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SoWhoCaresAnyway E23 The Harmony We Forgot in Chaotic Systems · SoWhoCaresAnyway

• 0:04
  Hello and welcome to So Who Cares.
• 0:07
  Anyway, the podcast that shares learning, innovation and ideas from the world of health and social care and beyond.
• 0:15
  My name is Ruth Germaine, and I'm inviting you to join me each week with my inspirational guests to hear about who cares what they do.
• 0:23
  Their passions, their knowledge and ideas, and importantly, the difference they're making to improve the health and wellbeing of people in our communities.
• 0:32
  I consider each of my guests to be incredible individuals, working with people in new ways or with key messages to share people from healthcare, social care, the voluntary sector, community groups, and more to join me each week to find out, so who cares? Anyway.
• 0:51
  To find out more about me, who I am and what I do, please head over to my website, www.reflectiveruthconsultancy.com,
• 1:02
  where you can also catch up with previous episodes and read my blogs.
• 1:10
  Hello and welcome to the next episode of So Who Cares.
• 1:12
  Anyway, and today I am delighted to be joined by Dr.
• 1:16
  Jane Stevens, who I met at a conference recently, uh, for primary care in Henon Midway.
• 1:21
  It was an education conference, and Jane came down to talk about sophrology, which was something I'd never heard about before.
• 1:28
  And, um, was completely new to me, but I was just really blown away by the passion that Jane had in the room, uh, that well that Jane had.
• 1:37
  And the room was absolutely, you could hear a pin drop with people listening to you, Jane.
• 1:41
  So I wanted to.
• 1:43
  Invite you down again.
• 1:44
  Um, you're a medical di, associate medical director at um, Darren Valley Hospital, but actually this is quite a different take and I think that's the bit that really ignited my, um, interest in inviting you along.
• 1:58
  So I'll hand over to you, Jane, to give a bit more of an introduction.
• 2:00
  Please, Ruth, thank you very much for inviting me to speak with you today.
• 2:05
  And share some of my personal story, um, and the work that I've done and the work that I'm doing in my current practice.
• 2:14
  Um, and I am very excited to talk about Sophrology, which is going to be a new word to many of your listeners.
• 2:22
  Um, and something that I'm very evangelical and love talking about.
• 2:27
  First, let me perhaps, uh, start with a bit of my journey to how I got to where I am now.
• 2:35
  So, as you suggested, I trained as a medical doctor and I specialized in hematology, and I worked as a consultant in the NHS, uh, practicing hematology for many years.
• 2:48
  Um, it was, whilst I was working in the hospital as a consultant, I became very interested in what we might call the ecosystem of the hospital.
• 2:59
  Uh, realizing that hospitals are environments where much work is done.
• 3:05
  Um, but there is also a lot of complexity, uh, in hospitals, um, and.
• 3:13
  The task of managing the individual patient in front of you, but, um, being part of a much bigger system and I became interested in that and particularly interested in the place of staff within that.
• 3:29
  Um, so it felt important that we didn't treat staff, uh, just as cos in a big mechanism.
• 3:38
  Um, but actually that we saw staff as.
• 3:42
  Human beings, uh, practicing a particular kind of science medicine or nursing science, um, but also with a very human dimension to it.
• 3:54
  And I felt often that sometimes that got lost.
• 3:58
  As the staff were perhaps getting lost in the system, how much more concerning that patients might also get lost in the system.
• 4:07
  And I think this quite natural curiosity that I had, uh, led me into medical leadership.
• 4:15
  I think I had an idea that if we configured the system so that we were able to care for.
• 4:23
  Who were delivering the care, then they would, uh, deliver, um, much better patient care.
• 4:30
  So if we took care of staff.
• 4:32
  They would take care of patients.
• 4:35
  That may sound idealistic, but it was something that I very much believed.
• 4:40
  And as I continued in my, uh, journey of clinical leadership, I found that I was getting more and more frustrated as I was holding this intention to care for my staff, uh, in order that they would deliver.
• 4:56
  Great care for patients.
• 4:58
  One of the reasons it was so difficult, I think, was because this was in the time of austerity.
• 5:05
  Um, I became a clinical leader, uh, just after 2010.
