Latest / The You Project / #2124 Life After Living - Dr. Matt Morgan

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#2124 Life After Living - Dr. Matt Morgan · The You Project

0:00
Speaker 1: Hi, good a team, it's a You project, It's Harps.
0:03
Speaker 1: Who else would it be.
0:03
Speaker 2: It's Friday night here in the thriving metropolis of Melbourne.
0:08
Speaker 2: It's been a beautiful day. I'm very excited. This is
0:10
Speaker 2: my third podcast today. It's almost dinner time, so I
0:14
Speaker 2: could fall over the line about halfway through. We'll see
0:16
Speaker 2: how I go, but I'm pretty sure my guests will
0:19
Speaker 2: keep me excited and plugged in. His name's Matt Morgan
0:22
Speaker 2: and I'm going to tell you about him in a minute,
0:24
Speaker 2: or he might because I hate reading bios because it's
0:26
Speaker 2: predictable and boring, so maybe Matt will do it for me.
0:29
Speaker 1: Hi, Matt, how are you?
0:31
Speaker 3: I'm very good? Thank you? Yet all is well? All
0:33
Speaker 3: is well?
0:34
Speaker 1: Thanks thanks for coming to play on the You Project.
0:37
Speaker 2: Just tell people where you're at at right now and.
0:41
Speaker 1: The potential interruptions that we're dealing with tonight. Yeah.
0:46
Speaker 3: Well, I'm coming to you from Old South Wales rather
0:49
Speaker 3: than New South Wales, so the original South Wales, the
0:53
Speaker 3: OG so in the UK. I'm at a small village
0:57
Speaker 3: just on the outskirts of Cardiff, and I guess there's
1:01
Speaker 3: three bits to my life. I'm a full time intensive
1:04
Speaker 3: care doctor by trade, so that's kind of my day job.
1:08
Speaker 3: But I also have two other bits to my life
1:11
Speaker 3: in that I've done research in the past in terms
1:13
Speaker 3: of medicine and other bits and bobs, but I also
1:16
Speaker 3: love public engagement and I fell stumbled into the world
1:20
Speaker 3: of writing a few years ago. And so I've written
1:22
Speaker 3: some books, done some stuff in the radio, and done
1:25
Speaker 3: some stuff on the TV.
1:27
Speaker 1: And what what is h one? What box? Does ah?
1:31
Speaker 1: One of those tick for you?
1:34
Speaker 3: Yeah? I see, I think it all does the same thing,
1:36
Speaker 3: if I'm honest. I told my careers tutor back in
1:39
Speaker 3: school when I was a kid that I wanted to
1:41
Speaker 3: be Fox Moulder from the X Files. That was my
1:44
Speaker 3: destination in life. But there's not much need of international
1:48
Speaker 3: spies in South Wales unfortunately, so that wasn't possible. So
1:54
Speaker 3: I kind of stumbled into medicine instead. And you know,
1:59
Speaker 3: actually it's kind of the same. My life is about
2:03
Speaker 3: trying to solve mysteries, whether it's what's wrong with people,
2:07
Speaker 3: and we use science to do that, we use machines,
2:10
Speaker 3: but ultimately at the end of all of those mysteries
2:14
Speaker 3: and plans is a human being, you know, a messy
2:17
Speaker 3: tricky human being, and that's what I love putting those
2:20
Speaker 3: two things together. Really.
2:23
Speaker 2: Yeah, And I guess in the middle of all of
2:25
Speaker 2: that problem solving medically and clinically and the complexity of
2:28
Speaker 2: diagnosing and treating and trying to figure out in real
2:32
Speaker 2: time under enormous pressure in a busy environment with a
2:35
Speaker 2: thousand moving parts, then on top of that, trying to
2:39
Speaker 2: be a warm, empathect human who to build connection and
2:43
Speaker 2: rapport and trust. It's like there's so many different components
2:47
Speaker 2: to that. And I feel like, for me, the doctors
2:49
Speaker 2: that I've loved are the ones that just treat me great.
2:52
Speaker 2: I almost don't even care about of course I care
2:55
Speaker 2: about their medical knowledge and skill, but it's more about no,
2:59
Speaker 2: I like her, I like him.
3:01
Speaker 1: I'm going back to that doctor.
3:03
Speaker 3: Yeah. I think that's so true. It's often not about
3:06
Speaker 3: what you say or how you say it. It's about
3:09
Speaker 3: how you leave people feeling, you know, And medicine is
3:13
Speaker 3: actually all about the choreography of navigating doubt gracefully in medicine,
3:18
Speaker 3: because medicine is full of it's not full of black
3:21
Speaker 3: and whites. It's full of gray zones and nuance. And
3:25
Speaker 3: that's what humanity is kind of all about really, So, yeah,
3:28
Speaker 3: that's a bit that's hard, and it's the bit I
3:30
Speaker 3: kind of enjoy.
3:30
Speaker 1: Really, do you think that.
3:34
Speaker 2: Being able to deal with pressure and perform under pressure,
3:37
Speaker 2: or as the Eastern philosophers call it, you know, being
3:41
Speaker 2: the calm and the chaos equanimity? Is that more about
3:44
Speaker 2: who you are just innately? Is that more about runs
3:49
Speaker 2: on the board? Is that about time? Is that about
3:52
Speaker 2: having that intention? Because I feel like, yeah, I'll shut
3:57
Speaker 2: up and I'll let you answer that.
3:58
Speaker 1: What do you think?
4:00
Speaker 3: It's definitely something you can get better at and train at,
4:03
Speaker 3: and that's why things like checklists and medicine can be helpful.
4:07
Speaker 3: You know, when you run into a room and there's
4:09
Speaker 3: there's chaos, there's all sorts happening. Your job is to
4:13
Speaker 3: bring order into those pools of disorder. And yes, there's
4:17
Speaker 3: ways of making your brain work to do that. But
4:20
Speaker 3: I think there probably are people naturally attracted to that chaos,
4:25
Speaker 3: and there are probably naturally attracted to know a very organized,
4:29
Speaker 3: structured clinic way. You know, you know exactly what's going
4:32
Speaker 3: to happen in the day. You know, I have no
4:34
Speaker 3: idea what's what's going to happen in a day. I
4:37
Speaker 3: go to work, I meet families on some boring Tuesday
4:43
Speaker 3: for the first time ever to give them the west
4:45
Speaker 3: news of their life, you know that. And for me
4:49
Speaker 3: that challenge is also the bit that keeps me going
4:53
Speaker 3: back the next day and the next day.
4:56
Speaker 2: Is there a Is there a process for you or
4:59
Speaker 2: a protocol or a way of doing that delivering that
5:02
Speaker 2: horrendous news that's most effective. I mean in terms of
5:08
Speaker 2: trying to manage all of those emotional, psychological, medical, real
5:12
Speaker 2: time variables.
5:15
Speaker 3: I think breaking bad news is one of the most
5:18
Speaker 3: important things we do, and communication is also the most
5:22
Speaker 3: dangerous thing we do. You know. It's not doing that
5:25
Speaker 3: big procedure, doing the tracheostomy, doing the lines. They are
5:28
Speaker 3: all the exciting things. They're probably not the most dangerous things.
5:32
Speaker 3: It's the words we use, actually there are so Yeah.
5:35
Speaker 3: For me, breaking bad news is a big part of
5:37
Speaker 3: my job. It's a big part of something I want
5:39
Speaker 3: to get good at. And yes, I've developed over the
5:42
Speaker 3: years a kind of structure for doing that which sounds weird,
5:47
Speaker 3: you know. I kind of break bad news, or at
5:49
Speaker 3: least I try to the same every time in a
5:51
Speaker 3: way in terms of that structure. But that doesn't take
5:55
Speaker 3: away humanity. If anything, having that plan allows me to
6:00
Speaker 3: spend more time, you know, thinking about that patient, that individual.
6:04
Speaker 3: But there's always certain things that I do doing that,
6:07
Speaker 3: one of them which may be helpful in you know,
6:11
Speaker 3: everyone's everyday life. Actually, well, there's two things. First of all,
6:14
Speaker 3: talk about the D word. It used to be the
6:18
Speaker 3: C word. It used to be you couldn't say the
6:19
Speaker 3: word cancer. And now when I walk through a park
6:23
Speaker 3: with my dog, there's people running around with cancer and
6:25
Speaker 3: all over their T shirts everywhere. You know, it's been democratized.
