got at a guaaphobia.

After a period of time, I locked myself when house for weeks, and it was that experience they got me thinking about, you know, maybe I need to just rethink life. And you know, it was really hard going through that period. It was probably actually one of the hardest things I've

gone through. The spine card injury has been difficult, but that was an experience where you become stuck inside your head, and I think when you're a prisoner of your thoughts, it's a much more difficult thing than being you know, I wouldn't even say limited, but having a different body now that I do. You know, I use a wheelchair and don't use my fingers anymore. But I feel that I'll be much more productive after this significant physical injury

than I was with that. It was a really good turning point in my life because I started thinking about

what I want to do. And I interacted with so many people then, because you know, you're struggling, and I was talking to friends, and I was talking to doctors, and I was talking to all these people, and I realized that, you know, people make a big difference in your life, and people are really important, and I wanted to I started thinking about doing something with people because I thought, wow, you know, just having a good conversation and having some help really change my world. And that's

why I wanted to be a doctor. And as soon as I made that decision, my life actually just changed very rapidly, and I came out of that depression and I was a new person.

call it the duality of the human experience. The duality of the human experience, which is the fact that we kind of live in these two worlds, the external and the internal. Obviously, the practical physical, three dimensional world where things happen, people have accidents, you know, pandemics come, whether happens, government happens, bills to pay, jobs, to go to roles, to play, situation, circumstance environment. That's the external world that

we inhabit. But the world that we live in is more that inner place of thought and feeling, emotion, idea and passion and love and hate and terror and joy and pain and excite and purpose and goals and beliefs and faith. And you know, isn't it interesting how like

your life from the outside. From the outside looking in, people would automatically assume many people, well, his life just got a whole lot worse, right, which would not be an unreasonable assumption based on the fact that, wow, you went from where you were to now you're in a wheelchair, to all these things. But almost illogically, it's like your life.

And I'm sure there are things about your life that of course are challenges, of course, but in terms of your life as an experience, your lived experience of life

now is better, Like it's just so interesting. But we are such an externally focused world where everything that when we talk about success, generally we're talking about stuff, you know, we're talking about you know, when we talk about success, we're normally talking about, you know, what we have, what we earn, what we own, what we drive, where we live, what we look like, what people think of us, our qualifications, our position, our title. And none of those things are bad.

But definitely when you go, wow, that that girl or that guy they're super successful, you're not talking about the fact that they've got no anxiety, or the fact that they're calm, or the fact that they've you know, they've got a joyful existence despite the fact that they live in a one bedroom flat, do you know what I mean?

to these things. I was. Actually it's an interesting thing to reflect on because just before I had my accident, I had all these things that I liked, Like I had this nice apartment overlooking the ocean and the city, and I had this car and whatever else, and you know those things, Like I was very attached to those things,

was attached to my belongings. But when the accident happened, I lost every single thing, like because money became a challenge and I just had to give it all up because I was in the hospital for seven or eight months, had to move around, and I think I was really stripped down from all that as well, Like I lost all the belongings and I lost all those things, and

I just had to start again from the basics. And that was a really good thing because again I got the opportunity to just strip down to the core and figure out what's important. So I totally agree that having that internal world that that that is that is important because you know, I use a wheelchair now, I don't use my fingers. I have all sorts of differences in my life from what it was before. You know, I love life, Like I wake up every day, I'm grateful

for a bunch of stuff. I look out the window and I see the sun and the ocean and gold courst and that that it's it. That's an awesome thing. I get to see here and talk to you today. That's pretty damn cool. And that wouldn't happen if my life was different. So I think, I think you've got to look at look at what you have in a different lens, and that really helps to shape shape the world that you've seen. There's a book called The Diamond Cutter, which I don't if you've ever come across.

a shape. But we have the ability to cut that diamond into whatever we want, and if we cut it right, you see it shine and you see all these different colors come through it, and that's like life. You have the ability to turn this rock into whatever you want.

