 Wow, being a doctor is a difficult job, and it seems so obvious saying that. I mean, you have to go through so many years of education, nine in my particular case, in one of the most difficult degrees possible, medicine, and then once you graduate, you spend day in and day out seeing and managing some of the most unwell people, both mentally and physically. You're often dealing with life-threatening emergencies, having difficult conversations with family and loved ones, and even dealing with death on a regular basis. That's a lot for any one person to go through. I really think that those of us who work in healthcare are exposed to a truly unique set of emotional challenges and stressors that most people in, quote unquote, normal jobs don't really have to deal with. My name is Nasser. I'm a doctor living and working in London, and we're actually joined by my lovely, lovely cat, Mish Mish. And in today's video, I wanna talk about medicine and mental health and why they're so intricately linked and difficult, as well as what I do in order to try and keep my mental health in check to stay happy, active, and positive in my life. So what makes this career so difficult? I think one of the biggest factors for me is the aspect of medicine where you're dealing with people. You know, I've talked about this many times before, but I think being a doctor is an incredibly social job. You spend most of your day talking to other people, a lot of which you've never met before where you're dealing with for the first time, and managing their anger, frustrations, and emotions can be a particularly difficult thing to do. For all the aspects of the job that I love for how social it is, and how much true, deep, and meaningful human interaction you have with others, it can be really, really draining. I usually notice this when I'm hanging out with my sister or my friends after work, and they ask me how my day was, and you know, a lot of the time I just say, yeah, everything was fine, but really my social battery is just completely depleted. I've often spent the vast majority of my day talking to patients, families, and colleagues, and so by the time I get home, I just don't have the energy or the headspace to jump into another social conversation. On top of that, there's a lot of times in medicine where you have to have conversations where you can't fully express yourself or truly say how you feel, and that means that you have a lot of this emotional bottling or harboring of your feelings that you can't necessarily display to the patients and the people in front of you. So just for example, if a patient is venting to me about how upset they are about the wait times, or the care that they've received, or something that's horrible going on in their life, as the professional in the situation providing the service, you kinda need to sit there and really listen to, and take in what the person is saying, show empathy and support, while also maintaining that professionalism, that professional boundary, the respectful boundary, and also trying to do your job of trying to figure out what the problem is, and provide them with adequate treatment, management, and care. And then you have conversations that are specifically difficult to engage in and talk about, things like talking to patients who are actively suicidal, and expressing these thoughts to you, or talking to family members about their loved ones who are actively dying, or have already died, breaking bad news to patients about scan results or findings that are gonna have very significant impacts on their life. I mean, these are conversations that are just plain hard, and there's no way around it. And as someone who really prides myself on taking my time with patients, really listening to them, and showing them that I care, and providing that empathy, it's very hard to brush off these conversations, and feelings without giving them the time, and investment that they deserve. All of this to say, I'm not entirely sure what to call it, but I feel like there's a lot of trauma, or emotional dumping that healthcare workers get, which I don't think you get in a lot of other jobs. I don't think the usual kind of office chit chat consists of any of the above, hopefully not anyway. But yeah, being a doctor involves a lot of regulation of both your own emotions, but also the emotion of the person in front of you, and kind of managing that, dealing with it and navigating it on a day to day basis, can sometimes be really draining and really challenging. I was originally gonna make this video by talking about all the difficult parts of mental health and medicine, and then talk about all the different ways that I deal with it, and my sort of coping mechanisms, and the things that I do to help manage those difficulties. But I think I'm just gonna switch them. We'll do one and one, one difficult thing about mental health and medicine, and then one technique or mechanism of how I cope with it. So let's talk about therapy and meditation. Therapy is something that you've heard me talk about plenty in the past. I've been doing it now for a few years on and off, and I just find it incredibly helpful. Just the ability to talk to someone else about your issues, your worries, feelings, and then receiving, you know, well catered feedback and advice, or just even words of support can make a really big difference. And there's certain things that I don't really wanna talk about with my friends or family or even colleagues. And for me, that's where therapy comes in. I think talking to another person is an incredibly powerful thing to do. And there's so much stigma around therapy, particularly in my family and in my culture about the idea that if you need therapy or if you're going to therapy, there must be something wrong with you. Which I think is absolutely untrue, and I've talked about this many times before. I think it's a very, very helpful exercise in maintaining your mental health. And kind of like I go to a doctor to take care of my physical health, I go to my therapist to take care of my mental health. So if anyone's watching this video and you're kind of on the fence about therapy or if you think it's a weird thing to do or something like that, please let me be the person to say that it's absolutely not. It's a fantastic way to kind of learn how to