Book Review: "Rest: Why You Get More Done When You Work Less" by Alex Soojung-Kim Pang

Many of us in medicine struggle to justify why we should slow down and give ourselves a break.

We’re used to putting others’ needs before our own.

We’re used to unrelenting unrostered overtime; oncall callbacks at 3am; weekend shfits trickling into birthdays and holidays; and working through illness.

If only there was a book that helped us justify to our evidence-based selves WHY we need to rest.

Alex Soojung-Kim Pang does this brilliantly in his easy-to-read manual, “Rest.

Alex is a Silicon Valley consultant used to seeing that other modern group of trophy chronic overworkers - tech workers.

No longer is “hustling,” “crushing” and “burning it” a badge of honour for your work.

And no longer are you badgering yourself for not “working hard enough”. You probably already are. This book teaches you how to work SMART.

Doctors know well (or should know!) that as physiologic stress hormones, chronic raised adrenaline and cortisol (which are essential hormones that help regulate our daily functions in normal health, not an evil in themselves!), can lead to raised blood pressure; heart disease; higher stroke risk; obesity; cancers; some thyroid disorders; some autoimmune conditions; and other conditions. As part of the body’s natural homeostasis/resetting, we all need sleep; good nutrition; regular exercise; and unregulated downtime- sitting and doing nothing, allowing ourselves to drift to boredom and creativity. (They say having bouts of boredom in our lives actually helps fuel creativity and innovation- hence why people struggle when they try to find a “job they love” that never bores them 24/7- the fact is, those peaks and troughs even in your dream pursuit, help you stay stimulated, curious and engaged with your passion!)

When we set that homeostasis out of whack due to shift work; chronic long hours (and everyone has a different set point for when they feel tired after a certain number of hours - your 40-hour week may be someone else’s 100-hour week!); irregular sleep habits; poor diet; and basically being “on” all the time; eventually, our bodies catch up and physically can’t take it anymore without an even longer rest, if it ever recovers.

Workplace burnout has recently been recognised by the World Health Organization as a “workplace syndrome” classified by the International Classification of Diseases (ICD)-11. This makes it even easier for us, whether we’re in medicine, tech or otherwise, to recognise signs of burnout, and the need to switch off and rest as part of our work/life routine.

Alex’s book gives tips from his research and work on this subject, and illustrates it with anecdotes from scientists who’ve raised productivity through napping; Stephen King’s writing routine; the benefits of walking; and other simple, inexpensive and time-effective measures for longevity in your work-life continuum. Like most books we recommend, it’s easy to read on the train, in bite-sized pieces, or all at once during your favourite reading time.

So, no more excuses. You deserve to Rest!

(The Medical Startup is an affiliate for Book Depository.)

Life As Usual - Managing Illness And Grief While Running Your Startup

The thing about illness is, it just hits you.

It’s unpredictable, it follows no rules (not always anyway, despite our best work as clinicians and scientists, biology is unique and will play its own role in each of us), and it hits you when you least expect it.

It’s damn frustrating, because our daily lives are built around routine, around schedules for work and appointments and goals and personal life. But illness doesn’t follow a schedule. The world doesn’t sit still while you suffer.

So what can you do?

You try to pace yourself, and take time off.

You limit your commitments; you rest; you take a break.

Then, when you feel better, you return to work, to your startups, to your passions - to your life as usual - and BAM! It hits you again. Or some other calamity related to the illness.

Whether it’s an illness hitting you, or your loved one; your life is disrupted again.

And think about the emotional trauma of impending bereavement; grief; or other foreshadowing..

Imagine this happening again, and again, and again, and again…..

This is reality for millions of people around the world.

And if it’s not cancer, child-related, or pregnancy-related, often the people affected are suffering in SILENCE- the kind where no one understands what’s going on with you.

How on earth can you live #lifeasusual while fighting something that’s bigger than you, that has no rule book, that pays no heed to your wishes, that doesn’t reward you for good rest and nutrition and self care?

You can recognise the things you can control.

All you can control is right in this moment.

The present.

Being mindful of your surroundings; of your circumstances; of the thoughts, fears and hopes in your head.