6:30
Speaker 3: But now it's not the it's the D word now,
6:33
Speaker 3: which is which is die? People don't say the word
6:36
Speaker 3: die or dead. And what you can't do in medicine
6:41
Speaker 3: is use euphemisms. You know, I've said in the past,
6:45
Speaker 3: you know, I'm sorry your mum has gone to a
6:47
Speaker 3: better place, and they'll say, well, where's that Sydney you know,
6:52
Speaker 3: bond a different hospital, you know, or they've moved on
6:57
Speaker 3: for example. You know you've got to say I'm really
6:59
Speaker 3: sorry to say your mum has died. You know, you've
7:02
Speaker 3: got to say that D word. And the other technique
7:05
Speaker 3: that I use is called the empty chair technique, where
7:08
Speaker 3: often what we want to know is what that person
7:12
Speaker 3: would want us to do, had they been able to
7:14
Speaker 3: tell us. You know, I'm not the boss, The family
7:17
Speaker 3: is not the boss. Is the patient who's the boss.
7:19
Speaker 3: So I often say, look, if your dad was here
7:22
Speaker 3: now listening to how and well he is after having
7:25
Speaker 3: this big operation and he's got multi organ failure, if
7:28
Speaker 3: he was sitting in that chair right there, and I
7:30
Speaker 3: point to a chair, what would he say? And that
7:34
Speaker 3: kind of gives families almost the permission to speak on
7:38
Speaker 3: his behalf, you know, not to say what they want.
7:41
Speaker 3: Because if it was my daughter, you know, I'd never
7:44
Speaker 3: be able to say the words, oh, you know, let
7:46
Speaker 3: her die. You know, she's been through too much. I
7:49
Speaker 3: couldn't say that. But if somebody says, you know, if
7:52
Speaker 3: she was sitting in that chair right and what would
7:54
Speaker 3: she say? It gives you that permission. And families often
7:58
Speaker 3: they crack a joke. Often they say he'd tell a
8:01
Speaker 3: real joke, or he'd swear you, he'd say, you know,
8:04
Speaker 3: just this is rubbish, just let me go. So yeah,
8:07
Speaker 3: those are the two tips, and I guess, coming back
8:10
Speaker 3: to the D word, the other thing I now do
8:13
Speaker 3: as a result of that and some of the books
8:15
Speaker 3: I've written, is if people in the streets or friends
8:19
Speaker 3: tell me somebody's somebody's died a relative of them, the
8:23
Speaker 3: first thing I do, I don't step backwards. I stepped forwards.
8:26
Speaker 3: I'll say, you know, that's terrible. I'm sorry. What was
8:30
Speaker 3: your mom's name? Tell me about you? Yeah, because I
8:36
Speaker 3: think you know, we don't die once. We die twice.
8:39
Speaker 3: We die when our body dies, and we die when
8:42
Speaker 3: people stop stop saying no name. And I think that's
8:45
Speaker 3: that's one way of recognizing that. Really.
8:47
Speaker 1: Wow, Yeah, that's beautiful.
8:50
Speaker 2: How how is your thinking around or your philosophy about
8:55
Speaker 2: death evolved since you were the medical student and you
8:58
Speaker 2: stepped into you're role as a doctor on day one
9:02
Speaker 2: till now? Do you think differently about it? Do you
9:06
Speaker 2: interact with people differently because of your experience and insight?
9:12
Speaker 3: I do. I guess I think about it a lot
9:15
Speaker 3: to start with, not in a pondering nihilistic way, but
9:19
Speaker 3: I'm faced with it, you know, daily. But yes, Weirdly
9:23
Speaker 3: for me, that doesn't make me sad or stressed. It's
9:27
Speaker 3: quite the opposite.
9:28
Speaker 1: Really.
9:29
Speaker 3: It shows to me, how you know, life and death
9:31
Speaker 3: are just eleven and one on a clock face. You know,
9:35
Speaker 3: they seem far apart, but they're physically close. And so
9:39
Speaker 3: if I've had a rubbish day and I don't know
9:42
Speaker 3: I've had a flat tire or a tax bill, I
9:45
Speaker 3: can go to work and see people tiptoeing along the
9:49
Speaker 3: edge of life and death and it just, you know,
9:51
Speaker 3: it makes those other things not seem like a big deal.
9:55
Speaker 3: You know, life is an emergency, and I'm reminding of
10:00
Speaker 3: that every day, which is well, in fact, I'm paid
10:02
Speaker 3: to be reminded of every day.
10:04
Speaker 2: Yes, a great, Yeah, it seems like being a good physician,
10:08
Speaker 2: apart from all the obvious stuff, is hugely about understanding
10:13
Speaker 2: someone else's experience. My research for my PhD is about
10:17
Speaker 2: a thing called metaperception, which is your ability to understand
10:21
Speaker 2: what it's like being around you. So what's the mat
10:24
Speaker 2: experience like for my patient or my team that I
10:28
Speaker 2: work with. And also, as you would know, a theory
10:31
Speaker 2: of mind is just in general, understanding someone else's experience
10:34
Speaker 2: in the moment, not necessarily relative to you, but I
10:38
Speaker 2: think that capacity to have that kind of in the
10:41
Speaker 2: moment awareness and to be able to read situations read
10:46
Speaker 2: people within reason, understand, not necessarily agree or align with,
10:50
Speaker 2: but understand what they're thinking, feeling, experiencing would almost be
10:55
Speaker 2: like a superpower in your job.
10:58
Speaker 3: Wow, I've never thought meta meta experiences.
11:02
Speaker 1: So metaperception.
11:06
Speaker 2: That's essentially the question at the center of all of
11:09
Speaker 2: that research is what's the me experience for them?
11:12
Speaker 1: So what's the mad experience? Like? You know?
11:15
Speaker 2: So me as a podcast we talk to So right
11:17
Speaker 2: now we're talking to thousands of people, and I'm always
11:21
Speaker 2: without being preoccupied by I'm always aware of I'm not
11:26
Speaker 2: talking to Craig. So what's the language I can use?
11:30
Speaker 2: What's going to be of interest to people? What do
11:32
Speaker 2: people want to hear? What don't people want to hear?
11:34
Speaker 2: So this trying to have, you know, without being a
11:38
Speaker 2: stand up comic. At the end of the day, if
11:39
Speaker 2: you and I deliver all this awesome information in the
11:42
Speaker 2: most boring way ever, people are turning off and tuning out.
11:45
Speaker 2: So it's like, how do we share these thoughts and
11:47
Speaker 2: ideas and stories in a way which builds connection and
11:50
Speaker 2: curiosity and rapport while not compromising our message?
11:55
Speaker 1: You know, And I think that's for you.
11:56
Speaker 2: How do I navigate this conversation with this It's very
12:00
Speaker 2: hard conversation with this person about this you know, complex
12:05
Speaker 2: thing or this unwanted thing. Obviously in a way that
12:09
Speaker 2: is going to be for one of a bit of term,
12:12
Speaker 2: the most digestible for them or their family.
12:15
Speaker 3: You know, Yeah, that's fascinating. I guess I've long thought so.
12:21
Speaker 3: There was a doctor in medical school I asked a
12:23
Speaker 3: very simple question at that early stage. I think I
12:26
Speaker 3: was a third year medical student, and all he asked
12:29
Speaker 3: was what does every patient and every family want? That
12:32
Speaker 3: was It was pretty short, and different people put their
12:36
Speaker 3: hands up and said different things. A few people said
12:39
Speaker 3: a cure, and of course that may be right, but
12:42
Speaker 3: one in five people in intensive care that I look
12:45
Speaker 3: after will die. They won't get that. Some people said
12:49
Speaker 3: a diagnosis. Yeah, that might be the case. And I
12:53
Speaker 3: think now I've come to I think I know the answer, well,
12:56
Speaker 3: at least I think I know a better answer. And
12:58
Speaker 3: I think what everybody wants is somebody to make sense
13:01
Speaker 3: of their story, because we are story and machines. As
13:05
Speaker 3: our doctors. You know, if you chop me in half
13:07
Speaker 3: right now, what we'll spill out our just stories, stories
13:11
Speaker 3: from the past, hopes of the future. So I guess
13:15
Speaker 3: that meta experience and that meta psychology I think about
13:19
Speaker 3: is how can I make sense of this patient's story.
13:22
Speaker 3: And for some people that may mean being super science
13:25
Speaker 3: y and saying, oh, you know, all about the fancy
13:28
Speaker 3: drugs and machines and procedures, and maybe it's that. For
13:32
Speaker 3: other people it might just be to say, look, you know,
13:34
Speaker 3: we've treated all the things we can treat. Those things
13:37
Speaker 3: aren't helping. We're now going to change our focus to
13:40
Speaker 3: making sure he's in no pain or distress. And then
13:43
Speaker 3: I'm sorry to say he's going to die, and I'm
13:46
Speaker 3: so sorry about that, you know, And that they aren't
13:49
Speaker 3: different things, they are the same things. And I also think,
13:53
Speaker 3: you know, we live life forwards, but often we understand
13:57
Speaker 3: it better backwards. So I want if that matter experience
14:01
Speaker 3: and that that changes with time. You know, Yes, we
14:06
Speaker 3: know about the remembering experience itself from Kanaman and others,
14:10
Speaker 3: and yeah, so those are the kind of things that
14:12
Speaker 3: go through my head really.
