#73 The Cancer Series (3 of 3). My Cancer Journey with Dr Lauren Macdonald

15th Oct 2020

On this episode I’m joined by Dr Lauren Macdonald, who worked as a doctor in Brighton for several years before being diagnosed with aggressive stage 4 cancer in 2014.

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The years that followed gave her a deep understanding of what it is to face a life-threatening illness. Consequently, she became fascinated by the emotional experience of illness, the mind-body connection, and the body’s ability to self-heal.

To optimise her chance of survival she explored Integrative Medicine, specifically focusing on nutrition, the gut microbiome, and stress management techniques, alongside conventional medical treatment. She achieved complete remission in 2016 and has gone on to study vedic meditation, Nutritional and Environmental Medicine, Mindfulness Based Stress Reduction (MBSR) and Ashtanga yoga.

We talked about:

  • Her cancer journey, what is like to be a doctor with cancer and her experiences within the NHS system
  • Stress and inflammation in disease
  • How she was able to overcome trauma in her life
  • Gut health and its importance during therapy
  • Her experiences of yoga and learning more about surrendering herself to the universe
  • The power of nature as a healer
  • Her personal use of psychedelics and her thoughts on its potential use in medicine

Episode guests

Dr Lauren Macdonald

Dr Lauren Macdonald is an integrative practitioner and an expert in the mind-body connection. After graduating from Cardiff University with a Psychology BSc she went on to complete a medical degree at Brighton and Sussex Medical School.

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Podcast transcript

Dr Rupy: On this episode, I have the pleasure of being joined by Dr Lauren Macdonald. Lauren and I knew each other from Brighton when she was a junior doctor and then subsequently in Sydney. And she worked as a junior doctor in Brighton for several years before being diagnosed with aggressive stage four cancer in 2014. The years that followed gave her a deep understanding of what it's like to face a life-threatening illness through the lens of being a doctor. And consequently, she became absolutely fascinated by the emotional experience of illness, the mind-body connection, and the body's ability to self-heal. Now, to optimise her chance of survival, she explored integrative medicine, specifically focusing on nutrition, the gut microbiota, stress management techniques, alongside conventional medical treatment. She is one of the lucky ones to have achieved complete remission in 2016 and has gone on to study Vedic meditation, nutrition and environmental medicine, mindfulness-based stress reduction, and Ashtanga yoga, and has just started psychiatry training back in the NHS after a stint abroad. We talk about a number of different things today, her cancer journey, what it's like to be a doctor with cancer and her experiences within the NHS system, stress and inflammation and its impact on disease, how she was able to overcome psychological trauma in her life from her diagnosis and experiences as a cancer patient, gut health and its importance during therapy, her experiences of yoga and learning more about the art of surrendering herself to the universe, and you'll learn a bit more about that during the podcast. The power of nature as a healer and her personal use of psychedelics and her thoughts on its potential use in medicine. I want to say from the outset, as with the whole series, none of this is intended to be medical advice. Dr Lauren is still a doctor within the NHS, and I commend her for being open and honest about her previous use of supplements and different dietary regimes, but this isn't to be construed as personal advice and both of us would always, always recommend discussing everything with your personal practitioner, regardless of what your medical condition is. It's safe to say and goes without saying really, but I do want to emphasise it on this particular episode that none of this is intended to be advice at all. I am really, really privileged to to know Lauren and I think you're going to find this episode truly inspirational. She really is an incredible person and I can't wait for you to listen. So without further ado, here is my conversation with Dr Lauren Macdonald. I just want to let the listener know, we've known each other for a long time. I don't think we we weren't particularly close when you were at Brighton and I was training in general practice, but I we definitely had like mutual friends and then it wasn't until we connected again in Sydney that I remember like having more of a meaningful conversation with you. But I thought maybe you could tell us about what you did prior to medicine and and what your journey has been thus far throughout your medical career.

Dr Lauren Macdonald: Wow. So that's a really big question and I'm not sure how much details to go into, but so, yeah, I definitely I remember meeting you in Brighton. I think it was on the volleyball, the outdoor volleyball courts actually. And I was a newly qualified doctor, probably been practicing for maybe six months or something. And prior to that, I'd been actually, well, I'd obviously just gone through medical school, but before that, I'd been working in advertising for a little bit. And before that, I'd been doing a psychology degree in Cardiff. So I'd had a bit of a kind of convoluted route into medicine anyway. And then

Dr Rupy: I didn't know about this advertising thing. Can you double click on that for a second? What?