You can control your breathing; whether you take a step forward or back (literally); whether you choose to sit in stillness, or with a book and pen, or with headphones on the train, or holding your loved one’s hand.

You can accept that things aren’t right for now, and possibly won’t be ever again, instead of trying to hide those feelings; and that makes it easier to take your next step.

It’s tough while running the startups in your life, tough trying to keep all the wheels in motion while trying to be there for yourself and others who are most important to you.

Allow yourself to not listen to those who don’t understand- because there are many, unfortunately, who will choose not to.

Remember, you’re doing your best.

You deserve to be kind to yourself.

To be continued…

Is #BalanceForBetter? International Women's Day 2019

This International Women's Day, and for all the days after it:

- I pledge to be kind to myself, because I know I haven't been; 

- I pledge that I will look after my health and wellbeing as well as I look after others'

- I will cheerfully accept that as women AND men we can't "have it all" or "do it all" at once, and enjoy knowing there's a season for everything

- I will take more walks, see more trees, swim more seas, and relax with Mother Nature

- I won't worry about the future; it hasn't happened; the past was a kind teacher, but the present is where we need to be

- I relish the journey, and enjoy each minute, being patient for the destination;

- I see "balance" as a continuum, as not equal halves or thirds or quarters in life, but more as a "flow" and that relieves pressure for women everywhere; 

- I am content and happy, and hope that you all are, too.

Happy International Women’s Day, everyone!

#BalanceForBetter  #IWD2019

Empowerment through eLearning in Medicine

You may have noticed on Instagram- I’ve been working on developing online courses.

The courses will have a difference to what’s existing already. There are literally thousands of fantastic courses online that will help you learn to code, sew, speak Spanish, and more.

But nothing out there exists specifically for medical workers and the entrepreneurially-minded out there, from a medical perspective, from real experiences.

How does startup thinking apply to you as a doctor, nurse, physio, engineer and so forth?

Where do you start when a great idea comes to mind?

What’s the truth about how clinicians really feel at times- burnt out, exhausted, demotivated, self-loathing even? How is this similar to how entrepreneurs in other industries feel? And how can all of you learn from these experiences and overcome them, or at least start to tackle them when you’re on the go, on rotation in the middle of nowhere, a busy parent on night shift, or taking a gap year overseas?

I realised that, by exploring all these topics the last three years, even when it wasn’t clear to me at first (this whole blog started by accident, after all!), the whole journey has helped me in my own personal and professional life.

I went through all of this myself, was burnt many times, and know what lies are out there, what superficial constructs have been built supporting the “Silicon Valley mindset”, how toxic this can be to you as a compassionate person who works in healthcare or wants to start in healthcare, and how the medical world is similar to this.

And also, what’s changing about these worlds, to accept more human elements, more authenticity, more vulnerability, and more real sharing of experiences and ideas.

Thinking of your path as your own Startup is one way to start healing yourself, to build resilience, and to encourage yourself when you’re alone, when you feel misunderstood, and things seem tough. Even if you never start your own tech company, it doesn’t matter. We can all learn from startup thinking, even if your pursuit is actually in art or music or sport.

And that’s the thing. From Day 1, I was keen to feature people who are like me- creative as well as in STEM- to help transform the dialogue in medicine, that we are just what our job roles say- RMO, RN1, Dietitian, and nothing else beyond that. What happened to the extracurricular activities we loved in school, and how they were promoted as part of our curriculums there?

I felt ridiculed and even stupid for having a strong creative passion from childhood, and trying to marry this with medicine, which I also enjoy. Really, we all use creativity to some extent in our daily lives. From showcasing interviews with photographers, magicians and jewellery designers, to gaining confidence for my own journey in the creative industries, and to being approached to help start other ventures, this journey has been incredible and taught me a lot that I can share with you, too.

I’ll keep you posted- best is to sign up to the Mailing List at the bottom of this page, and/or follow on social media; if any questions about what particularly you’d like to learn or are struggling with, please send me an email at info (at) themedicalstartup.com.

Thank you for being part of our journey throughout, can’t wait to share more!

Cheers,

Louise

Success At All Costs?

I touched on this briefly in my New Year’s post.