be more emotional and in touch with your feelings and thoughts and process those feelings and thoughts in a way that I just simply never used to do before. I would highly, highly recommend it. Another method of dealing with all the stress and mental toll that comes along with being a doctor is with meditation, which I do using Headspace, who are very kindly sponsoring this video. So Headspace is a mindfulness and meditation app that I absolutely love. What I think is particularly great about it is just the absolute variety in different types of mindfulness and meditation activities that it has. So if you want, you can listen to guided meditation where you focus on breathing exercises and someone is talking to you. Hi, this is Dora. Today, we'll be trying the grounding technique to help settle your mind and body and rediscover a sense of balance whenever you need it most. About how to let go of things from your day or how to note on particular thoughts and feelings that you had throughout your day. Or if you want, they have different soundscapes of all kinds of relaxing, calming settings and noises, things like being in a laundromat, being by a river or a creek, being by the sea, wind on top of a mountain, thunderstorms, you know, everything in between. They've also got podcasts. And each day, it kind of gives you a recommendation of different mindfulness and meditation activities that you can do to start your day, things you can do in the afternoon and then at night before you sleep. So I feel like it has you covered from the start of your day right until the end. As I've discussed at length in a lot of other videos, being a doctor comes with quite a few challenges and stressors. And as part of me trying to keep on top of my mental health, I've taken up meditation with head space. Before I go to bed, I just try and spend 20 minutes to just focus on myself. I sit down and I journal for about 10 minutes, which gets me remembering about what happened in my day, how I felt, et cetera. And then I sit down with head space to try and actually think about those things. Hello, it's Eve here. After I've written them down, I sit down and I try and process those feelings and think through those feelings and what it meant to me and how I felt, et cetera. I found this so incredibly helpful. I've said a few times before on this channel that I'm not really a reflective person and I didn't used to think about my actions or feelings very much, but my God, meditation has been really, really great. As you begin to let go of any worries, it moves up into the upper half of the legs. I know this sounds so silly to say out loud, but like I actually think about my life now. I used to be on this kind of treadmill where I would just do activity one, then activity two, then activity three, and I won't really think about what those activities meant to me or how I felt about them, but now I actually take the time to do that and it's been fantastic. I think it's made me a better person, a more emotionally intelligent person, and I find myself being more empathetic with my friends, my family, and even my patients. I really like meditation because it just gives me so much internal peace. Sitting there with my own thoughts and my own mind, actually trying to listen to myself and trying to feel my emotions instead of just surprising them, not thinking about them or distracting myself by being on my phone or watching a video or listening to music, has been a particularly cathartic experience and I would highly recommend it. If you want to see how Headspace might be helpful for you, you can try it out completely free for 60 days. All you have to do is click the link that's in the description down below or on screen here or scan the QR code that I'll put up here on the screen. I think it would also be a really helpful exercise to let me know in the comments section what you guys do for your own self-care, how do you take care of your mental health. I'm always looking for new things to try out. Thank you so much to Headspace for sponsoring this video. Check them out if you think you might enjoy it as well and let's get back to it. Okay, so this is a tough one and it's effectively baked into the job of a doctor. We're chronically understaffed, overworked and feeling tired. Some specialties are better than others but all of them, especially when you're more junior, involve lots of on-call shifts, lots of weekends and lots of nights. Working on the weekend sucks. It's the time when all your friends and family are available and having fun and you're stuck in the hospital doing some really, really difficult work and then don't even get me started on nights where you have to flip around your sleep schedule every few weeks and effectively becoming dead to the world. Like when I'm on my night shifts, I literally cannot do anything else in my life. I just look at that week in my calendar and I know that I'm not gonna check my emails, I'm not gonna catch up with friends, I'm not gonna go to the gym, I'm not gonna cook my own food. I'm literally just gonna be at work for 13 hours a day and then come home, quickly eat something and go back to sleep ready to do it all over again. You spend so much time preparing for, getting to the hospital, being at the hospital, then getting back from the hospital, unwinding and then that's it. Like your entire day is gone. There's no time for the gym, no time for socializing, no time for hobbies like this YouTube channel or your other passion projects you might have in your life. You honestly feel so disconnected from the world because you know that you just can't do anything else in your life whilst you're on nights. Having a schedule like this makes it really hard to have regular activities in your life. For example, going to the gym three to five times a week, attending your weekly basketball game on a Saturday or attending friends' birthdays, dinners and social events. Every week is different and every week changes the types of shift you have, whether they're at night or during the day or whether they're on the weekend or during the week. So it makes it quite difficult to plan things long term or even have something steady ongoing in your life. And if you've watched this channel for some time then you know how much of a motivated and high energy person that I am. And