Dr Lauren Macdonald: I had a really visceral reaction to, no kind of disregard to anyone's working in advertising, it's absolutely needed. But we, yeah, I just, I'd sit in the office and I just kind of thought, this isn't what I want to be, do I really want to spend my life doing this? I didn't feel like I was personally doing enough to help people in the way that I wanted to be helping them. So on a spur of the moment thing, I just opened up a UCAS application one day and applied and it just snowballed and then before I knew it, I was at medical school. And I loved learning. I really love learning about the human body and it complemented my psychology degree in some ways because obviously I'd spent three years learning about the mind and then finally I was switching into the body. And obviously there was still some crossover, but so yeah, that's that was my route into medicine, but I then qualified, you know, finally as a mature student, felt like I was getting, you know, catching up with everybody who was way ahead of me in terms of jobs and buying homes and all that jazz. And then not long after qualifying, I was diagnosed with cancer. So that was back in 2014, February the 14th because I remember thinking this is absolutely the worst Valentine's Day I'm ever going to have. And yeah, so that was that's really been, I mean, there's a very clear pre-cancer and post-cancer part of my life because it really has changed. The last six years have been so challenging in so many ways and yet they've also allowed me to grow and have experiences that I would never have had if I hadn't have had cancer. So it's a real mixed bag of some blessings in there, but I don't want to sugarcoat it, it's been really difficult. It's, yeah, anyone who's currently going through it or has been through it will know how hard it is. So yeah, that's where, that's where I am. And now I'm back at work full time and yeah, just navigating this new world of trying to stay true to myself and carry with me into work and life everything that I've gained over the last few years. There's still a lot to learn. I'm very much on a journey of growing and learning more about medicine really. I think we get quite a, well we definitely get a conventional approach to medicine taught to us at medical school and having cancer really opened up my eyes to integrative medicine and complementary medicine and all of the amazing practices that we can do to empower ourselves as well. So yeah, that's where I am.

Dr Rupy: I really want to explore some of those topics that you just mentioned at the end of that, but I think prior to us talking about how your own experience as a patient has changed the way you look at medicine, perhaps in the and the way it's taught as well. Perhaps we could talk a bit about the process of being diagnosed and how you found out in the first place and and a bit about the type of cancer that that you had as well.

Dr Lauren Macdonald: Yeah, so I had malignant melanoma. I'm still actually classed as having malignant melanoma. I think once you're, you know, you've given, you've been given the diagnosis, especially because my cancer progressed to stage four, although I am called, you know, NED, no evidence of disease. I sometimes say I'm in remission, but you know, that hasn't come from my oncologist. That's just something that I say. But yeah, no evidence of disease gratefully at the moment. But, the thing with melanoma is you never, it's one of those cancers, there's a few key ones and I know you'll know these cancers that you really do not want to get. And as a medical student, I remember hearing about melanoma, ovarian cancer, pancreatic cancer. There was a few that were really, um, kind of just scared me to get. And yeah, lo and behold, as a newly qualified doctor, I get diagnosed with melanoma. And it was a really strange experience because I had noticed a lump on my knee. So it wasn't, you know, you have a normal, there's this A B C D E that as doctors we're taught about to look out for. And instead, mine wasn't a changing mole, it was a new tiny, tiny lump on my knee. But there was just an intuition, there was alarm bells that were going off. So I went to my GP at the time and he actually said he didn't think it was anything to worry about, which unfortunately, now I've heard that so many times in the cancer community and this is not pointing fingers at GPs because I really know how difficult it is. But I should have probably carried on pushing because there was something screaming inside me, this isn't right, I'm not sure about this. But I left it then. I think there was a reassurance and maybe I wanted to be in denial that something was wrong. So I left it for six months, which in kind of cancer terms is huge. And there was a niggling feeling at the back of my head that I should go back. And it wasn't until I was shaving my legs one day in the shower and I just nicked the top of it and it just poured with blood. And I was on my way to work, I was about to go in, I couldn't go to work, I had to go straight back to the GP and before I knew it, I was actually having surgery two days later, a wide local excision. And the strangest thing was that one of my colleagues, someone I've been working with, another doctor, I went to a different hospital for my first surgery and he came in, he's pulled back the curtain to give me my, put my cannula in. And it was this weird, it really was a kind of sliding doors moment of me transitioning from doctor to patient because we'd literally the week before we'd been colleagues on the ward looking after other patients. And suddenly, I've just got a snapshot in my head of his face because he was so shocked to see me in the bed. I was so shocked to see him pulling back the curtain. And it was just this moment of just having to realise where I was. I think I've been in denial up until then. So yeah, that was, that was my entry point into cancer and all the surgeries and everything I've had since then.