What saddened me when I dug deeper into medical startups in 2016 was that, quite often, success was seen as something to achieve at all costs, with no respect for customers, colleagues, or the wider community.

Even if a brand has a carefully constructed facade, it will all fall apart behind the scenes if you don’t genuinely care.

Coming from the similarly ruthless world of physician training, I found it very disappointing, especially when startups and the entrepreneurial world are trying to attract more clinicians.

Most clinicians are attracted to healthcare because of the caring aspect. They genuinely want to help make a great contribution to people’s lives, through direct patient-clinician contact.

That compassion and vulnerability can be misused by unscrupulous individuals and companies, and even with a strong Corporate Social Responsibility (CSR) program, the WHY behind the company can be lost.

Is any industry safe from this?

No.

But it’s up to us, the individuals, to keep our values in mind, and live them.

For real.

Are you living your Mission Statement?

Thank you, 2018 :)

It’s strange sitting here, 1.5 hours before midnight in my home city, 2.5 hours til 2019 in my current one.

But it’s a great time for reflection, particularly when you and your other half saw the Early fireworks as he’s oncall tonight.

2018 was a huge year for me.

One of my faves, Ariana Grande herself said it best- “I find it interesting that this has been one of the best years of my career and the worst of my life.”

I guess personally, it wasn’t the absolute worst it could have been for me, but it definitely had a huge amount of challenges that really rocked me- but also gave me the extraordinary chance to reset and reframe the difficult situations in my personal life.

You can dread each day and its challenges, or you can reframe it to be uplifting for someone else who’s going through a hard time.

Every day counts.

I really believe that, no matter what challenges your career throws at you, you and your loved ones come first.

They’re your anchor, they’re your reason, your “Why” in most cases.

And you should never be ashamed of putting your wellbeing first.

Because no matter how big your career gets- and I believe that your career is your startup - you’ll enjoy it more when you respect yourself.

If you need more time before saying “Yes” to a project, ask for it.

If you feel pressured to work weekends and public holidays because that’s “the startup way,” but you’re actually more productive just working on odd weekdays, go ahead and set your boundaries.

If your personal circumstances mean it’s more favourable for yourself and your family if you work a bunch of part-time and casual freelance roles, go ahead and do it.

If you feel your co-founder’s doing something dodgy, reassess and consider trusting your instincts.

If someone’s being two-faced, don’t be afraid to call it out.

If you love doing several other things along with medicine, allow yourself to do it.

Give yourself permission.

And many more examples like this.

Everyone will be better off for you owning your power.

—-

Someone wise I met recently gave me that wonderful piece of advice.

“Own Your Power.”

Own your decision-making capability, your strengths and skills, your relationships, your identity.

People will try to take advantage of your vulnerability.

So-called “friends” and “partners” in startups and medicine will show their true colours to you, even when the rest of the world can’t see it immediately.

It’s disheartening. It can be isolating, and you can question yourself and your perception, wanting to believe you’re wrong.

It’s okay, because questions are healthy, and I’ve learnt how valuable it is to be mindful, and become more self-aware.

It’s a great defence mechanism, mindfulness. I’ve found it’s a great decision-making tool, productivity booster, and mental health balm. (Ooh, I should package that! Next to the lip balm jars!)

But I guess my rambling here right now is to say,

THANK YOU.

Thank you, 2018, for teaching me even through my weaknesses and dark times this year.

Thank you for giving me the chance to grow stronger.

Thank you for helping me to speak my truth.

Thank you to every single one of you who stumbles across my page; who reads my articles from way back when; who follows and likes (for real) my stuff on social media; who has become a true friend from this crazy journey; who has bumped into me at some event or clinic somewhere around the world and said hello; who believes in me even when I don’t; who believed in me even when it doesn’t all make sense.

I can’t wait to share 2019 with you all.

Have a wonderful New Year and enjoy the celebrations :):):)

*I think I am serious about the mental health balm!