• 5:11
  Money was very tight in the system at that point.
• 5:15
  And also the care was very much driven by targets.
• 5:20
  Uh, the four hour target for the emergency department, um, targets for referral to treatment time and particular to my practice.
• 5:30
  'cause my practice was in cancer, the cancer targets.
• 5:34
  Now, I, uh, don't dispute that.
• 5:37
  Targets have a place in healthcare, but they mustn't displace other important things, um, such as the, the quality of care and the humanity with which we deliver that care.
• 5:50
  And I began to feel that.
• 5:52
  Pursuit of targets and the financial austerity was beginning to cause stress in the system, which was displacing some of the more human aspects of care.
• 6:03
  And as I began to notice that more and more, I realized that I was getting more and more frustrated, uh, as a clinician.
• 6:14
  A couple of things happened to me, uh, which I won't relate here, but I actually found that I was at a point where I felt I couldn't continue on the path that I was on, and I made a rather dramatic decision.
• 6:29
  In 2016 to give up my clinical practice and my leadership role in the hospital.
• 6:37
  Um, I'd recently completed, uh, a Master's in Business Administration, an MBA that's called, and I thought that that would really equip me to be a better leader.
• 6:49
  Perhaps it did, perhaps it didn't.
• 6:51
  But the outcome was that actually I stepped outta the system completely.
• 6:56
  Um, I guess I could frame it that I had an itch that my master's study hadn't quite scratched, and I decided to pursue my thinking, um, within the context of a PhD.
• 7:09
  So I embarked on a PhD.
• 7:11
  Um, the PhD program was one of organizational change, and the organization that I was curious about studying was the provision of healthcare in the United Kingdom.
• 7:24
  Um, I think I was probably quite burnt out when I started the PhD study.
• 7:31
  I was probably quite angry, um, and quite bewildered that I as a passionate young doctor and a willing clinical leader, felt in some way that the system had chewed me up and spat me out.
• 7:47
  Uh, and I was really curious about that.
• 7:50
  Um, and that was the.
• 7:52
  Uh, tenure of the work that I did during the, the PhD, certainly in the early years.
• 7:59
  And then, um, Ruth, I need to tell you about a very, um, tragic episode that really informed my practice.
• 8:09
  I received a call from the chief exec of a hospital.
• 8:13
  They didn't know me personally, but they knew the path I'd taken.
• 8:19
  They invited me into the organization, um, to look at a set of circumstances whereby one of their senior clinicians had taken his life by suicide and they wanted to understand whether as an organization they had failed, uh, by omission or commission, um, and in some way contributed to this really tragic.
• 8:49
  Um, event.
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  And as I went into the organization and began to speak to people who were around this particular doctor, and I also spoke with his family, um, I realized that perhaps we'd both been on a journey whereby the stress of the system had become internalized and we had found our circumstances to be untenable.
• 9:15
  Uh, obviously I had.
• 9:17
  Come outta the system, uh, and managed to pull myself back and take some time for myself.
• 9:24
  Um, but in doing that piece of work, um, I felt very galvanized that actually if I could do anything in my power to prevent any other healthcare professional taking their life by suicide, then that was what I wanted to spend the rest of my career doing, supporting staff.
• 9:45
  In the really important necessary work of healthcare.
• 9:50
  Um, I completed that, uh, investigation in 2019 and I asked the medical director whether I might continue to work within the hospital studying the lived experience of healthcare providers, um, in order to inform my PhD research.
• 10:10
  I remember having that conversation with him in February, 2020.
• 10:16
  And although he was very willing for me to continue to work in the hospital, I could see that he was distracted in his thinking by a virus that seemed to be barreling its way towards us from China.
• 10:29
  And so when COVID.
• 10:32
  Arrived.
• 10:33
  It seemed a very logical thing for me to do to offer my services to that hospital.
• 10:39
  I was still a doctor.
• 10:40
  I felt I must contribute to the management in some way of the pandemic.
• 10:47
  And actually what that medical director asked me to do was to figure out how.
• 10:52
  As a hospital, uh, they might support their staff, uh, through whatever was coming towards us.
• 11:00
  We really knew not what in March, 2020.
• 11:03
  Um, and so that's what I did.