Dr Rupy: Yeah. And and that lump, was it changing at all during that six month period? Was it

Dr Lauren Macdonald: No, and I kept an eye on it because obviously that's what we're taught, if it's changing in colour, diameter, it didn't really change and that was I think again, I wanted to reassure myself. And I think I really truly did have a bit of an anomaly. I don't want to panic anyone listening who has had, who maybe has a mole or a small lump. Um, it was, I think I have, you know, I had a nodular melanoma, which is not as common, but also really aggressive as well. It's within the melanoma family, that's the one you don't want to get. And yeah, so it wasn't really, otherwise I think I would have gone back sooner. But as I say, I think at the back of my head, I wanted to be reassured, I wanted it to be okay. And unfortunately that that GP telling me it was nothing to worry about, it was something else that he said would probably fade within a few months. That was what I needed to hear at the time. But yeah, it's just so hard diagnosing cancer is really challenging and I really feel for GPs. So although I was obviously, I went through a bit of a period of all of the emotions, you know, the anger and the frustration at him, actually, it's just human error and we, these things happen, sometimes you slip through the net.

Dr Rupy: Yeah, absolutely. And you know, I shudder to think of the number of patients that throughout my clinical career might have slipped through the net. And it's it's going to happen the longer you're in medicine, the odds are stacked against you to to miss something like that, especially something as non-conforming to what you what we're taught at medical school and throughout postgraduate education as well. But that experience of you suddenly becoming a patient and and that I can imagine, I've got that scenario in my head of of the curtain being pulled back and your colleague looking at you. Was that the first time you realised what it was like to be a patient and actually truly empathise with, you know, something that we do as as doctors on a on a daily basis?

Dr Lauren Macdonald: Yeah, I was a real vulnerability because it was late at night. He'd been really busy, so he didn't get round to me till about 11:00 p.m. So you're already feeling quite tired. All the sounds are going on the ward, the lights are bright, you're already feeling really out of your comfort zone. And it was that on one level, it was comforting to see a familiar face. And then it really brought it home that I was the patient. I wasn't the person putting in the cannula, I was the person having it done to me. And I just for the first time, I felt so vulnerable and it was strange because I hadn't been a patient before. Ironically, I've been a patient so many times since that moment, but at the time it was all very new to me. And I really understand now how scary it is. You know, hospitals were familiar to me. I'd been, you know, got just gone through medical school, I've been working on the wards. And yet, even if it is familiar, it's still when it's you and you're in that position and you're just feeling lonely and it's just not where you want to be at the end of the day.

Dr Rupy: Yeah, yeah. And as a young person as well with that diagnosis, I remember on on your podcast, I talked about my experience of suddenly becoming a patient, again, like really early on to my medical career. And one minute you're strutting up and down the ward and you're seeing patients and you're part of a team and the next minute you're in the hospital bed, which is just so alien and so foreign and and really embarrassing as well. It's almost like, you know, in a way, you're weak and you go through these emotions where you don't know whether you can be a doctor and all these different things. So, yeah, in a small way, I can I can relate, but obviously with a with a cancer diagnosis, it's it's it's like a whole huge load of of emotions to go through.

Dr Lauren Macdonald: Yeah, there's it's interesting. There's I noticed that at times I was angry, there was the denial, there was the shame at having a cancer diagnosis, which it took me a while to speak out loud. And obviously that was a lot of fear driving that, but there was definitely some shame there, which I wasn't expecting. I mean, not that I'd ever planned to have a cancer diagnosis, but I just was didn't expect that to come up. But I think that comes up a lot. It's a, I don't know what it is driving that shame, but it's it's a really powerful emotion when you're feeling it.

Dr Rupy: And so after the initial diagnosis, you had the wide local excision. What was your and I don't want to press on open on any, you know, former wounds or whatever or get you to relive those experiences because I can understand how harrowing they were, but what what was the journey thereafter to the point where, you know, maybe not as fast forward as we are right now, but but along that, you know, the first year or so.