14:15
Speaker 2: Yeah, yeah, And I guess understanding that everybody has, you know,
14:20
Speaker 2: their own language and their own level of understanding, and
14:22
Speaker 2: how do I communicate, like my mum and dad are
14:25
Speaker 2: eighty six and they're both. They're not awesome at the moment.
14:29
Speaker 2: You know, there's a bunch of medical issues and a
14:30
Speaker 2: bunch of challenges, and I'm very careful about the words
14:37
Speaker 2: that i use, the terminology, the explanations, the conversations, you know,
14:43
Speaker 2: the language, so that I'm informing them and I'm I'm
14:48
Speaker 2: supporting them and I'm not terrifying them. You know, it's
14:52
Speaker 2: a real kind of almost conversational juggling act about how
14:56
Speaker 2: do I talk about this in a way where I'm
14:58
Speaker 2: not compromising. I'm making sense to them, but I'm also
15:03
Speaker 2: being compassionate and aware in real time.
15:07
Speaker 1: You know. It's an interesting thing.
15:10
Speaker 3: Yeah, and you mentioned the words you use are actually
15:13
Speaker 3: really important. I push back against this phrase. You know,
15:16
Speaker 3: it's not what you say is how you say it. Well,
15:20
Speaker 3: I don't think that's true. Actually, I think it's what
15:22
Speaker 3: you say quite a lot of the time. And you know,
15:24
Speaker 3: Lichtkenstein said, the limits of my words are the limits
15:29
Speaker 3: of my world, and the words we have to describe
15:32
Speaker 3: things are actually really important, and subtle changes can change that.
15:37
Speaker 3: You know, we don't say that we're a ceiling of care.
15:41
Speaker 3: We say that there aren't any treatments that will help left,
15:44
Speaker 3: but there's always care left, for example, and there's subtle
15:48
Speaker 3: changes for for parents and for children that can make
15:51
Speaker 3: a real difference. So yeah, I agree.
15:53
Speaker 2: There's an idea in psychology you're like this. It's called
15:56
Speaker 2: the false consensus effect, and it basically just speaks to
15:59
Speaker 2: the fact that most people think that other people think
16:02
Speaker 2: like them, and that they think that their intention will
16:07
Speaker 2: be the other person's experience.
16:09
Speaker 1: Yeah, yeah, but knowing that that just isn't true.
16:13
Speaker 2: So I'm you know, if I'm coaching someone or working
16:16
Speaker 2: with an audience or a group or whatever consulting, which
16:19
Speaker 2: I do all of that stuff, I'm always trying to
16:23
Speaker 2: understand where they're at so that I can I can
16:26
Speaker 2: be what I need to be for them, not be
16:28
Speaker 2: what I need to be for me, you know, like
16:30
Speaker 2: what's going to move the needle, what's going to help,
16:32
Speaker 2: what's going to be helpful, what's going to be unhelpful.
16:34
Speaker 2: I can talk to someone and I create more of
16:37
Speaker 2: a problem than a solution, depending on what I say
16:40
Speaker 2: and how I say it, you know, And I think
16:43
Speaker 2: that that sometimes when you're talking to an expert in
16:46
Speaker 2: inverted commas, it can be kind of terrifying, overwhelming.
16:52
Speaker 3: Yeah, and you know you need that shared mental model.
16:55
Speaker 3: I think it's another way to put that, I guess.
16:57
Speaker 3: And in terms of that language, the average reading age
17:01
Speaker 3: in the UK, you know, where I live, is probably
17:03
Speaker 3: around ten actually, and things are changing with books, you know,
17:07
Speaker 3: even I love books, I love reading, and even you know,
17:11
Speaker 3: I struggle now to have that concentration. I have to
17:15
Speaker 3: physically put my phone in a drawer, go to a
17:17
Speaker 3: place that I can read. So so that reading age
17:20
Speaker 3: is maybe even changing more. And people who have health issues,
17:25
Speaker 3: you know, sadly, it's still true to say that sickness
17:29
Speaker 3: is often an illness of the poor. We know, socioeconomic
17:33
Speaker 3: factors play hugely into health inequalities, and so that reading
17:38
Speaker 3: age may maybe even lower. So yeah, you've got to
17:41
Speaker 3: be really purposeful about not only thinking about that experience
17:45
Speaker 3: of the words, but also that the physical language you're
17:48
Speaker 3: using yourself.
17:49
Speaker 2: Actually, this is a kind of a question from left field,
17:54
Speaker 2: but tell me about your work as and the intersection
17:59
Speaker 2: with AI, you know, because this is so elergent, it's
18:03
Speaker 2: developing every day. It's like, tell me about you and
18:06
Speaker 2: the integration of that into your life.
18:09
Speaker 3: I've always been a bit of a techno geek and
18:12
Speaker 3: a techno file. I had a ZX spectrum computer when
18:15
Speaker 3: I was a kid with rubber keys. I used to
18:17
Speaker 3: you know, I still love and love technology. And it
18:21
Speaker 3: came to about halfway through my training and I had
18:24
Speaker 3: an opportunity to do some research into severe infection or sepsis.
18:30
Speaker 3: And in fact, i'd cared for a seventeen year old
18:33
Speaker 3: called Chris who was a student who sadly died after
18:37
Speaker 3: taking a holiday with school abroad in Kenya, and he
18:42
Speaker 3: died a few days after his eighteenth birthday party in
18:45
Speaker 3: the intensive care unit with infection with sepsis. And that
18:49
Speaker 3: really motivated me, as I'm going to do this, so
18:51
Speaker 3: I'm going to take time out. So I spent three
18:54
Speaker 3: years doing a PhD trying to work out the immunology
18:57
Speaker 3: of severe infection and sepsis, and it kind of struck
19:01
Speaker 3: me at the time. We were using a load of statistical
19:04
Speaker 3: techniques to look at this data, but they were techniques
19:09
Speaker 3: from you know, the ancient past, from hundreds of years ago,
19:12
Speaker 3: using loads of t tests and loads of boring statistics.
19:16
Speaker 3: And a friend of mine worked in finance and we
19:20
Speaker 3: were talking one day about how he was trying to
19:23
Speaker 3: predict the next trend, and he was not using one
19:26
Speaker 3: marker or one statistical test. You know, they were using
19:29
Speaker 3: hundreds and hundreds and modeling them all, and they were
19:32
Speaker 3: using this weird thing called neural networks that Nod turd of.
19:36
Speaker 3: So it struck me that, well, you know, life is
19:39
Speaker 3: more complex than the stock market. Biology is far more complex.
19:43
Speaker 3: We should be using multiple markers together, not just single things,
19:47
Speaker 3: and we should be modeling them. So I actually borrowed
19:51
Speaker 3: some techniques from finance and used neural networking on a
19:56
Speaker 3: program called R at the time to try to combine
19:59
Speaker 3: mark and you know, it blew away the other ways
20:03
Speaker 3: of doing things in terms of predictive power. So that
20:07
Speaker 3: was back before AI was spoken about much. So I've
20:12
Speaker 3: been interested in that field for a long time. How
20:15
Speaker 3: I use it today, I guess there's in three ways, predominantly,
20:20
Speaker 3: Number one to help me learn and to teach others
20:23
Speaker 3: in terms of having a structure. Number two, to help
20:27
Speaker 3: with tricky and rare diagnoses and keep up to date
20:31
Speaker 3: with the literature. But number three, the most common now
20:34
Speaker 3: actually is what we're doing now. So I speak to
20:39
Speaker 3: patients in what we call a follow up clinic maybe
20:42
Speaker 3: six months after they've survived critical illness. And they're quite tricky,
20:47
Speaker 3: long conversations at half an hour minimum. They cover everything
20:51
Speaker 3: from sexual dysfunction to trachiostomy scars. And I used to
20:57
Speaker 3: do that and then type all the notes afterwards and
20:59
Speaker 3: forget things and not pay attention to that person. And
21:05
Speaker 3: now actually we use in some ambient voice technologies to
21:08
Speaker 3: capture a lot of that, to do some of the
21:11
Speaker 3: documentation for us so that we can really concentrate on
21:14
Speaker 3: the person in front of us. So, yeah, that's probably
21:17
Speaker 3: the way I interact with AI the most today.
21:22
Speaker 2: And more broadly. And then we'll jump off this. But
21:25
Speaker 2: what are the pros and cons?
21:26
Speaker 1: Do you think?
21:27
Speaker 2: But if you know of it seems to be you know,
21:33
Speaker 2: invading it's not the right word, but infiltrating, becoming part
21:36
Speaker 2: of so many industries, even in psychology. My first degree
21:40
Speaker 2: was in exercise physiology, you know, in the exercise space,
21:44
Speaker 2: in the nutrition space, in all kinds of wellbeing fields.