• 11:05
  I set up support services as best I could, um, in the, the hospital.
• 11:12
  Um, and really my practice was simply creating a space where staff could come and I would listen to them talk about whatever they felt they needed to talk about.
• 11:22
  And.
• 11:24
  It was difficult work because there were a lot of, um, very traumatized people, um, who were working on the frontline during COVID.
• 11:36
  Um, but it also felt to me really important work.
• 11:39
  And Ruth, I'm gonna fast forward now in my story, actually okay.
• 11:43
  To August, 2021.
• 11:47
  So in August, 2021, I'd been working, um, at the hospital, looking at staff support for about 18 months.
• 11:55
  And I felt I really needed to write up, uh, my PhD thesis, uh, informed greatly by, by my experiences working with people during COVID.
• 12:07
  Um, and it was whilst I was in the period of writing up my, um, PhD, that I was invited to a GP garden, uh, in North London where they held events.
• 12:19
  It was called the listening Space.
• 12:22
  And I was invited to, um.
• 12:25
  Meet with a professor of medicine, uh, from Harvard, who was visiting London at that time.
• 12:32
  Uh, I'm embarrassed to say I can't remember too much about the professor of medicine from Harvard, but what I do remember is somebody tapping me on the shoulder, um, at the end of the meeting and saying, Jane, I heard what you were saying about NHS staff, and I could hear your passion for helping.
• 12:53
  NHS staff in the work that they do.
• 12:56
  She said, can I just tell you a little bit about my story? Um, and I said, okay, of course.
• 13:04
  And, uh, she is the director of a retreat center that's owned by, uh, her family and in lockdown.
• 13:12
  In 2020, the family piled down to the retreat center to spend lockdown there, and they had a really incredible time.
• 13:21
  Working the land, working the fam, uh, working on the building.
• 13:25
  But they were always aware that not 10 miles up the road, there was a hospital, uh, where staff and patients were having a very different experience.
• 13:36
  And the retreat center is in the Darin Valley.
• 13:41
  And the name of the hospital where I was working is Darin Valley Hospital.
• 13:45
  Yes.
• 13:46
  And as soon as we made that connection, I got goosebumps and I said, uh, to Jesse, that's her name.
• 13:53
  I said, Jesse, can I bring my staff down to your retreat center? And she said, please, we are just trying to set up a retreat program for NHS staff.
• 14:03
  So it was, um.
• 14:05
  An amazing, uh, meeting.
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  Um, and sure enough, I went down to experience, uh, a retreat myself, um, a few weeks later and it was an extraordinary experience.
• 14:19
  We went into the forest, um, and did something called forest bath.
• 14:25
  Uh, which is kind of a mindfulness practice, but being in the forest surrounded by trees, and that was really extraordinary.
• 14:32
  Um, and I also got introduced to something that I'd never heard of before called Sophrology.
• 14:39
  Um.
• 14:39
  I'm going to come back to Sophrology in a moment, but just to conclude about the retreat program.
• 14:45
  So, um, I was able to find some charity funding, um, the following year to take our ITU staff.
• 14:55
  Through the retreat program and then our emergency department staff through the retreat program and also staff from our medical and surgical wards.
• 15:05
  And the retreat program has been a wonderful experience, not just for me and the team that, uh, has evolved to run these retreats, but we've also taken almost 2000 members of NHS staff and social care staff through the retreat.
• 15:22
  Program in the last three years, um, is called out in the fields.
• 15:26
  And we do have a website, so out in the fields.org.
• 15:31
  Uh, and you can learn all about the retreat program.
• 15:34
  But let me talk now about Sophrology because Sophrology, as I've explained, was something that I came to know through the retreat program.
• 15:42
  Um, but actually in discovering Sophrology for myself, um, I think of all the things I've done in my entire career, um, I've been a doctor for many years.
• 15:56
  I've done an MBA, I've done a PhD, but Sophrology is the thing that has really changed me from the inside out.
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  So let me try and explain.
• 16:06
  Nephrology to you.
• 16:09
  PhD ology was developed by a Colombian, uh, called Alfonso Cicada.
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  And Alfonso Cicada studied medicine in Madrid, uh, graduating in the 1950s, and as, um, a young medical student into being a young doctor.