Dr Lauren Macdonald: So it was a really bumpy journey. And so that was me when I was having the wide local excision, which for anyone who doesn't know, just means they take, the surgeon took a really good amount of flesh, basically tissue from around the tumour. And gave me the best possible chance of it not having gone into the lymph nodes or the blood vessels. And it came back with clear margins, so that meant there was no cancer in the surrounding tissue. So that was a really good prognostic factor at the time. And yet, there was something in me, I think maybe it was because of my medical background. I think sometimes being a doctor really helps us and other times it really doesn't. But I just had a niggling feeling that this wasn't going to be the end of it. I knew that melanoma was renowned, it's called the wandering cancer. It loves to infiltrate and travel around the body and it does it so well. And I carried on having scans every three months to check where I was at. And about six months later, it was interesting, I'd gone to Glastonbury festival and I was wearing a jumpsuit and I had spent most of the festival pressing on my right groin through, I had my hand in my pocket and I could just feel a tiny, tiny lump, but it was more it was pain. So I came back and spoke to at the time I was still under dermatology and oncology and said, look, I think there's something going on here. Again, intuition has been such a big part of this for me. And I was told, and again, not kind of being down on my colleagues, but that I should know that tumours or cancer cells in lymph nodes are very rarely painful. So it probably wasn't anything to worry about. But there was just a niggling feeling, there's something going on here, but my scans weren't due for another few months. And I ended up actually being referred to health psychology because they were worried that I'd got really anxious, which on one level, I completely understand that's, you know, a cancer diagnosis is really, really scary and of course, you worry that it's going to come back all the time. But at this point, I just put my foot down and said, I really don't think it is health anxiety. I think there's something legitimate going on. And I pushed for an ultrasound scan. And I really remember the radiographer when she was doing the biopsy, she straight away was like, oh, there is something there and I'm a little bit concerned and did a biopsy. And I could tell by her face as she was pushing the needle into to get the core biopsy, that she wasn't happy and she just said, look, if I'm honest, it's got that feeling. You get, you really get used to what's benign and what's potentially cancerous. And I don't want to tell you up front, but I don't have a good feeling about this. So that was me progressing to stage three. So once it's I had I had the biopsy result, yes, it was cancer and that was me at stage three. And again, this was towards the end of 2014. So I ended up having going back into surgery, back into the hospital, having a groin dissection, which is a removal of quite a lot of lymph nodes at the top of my right leg. And I spent my 30th birthday, I actually was allowed to leave the hospital after two weeks in hospital recovering. He found out the surgeon who was a complete legend, found out it was my 30th and said, okay, you can leave, that's fine. But I had to leave with drains. Anyone who's had, you know, whether it's mastectomies or other surgeries, quite often you have to have these drains which contain your blood and your lymph and they're pretty, they're not ideal. You don't want to be really walking around with them, but he said, okay, you can leave for your 30th birthday party. Some friends had put a little party on for me. As long as you keep these drains in. So I ended up having to strap these drains to my leg and that's how I left the hospital as stage three. And it was so sad because I, I got out, I had, you know, everyone had been amazing. They'd actually carried a sofa down to Brighton beach for me to sit on and everyone arrived and there was balloons and it was just, it was so lovely after two weeks in hospital. But about 11:00 p.m. I started to feel really, really unwell and I actually ended up back in A&E on IV antibiotics with cellulitis. So the first, you know when people talk about their 30th and mine's so memorable for all the wrong reasons. But after that, after I was out, I was clear, I was so-called no evidence of disease in remission for a year. But again, there was this niggling intuition that melanoma, unfortunately, has a way of coming back. And I was, I'd gone back to work. I was actually in a GP job and I'd had a routine scan. This was about a year after, so I was about 31 at this time. And I had a routine follow-up scan and I actually got a phone call to my mobile phone while I was at work and stupidly I answered it between seeing patients. And someone on the end of the line was just saying, look, I'm booking you in for an emergency biopsy tomorrow. But I had no idea because I hadn't actually had my, this is a unfortunate thing that occasionally happens in the NHS and my oncologist said to me, doctors tend to either get an amazing service and things go so well or you really pull the short straw. And I think unfortunately, because I know the NHS service is incredible and most people have a really good journey through it. But I was there sat in the GP surgery on my mobile, about to see another patient, hearing that the cancer was back, but the poor admin lady wasn't able to tell me anything more. So I was just, again, the worst way to find out. And yeah, I went off to my appointment the next day, saw my oncologist and she confirmed the cancer was back in my adrenal gland, my lung, and my chest wall. So that was me progressing to stage four at that point. That was 2016, no, 2000, what was I? So yeah, 2015.

Dr Rupy: Wow. I mean, anyone hearing this for the first time, and I'm sure you've shared these stories on your podcast and stuff, must just think this is crushing on a physical and an emotional level. I mean, there's two things I want to talk about. The first of all is the intuition, because I hear this a lot from patients, particularly from parents of patients as well, in paediatrics, this intuition that something's quite not right. And what that felt like and whether that was hanging over you the entire time. And also like, during this period of your life, how are you dealing with those emotional setbacks that seem to just occur one after the other?