I've said it too. You know, there's all that normal stuff, right and so when you know it, this is no revelation when I say that we don't appreciate some things often until we don't have those things, and then the thing that we didn't really value is the thing that

that's all we want right now? Do you think that, like when I watched your story, and I'm not just saying this insincerely because you're here it firstly, thank you for thank you really from the bottom of my heart for what you do, because just watching you and watching you,

you know, so to give there's some context everyone. If Denessh's got to be at work at seven point thirty, he's getting up at three thirty or four for all the stuff he's got to go through to be at work, so he's not rolling out of bed at six thirty and you know, having a dart in the car on the way to work, in a coffee and shaving it at the lights, and you know, putting on yesterday's jocks. He's getting up. Okay, that's my life, all right. He's getting up four hours and taking hours to do what

would take us to do minutes. But and I was watching you, and I'm thinking what I really thought, because I always tell myself how busy I am, right, and I don't think I'm a marter. I think I cope with it well. But I have this in a dialogue, and I am busy, but because I'm doing full time work and full time study. But my busy compared to your busy is nothing, and my adversity compared to it. And I know that you don't look for sympathy or accolades. I get that. So I know you're going to deflect,

but don't fucking deflect, right, as you've been told. Right, I was looking at you when I was going I need to work harder, because I'm kidding myself. I was watching what you do, and it just I found it truly inspiring. My question to you, is, how can people find that like a significant shift in perspective and thinking without going through a catastrophe. Do you think that's possible? Do you think it's because when your life changes, the way that your life changed once it or not, your

perspective is different. It's like it's involuntary. You now have to have a different mindset and thought process of just for navigating life and the world. And you know, we hear of so many people who have been through something like you, who not only do you perform, but you like like new Denesh is out performing Olddnesh. I know that's not the right to did you know what I mean? Yeah? Like, is can we get that perspective without the drama and the trauma and the tragedy.

or I'm challenged by these thoughts. Maybe I need to look outside, or maybe there's a better way to deal with it, or maybe there's a different way to think about it. But you have to go looking for that, and I think it's a process. I'm also lucky in that I grew up in Sri Lanka until I was ten years old, and Sri Lanka went through a war which just finished in the late two thousands, and it

was a really difficult thing for people. So when I was growing up there, I actually had this memory which I talked to my mom about just recently, and because I didn't really think about it, was in the back of my mind. It popped up every now and again.

But it was this when we were driving around Sri Lanka one day to me mom and dad, and there was a bunch of there are all these columns of smoke in the horizon, just black corns of smoke, and then when we drove up to it, we saw people being burnt alive in piles of tires, and there were suicide bombings, there were people dying, like my uncles died

in the war, and people are living in fear. I remember, you know, we had times where people were hiding out in our house during their life, and parents really catch different buses to work because if one of them gets blown up, the other one would make it home for

the kids. So people through a really hard time. And when after the accident, I also went back and I saw, you know it, we're so lucky in Australia, like this is truly the country, I think, because I went back there and I saw what happens to a lot of people with spinal cord injury. There. There's no social support systems, there's no in theis, there's nothing like that, and a lot of people just go home and die. They don't have the opportunity to work, they don't have wheelchairs whatever else.

So just seeing that different perspectives, many thinks, you know, I am so damn lucky to have this opportunity to live the way I do, to be to seek education, to seek employment, to be able to hopefully spread a good message so that that's really mean a driving force for me as well, just to think about how lucky I am to be greatful for the things that I have. So that perspective has been really important.

Can you give us a snapshot of you know, I know your days vary, and I know you're a doctor and a lawyer now over retriever that you are, but give us kind of a snapshot of a day.

at night. But we did a sleep study a little while ago, and I found that, you know, my oxygen saturations dropping huge, and I was waking up about four times per hour. So this sleep was really poor, and so sleep is a challenge. But I wake up and then my mom, who's been around all my life, she's been a big positive force. She helps me have some breakfast.