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  The thing that he was most interested to study was consciousness and it in fact, nephrology translates of the, as the study of consciousness in harmony.
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  And when he was a young psychiatrist, he perhaps a bit like I did, became quite disillusioned quite quickly with the western model of medicine as he experienced it.
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  And he was practicing as a psychiatrist, working with quite a lot of people who'd been traumatized by the Spanish Civil War, and were experiencing quite serious mental health problems.
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  And in the practices available to him at that time, he didn't find what he was hoping for in terms of therapeutic interventions.
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  It so happened that he was married to a yoga teacher and she said.
• 17:25
  Or to perhaps together, they decided that they would go and look at other practices, um, that might inform him in his study of consciousness and also interventions for mental health.
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  So he was able to study the yogis in India.
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  He met, uh, the Dalai Lama, who was by then a young man at that time.
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  And so he was introduced to Tibetan Buddhism and the meditation practices of Tibetan Buddhism.
• 17:57
  And he also went to Japan to study Zen and drawing on these traditions, um, these ancient Eastern traditions.
• 18:07
  He came back to Europe, um, at a time when.
• 18:11
  Existential philosophy was quite dominant, uh, in thinking.
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  And he packaged Tibetan Buddhism, Zen and the practice of yoga into kind of phenomenology, which is studying the moment and over years.
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  He came to really refine his method and his practice.
• 18:32
  Um, and this is, um, what is now known.
• 18:37
  I'm very well known in continental Europe as nephrology, not so well known in English speaking countries because a lot of the texts are written in French and Spanish.
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  And so as I, as a student of nephrology have wanted to study some of the texts, I've had to get out my schoolgirl French and Google Translate and literally sit with a pencil trying to translate.
• 19:03
  Some of the text so that I could have a richer, deeper understanding.
• 19:07
  Um, we're very fortunate to have a Sophrology Academy, um, which is located in Kent and they run, um, training courses throughout the year.
• 19:18
  Um, and that's where I was able to study for two years to become an accredited sophrology practitioner.
• 19:25
  So what does a nephrology session involve? Uh, well, it has three main things.
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  It has gentle movements that are drawn from yoga.
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  So I say gentle.
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  You don't need to be particularly bendy.
• 19:40
  You don't need a mat or Lycra.
• 19:43
  Um, but anybody who's practiced yoga might recognize some of the movements that we use in a sophrology practice as drawn from yoga.
• 19:52
  The second thing we would do in a serology practice is bring awareness to our breath.
• 19:59
  So the movement brings awareness to our body, and then we would bring awareness to our breath.
• 20:05
  And, uh, there's many different breathing practices that we would use, um, that we kind of develop a toolbox of things.
• 20:15
  Um, and the final piece of a sophrology practice is to engage our imagination.
• 20:21
  Uh, and particularly in a positive way.
• 20:25
  Uh, so we draw on positive mental images, positive emotions, uh, and in that way anybody who is aware of, um, positive psychology.
• 20:37
  Uh, would recognize a lot of the practices.
• 20:40
  So a nephrology practice can last anything from just a couple of minutes, perhaps waiting for the kettle to boil.
• 20:49
  I might, uh, connect with my body to a few of the nephrology practices that I recognize.
• 20:55
  Although when we are training a nephrologist, a practice can last up to an hour.
• 21:00
  And that's quite important.
• 21:02
  But let me, uh, perhaps try and explain how Sophrology has impacted on my life.
• 21:10
  Um, so through the practice of Sophrology, um, I have come to understand a lot more about.
• 21:20
  How, uh, health is not really about the absence of sickness or illness, um, but health and wellbeing, um, is perhaps connected with some more vital energy or sense of vitality, wellbeing that we might have.
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  And my practice these days is actually two.
• 21:47
  Try and focus on the elements that bring health and wellbeing, not just to myself, um, but as I observe them in other people.
• 22:00
  And through being really curious about this, I have stumbled across another word, which is SLU Agenesis.
• 22:09
  And again, that is not.
• 22:11
  Uh, a word that either rolls off the tongue or that many people will have heard of.
• 22:17
  But having described sophrology to you, uh, I'd really like to now just talk a little bit about this practice of Salu Agenesis.