Dr Lauren Macdonald: So I think to answer your question about that first, first of all, I just remember thinking, just give me a break, please. I just, I felt like I couldn't catch my breath because I was having scans every three months and it felt like for about 18 months or two years, every time I had a scan, it was bad news. And I was exhausted. I didn't have time to fill my cup up enough to prepare myself for the next kind of wave to crash over me. So that was really, really hard. And I hadn't, it took me a while to find all of the emotional and spiritual practices that I now know are so important. I've been so focused on really from stage, between stage three and stage four, I'd had a whole, nearly a whole year of being in remission. And I'd thrown myself into learning everything I could about integrative medicine and nutrition and I was even trying some weird and wacky things because that's what you do when you've got cancer and you're petrified and you think it's going to come back. So I tried the Budwig protocol, which is where you mix cottage cheese and ground flax seeds and it tastes absolutely foul.

Dr Rupy: I don't think I've heard of that. Wow.

Dr Lauren Macdonald: I was trying anything. I was, and I don't blame anyone who does this because I had, you know, all of this medical knowledge and yeah, I was still scouring the internet at 4:00 a.m. looking for cancer cures because that is just so often what you do because you are so scared and you think maybe there's something they haven't found out yet, maybe there's an underground something that hasn't been researched enough that will actually help me. So yeah, I was trying strange things. I was doing then, you know, sensible things. I went plant-based, I reduced my sugar, reduced my dairy, and I was juicing twice a day. I spent a ridiculous amount of money on a masticating juicer. And but I'd really focused on my body between stage three and stage four. And to be honest, when it came back, I was really fed up because I just thought, for a whole year now, I have been eating so carefully and the things I were eating were specific to, I'd done my research, I thought, right, what's going to help either kill cancer cells or reduce what's called angiogenesis, which is where cancer cells try and recruit new blood vessels to help them grow. So I was eating pomegranates and shiitake mushrooms and Brazil nuts and all of these things. My diet was really, really regimented and specific. And I hoped that I was, that was me done, I was going to be in remission for life. So when it came back, to be honest, I just thought, sod all of this, I'm going to eat whatever I like, I'm going to have fun, life's too short. And then after a few, I mean, what's interesting of course is it really affects your mental health. When you start eating rubbish again, you don't feel so great. So actually after about six weeks or two, two months, I started eating healthily again. But then I brought in the other practices, which I hadn't really been focusing on. So I think it was the turning point for me, it was interesting. I I noticed that as I, as the cancer progressed, you'd think actually I would have struggled more. And yet actually, I felt much calmer and more at peace when I kind of transitioned into stage four because I'd started to have all these practices. So I'd started practicing yoga and meditation and just all the things that you know help, being out in nature or journaling. And having fun. I definitely brought a lot more fun back in then. And I went on some epic holidays, much to the Royal Marsden's disgust. I flew off to Colombia in the middle of Zika virus, which they said, please do not do this. But there was a drive in me then, I just thought, no, I don't know how long I've got left because stage four, you know, back not that long ago, 10 years ago, the survival rate for stage four melanoma was about 12 months. And I'd already lost quite a few friends, patients that I'd met in the cancer community who also had stage four melanoma. So by that point, I was just in a different state and I really feel that the final piece that brought it all together and really enabled me to get through that period was coming to an absolute point of surrender. I've been doing everything I could for so many years, you know, alongside conventional medicine, absolutely. And it was finally just going, I'm I'm going to, I'm going to give this up to a higher power. I've done my bit. I've I've learned so much and brought so much in and now I need whatever it is, God, the universe, my ancestors. I actually remember going outside and looking at the stars and just thinking, whoever is up there looking down over me, I really need some help right now. If you can do anything, I'm not done on this planet yet. I'm not done on this earth. Please give me more time, help me. And it was a point of surrender. I felt lighter. Um, it took the pressure off me and I think that has an amazing effect on our nervous system because when you're in that fight, flight, so stressed, it's obviously just suppresses your immune system and all of that. So actually getting to a point of surrender, which I don't think, so many people say, how do you get to that point though? And I don't think you can can really push it. I think you can, of course, do the practices that can help you get there. Um, meditation, breath work, and just spending time in nature, you know, nature is my absolute church. It really helps me to connect to something beyond myself. But that point of surrender really helped. So I'd say that was how I got through the period. But of course, it wasn't always easy and there was a lot of numbness. I think interestingly, you learn a lot about yourself when you go through a really stressful period. And for some people, they are in that hypervigilant state. And for me, I really felt numb. Um, which was, it wasn't until I'd come through it that I realised just how numb and probably depressed really I was. And looking back, I wish I could tell my younger self to go and seek some therapy because I I never saw a therapist or counsellor, psychologist, anyone all through that period. And only now do I realise how valuable that would have been. I really had that, get my head down, get through this, try and get through it on your own. And actually the best thing I realised I could have done was to reach out and just say, speak about it, even if they didn't have anything to say back to me, just get it out of my body and really help soothe myself.