21:48
Speaker 2: I guess in business in is there anything that worries
21:51
Speaker 2: you about the integration of AI into medicine.
21:55
Speaker 3: Well, first of all, it's definitely transformative. There's no doubt
21:58
Speaker 3: about that. If I was training in medicine today, I
22:02
Speaker 3: would perhaps think carefully about different specialties. Would I train
22:06
Speaker 3: in radiology where I need to interpret images? Possibly not,
22:10
Speaker 3: But if I loved radiology, I'd probably train in a
22:14
Speaker 3: form of radiology that's still interacted with people, in terms
22:18
Speaker 3: of interventional radiology, maybe the people who look at images
22:22
Speaker 3: and then do something with them. So it's definitely transformative. Yes,
22:26
Speaker 3: there's risks, there's risks to everything, especially around data and
22:30
Speaker 3: hallucinations and confabrillation and all those things we read about.
22:35
Speaker 3: But for me, you know, humans are contextualization engines and machines,
22:41
Speaker 3: those story machines, and yesa I is already helping with
22:46
Speaker 3: things like diagnostics, for example, or advising what treatments are
22:51
Speaker 3: more likely to help, or research. But for me, that
22:55
Speaker 3: should just give me more time doing the really difficult things,
22:59
Speaker 3: which is explaining, contextualizing, you doing some of those practical things,
23:05
Speaker 3: and more time to do that is great, that's amazing.
23:09
Speaker 3: You know, I don't want to be working out really
23:12
Speaker 3: complex scoring systems to work out what severity of disease
23:16
Speaker 3: different people have. If I'm told that that gives me
23:20
Speaker 3: more time to actually manage that disease, for example. So yeah,
23:24
Speaker 3: I think overall, I'm hopeful, with the right safety guards
23:28
Speaker 3: and safety rails that it will allow doctors, nurses and
23:33
Speaker 3: others to do the care bits of medicine, which which
23:36
Speaker 3: is the important bits.
23:37
Speaker 2: Really, it's doing your work for you, not globally speaking,
23:43
Speaker 2: but for you. Does it make you more or less open?
23:47
Speaker 2: Maybe this is the wrong question. You can figure it
23:50
Speaker 2: out to spirituality, to something other than what we can
23:54
Speaker 2: see and feel and poke and touch. You know, has
23:57
Speaker 2: it opened the door or closed a door on neither.
24:01
Speaker 3: I don't describe myself as religious, but I probably describe
24:05
Speaker 3: myself as spiritual. Or what do I mean by that? Well,
24:10
Speaker 3: I'll give you a practical example. My latest book is
24:13
Speaker 3: called A Second Act, and that follows the lives of
24:17
Speaker 3: ten patients, all of which have had a cardiac arrest.
24:20
Speaker 3: So their heart had stopped from different causes and causes
24:24
Speaker 3: as strange as being hit by lightning, being buried in
24:26
Speaker 3: an avalanche, self harm, heart attacks, all sorts, but all
24:31
Speaker 3: of them survived. They survived because they had CPR, they
24:36
Speaker 3: survived because of medicine, and they survived because of reasons
24:40
Speaker 3: we don't know. And all of their lives changed remarkably actually,
24:45
Speaker 3: and the book is less about the medicine and more
24:47
Speaker 3: about what dying can teach us about living, because I'm
24:51
Speaker 3: fed up of Yeah well, I was kind of fed
24:54
Speaker 3: up of influencers and tech pros telling us how we
24:58
Speaker 3: should live. You know, these are the people who know,
25:02
Speaker 3: the people who've seen both sides. They know what's really
25:06
Speaker 3: important in life. And in fact, what they tell us
25:10
Speaker 3: is that we have two lives. It's just the second
25:13
Speaker 3: begins when you realize you have one. You know, they've
25:16
Speaker 3: all radically changed what they do. But through this journey
25:21
Speaker 3: there were a few interesting things. Number one, I held
25:24
Speaker 3: my own living funeral is one thing I did, which
25:27
Speaker 3: was an amazing experience.
25:30
Speaker 1: I think, everybody, what does that tell us? What that mein' stock?
25:34
Speaker 3: Yeah, well, I kind of got to the end of
25:36
Speaker 3: the book. I thought i'd finished it, and writing a
25:38
Speaker 3: book is a bit like trying to solve a puzzle
25:40
Speaker 3: that only you can solve. There was something missing, there
25:43
Speaker 3: was something big missing, And I spoke to my editor
25:45
Speaker 3: and I kind of said, look, you know, I've written
25:47
Speaker 3: it all, but how can I sympathize or empathize with
25:50
Speaker 3: what these people have been through. You know, I've never died,
25:55
Speaker 3: and i'd recently had the funeral of my aunt. She
25:57
Speaker 3: was ninety seven, great Auntie Wynn, and I did a
26:02
Speaker 3: eulogy where I wrote her a letter because I struggled
26:06
Speaker 3: to write about her, so I wanted to write a
26:08
Speaker 3: letter to her. And I went to this funeral and
26:11
Speaker 3: he had all the stuff she loved. She would have
26:14
Speaker 3: loved it, had a favorite people, music, food, all those things.
26:18
Speaker 3: And then it kind of struck me, well, you know,
26:21
Speaker 3: why do I have my own funeral. We don't wait
26:23
Speaker 3: until you're dead for that. Why don't you do it before?
26:28
Speaker 3: So I wrote to a local chaplain actually in our village,
26:30
Speaker 3: and said, HI had quite like a funeral, And they
26:33
Speaker 3: wrote back and said, yeah, that's fine.
26:36
Speaker 1: Are you dead yet? Yeah?
26:38
Speaker 3: Well yeah, they said you need to be Christian and dead,
26:41
Speaker 3: and well that's a bit awkward because I'm neither. So
26:45
Speaker 3: instead we went away with a group of eight friends.
26:49
Speaker 3: We had a proper celebrant, a humanist celebrant who did
26:52
Speaker 3: things properly. All of us had a eulogy written by
26:55
Speaker 3: the people who love us. We chose our favorite songs,
26:58
Speaker 3: our favorite readings, and this wasn't just you know, this
27:01
Speaker 3: wasn't an excuse for a guy's trip away. This was
27:06
Speaker 3: kind of.
27:07
Speaker 2: Wasn't a thinly disguised what you're say what you're saying.
27:11
Speaker 3: You know there was red wine there, but that was
27:14
Speaker 3: that was a nod to the service.
27:17
Speaker 1: I'm still suspicious.
27:20
Speaker 3: And what we did we did all the things in
27:22
Speaker 3: the book that these ten people had been telling us
27:24
Speaker 3: to do. So we enacted all of those throughout the weekend,
27:27
Speaker 3: whether it was look back at old photos, use the
27:30
Speaker 3: power of music for example, do things you're bad at.
27:33
Speaker 3: We all made homemade nocky by my Italian friend that
27:36
Speaker 3: we were terrible, and then we had a formal service
27:39
Speaker 3: where we took it in turns to read each other's eulogy,
27:42
Speaker 3: listen to music played by my friend, and it was transformative.
27:48
Speaker 3: Nobody came away from that weekend the same. We've all
27:52
Speaker 3: changed things radically in our life and this isn't This
27:56
Speaker 3: sounds weird, but it's not weird. We've always had as
27:59
Speaker 3: human ceremonies of kind of age ceremonies or reflecting ceremonies.
28:05
Speaker 3: The Greeks had the Euclidean mysteries where they went into
28:08
Speaker 3: a cave maybe they took some alcohols, some drugs, and
28:13
Speaker 3: they confronted their own mortality. And they would do this
28:16
Speaker 3: in the middle middle of their life. We've always done this,
28:19
Speaker 3: it's just now it sounds weird. So yeah, if there's
28:22
Speaker 3: one thing your listeners can take away, I think everybody
28:26
Speaker 3: should have a funeral before they die.
28:29
Speaker 1: How did it impact you? I love that.
28:31
Speaker 2: When you first said that, I'm like, bro, come on,
28:34
Speaker 2: But when you unpack it, I'm like, I might have one.
28:39
Speaker 2: How did that impact Did you say it was profound
28:41
Speaker 2: that you were different? Did you think differently? Did you
28:45
Speaker 2: feel differently? Did you view was your perception of things changed?
28:50
Speaker 3: Yeah? The things that got to me the most, if
28:53
Speaker 3: I'm honest, weren't. It wasn't the reading from my own
28:57
Speaker 3: part of the ceremony. It was my friends them not
29:01
Speaker 3: being there. That was the thing that got us all.
29:04
Speaker 3: But also listening to what your family say about you
29:06
Speaker 3: in a eulogy before you're dead is very enlightening. Like
29:11
Speaker 3: you said before about metaperception, you think you know what
29:14
Speaker 3: other people think about you or what you feel.