• 22:26
  Yes.
• 22:27
  So where Sophrology is the study of consciousness in harmony, uh, Saluto Genesis refers to.
• 22:35
  Study of the factors that bring health and wellbeing to us.
• 22:41
  Uh, we might be more familiar with the term pathogenesis or pathology.
• 22:48
  Pathogenesis, of course, is the study of sickness and disease and salu.
• 22:55
  Agenesis is right at the other end of the spectrum to study the factors that bring us health and wellbeing.
• 23:01
  As we think about it, it's surprising we don't do this more often.
• 23:05
  Yes.
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  Think about the factors that bring us health and wellbeing.
• 23:10
  Dilu, agenesis as a term, um, was coined by a guy called.
• 23:17
  Aaron Antonovsky.
• 23:19
  Aaron Antonovsky was, uh, an immigrant to New York in the forties, 1940s.
• 23:28
  He was Jewish and he was fleeing, um, the Nazi regime in Germany.
• 23:33
  And landed up in New York.
• 23:35
  Um, and he trained as a medical sociologist and his practice and his research practice, uh, actually took him to studying Holocaust survivors.
• 23:49
  And in the course of his studies, he identified a minority of women who had survived the Holocaust, but went on to lead what we might call adjusted or or normal lives.
• 24:05
  They were able to form loving relationships.
• 24:07
  And he observed that they had a health and vitality, which was unusual, uh, for the majority of Holocaust survivors, who were in many ways broken by their very difficult experiences.
• 24:23
  So he went on to study this group of women and to try and identify what.
• 24:30
  Qualities they might be either experiencing or demonstrating that brought them a sense of wellbeing and antonovsky unifying theory.
• 24:41
  Um, which is really the theory of salu.
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  Agenesis is summed up by.
• 24:47
  A sense of coherence in life.
• 24:50
  So he identified that these women had somehow managed to achieve a sense of coherence in life.
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  And this is what he went on to study as the theory behind Salutogenic.
• 25:05
  And just to unpack that a little bit more, he identified three main things, um, in.
• 25:13
  In these women and in, uh, the other people that he studied that created a sense of coherence in life.
• 25:22
  And these three things were first, that life was somehow comprehensible.
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  That the external circumstances and indeed the internal impulses that we experience as human beings.
• 25:37
  To some extent make sense to us, so we are able to experience life as in some way comprehensible.
• 25:46
  The second thing was that life, or is that life is experienced as manageable.
• 25:52
  So the inevitable stresses and strains of life as we experience them, we also feel that we are able to manage them.
• 26:02
  Also manage our internal environment, manage our emotions, manage the impulses that might make us choose to do things that we have a sense of manageability about life.
• 26:16
  And the third thing, and perhaps to me the most interesting thing is that life is meaningful to us.
• 26:23
  And just staying with that thought about life being meaningful, um, it takes me to the work of Viktor Frankl.
• 26:33
  Viktor Frankl was himself, uh, a Holocaust survivor.
• 26:38
  And wrote about his experiences of being in the concentration camp and how he came to try and make sense of that experience in his, um, book, man's Search for Meaning.
• 26:50
  And in the historical character of Viktor Frankl, I am able to unite both Sophrology.
• 26:58
  And Saluto Genesis.
• 26:59
  'cause Vitor Frankl met both Alfonso cic, who developed nephrology, and he also was a huge influence on Aaron Antonovsky, who developed the theory of Saluto Genesis.
• 27:16
  And so in thinking about Viktor Frankl uniting both these schools of thought and both these characters, um, those that know the work of Viktor Frankl, um, suggested that if we can find one reason to keep on going that that sense of purpose and meaning in life.
• 27:36
  Is enough to sustain us through whatever we are going through.
• 27:41
  And Viktor Frankl, whilst he was in the concentration camp, learned that his son was still alive and that was what gave him the purpose and meaning to go on living when otherwise he probably could have given up.
• 27:58
  And I'm so grateful that he did because, uh, in Viktor Frankl finding a reason to go on living.
• 28:05
  And the work that he did, uh, after the war finished, um, influenced both, uh, cicada Antonovsky and has given us both the practices of Sophrology and Salu Agenesis.