Dr Rupy: Do you think that was the inner medic in you of like, you know, just persevere, fight on, find out everything you can about other ways in which you can help yourself and get through this? Or is that something of a facet of your

Dr Lauren Macdonald: I think it's more a personality trait. Yeah, I think it's my, everyone has different ways of coping and researching and being quite methodical and logical is my go-to. And even I remember the oncologist saying to me at one of my appointments, Lauren, are you sure you're okay? Because I've never seen anyone react like this before because I, I can't even remember, it was all such a blur, but I think I was saying, you know, okay, what's the next plan and then what do we do? And I guess that is probably the doctor in me coming out as well. But definitely personality as well, which I don't think's healthy. I'm a huge fan as you know of Dr Gabor Maté and all of his work and having read so many of his books, I really realise that actually suppressing your emotions is not a good thing and trying to just put your head down and get on with it is definitely not the way forward in terms of helping your body be in that self-healing state. So, yeah, there's been a lot of lessons along the way. It's not been plain sailing.

Dr Rupy: Definitely. The conversation that you've had with Gabor and Jeffrey Rediger as well, like on your podcast are awesome. I highly recommend anyone listening to this go stop this right now and go listen to those. But, one thing I wanted to pick up on there was, um, your experience of being part of the cancer community and you mentioned you lost some friends. How important was that community and and was that a way in which you shared different coping mechanisms in terms of the surrendering and perhaps even the introduction into the food and and lifestyle aspects?

Dr Lauren Macdonald: So I think it was it's it's mixed. In some ways, being part of and I'm I'm still on many cancer community Facebook groups or various forums. And sometimes it is the most helpful thing when you need it. And other times it can be really challenging because you're already so in that world, what you actually need is to be out of it and to be connecting with your friends and family and it's it's hard because you, especially if you're an empathic person, you will inevitably take on other people's grief and struggle as well. And there's something to be said for your own boundaries and just looking after your own energy. And of course, you want to also support other people. So there's you just have to kind of work that out. So, so sometimes yes, sometimes no. And but the greatest thing for me was actually finding a girl in Australia who was about six months ahead of me. Our stories are so similar, it's ridiculous. And we still talk now, which is lovely. But she had progressed to stage four about six months or maybe a little bit before me. And then she'd started this amazing new drug, Pembrolizumab, which is an immunotherapy. And she, like me, had been one of the first patients in obviously I was in the UK, she was in Australia, but to get the drug off trial and she'd had a really quick response and she was in remission about four months later. And I found her and she was just a lifeline. I think it's hope. I think it's giving you that hope when you're in such a dark place and you're just hearing these stories because so so often the stories that make the news or the headlines are unfortunately the stories that have people have died, people are sick. And you don't often hear the success stories and of course they're out there. People who are survived are quite often just out there living their lives and maybe have distanced themselves from the cancer forums because they they don't want to necessarily stay in that space and they're moving on. So finding her was amazing. Yes. So and I paid it back. I've made sure I've tried to connect with people who I see are a few years behind me because I think that element of hope is just so amazing and so powerful.

Dr Rupy: Yeah, well, I mean, everything you do right now, I think is a sense of hope and positivity for for people who are going through this or even families who are going through this as well. So I think you're definitely paying it back, mate.

Dr Lauren Macdonald: Hope, hope without being unrealistic, I hope, because of course, even now as I sit here, I'm not, I don't necessarily, who knows how long I'm going to be here. At the moment, things are well and I'm so grateful for that, but yeah, definitely hope but with with a strong grounding in realism as well.

Dr Rupy: Yeah. I'm curious to to know, I mean, you mentioned that you were on the internet looking for, you know, anything out there that that could have helped you during treatment. But what did your oncologists and and other sort of professionals who were helping you go through it and treating you think about your lifestyle changes or did you even tell them about what other things that you were doing?