29:17
Speaker 1: You know.
29:17
Speaker 3: One of my friends who went there, the wife wrote
29:22
Speaker 3: an amazing eulogy, is beautiful and they said, what an
29:25
Speaker 3: hard worker this person was. They were always thinking of
29:29
Speaker 3: their work and their patients. Even when they went on holiday,
29:32
Speaker 3: they would take their laptops not to miss anything. And
29:36
Speaker 3: she wrote, this is a really positive thing to say,
29:39
Speaker 3: what an amazing guy he was. And actually he listened
29:42
Speaker 3: to it and went, wow, is that what my family
29:45
Speaker 3: is going to remember about me? Is that what's the
29:48
Speaker 3: most important bit in my life? And they say all
29:51
Speaker 3: of them made big life decisions. What did we do
29:55
Speaker 3: well at the time, we were living in Australia. Actually
29:58
Speaker 3: we were living in Western Australia in Perth, which is beautiful,
30:02
Speaker 3: amazing colleagues, amazing hospital in Australia yet working through Curtain
30:08
Speaker 3: University and the Royal Perth Hospital. Loved our time there,
30:13
Speaker 3: but lots of things were happening. Family back home were
30:16
Speaker 3: becoming and well we had some health issues there for
30:19
Speaker 3: my own children. There were just lots of little moving
30:22
Speaker 3: parts and actually after that weekend we decided to come home.
30:28
Speaker 3: And that was a really hard decision and we didn't
30:31
Speaker 3: do it because we were unhappy there. We did it
30:34
Speaker 3: because of connection. Meaning we've got a word in Welsh
30:38
Speaker 3: called canevin which means your connection to place and people,
30:42
Speaker 3: and we did it for all of those boring reasons
30:46
Speaker 3: after that weekend, So was it all that, you know,
30:50
Speaker 3: probably not, but it was it partly that definitely, And
30:54
Speaker 3: other friends changed jobs, changed careers, started doing a lot
30:58
Speaker 3: of charity work, stopped doing a lot of things that
31:01
Speaker 3: they were doing before, as well as start new things. So, yeah,
31:04
Speaker 3: an amazing experience. One of the best moments of my
31:08
Speaker 3: life was thinking about my death.
31:11
Speaker 1: Was it in the moment the experience? Was it said?
31:15
Speaker 2: Was it enlightening, was it confronting? What was it being
31:19
Speaker 2: in the middle of that? And did it feel real?
31:23
Speaker 3: It absolutely felt real. Putt it this way. There's a
31:26
Speaker 3: lot of talk about toxic masculinity, and we were a
31:30
Speaker 3: big selection of different people who went, but there's nothing
31:34
Speaker 3: that counteracts that more than you know, it ended with
31:38
Speaker 3: eight of us, I think, mostly undressed together in a
31:42
Speaker 3: hot tub listening to some acoustic music. You know, there
31:46
Speaker 3: was no toxic masculinity involved that weekend. Yeah, it was
31:51
Speaker 3: all of those things, and I think it was constructed
31:54
Speaker 3: in such a way to nudge those emotions. You know,
31:57
Speaker 3: music is such a powerful way of doing that, as
32:00
Speaker 3: our words and readings, Although our families weren't there. We
32:04
Speaker 3: had their words read out to us. Yes, the celebrant
32:08
Speaker 3: did it amazingly. The reading he used was incredible and
32:12
Speaker 3: in fact, if you want, at the end, I can
32:14
Speaker 3: read the passage which it ended with. There was good
32:18
Speaker 3: lighting and there was ceremony to it, so there was
32:21
Speaker 3: a candle lit blown out as you died, re lit
32:24
Speaker 3: as you lived. So it was done. It was done
32:27
Speaker 3: really well, and it was all of those things.
32:29
Speaker 2: Actually, do you have a theory on why we are
32:35
Speaker 2: in twenty twenty six? Seemingly anyway, it's so scared of
32:37
Speaker 2: death when it seems over time My understanding anyway is
32:44
Speaker 2: that that wasn't always the guys. I mean, of course
32:46
Speaker 2: people have been scared of death forever, but it seemed
32:49
Speaker 2: to be a lot more accepted and embraced and spoken about.
32:53
Speaker 2: But it's almost like, as you said, taboo, you know,
32:57
Speaker 2: we tend to avoid it. We don't want to have
32:59
Speaker 2: hardcome sagis. It's almost like we don't want to feel
33:02
Speaker 2: those things.
33:05
Speaker 3: There's a brilliant book written by a mortuary assistant called
33:11
Speaker 3: it's one of the best titles of a book I've
33:13
Speaker 3: ever heard. It's called When Smoke gets in your eyes
33:16
Speaker 3: because she works in a crematorium, and she details how
33:21
Speaker 3: the death industry, if you like, has changed, how it
33:24
Speaker 3: was really born in the American Civil War when people
33:27
Speaker 3: had to be transported from far away back home, and
33:31
Speaker 3: actually now it's this big industry. And you know, nine
33:34
Speaker 3: out of ten people want to die at home and
33:36
Speaker 3: only what you know, nine out of ten people die
33:38
Speaker 3: in hospital, So there's this big mismatch there. It also
33:42
Speaker 3: used to be in the home, as you say, around
33:44
Speaker 3: the home, and now we don't see death around us.
33:48
Speaker 3: It's sterile, it's in hospitals, it's managed. And I get that.
33:54
Speaker 3: But at the same time, I know Steve Jobs said
33:57
Speaker 3: death is life's greatest invention, and it doesn't feel like
34:01
Speaker 3: that at the time, but it is the thing that
34:04
Speaker 3: motivates us to do things and to bring meaning. In
34:09
Speaker 3: terms of being scared, I think, you know, the way
34:12
Speaker 3: I describe is I'm not scared of death, but I'm
34:15
Speaker 3: scared of dying. And I think it's that process is
34:20
Speaker 3: the uncertainty in the tricky bit. And we know, certainly
34:23
Speaker 3: in this country, the investment in things like palleative care
34:26
Speaker 3: services is very low. You know, it's charity funded a
34:31
Speaker 3: lot of it. So I'm also the ambassador for a
34:34
Speaker 3: brieve Man charity and it's always amazed me how there's
34:38
Speaker 3: support for lots of things in life, tough times, but
34:42
Speaker 3: so little for when somebody dies, you know, and that
34:46
Speaker 3: will happen, it will happen to all of us. So
34:50
Speaker 3: this brief Man charity, called to Wish now provides immediate
34:54
Speaker 3: breavement support and not just a phone call or website,
34:58
Speaker 3: you know, an actual human as well. As they do
35:01
Speaker 3: these amazing boxes that we can do, handprints and haircuttings
35:04
Speaker 3: for young people who die in the intensive care unit.
35:07
Speaker 3: So yeah, I'm really passionate about that brievement support and
35:12
Speaker 3: I think that will perhaps go some way to help.
35:17
Speaker 2: A few years in fact, six years ago now, I
35:21
Speaker 2: was in the gym training with my training partners, so
35:24
Speaker 2: I made of mine and we've been training together for
35:26
Speaker 2: twenty years ish and I can tell you exactly when
35:30
Speaker 2: it was. So it was on a Friday night at
35:33
Speaker 2: seventeen oh five. He had a cardiac arrest, didn't have
35:38
Speaker 2: a heart attack, had a cardiac arrest.
35:41
Speaker 1: Dead and so I was in the gym.
35:44
Speaker 2: There was probably twenty five people in there, and I
35:48
Speaker 2: started working on him within I don't know, fifteen seconds
35:52
Speaker 2: when I because he fell face down and he's a body.
35:55
Speaker 1: He was a bodybuilder.
35:57
Speaker 2: Like he's still alive by the way now, but he
36:01
Speaker 2: fell face first, one hundred and five kilos of just
36:05
Speaker 2: this lump of fucking human that it's like, if you're
36:08
Speaker 2: going to die, can you die face up?
36:10
Speaker 1: It's just easier. I mean, like, I don't be hungrateful,
36:13
Speaker 1: but bro, you made it hard.
36:15
Speaker 2: So then I've got to flip and as you know,
36:17
Speaker 2: one hundred and five kilo person, that's just limp. Anyway,
36:21
Speaker 2: so's to turn him over. But it's amazing what you
36:24
Speaker 2: can do in that kind of situation. But anyway, I
36:26
Speaker 2: turned him over and I started working on him. An
36:28
Speaker 2: interesting thing was he was dead from or he was
36:33
Speaker 2: you know, dead from seven five to seventeen twenty two,
36:37
Speaker 2: so seventeen minutes, and there would have been twenty five
36:41
Speaker 2: other people give or take in the gym.
36:43
Speaker 1: Not one person would help.