• 28:20
  So I've shared a little bit about the practices that I am interested in and how I got to know about.
• 28:27
  Them.
• 28:27
  And what I'm really keen to do, um, is to continue to work with people practicing nephrology.
• 28:34
  And we have a lot of nephrology, uh, opening up in our hospital.
• 28:39
  I try and do a nephrology practice with staff in the boardroom.
• 28:45
  Every Thursday at four o'clock.
• 28:48
  And, uh, we love doing that because it feels even yet a little bit subversive that we're practicing sophrology in the boardroom of our hospital with the blessing of our chief exec, I must say.
• 29:01
  But to be doing those practices and thinking about health creation and how, not just focusing on the diseases and the illnesses that we tend to.
• 29:14
  Um, have dominated us in our practice in the NHS, but thinking about how we can create health and bring vitality.
• 29:23
  Um, my practices with NHS staff, as I have described, but my hope is that they will go on and share some of their experiences with their patients and thus be bringing practices of health creation to, to patients as well.
• 29:40
  Jane, you, I mean, your passion that I had before has come through.
• 29:43
  Um.
• 29:45
  Along with that, you, you are really clear in explaining what this is and taking us on your journey, what led you there, which was the fact that you used the term yourself, that you felt burnt out and you were aware that there were systems in place that weren't helpful to staff and in not being so helpful to staff.
• 30:02
  That wasn't helpful, helpful.
• 30:04
  To the people that you care for and that drove you.
• 30:07
  And then you talked about that story of, you know, how difficult it was during COVID and that doctor that unfortunately took his own life, which unfortunately isn't a, um.
• 30:20
  An uncommon story.
• 30:22
  Um, anybody in the medical world will, will know that.
• 30:25
  And I think it's quite well recognized because of that emotional toil and that emotional labor that can, that can cause injury really.
• 30:33
  But that drove you not to to stop, but to just go and look out elsewhere and to see what else there was.
• 30:40
  And there's so much and it.
• 30:42
  Just found this so interesting.
• 30:43
  And I'm just gonna talk a little bit just as sort of way of reflecting about some of the other podcasts that it relates to, because there's so much interrelation.
• 30:51
  I mean, the first ones that I was thinking about was Dr.
• 30:54
  Rebecca Myers, who spoke about the emotional labor, emotional toil, um.
• 30:59
  James Metcalf, who actually works for the North York Moores Trust, um, he takes people out and walks into the countryside and really thinks about that.
• 31:08
  And this morning I was doing a podcast, which I'll probably release before this once because I want to mention it now with, um, a nurse called Cheryl Young, which is about, um, professional nurse advocates, but she's doing very similar things.
• 31:22
  Spending time making a space, listening to people.
• 31:25
  It's not sophrology, but she's taking people out into the open air.
• 31:28
  She's doing things for the staff and really thinking about that health and wellbeing.
• 31:34
  But what you started to touch on as you went through and, and I think really links in really well was about the fact that.
• 31:41
  People need that, that meaning.
• 31:45
  And early on I, one of the early episodes I interviewed a GP called Dr.
• 31:49
  Mark Spencer, who was in, um, who works in Fleetwood.
• 31:54
  And he spoke about taking a completely different approach and beginning to sort of, rather than people that were coming to him because.
• 32:00
  Of all the issues that were going on in their society and the system wasn't really fitting them.
• 32:06
  It took a completely d different hope.
• 32:07
  And what he said was by building up the community to actually help themselves, he, they created hope.
• 32:14
  Mm, they created hope.
• 32:15
  Yeah.
• 32:15
  And that was, that was the mi, you know the title? I can't remember exactly, but it had hope in there.
• 32:20
  The fact that we need hope in order to carry on, which is around that meaning.
• 32:25
  And then it went.
• 32:26
  The other one that it really then clicked in, which is very similar, is um, a gentleman called, uh, Cormack Russell, who has studied and talks about and actually practices asset-based community development and talks about the fact of thinking about your community, who they are, and making sure that actually.
• 32:44
  How are we creating health rather than institutions, which the NHS is, you know, in, in whatever guys we put it in a hospital, primary care, wherever else, rather than them coming in and saying, right, we can do this to you and for you.
• 33:00
  Yeah.