Dr Lauren Macdonald: So, again, I just I feel like I'm just saying negative things about the NHS and my colleagues. I'm not. Um, so, and you've got to remember as well, this was back in 2014, 2015 and a lot has changed. It's been so fascinating to be connected to this space, whether you call it lifestyle medicine or integrative medicine, because so much has changed in the last five, six years. And the wellness world really, it wasn't really a thing. When I first started, when I was going off to buy my chia seeds or lentils, you know, I was still having to go and find it in shops that, you know, it's everywhere now, but then it wasn't the case. So my oncologist, it wasn't actually my oncologist, it was my dermatologist at the very beginning. I said, look, I'm taking these various supplements. And I I don't think I was being ridiculous at the point, which to be fair, I then did escalate it after a later date, I did absolutely escalate my supplement taking. But at the point, I was being quite sensible. I was taking a multivitamin, I was taking selenium, coenzyme Q10, a fish oil, and vitamin D, I think. And I said, and I'm also having a lot of turmeric and garlic and lots of herbs. I'm juicing parsley, you know, I listed off all this. And I remember her just turning to me and saying, Lauren, you're an educated doctor, what are you doing? And my mom, my mom was actually in the consultation with me and we both left and just, I felt a mixture of a bit crushed, but also really angry because everything I've been doing to try and empower myself, even if it wasn't working, as long as it wasn't doing me harm, and at the time I wasn't on any medication, anything could interact with. And yeah, I just felt, I felt really disappointed that I wasn't being supported in my journey of empowerment. And I just, I did actually, personally for me, I I chose to ignore that advice. She asked me to stop. And I think so many cancer patients, and this is something that I think, I think this is so important why oncologists and doctors need to be so careful about the way they speak to cancer patients because what can happen is you hear that and yet you're driven by your research or driven by sometimes just pure fear. And then you just don't disclose it to future oncologists, future doctors. And that can have a huge impact as well. And a prime example of this is that when I actually started the immunotherapy, I was really interested in CBD and cannabis because I'd read quite a lot about the fact that it can actually help with cancer, especially with pain and things like that. But you know, potentially in the future, we might find out it really does help to actually treat cancer as well. But I'd dug a bit deeper and found some research that suggested that actually having any form of cannabis, whether it's CBD or whatever, while you're on immunotherapy would actually maybe be detrimental because it could prevent your immune system from essentially being ramped up, which was the thing my drug was set to do. So of course, in that prime example, if I had not, if I had just gone ahead with it, I wouldn't have felt comfortable probably telling my oncologist. And yet they'd have wondered maybe, oh, why is immunotherapy not doing anything? So I think keeping that open dialogue is so important. And of course, you want to make sure people aren't going too crazy, which I later did and I was taking about 30 supplements if I'm honest when I was at the end towards the end of having stage three, and I I realised I'd just lost it basically. I was I was running on fear and I needed to bring it right back. But again, I don't think I did disclose any of those supplements at that time to any doctor because I knew I had a feeling that I would know the response. So, yeah, it was it was really interesting to be on the receiving end of that.

Dr Rupy: Yeah, I I don't think you're being negative at all, actually, to be honest, Lauren. I think we need to have more open communications about this. And luckily, um, there is a renewed interest from the medical field in uh, different ways in which we can use food to heighten the efficacy of therapy, particularly immunotherapy. Um, but also more oncologists who are open-minded about this as well and actually have the the the method of speaking to patients that isn't disheartening because I think the emotional tool, as we're going to talk about a little bit later, is super important during this process. So, yeah, I don't think you're being negative at all.

Dr Lauren Macdonald: And there's definitely, there's definitely been a change because five years ago when I was, I was telling other patients on the chemotherapy unit, you know, you must look after your gut health. This is key, go and buy your prebiotics, probiotics, eat this. And one of the nurses actually said to me, Lauren, please stop doing this. Like you can't go around telling people what they need to be doing. You're not their oncologist, which was fair enough, fair enough point. And yet, it's so nice that I now get messages from people saying, thank you so much for telling me to have a look at my gut health because now the research is coming out suggesting actually that can play a really important role alongside immunotherapy and that their oncologists are now actually recommending to them to eat prebiotics and probiotics, which is wonderful because obviously the science was there, but it was so preliminary and I do understand that it does take a while. You don't want to jump straight in until you know something is going to help and not be cause harm. And yet, so often with these lifestyle measures, just eating healthily and drinking your kefir or eating your sauerkraut, how much harm can you really do? So, yeah, anyway.

Dr Rupy: Yeah, when it comes to food, I think, you know, there's a balance to strike between being anxious about food and, you know, what is reasonable for patients. But I think it's very hard to do harm with just improving your diet by increasing plants and, you know, doing a few basic measures. But it is interesting to note that it's now become sort of, not mainstream practice, but it's definitely becoming like sort of like a foundation that most people know about. Um, I'm interested to know, and I don't want you to, I don't want you to feel like you're ragging on the NHS too much at this point, but I'm interested to know about what kind of dietary advice were you given if any during the early stages of your treatment?

Dr Lauren Macdonald: So I had no dietary advice at all. And I had no mental health advice. I had no emotional support. And I hear from other friends, other people who've had cancer that they have had an amazing journey through the NHS and they saw nutritionists and they saw counsellors. So I think maybe I don't know whether people were looking at me thinking, oh, she's a doctor, she's kind of got it covered, she's seeking her own support. But yeah, I didn't, I didn't receive anything at all. And it was really interesting because I've gone, I've now gone on to do a nutritional qualification. And I've realised how little I knew. I know that you've just finished your masters as well, but the biochemistry and it was just mind-blowing and I realised actually that it really is helpful to go and seek expert advice rather than just trolling the internet yourself because if you Google pretty much anything and cure for cancer, you can find something that will support that. So what you need is expert advice, otherwise you can just be, yeah, buying all sorts and hoping it does something.