I really do try to keep up with all of my outside of work activities as much as possible. But even for someone like me, sure you've seen on this YouTube channel in particular, I just can't upload nearly as frequently as I used to before because I'm just so drained from work and there's a lot of other things going on in my life, social life, gym, food and friends, all of that that just have to take priority. So I'm doing my absolute best anytime that I can. I'm sitting down to film these videos, but it's just, it's really tough. Okay, I have got so many good things to say about exercise. You know, until you're a person who exercises regularly, you just can't quite understand the feeling and that itch that you get to go back into the gym and lift some weights or put on your shoes and go running outside, even if it's cold, raining or snowing, it's just this incredible feeling of euphoria and relief that you get. It just helps shed all of this weight and stress that you have on your shoulders when you go and you exercise. No one has ever left the gym and thought to themselves, God, I hated that so much. I'm never gonna go again. You always feel leaving better. You look better, you feel better and you just, it's just such a great habit to build into your life. I've talked about exercise for years on this channel and I'll continue to talk about it probably forever because I think there's really no replacement for it. Going to the gym or exercising in general, however you wanna do it, walks or runs, cardio, swimming, whatever it is, it just works wonders for your mental health and your physical health in a way that nothing else really can. I truly feel like I'm sweating out my stress when I go to the gym and it's just an hour, an hour and a half where I kind of forget about the world. I forget about my life and all the responsibilities that I have and what I'm doing, the bigger picture, I just get to go and focus on myself and do something for me and just really enjoy that time with myself. Personally, I often go through phases of wanting to run a lot and then wanting to go to the gym a lot. So I'll get into a running routine for something like six months to a year then I'll realize I've lost all of my muscle mass and I'm getting a bit bored of running. So I can go back to the gym, build up my muscle mass and have lots of fun there and then I get bored and I go back to running. I'm currently in my gym phase. But honestly, whatever exercise you do, it honestly doesn't matter. It can be just yoga or Pilates on a foam, what are they called? They're little foam things in your house. The mat, the foam mat. You can just have a foam mat and follow a YouTube video online for any kind of workout. You can go to the gym, you can run, you can go swimming, you can go for walks in your neighborhood, runs in the park, whatever it is, just any form of exercise. The best thing in the world. God, yeah, this is one of the hardest parts of being a doctor. I feel like there's really nothing quite like having a patient die that you've known, that you've spoken to, where you've been involved in their care for days or for weeks. Sometimes you've met all of their family and you give them updates on a regular basis. They know you, when they see you in the morning, they're all excited and say hi and then when you go see them with the patient, ah man, it's just, it's really, really tough when a patient dies. You'll almost feel like you know this person and in a lot of ways you do, depending on how involved you've been in their care and how long you've actually been seeing them and know them for, you really know this person and you know their family and then just one day they're not there anymore. And not only are they not there, you often have to go and confirm their death. You are there with the patient after they've passed away. You often speak to the families, offering them some consolation, some information about what might have happened if they weren't there. And it's just, it's a lot, it's a lot. Having to call families overnight when I'm in the hospital to let them know that their loved ones are really unwell or are likely in their last few hours before they pass away and seeing them when they come in and managing the very emotional states that people are in around situations like this is really, really tough. And I feel like it doesn't get easier. Like it somehow gets easier with time but not for the reasons you might think. So it's not one of those things where you see it so often that you become desensitized to it. Cause I think each patient death is different and each one is kind of meaningful in its own way. But you learn a little bit better how to manage your emotions around it or how to cope with these types of feelings and deal with the family members in a better way than you maybe did before. And you know, I say all of that on my last set of night shifts I had three patients die in one night. And when I left in the morning even when I was at handover handing over to the day team I was really like shook. I found it hard to talk about them and what had happened and explain in the handover kind of the medical aspect of everything that was going on and why they passed away. And it's just a lot of patient deaths are associated with a decent amount of trauma. You know, you have family members crying, screaming to do something or depending on how much they know how on board they are with the medical plan and things like that it can be really, really traumatic. And also just caring for the patient in that time when you can see they're really unwell trying to make them comfortable trying to improve them or be there for them if you can it's a really difficult thing to go through. And it's hard to explain I'm not great at explaining these things anyway but this in particular is quite difficult to get across I think. And then having to do this depending on the specialty you're in on a weekly basis more than a weekly basis it can be a lot. I feel like any one person you can't experience this full on sadness and emotional hurt and pain every single time one of your patients dies you eventually I think put up some kind of walls or defenses to just better manage that situation for yourself really if for nothing else. If you actually think about what's happening every time and take in