• 33:00
  Saying actually, what have you got that we can build it upon? So I know I've took a bit of journey there to say, but I thought there's so many bits that it links into.
• 33:08
  Mm-hmm.
• 33:10
  But actually this covers so many of those things and your passions come through.
• 33:14
  So I dunno what your thoughts are now.
• 33:16
  I've said all of that, um, but it'd be really interesting to hear your reflections on and particularly what, what needs to happen as well.
• 33:24
  So I'd like to hear that too.
• 33:26
  So I, I think one of the, um, strands of my thinking.
• 33:31
  Is that we have without doubt had a golden age of medicine, um, in the latter part of the 20th century.
• 33:41
  Um, mapping the human genome, for example, led to massive improvements in, um, cancer therapeutics.
• 33:50
  Um, we.
• 33:52
  Understand how much more to manage cardiovascular disease risk and mitigate against some of those risks.
• 33:59
  And we've achieved so much.
• 34:01
  But I think in achieving all that, we also allowed our focus to slip away from the individuals.
• 34:11
  Uh, and all that comprises, um, us in our fullest humanity.
• 34:17
  And I think that the people that you've.
• 34:21
  Uh, mentioned and that you've spoken with previously are identifying the fact that we've maybe shifted our gaze away from people onto pathology, and we need to shift our gaze back to holistic medicine or the, the fullness of human beings.
• 34:40
  And one of the things that, um.
• 34:42
  And Kovski really appreciated was that poverty and loneliness, lack of social connection, lack of opportunity, had a very negative impact, um, on health and wellbeing.
• 34:59
  I've led a very privileged life.
• 35:02
  I've lived in England, which is, you know, at the end of the day, a wealthy country.
• 35:08
  So I have had.
• 35:09
  Every opportunity given to me, and yet we can still allow negativity to dominate our thoughts and our experience.
• 35:22
  And I think the movement of creative health, which is really gaining some traction in the country, um, is trying to look at the other determinants.
• 35:35
  Of health and wellbeing.
• 35:37
  The NHS speaks a lot, uh, about population health at the moment and the social determinants of health.
• 35:45
  And I think that I'm coming at that and these people that you've described are coming at that as well, um, from a different angle.
• 35:54
  I think everybody that you mentioned somewhere along the line is drawing on nature and the outdoors.
• 36:00
  Yes.
• 36:01
  You described people going for walks.
• 36:03
  People, um, being out and about, I think nature connections is really important for us.
• 36:10
  And, um, my colleagues who are forest bathing rights talk a lot about this.
• 36:16
  Um, forest bathing is a translation of the Japanese shin rinku, uh, which is to bathe under the canopy of the trees.
• 36:25
  Uh, and we may, um, naturally be drawn to trees or not, but actually what we've learned is that.
• 36:32
  Trees actually secrete something called fight on sides.
• 36:37
  Um, and these phyton sides, um, are what gives the forest its particular smell that earthy, leafy smell, but actually fight on sides when we breathe them in.
• 36:49
  Uh, actually have a very positive impact on human physiology, whether it's lowering blood pressure, um, regulating the autonomic nervous system, indeed enhancing the immune system, uh, by increasing something called natural killer cells.
• 37:07
  So we are now learning an awful lot about how being in nature.
• 37:13
  Is actually good for us.
• 37:15
  It's good therapy to be outside.
• 37:18
  Um, the brain likes to look at fractal patterns.
• 37:22
  Fractal pattern is classically a tree with its big trunk and the branches that get smaller and smaller and smaller.
• 37:29
  It soothes our brains to look at trees.
• 37:32
  Um.
• 37:34
  It's the reason why we put pot plants on our desks because we like to look at the fractal pattern, so being out in nature, um, but also all the creative arts, whether it is poetry, um, or dancing music.
• 37:54
  Drawing all these creative things that we might think, well, we have to go to art college to be able to draw.
• 38:02
  Uh, we don't, anybody can doodle.
• 38:04
  And there's something about the creativity that comes through us.
• 38:08
  Um, and I think that we need to start focusing on these other things that bring us health and wellbeing.
• 38:17
  Uh, I talked about Salutogenic as, um.
• 38:23
  The focus on things that.