The first thing I do when I open my eyes is to think about a couple of things that I'm grateful for, three to five things, and it could be like, you know, I'm grateful for the job that I have, and grateful for where I live, and grateful for being alive. Whatever. I think of five things that pop into my head and I put on something positive to listen to. I have breakfast, and while I do that, I get the day started. So I reply to the emails I reply to. I go through my calendar and set up whatever I

have for the day or the week. So I try to be really efficient and I try to be reliable with what I do as well. Someone shoots me an email and trying to make sure that it's replied to within twenty four hours and that sort of thing. So just still things because I think those little things matter for life, because big things are built on a collection of small things done well. So we do that, and then I got a team of a great bunch of guys, so one of them will turn up in that hour

and then we get the day started. So they will help me get into the shower on a wheelchair built for that, and that that whole morning process with the showering and the personal case is quite It can be quite painful. It can be you know, like pressure fluctuates, like it's actually a bit of a challenging process. And I have a shower, I got some music going on by this point, and I get out of the shower, so by then another hour, hour and a half might be gone. Yeah, And then we get back into the

bed and we start getting dressed. Before we get dressed, we're going to go through the skin. Because another thing is fine and corny is that you get wounds. You can't feel the rest of your body. Sometimes there are pressure points that you get. If there's prolonged pressure, your skin just starts to break down. Then you get a wound. So I've got a very superficient woden at the moment

that we need to get under control. So you do the skin check, you dress that, and then you start to get you know, put your clothing on, whatever else. I wear a brace around my belly because my lung function. I don't have any lung excellent muscles to support that lung function. So it helps me breathe, It helps me maintain good blood pressure, and it helps me sit upright. And it also helps helps me speak because when I first had the accident, I couldn't speak a full sentence

like I am now wow. It took a while to get that going again. So that supports all that. So we put the brace on, we put the shorts on, and that that involves a lot of rolling back and forth and get up, put the shirt on, and you know, I'm a pretty vain guy. I like to look as good as I can, So do the hair, to do the moisturized daily, all that other junk, and then we get out the door. So I go to work and

the shifts, you know, I get to work. So typically, you know, the eaty has been pretty good in that they put they've started putting me on evening and night shifts just so I don't have to get up at four am as much. Oh god, because my boss actually so one of those videos that I don't know you're getting up at four to get to work. We could just put you on more evening shifts if you like. And I'm like, well, yeah, I mean they'll be helpful

so that they're being awesome. And so I generally start work at one pm or ten pm if I'm doing a night shift, and then I'll get home at about anywhere between. It varies. I'll get anywhere in between eleven thirty pm. Just sometimes, you know, the latest would be like one ish. If something's significantly dragging on, then the bed process will take an hour or two. Grab some dinner, get some sleep, start the press again.

going through. And I've I've talked with parents whose kids have been significantly injured or going through things, and they just said that it gave them a lot of hope to then see someone coming out of that recurring. So, you know, I think the medical care is one aspect of it and I try to be the best doctor as I can, but I think it's what you it's

the other stuff that you do with people. And there was a doctor, you know, I who sadly passed away, but I think he likes to quote it was Maya Angelou who said, people remember how you made them feel mm hmm, and that's what they're left.

and of course, you know, which is a necessity. But then on top of that, when you bring empathy and awareness and kindness and presence where I'm actually here and I'm with you and I present, I'm not thinking about my lunch, I'm not looking at my watch, I'm not I'm not in a hurry. You know, that's such a gift to people. And you know, I think that's when people love their doctor. That's what they love about their doctor.

What they love about their doctor is how that doctor makes them feel or how they how connected they feel to that person. Of course, you're want someone with knowledge and skills, but that's a given. But you know, so that's Do you think that just to me doing a bloody monologue, shut up, ups. Do you think that pre accident, post accident, your level of empathy changed?