36:46
Speaker 2: Wow, not every Everyone just had this look of terror
36:50
Speaker 2: on their face. And I'm not saying an I hear,
36:53
Speaker 2: I'm definitely not, but I'm definitely not going to stand
36:56
Speaker 2: there when you know my mate or anyone for that matter.
37:01
Speaker 2: But I started working on him, and I was trying
37:03
Speaker 2: to get somebody to give me a hand, right, because
37:06
Speaker 2: two people's better than one. And yeah, nobody would come
37:09
Speaker 2: forward at all. And in the end, I just there
37:11
Speaker 2: was one guy looking at me and I asked him
37:14
Speaker 2: what his name was and he told me and I
37:16
Speaker 2: doesn't matter, but let's go Steve. I said, Steve, you
37:19
Speaker 2: need to come over here. I don't know what to do.
37:21
Speaker 2: It I go, I know what to do. Just come
37:23
Speaker 2: over here. But apart from and you know, he was
37:28
Speaker 2: came back online seventeen minutes later. The paramedics got there
37:32
Speaker 2: in about eleven minutes, so he was it was just
37:34
Speaker 2: making him for a long time.
37:37
Speaker 1: But yeah, just the ris. Obviously the main thing was that.
37:41
Speaker 2: But my secondary awareness later was how nobody wanted to help,
37:47
Speaker 2: how terrified everybody was, and even in the face of
37:52
Speaker 2: like this is it doesn't get any more important than this.
37:56
Speaker 1: I know you're uncomfortable, but for fuck's sake, you know,
37:59
Speaker 1: get over here.
38:00
Speaker 2: Yeah, and yeah, that was a really big lesson for me.
38:03
Speaker 2: But also it is I mean, this is just my experience,
38:07
Speaker 2: and I'm sure it's completely different for everybody else, but
38:10
Speaker 2: I couldn't believe how focused I could become, like, how
38:17
Speaker 2: completely consumed and focused and in the moment, And yeah,
38:23
Speaker 2: it's a weird experience. Weirder for him, I'm sure, but
38:27
Speaker 2: it's a weird experience being that person doing that when
38:30
Speaker 2: it's someone that you love as well, right, and in
38:33
Speaker 2: a public place with people just staring at you like fish,
38:36
Speaker 2: you know. Yeah, So that was that was a steep
38:41
Speaker 2: learning curve and a real moment of awareness. And yeah,
38:46
Speaker 2: it's funny how and people, I guess this sounds cheesy,
38:50
Speaker 2: but for me, just in that moment, you realize, well
38:54
Speaker 2: I realized that for me, how obviously, in that moment,
38:57
Speaker 2: maybe beyond how little everything else matters, it's like, oh,
39:01
Speaker 2: all that thing, all that shit that I waste energy
39:04
Speaker 2: and emotion and focus and tension. And I'm like, you know,
39:10
Speaker 2: I was in this moment having this kind of inner breakthrough.
39:14
Speaker 1: At the same time. So and he was.
39:17
Speaker 2: He was so obviously when he was well enough, which
39:21
Speaker 2: was he was in a coma for a day or two,
39:22
Speaker 2: but surprisingly totally apart from a crap memory for about
39:27
Speaker 2: six months. But after that, like right now completely fine,
39:31
Speaker 2: got a pacemaker.
39:32
Speaker 1: Well, yeah, that I'm like what was there? Like, what's
39:37
Speaker 1: the deal? What what did you see? Did you see Jesus?
39:40
Speaker 3: Was there? A light? Was there?
39:42
Speaker 1: And all he remembers inverted commas is just complete bliss.
39:46
Speaker 3: Yes, well complete. You know what an amazing First of all,
39:51
Speaker 3: what an amazing thing you did. And I know you
39:54
Speaker 3: know this, but I'm going to see it anyway. You know,
39:56
Speaker 3: if it wasn't for your hard work, he would have died.
40:00
Speaker 3: You know, he's alive today because of what you did.
40:03
Speaker 3: And for people listening. You know, I can't stress enough
40:07
Speaker 3: the importance of CPR in people who have a cardiac
40:11
Speaker 3: arrest and cardia arrest's eighty percent happen in the workplace
40:15
Speaker 3: or the home. So if you learn to do CPR,
40:18
Speaker 3: the likelihood is you will help somebody who you know already.
40:22
Speaker 3: You know, a family member, a friend, somebody like your
40:25
Speaker 3: friend in the gym. So you know. People listening to this,
40:29
Speaker 3: go out, look online. There's so many easy ways to
40:32
Speaker 3: do this. It's not hard. You will not do harm,
40:35
Speaker 3: you will only do good. If somebody collapses, they aren't
40:38
Speaker 3: breathing properly and they're unconscious, you put your hands together,
40:42
Speaker 3: you put it in the middle of their chest, You
40:44
Speaker 3: press down until you feel something move. You do it
40:47
Speaker 3: to the tune of Staying Alive by the Beg's or
40:51
Speaker 3: Pink Pony Club by Chapel Rohan. If you're so inclined,
40:55
Speaker 3: and every minute that you delay doing that, the chances
40:59
Speaker 3: of that persons in plummet. So do it, and do
41:02
Speaker 3: it quickly. You won't do any harm. You know, it's
41:05
Speaker 3: such a simple intervention. And for your friend, you know,
41:08
Speaker 3: the reason he lived wasn't because of intensive care or
41:12
Speaker 3: the coma or doctors. Who was because of you. And
41:16
Speaker 3: that power is in everybody's hands to do that. You know,
41:19
Speaker 3: we can't undo damage which is done before coming to hospital. Yeah,
41:26
Speaker 3: I guess the other thing to say in terms of
41:28
Speaker 3: after life, lots of people ass me about is that,
41:30
Speaker 3: you know, is there an afterlife? What about experiences people have?
41:34
Speaker 3: I wasn't originally going to put anything in the book
41:36
Speaker 3: about that. And yet out of those ten people, at
41:41
Speaker 3: least state of them described something which was identical. And
41:45
Speaker 3: this was that when they were having a cardigressed or surviving.
41:49
Speaker 3: It's very cliched, but it's true they saw something that
41:52
Speaker 3: was bright. There were other people around them, family members,
41:55
Speaker 3: They had a Life Review. They felt that they weren't alone.
42:00
Speaker 3: They maybe heard things. And you know, I'm a scientist,
42:03
Speaker 3: I said, I'm not religious, I'm spiritual. So I looked
42:06
Speaker 3: into this in a lot of detail, and you know,
42:08
Speaker 3: there's an amazing study done by accident. There were researchers
42:13
Speaker 3: who were doing studies on brain waves and they were
42:16
Speaker 3: scanning the brains of people. And there was one elderly
42:19
Speaker 3: person who had a terminal disease, but he was in
42:23
Speaker 3: the study for another reason. You know, it was nothing
42:25
Speaker 3: to do with the disease, but because he had a
42:28
Speaker 3: terminal disease, he had to do not resuscitate, order in place.
42:31
Speaker 3: And it just so happened that during this study he died,
42:36
Speaker 3: and so they were able to capture the brain waves
42:40
Speaker 3: during his death. And when they analyzed those the bits
42:44
Speaker 3: that lit up. Guess what they were. They were the
42:47
Speaker 3: bits that related to light perception. They were the bits
42:51
Speaker 3: related to memories, especially photo and visual memories. They were
42:56
Speaker 3: the bits related to feeling the presence of people and consciousness.
43:00
Speaker 3: And so I think it's true. You know, when you die,
43:03
Speaker 3: your life flashes before your eyes. You're not alone. You
43:05
Speaker 3: see a bright light, and I think that's probably not
43:09
Speaker 3: because of religious reasons or spiritual reasons. I think that
43:13
Speaker 3: is the process of cell death and that was shown
43:18
Speaker 3: in this unbelievable experiment.
43:21
Speaker 1: Wow, you could never plan that experiment.
43:24
Speaker 2: Right, No, if you want to play, I get as
43:27
Speaker 2: somebody who's really just got one foot out the door
43:31
Speaker 2: and maybe you know one toe in.
43:33
Speaker 1: Wow, that's amazing. That's I did not know about that.
43:39
Speaker 2: So just having a quick look on my screen here,
43:43
Speaker 2: So you wrote, so the twenty twenty five book, Second Act.
43:46
Speaker 2: That's out now, because when I had a lot that
43:48
Speaker 2: was like about so that's out now.
43:51
Speaker 3: Yeah, it's out in all good and bad bookshops. It's
43:54
Speaker 3: on Audible and Spotify and other places. You might want
43:57
Speaker 3: to listen to autobooks too.
43:59
Speaker 2: So first book twenty nine ten, if my data is correct,
44:02
Speaker 2: here critical stories and realities of intensive care medicine. Give
44:06
Speaker 2: us a snapshot of that. And this not a sales pitch, everybody,
44:09
Speaker 2: although it could be, it doesn't matter. Give us an
44:12
Speaker 2: insight into that book.