Deceleration as a Tool for Identity and Preventing Burnout

I was listening to The Tim Ferriss Show (his podcast), Episode #295, where he goes into “The 4-Hour Work Week Revisited.” If you’ve read any of his books, or even if you’ve just heard of “The 4-Hour Work Week,” I highly recommend listening to it. He has some thoughtful insights from the unprecedented response to his most famous book on working well, productivity and “lifestyle design”, and answers some of the most commonly asked questions he’s received since first publishing it over ten years ago.

Approximately midway through the episode, Tim discusses what he believes is the most important and overlooked chapter, “Filling the Void.” In a nutshell, the chapter is about what the reader could do after finding their success on their terms; automation, fantastic cashflow, a great team, flexibility, low stress; as detailed in the book. However, Tim has found that people too often mistake the chapter as being a treatise on the benefits of lifelong idleness after achieving “success” in this manner. Furthermore, he believes people who misread this chapter may misunderstand how to relax well.

“It’s about contribution; getting yourself out of a ‘me, me, me!’ focus, so that you’re hopefully putting a positive dent in the world, in a way that extends outside of yourself and your immediate family, and hopefully has some persistence over time,” says Tim. “And taking the tools you’ve developed in a business capacity, and applying them to impact in some fashion. I expect many people skipped (the chapter) because they don’t expect to succeed…. But (perhaps) what started out as a party or a celebration ends up being really lonely, they feel isolated and don’t know how to address that…. and by thinking about filling the void, about starting to incorporate those pieces into your life, BEFORE you end up in a challenging psychological position where you end up being reactive, … since you haven’t filled the void with anything non-business related, you’re going to continue to work for work’s sake. This is really common for people who succeed in any capacity. .. It’s really rare you see someone who’s been in sixth gear for a very long time, who then retires and is really good at chilling out. Learning to relax and enjoy other aspects of life, and engage with people around you- friends, community or built community- those are skills you need to practice and develop, just as you need to develop and practice the skill of split testing (ie. A-B testing) to anything else. It’s not a default ability you have as soon as you stop.

“They can be really existential (issues) for someone. If the business has been your identity for a long time, and all of a sudden you want to replace that, if you don’t have a compelling replacement, you’ll just continue working because you don’t want to have to sacrifice that identity.”

(If you don’t have a business, feel free to replace it with “work” in the quotes above to apply to your situation.)

I think this is why people have trouble taking a break; even if you haven’t felt that you’ve reached your ideal of “success” yet; even if you’ve failed or had a hard time and wanted to distance yourself from your work for a time; in order to recuperate. If your identity’s so wrapped up in your work (and don’t worry, you’re not odd- it’s very common in medicine and startup land), you’ll feel that strange sense of time stretching out, empty and unfilled, and you’ll perhaps feel guilty for having that free time, and try to keep “busy” by filling it up with quick dopamine rushes, which may be simply starting a bunch of new projects with too much zest (who doesn’t love enthusiasm?), or at their extreme, can include overspending, binge eating, even drugs and so forth.

Or maybe you don’t experience any of that, but you think that to fill that void, you have to go back to work ASAP. And if that work environment was toxic for you, or you had issues to work through that you didn’t get addressed while having time off, those issues can quickly reappear, or be amplified, creating an even worse situation for yourself.

And the worst is that you may feel you’ve trapped yourself.

But there’s always a good way out.

You can be proactive about this.

As Tim suggests, no matter where you’re at in life, you can start today by asking yourself if you’re enjoying enough time with your friends/loved ones; if you’re doing something meaningful to you that is part of your identity, like a hobby that isn’t directly related to your work; or you can start something new, a new activity or hobby that helps build your identity beyond your medical life or startup life. You need to know that you’re valued beyond the workplace. And if you do find that you want to go back to work, that’s okay, but you could consider an option of trying a different work environment; working fewer hours/part time; or changing your work style in some other way. (A burnt-out, bullied doctor shouldn’t necessarily jump straight back into the exact same workplace; locuming a couple of days in a different workplace, or volunteering your compassion, integrity and other qualities into a tutoring job for homeless children, let’s say, could help you recuperate and feel fulfilled beyond your initial job description.)

It takes time to decelerate; even a car doesn’t do it gracefully when the brakes are slammed on! Patience with yourself will go far.

Feel free to comment below with your thoughts!