I looked at his lecture, I'm like, fire, this guy is awesome. I want to I want to be like you know, I want to do what he's doing and whatever else. And then he happened to be in the ambulance when I had that accident.

years later, that's that. I think that's pretty powerful. I was within for maybe fifteen, twenty, maybe thirty minutes, and he made that impact on me, which has been life probably gonna be lifelong, and has a flow and effect to my own patients.

being around that person definitely, you know. And then there are other people converts sleep and you go, oh boy, oh, this is a struggle. I try not to be the latter. I'm sure sometimes I am unless I apologize. I apologize. So so you so you finished law mate, and you kind of went not for the moment, and but you correct me if I'm wrong. You went back with not recently, not went back, but you qualified as a lawyer recently. Is that right?

that I've been doing. So that that was a nice moment.

So when you graduate as a doctor in Australia, you you you're guaranteed a job if you're a domestic student and you put your name into this ballot and you put down where you want to work, and then you're the ballot system sort of. You know, get you a job. But I've just got a letter saying that, hey, you've got you you know, because of your spine cort injury, we need to take your name out of the ballot

more consider it separately. But this just turned into this massive, long process and they wouldn't really tell me what what this what the details of this process was. They all these delays. They wanted me to get medical medical reports, and I got registration as well, so I've got registration whatever else I mean, then there were saying, you know, you're probably not going to start work with your with your colleagues, and so it took a lot of advocacine.

It took a lot of support as well, you know, from the community, from the media, from other doctors and some politicians as well. Like it took a lot of work and advocacy to get the job initially and even since then, like in twenty eighteen, I was called coos Helts Junior Doctor of the Year. But even after that, I've you know, it's become a lot smooth sailing. Like I work in the ED and it's a great team and a great set of bosses that I work on it.

But along the way I've still had some challenges where you know, no matter how hard you work and no matter how well you try to do, the people still ask questions. So I had a few bumps along the way, but I think now now I'm in a great spots and work works going smoothly. But it certainly took a lot of fighting to get here. But it's been worth it, you know. Like like I said, it's worth it for

the patients. It's worth it for the people that I get to do things for, even though they're establishment wasn't as supportive.

just about those basic qualities. And I'm trying to always try to make sure that a person of integrity, that I'm always giving back and I'm always trying to do good for the world, because I think that that's important. Spiritually, I think it's it's still a search because I also don't want to do something, you know, whether it be like a formalized faith system or whether it's something I don't want to do something just because to do it, like I really want to feel it, you know, if I.

and thought process need to align with that particular theology or philosophy or way of being. I guess, but yeah, it's it just interested me because I think when I was training you might find this interesting. But I was training a year ago and a year ago and a week with my training partner. So it was literally about, you know, fifty three weeks ago. I was in the gym with my training partner, who's cutlety, is younger than me, very fit, very strong, very lean, doesn't drink, doesn't smoke,

healthy lifestyle, all that stuff. Did a set of thirty chin ups the neesh, and because he's a journeyus, he held his breath the whole time. So held his breath for thirty chins, came down, had a cardiac arrest. Yeah, dude died on the gym floor. Dead. They're dead dead.

So I started working on him, you know, straight instantly, Like there's like twenty seconds maybe within from when he exhaled, and you know, it was a bit there's a few things going on that we won't go into, but so I started working on him, and he was The paramedics got their ten minutes later, and he was dead for seventeen minutes. But it's just interesting how people go like when anyway, he's fine, now he's got a pacemaker, and they don't even know why because he didn't have a

heart attack. He just arrested, and I think it could have been. He also had before training this progressing from your story, sorry but you might find it interesting. But before he trained, So this is the guy that doesn't drink, doesn't do drugs, all this, he used to have this pre workout kind of you know how some of the the groovers have pre workout stuff, right. And I looked

at it, and he had a double dose. And I did the I did the calculations, and my best guess is and remember it's in about I don't know, one hundred mil of liquid, about the same as ten coffees.

home working under the car or something, you know. So, but it's funny because in that moment he Some people have these really life changing encounters or moments or and he's like, nah, it's like when to sleep for half an hour whatever. Absolutely, the people that you've worked with that have had you know, I just watched this weird show called The OA two seasons on Netflix. Don't watch it anyone, but it's a whole show about near death

experiences and interdimensional travel. Clearly, I've got too much time on my hands, and this is why I'm struggling with my research. That just came to me. But anyway, you know, the people. Do you have much of this around people who have died or nearly died, or where there's some awakening, some big moment or revelation or spiritual wake up.

it's up. Certainly. There was a one time where I had an issue with my lung and they thought that it was cancer initially and waiting for that result, and you're just sitting there and going, oh my gosh, if yeah, please let this not be cancer and I will live an amazing life. Yes, So you do have those moments where things you start to think about things different, or you kind of reground yourself.