• 38:25
  Bring us, uh, health and wellbeing.
• 38:28
  Um, and anybody who has sung in a choir will know that there is not just the joy of the performance and perhaps being with people in a social environment, but think about the breath control.
• 38:42
  Um, and all those positive, um, aspects of, of breathing, particularly if you've got any form of lung disease.
• 38:50
  So there are now established programs like dancing for Parkinson's Yes.
• 38:55
  And Brain Odyssey, which is, um, a group of performing artists who actually go onto stroke wards.
• 39:02
  And talk to people who've recently had strokes who may be with a new disability or a new difficulty in talking.
• 39:11
  Um, and through the use of performance art, uh, they run workshops for survivors of stroke or any other kind of brain injury, a huge impact on health and wellbeing.
• 39:26
  So.
• 39:27
  I really think we need to not just start studying and understanding, but dare I say it, funding some of these creative health opportunities.
• 39:39
  We may find that they're an awful lot cheaper than pharmacology.
• 39:44
  Um, and as effective, if not more effective in many ways.
• 39:49
  Thank you.
• 39:51
  Yeah.
• 39:51
  I mean it's just so many things aren't there that are out there and I think there are pockets of it happening.
• 39:57
  As you say, there seems to be a real shift in movement, doesn't there, to these types of things? I think there is.
• 40:02
  Really do.
• 40:03
  Yeah.
• 40:03
  Yeah.
• 40:03
  Which sort of, which gives hope, you know, that we spoke about earlier on, but I think it's really.
• 40:08
  How do we make this mainstream and, and how do we make this happen? So with that, I'm just going to ask, what, what are your concluding thoughts? What, what really needs to happen to generate this? You know, if, if there was a magic wand, or how do we make the magic wand happen? What, what do we do and how do we make sure that this becomes something that's not just, there's a pocket here, there's something amazing there, but this is something that everybody thinks about and is everybody's business.
• 40:35
  Yeah.
• 40:36
  Um, I think we need to raise it in people's consciousness.
• 40:40
  Um, so people need to know about these things that are happening and.
• 40:45
  Start to, uh, notice them.
• 40:48
  Notice what brings you personal joy in your life.
• 40:54
  Notice those moments where you have a sense of health and wellbeing and consider.
• 41:01
  What am I practicing? What am I experiencing, um, that is bringing this sense of vitality, uh, and joy to me.
• 41:11
  I remember taking one person into the forest.
• 41:15
  His observation was that when he takes his toddler out into the forest and the toddler stops in amazement.
• 41:25
  At a leaf, yes, that's just fallen from a tree.
• 41:29
  He would say, come on, stop dawdling.
• 41:31
  We, we are on a walk.
• 41:33
  And actually having been, uh, on a forest bathing experience, he said, I'm gonna stop now with my toddler and say yes.
• 41:41
  Isn't this amazing? So just beginning to notice all the things that bring us joy, bring us excitement, and trying to maximize these, enjoying being with our friends and family, putting away our mobile phones, and thinking that social media or digital solutions are the solutions.
• 42:04
  Actually just coming back to ourselves, our bodies, our nature, and the beautiful world in which we live.
• 42:10
  I think that would be my prescription.
• 42:13
  Thank you, Jane.
• 42:14
  And the more that we can get that to happen, and the more of those prescriptions that happen as say there does seem to be a trend, then the better.
• 42:21
  Yeah.
• 42:21
  So thank you.
• 42:22
  I hope so.
• 42:23
  I think you're right.
• 42:25
  So thank you for joining me today.
• 42:26
  I've really enjoyed having you as a guest on the podcast.
• 42:29
  It's your drive, your passion, and the fact that you've kept this going and you're really doing everything that you can to try and change this in so many ways.
• 42:36
  I know we've only touched upon what you're doing today, really.
• 42:38
  So thank you for doing all of that, and as I say, thank you for joining me today.
• 42:42
  You're welcome.
• 42:43
  Thank you, Ruth.
• 42:43
  Thank you.
• 42:43
  Bye-bye.
• 42:44
  Bye-bye.
• 42:46
  Thank you for tuning in to, so Who Cares.
• 42:49
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• 42:54
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• 42:59
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• 43:06
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• 43:15
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