everything that's happening from the patient and the family that's a huge emotional burden I think a huge toll that it takes on you personally. And so I think over time you probably start to develop better and better ways of dealing with it. I think something that's incredibly helpful is debriefing with colleagues. This is really useful actually. So a lot of the times when someone passes away the senior who's around often has a debrief with the colleagues who are looking after that patient oftentimes with the junior colleagues so like myself, F1 and F2 doctors you just kind of go to a separate room you talk about what happened what you think went well what you think maybe didn't go so well how you're feeling and these kinds of things it just helps to talk them out sometimes with a senior doctor who's been involved in that patient's care who kind of understands what you went through and what you were dealing with or managing as well but not everyone does that. A lot of the time someone dies and you're just expected to move on and get back to work and this happens all the time. We often get called for crash calls so very unwell patients who need immediate medical help and management. We go see that patient a lot of the times we do everything that we can do but the patient dies anyway and then after that someone types up the notes everyone goes back to the respective ward or Amy or wherever they were and you just move on and you have to do the remaining jobs for the day see the next patient, et cetera so it's quite tough to kind of just flip and move on and doing things like journaling and meditating and therapy have been incredibly helpful for me to kind of get these feelings out there and work through them in a meaningful way which I didn't necessarily do before. Pretty dark topic overall. Think, let's go into the next chapter to talk about a way that I deal with this and that hopefully makes me a better person through it. I wanna end this video on a high note and talk about journaling. So this is something that I only started doing recently after a trip to New York a few weeks ago. I'm actually on day 20 or so right now so haven't been doing this for months or anything like that but oh my goodness I've been really enjoying it and I definitely wanna keep this up for a while moving forward. I try to make journaling as easy of a habit as possible. So instead of writing things down with a pen and paper which would take a very long time and probably make my hand tired I've just got a note on my laptop and I just type it out instead. The faster I can get my thoughts out of my head and onto a paper, the better I'll be. So I've actually just set a reminder on my calendar to ring at 10 p.m. every day and it just says go journal and it's just a reminder for me to before I sleep when I get into bed with my laptop just pull it out, open this note and I just start typing. Like I don't really think too hard about it I just get everything out onto the paper of what's happened in my day. It's more of a kind of factual representation of what's happened in my day and then I try to do a little bit of thinking and feelings and kind of what's been going on from the mental point of view but most of that I do with the meditation like I talked about before. That's when I like really try and think about the feelings and the emotions and process what happened during the day but journaling lets me write down what happened in the day in a really interesting way and then scrolling back up and having a read through what I was thinking about or what I was feeling or what I did a few days ago is a really interesting thing because I would otherwise never ever do that. Have a think about the last time you thought about how you felt one week ago. You probably never did that, right? I feel like without writing things down like this without journaling I would never be able to think back and ask myself how did I feel last Saturday after I left my friend's house party and during that day I'd had a difficult time at work. I would probably just think to myself I felt fine but when I go back and I read my journal and it's broken down into different things that happened that day and I talk about how I felt about this, how I felt about that. It's just a completely new experience for me that I haven't done before and in doing this I found that I've really unlocked some skills that I didn't realize that I had. I spend a lot of time reflecting now looking at what I wrote a few days ago and thinking to myself that really didn't work out how I thought it would or thinking yeah that was a good idea, like I need to do more of that. I'm finding myself much better at understanding myself as a person and realizing why I'm doing the things that I'm doing or how I'm feeling about the things that I'm doing but through journaling and through meditation I've actually found that it's a very valuable exercise. Thinking about why you do the things you do is extremely valuable and I haven't really placed enough emphasis and value on that in the past but it's a habit that I've really, really been enjoying and I wanna keep up for a long time. All right, and that brings us to the end of this video. I know that I've been a little bit more vulnerable and open than I maybe usually am in my videos but it's a topic that I think has become more and more important to me personally as time has gone on working as a doctor and I think it's important to speak about to open the door for others who may not do this or think that it's valuable or think that it's not cool or something like that because I know I used to be one of those people and only through listening to my friends talk about their mental health and how they deal with it and watching other people on YouTube talk about how they deal with their mental health. That's what got me into thinking about my mental health which I otherwise never would have done so hopefully this video does that for at least a few people who are watching and if all of the methods and techniques that I talked about in this video don't work for you you know, you can always get a cat. Cats are a 10 out of 10 mental health and stress reliever. Isn't that right, Mishie? No, isn't that right? Yes it is, yes it is so right. Right, baby, yes it is. Hello, hello. Do you want to say hi to the camera? Yeah.