So it's it's very different. But I think you also start to realize maybe normal isn't so important, you know, maybe maybe it's about building a deeper connection and it's more about I think you start to value the fundamentals a bit more about that, like even physically, you know, and how long does that physical thing ask in a normal?

that helped me out, whatever else. So a lot of it is very visible now, so that adds another dimension to the relationship. But I think you just take it one step at a time and and I think a lot of it is also in your own head. It was in my own head. You know, you're scared about a lot of things, You fear a lot of things, but then they're like, oh hey, actually this is okay and it works. So relationships were like that, but it's definitely not straightforward, and I think that's OK.

sort of response, and you do. I think you do so much damaged at kids thinking back, but it's really not what we need today. We need kids to be able to feel that they can do anything, be anything. So my mom was actually fortunately the opposite of that, and she always encouraged me to She helped me start

my own business when I was in high school. I got flying lessons when I was in high school, she taught me how to drive She told me how to shave, She taught me how to do all this stuff, taught me, you know, how to look after my bank account, all that, and all these ideas like medical school, being a lawyer like she's she's made a big influence and even today, you know, my dad, their marriage didn't survive this accident,

but she's been there every single day. I'm taking this journey with me, So we're really close and it's just a different relationship and I'm very grateful to have her in mamma, and it's just been an awesome thing, you know. But I guess that's another thing that it adds another unique dimension to another interpersonal relationship, because there's that as well amazing.

as a medical student if that was applied. So we me and this guy called Harry Emon, who is a guy a person preceded me. He got Gillan Barre syndrome and he was in medical school and used a wheelchair. And Hannah Jackson who's a GP in Tasmania. She has osteogenesism. Perfecto music will just so we got together and said, you know what, we need to start changing some of these things and sharing our experiences with people who want

to navigate this maze that we have. That's how it came about, and it's been an awesome journey because those policies are being rewritten. Now we've done We've managed to chieve quite a few things in Australia around making medicine more inclusive. So it's been a really cool journey. Now we're looking at jeez, what's next.

I'm fucking this up, so correct me. But with are they're looking at technology now that will kind of almost the electrical impulses will bypass the injury site to innovate the muscles to be able to walk or ride or like. Is that what they're looking at.

their hind limbs again. After me, wow, So then they did autopsy on these mice and they found that after the lesion that they caused in the spinal cord injury, new neurons had grown back, so the board had pickened out again by about twenty five percent. So this is really exciting. And they've applied some of these therapies to humans with electrical stimulation drugs and also thought control using EG, which is what we're doing. So we put all these

things together. In early human trials, they're found that the people are able to voluntarily move their things again for the first time in history. So it is happening. It's been shown to be possible, and we're building all this science here. So that's my that's what I do outside of clinical work, and you know, a part of that is actually engaging the mind and train you know, because

with traditional rehab, people aren't actually engaged. They're not thinking about walking, they're not thinking that, but here you're forced to do that. And the drug therapy is actually an anti anxiety drug that's been around for ages. That's what's been used in a lot of these trials, and we you know, the hypothesis is that because if you use antidepressant, it doesn't really work that well without psychotherapy, right, you

need and that's that's probably that's a training mechanism. So these drugs probably prime the nervous system for change and then you have to train it to change. So that's what we're doing and it's really exciting. We've got two million dollars from the Murtor Accident Insurance Commission the Queensland Government late last year and we're just plowing on with this work. And you know, I want to stand.