44:14
Speaker 3: Yes, this was a book that I wrote after meeting
44:18
Speaker 3: some families who you know, after they'd loved ones had
44:21
Speaker 3: been through intensive care and survived or not. They often
44:24
Speaker 3: you know would say, well, you know, we didn't know
44:27
Speaker 3: anything about this place, you know, and this was before COVID,
44:30
Speaker 3: and so things like ventilators and the intensive care unit.
44:34
Speaker 3: Nobody kind of knew what it was. And I'd spend
44:37
Speaker 3: decades of my life researching strange topics and niche topics
44:42
Speaker 3: like sepsis and immunology, and I'd kind of forgotten about. Well,
44:46
Speaker 3: these people don't even know what intensive care is and
44:48
Speaker 3: what it can and cannot do. And so this book
44:52
Speaker 3: is a book full of stories and science all wound together,
44:57
Speaker 3: telling the story of the intensive care unit. And it
45:00
Speaker 3: also starts the opening chapter starts with the world's first
45:04
Speaker 3: intensive care patient, which was a little twelve year old
45:07
Speaker 3: girl called viv who should have died in the nineteen
45:12
Speaker 3: fifty two polio epidemic in Copenhagen, and instead the intensive
45:17
Speaker 3: care unit was born. Somebody made a hole in her neck,
45:20
Speaker 3: put in a tube, got teams of medical students to
45:23
Speaker 3: squeeze a bag to three hundred medical students in the
45:26
Speaker 3: end squeezing this bag for all day, every day, and
45:30
Speaker 3: VIVI lived. She survived, She lived, she fell in love,
45:34
Speaker 3: she got married, She had a dog called Bobby. It
45:36
Speaker 3: was an amazing story. And so intensive care was born
45:40
Speaker 3: in the middle of a viral pandemic back in nineteen
45:43
Speaker 3: fifty two, and then it probably became more known about
45:47
Speaker 3: my job. Intensivist first went in the dictionary during that
45:51
Speaker 3: other big viral pandemic that we had recently. So, yeah,
45:55
Speaker 3: that's the story of intensive care. That's incredible. The world's
45:59
Speaker 3: first human powered ventializer or whatever is that the right word,
46:05
Speaker 3: that's sound. Yeah, that's incredible. And is there been in
46:08
Speaker 3: terms of the the raceources and the you know, the
46:12
Speaker 3: science and the technology. Has there been a kind of
46:15
Speaker 3: a consistent evolution of what we have or is there
46:18
Speaker 3: been as there being a big kind of incline over
46:23
Speaker 3: the last five or ten years. Yeah, intensive care is
46:26
Speaker 3: unrecognizable from what it was. It started off very much
46:31
Speaker 3: as a machine and science and physiology based place where
46:35
Speaker 3: you know, you would be put onto a machine and
46:38
Speaker 3: then time would be the healer. And we've kind of
46:41
Speaker 3: been through three iterations I think with intensive care. In
46:44
Speaker 3: the early days, we thought doing more was the best
46:48
Speaker 3: thing we could do, So we would put more and
46:50
Speaker 3: more oxygen, more and more fluids, more and more blood
46:53
Speaker 3: into somebody to try and maximize their survival. And then
46:57
Speaker 3: when we went through a phase of actually, no, you know,
47:00
Speaker 3: in all these things actually cause aggregate harm rather than good,
47:04
Speaker 3: and so we got to a phase of just trying
47:06
Speaker 3: to keep things normal. And now I think it's fair.
47:09
Speaker 3: We're in a phase of intensive care where actually we
47:12
Speaker 3: allow your physiology to be abnormal because it's adaptive. We
47:16
Speaker 3: try to do less things which cause harm. So we're
47:19
Speaker 3: very much in that place now. And the advent of
47:23
Speaker 3: personalized medicine is finally coming in, so we can use
47:26
Speaker 3: drugs which help you know you, rather than just in trials.
47:31
Speaker 3: So yeah, intensive care is a radically different place, and
47:34
Speaker 3: you know it works. There have been tens of millions
47:38
Speaker 3: of people who are alive because of intensive care. And
47:42
Speaker 3: even when we can't save a life, as we've talked about,
47:46
Speaker 3: it's also a place where we can save a death.
47:49
Speaker 3: We can be honest about the things that do and
47:51
Speaker 3: don't work. And you know, like with your friend who
47:54
Speaker 3: had CPR. You know, unfortunately for every person who makes
47:59
Speaker 3: it to hot hospital after CPR, around half of them
48:02
Speaker 3: will still die. That doesn't mean doing CPR wasn't needed.
48:07
Speaker 3: What it's done is give somebody a chance to see goodbye,
48:09
Speaker 3: which is sometimes you know, as important. So yeah, it's
48:13
Speaker 3: a great place to work. I love my job.
48:17
Speaker 2: I feel like your brain is this combination of science
48:22
Speaker 2: and curiosity but also creativity. You are quite creative. I
48:27
Speaker 2: mean you've written books, of course, but do you see
48:29
Speaker 2: yourself as creative? But I mean I can make an
48:34
Speaker 2: astray with clay, or I can write your ballad, But like,
48:39
Speaker 2: to me, like problem solving is creativity.
48:42
Speaker 3: Right, Yeah, I definitely can't make an astray. You don't
48:46
Speaker 3: need to see me dance. Yeah. I guess I struggle
48:50
Speaker 3: with word creativity because but perhaps this is my conception
48:53
Speaker 3: of it. You know, for me, creativity comes from having
48:56
Speaker 3: a structure, doing the work and hanging things and finding
49:00
Speaker 3: things through serendipity on that structure. And I guess you
49:03
Speaker 3: know that that kind of is creativity. But I'm not
49:07
Speaker 3: creative in terms of like whimsical creativity or being able
49:11
Speaker 3: to just pluck things out of the air. I need structure.
49:14
Speaker 3: I need something to do in order to do that.
49:19
Speaker 3: For example, when I was on holiday last year, I
49:23
Speaker 3: reread a book I love called The Meaning of Lift
49:25
Speaker 3: by Douglas Adams, same author as Hitchhiker's Guide to the Universe,
49:30
Speaker 3: where he describes words which should exist but don't exist
49:34
Speaker 3: to describe everyday experiences. And I love this book, and
49:38
Speaker 3: it struck me that in medicine we've got loads of
49:41
Speaker 3: experiences we go through they don't have words. So it
49:46
Speaker 3: was that that motivated me to start this weird idea
49:49
Speaker 3: called the Dictionary of Blood and Silence, where doctors and
49:52
Speaker 3: nurses submit words which should exist.
49:56
Speaker 2: Creative you're absolutely creative, well and also a weirdo, but
50:02
Speaker 2: fuck yeah, that's much.
50:05
Speaker 3: I feel much more comfortable with being interested than a
50:09
Speaker 3: creative or you're a gifted weirdo.
50:11
Speaker 2: I wanted before you go, and thank you so much
50:14
Speaker 2: for your time. I love I love what Your second book,
50:17
Speaker 2: so twenty twenty three one Medicine What Animals can teach
50:23
Speaker 2: us about human health with a lot of my listeners
50:26
Speaker 2: are big animal people, so please do tell.
50:30
Speaker 3: Yeah, I've long been obsessed with what's called comparative physiology.
50:34
Speaker 3: In other words, how do the bodies of these crazy
50:37
Speaker 3: animals work? You know? How is it you can be
50:40
Speaker 3: on a flight from Perth to London and there's a
50:44
Speaker 3: bird at thirty thousand feet You know how does that
50:46
Speaker 3: work without an oxygen mask? Why have kangaroos got three vaginas?
50:51
Speaker 3: You know, these are the kind of questions that keep
50:53
Speaker 3: me up at night.
50:55
Speaker 1: On how do I not know that? Is that bullshit?
50:57
Speaker 1: Or is that real?
50:58
Speaker 3: No, it's real, It's absolutely real.
51:01
Speaker 1: And in fact my terrible Australian.
51:05
Speaker 3: Absolutely terrible. Yeah, I'm a much better Australian.
51:10
Speaker 1: You know.
51:10
Speaker 3: Well, it's the Brits, of course, who come over and
51:12
Speaker 3: straight away go and see a kangaroo within within five
51:15
Speaker 3: minutes of landing, so it's very standard. But it's these
51:20
Speaker 3: marsupials which actually led the groundwork for the development of
51:25
Speaker 3: artificial fertilization techniques. It was studying kangaroos and marsupials which
51:32
Speaker 3: led to that how does a giraffe breathe? You know,
51:35
Speaker 3: how on earth does it manage that? And yet in
51:38
Speaker 3: intensive care, if you've got pipes in which are too long,
51:41
Speaker 3: we struggle to ventilate you. And yet giraffes do this
51:44
Speaker 3: every day. So yeah, I became super obsessed with this topic,
51:49
Speaker 3: traveled all around the world, meeting these animals in their
51:52
Speaker 3: natural environment and trying to put the lessons from animals
51:58
Speaker 3: into practice in human medicine, and it turns out we've
52:02
Speaker 3: kind of been doing this for years. We just don't realize.
52:05
Speaker 3: You know, the way we ventilate people with pipes in
52:08
Speaker 3: people with asthma is actually the exact same way as
52:11
Speaker 3: giraffes breathe. It's just we think we are the clever ones.
52:15
Speaker 3: We've only rid it out in the last you know,
52:17
Speaker 3: twenty years. Giraffe's been doing this for two hundred million years,
52:20
Speaker 3: so you know, they are the clever ones. And the
52:23
Speaker 3: book is littered with these things.
52:25
Speaker 1: Really, what is their neck like two meters long or something?
52:29
Speaker 3: Yeah, two point five meters long. And not only that,
52:33
Speaker 3: but it has to get blood, of course, to the
52:35
Speaker 3: end of its neck where its brain is. And in
52:39
Speaker 3: intensive care when people have brain injuries, we think we're
52:42
Speaker 3: really clever. We use drugs to increase your blood pressure,
52:46
Speaker 3: to increase perfusion to your brain. The way that we
52:49
Speaker 3: strap pipes on doesn't block the veins in your neck,
52:53
Speaker 3: for example. We think we're really clever, and actually it
52:56
Speaker 3: turns out, well, giraffes have got the highest blood pressure
52:59
Speaker 3: of all land animals. They have a systolic blood pressure
53:02
Speaker 3: of three hundred millimeters of mercury. They are doing exactly
53:06
Speaker 3: the same thing as we've worked out how to do
53:08
Speaker 3: in the last fifty years or so. So yeah, basically
53:11
Speaker 3: animals have got there pretty much before us in most
53:14
Speaker 3: medical inventions.
53:16
Speaker 2: How ironic that high blood pressure is going to keep
53:19
Speaker 2: them alive? Yes, you know this is probably this is
53:24
Speaker 2: a bit divergent, but kind of vaguely in the same space.
53:31
Speaker 2: I mean, I think there's a fair bit of evidence
53:33
Speaker 2: that talks about you know, so for people who love animals,
53:36
Speaker 2: you know, that can extend their life, that can lower
53:38
Speaker 2: their blood pressure and heart rate, that can produce different
53:41
Speaker 2: you know, chemicals, it can turn on the parasympathetic nervous system,
53:46
Speaker 2: you know. So there's for people who love animals, of course,
53:49
Speaker 2: and probably their animal the most, there's a real physiological impact.
53:53
Speaker 2: There's an impact on the immune system, you know, and
53:55
Speaker 2: conceivably it might make some body literally live longer just
54:00
Speaker 2: with that one variable.
54:01
Speaker 1: So that that's fascinating.
54:04
Speaker 3: Yeah, Companion animals and also now therapy animals are a
54:07
Speaker 3: big topic. There's there's a chap in that book you
54:10
Speaker 3: mentioned which is called one medicine called Kevin Hines. Kevin
54:14
Speaker 3: Hines is part of the two percent club, the two
54:17
Speaker 3: percent of people who jump from the Golden Gate Bridge
54:21
Speaker 3: in order to die and yet survive. And that's what
54:24
Speaker 3: Kevin did. And the reason Kevin is alive, Well, there's
54:28
Speaker 3: lots of reasons why, but the two of them relate
54:31
Speaker 3: to animals. First of all, he was kept suspended in
54:35
Speaker 3: the water by a sea lion, by a sea lion
54:39
Speaker 3: called Herbert. And we know this is there's video footage
54:42
Speaker 3: of it when the coast guard rescued him. So that
54:45
Speaker 3: was the first thing that saved Kevin. And the second
54:48
Speaker 3: thing was his companion dog, who you know, did all
54:52
Speaker 3: of those things that you mentioned. We now have therapy
54:55
Speaker 3: dogs in the intensive care unit. We had an amazing
54:58
Speaker 3: therapy dog who sadly di eye last yew, called Maggie.
55:02
Speaker 3: And the first time Maggie came into the intensive care unit,
55:05
Speaker 3: a patient tute had a massive stroke. Moved that right
55:10
Speaker 3: side for the first time and they moved it to
55:13
Speaker 3: stroke Maggie, and Maggie was also hugely helpful for staff members,
55:18
Speaker 3: you know, for all those reasons you're outline. So yeah,
55:23
Speaker 3: and I think there's a quote which summarizes this the best,
55:26
Speaker 3: really from a very famous philosopher who says that lots
55:30
Speaker 3: of people talk to animals, but not many people listen.
55:33
Speaker 3: That's the problem, and that philosopher was Winnie the Pooh.
55:37
Speaker 3: But that's what this book tries to correct, really, is
55:41
Speaker 3: that you know, we need a reciprocal relationship. We shouldn't
55:45
Speaker 3: just be exploiting animals for their flesh or experimenting on them,
55:50
Speaker 3: and yet they then can't access the very medications that
55:54
Speaker 3: they have helped bring to market, for example. It's a
55:56
Speaker 3: crazy setup. So yeah, it's a it's a book which
56:00
Speaker 3: is all about travel, crazy animals, science, and some morality
56:04
Speaker 3: in there too.
56:06
Speaker 2: And one of the great philosophers of the twentieth century,
56:09
Speaker 2: we near the Pooh to set the right century. It
56:13
Speaker 2: couldn't have been the nineteenth for sure.
56:16
Speaker 1: It's longer. Hey, Matt, thanks for taking the time.
56:19
Speaker 2: You're fascinating, and I think I saw a couple of things,
56:24
Speaker 2: just some videos of you. I think also you're a
56:28
Speaker 2: very good storyteller, which is nice. It's like people connect
56:31
Speaker 2: with stories and you know, rather than data or like
56:34
Speaker 2: the information is great, but you wrap that information, you know,
56:38
Speaker 2: like just talking then about Maggie. You know, it's like,
56:41
Speaker 2: so here's the information. You know, animals, let me tell
56:45
Speaker 2: you a story about Maggie, the dog that was in Icy.
56:47
Speaker 2: You know, it's like that's such a way to bring
56:50
Speaker 2: things to a real, relatable human level, you know.
56:54
Speaker 3: So yeah, well the way up, and thank you for
56:58
Speaker 3: allowing those stories to be told. You know, through what
57:00
Speaker 3: you're doing that's super important. So thank you.
57:05
Speaker 1: Absolute pleasure. I don't know whether or not you so.
57:08
Speaker 2: Matt's three books are Critical One Medicine Critical So Stories
57:12
Speaker 2: and Realities of Intinsive Care Medicine, the middle one one Medicine,
57:17
Speaker 2: What Animals can teach Us about Human Health, and the
57:19
Speaker 2: most recent one, Last Year Go and Get Yourself nine
57:21
Speaker 2: copies a second.
57:22
Speaker 1: Act, Life after Cardiac Arrest.
57:25
Speaker 2: Is there any website or any anywhere you want to
57:28
Speaker 2: point people towards any other resources or anything.
57:32
Speaker 3: Yeah, I'm on all the usual socials apart from TikTok,
57:35
Speaker 3: I think. So. I'm doctor Underscore Matt Morgan on Twitter
57:38
Speaker 3: and Instagram, And there is a website which is Dr
57:41
Speaker 3: Matt Morgan that you can find a lot of my
57:44
Speaker 3: free writing. I write some columns for medical journals. They're
57:47
Speaker 3: all on there. So yeah, you can check that out.
57:50
Speaker 1: Just quickly. Do you do corporate stuff, like, do you
57:52
Speaker 1: talk to corporate groups?
57:55
Speaker 3: I've done a few. Yeah, I've done a few. Yeah,
57:59
Speaker 3: something something absolutely I can do if people are interested
58:02
Speaker 3: in that, and they mostly relate to dealing with work
58:06
Speaker 3: under pressure is a big part of that. Communication, breaking
58:10
Speaker 3: back news is a big part of that, as well
58:13
Speaker 3: as the individual topics in terms of life after death
58:18
Speaker 3: for example. So those are the three which are the
58:21
Speaker 3: most suitable I think for those kind of settings.
58:24
Speaker 2: And we got through a whole hour without an interruption
58:26
Speaker 2: from a kid or a canine.
58:28
Speaker 1: So well, you.
58:31
Speaker 3: Can't see under the table luckily there's no kids, but
58:33
Speaker 3: there's definitely a canine.
58:35
Speaker 1: So yeah, thank you. Well say goodbye here, but Matt,
58:38
Speaker 1: thank you so much for being on the new project.
58:40
Speaker 3: Lovely to see you.