Dr Rupy: Yeah, I mean, the internet in general just needs a massive filter on all these different things. And the way you do that is by getting a trusted practitioner who's who knows the field, who can, you know, speak confidently about on the basis of all the research that they've done. And you know, even now on a, you know, for the next however long I'm going to be involved in the nutritional medicine field, I'm going to be learning on a daily basis because there's just so much stuff to learn. It's like medicine as well. Um, and being sort of humble to the fact that you'll never ever be an expert, I think is quite, um, comforting in a way because you're always, you're always learning. But what I'm interested to to into how you made that transition because after your stage three and then doing all these weird and wonderful supplementations and and changing your diet and then still progressing to stage four and being crushed by that, how did you then sort of, um, introduce more of the mindfulness-based therapies, environmental therapies? Was that something you've always been interested in or did it come about as a result of sort of that that period of time?

Dr Lauren Macdonald: It was, I mean, I'd always been interested in yoga. I'd practiced yoga once or twice a week going to a class. And I'd always loved being in nature, but it really changed why I was doing it. So my yoga practice became about feeling safe in my body because I, what was interesting is the tumours that started growing, especially my chest wall, I could visibly see them. They were really lumpy, they were sticking out. The tumours were getting blood vessels, kind of recruiting blood vessels to them. So there was, it was pretty gnarly really to to have a look at and a friend when I went off to Colombia with her, she said, she said she just remembers seeing me in my bikini and just these huge tumours being there. So it was really, it was a daily reminder that I had cancer. And I did start to feel like my body was betraying me in some ways. And yeah, when I was on my yoga mat, when I was practicing yoga, I felt so strong and it was so strange because I remember thinking, there is no way I can die. This body is so strong and healthy. I'm fine. I'm absolutely fine. But I only had those thoughts when I was on my yoga mat. And then of course, when I was in front of the mirror looking at these rapidly growing tumours, I was terrified. So I think that's why my yoga practice became so important and that led me to go off to India and do yoga qualification. Again, not really at the time thinking I was ever going to practice, you know, teach yoga, but I was so intrigued at how I was able to be on paper so ill and yet feel so strong and healthy when I was on my yoga mat. And obviously that then brought in the meditation and breath work and really introduced me to more spiritual practices, like chanting, which I now love, which I don't do enough, but things like Kundalini yoga and yeah, that was, that was really what was pushing that at the time. And it's the same, the same with being out in nature. I would, I'd always loved being out in nature, but I think I went through a really low period between, so basically when I was diagnosed with stage four and when I had that awful phone call when I was sat in the GP surgery, and unfortunately, I was seen by the Royal Marsden who I have to say, I want to give a massive shout out to because they have been incredible throughout my whole treatment with them. But they basically, they just said, look, there's no treatment for you at the moment. We can carry on cutting out tumours. And by that point, I'd had four surgeries, I think. But it almost felt like it was cat and mouse. They were just chasing, they weren't getting to the root cause of the cancer. They weren't, it was just how long are we going to play this game of cutting these tumours out and yet, literally, the one on my chest wall, they cut out at one point. And the lovely surgeon was so sweet. He said, look, you're a young woman, I'm going to do it really well and tight, like make sure you've got a tiny scar and I'll put this special dressing on that will hopefully make sure the scar heals really nicely, you won't really see it. And he said, but keep it on for four weeks because then that will improve the healing. And when I took the dressing off, the tumours had already sprouted up in that area. So that's how quickly they were coming back. And so I was in this a bit of a sticky position for about three months because the my oncologist at the Royal Marsden just said, look, unfortunately, there is no treatment available at this moment for you. That you are not eligible for any trials and immunotherapy hasn't yet been approved by, well, I think NICE had just approved it, but it hadn't come onto the NHS yet. So he said, hold tight, which are not words you want to hear when you've got stage four cancer. Hold tight, potentially in the new year, the treatment will be available. So I had such an awful Christmas that year because I knew I had these rapidly growing tumours and yet there was no treatment other than keeping potentially cutting them out, which was not ever going to get to the bottom of it. By that point, you know, I had the tumours in my lung and my adrenal gland as well. And so I just went through a bit of a low patch and the best thing had happened that my brother had bought a puppy, a Vizsla puppy, which I mean, they're just so great. And then he had to go up to London for six months. So I actually inherited a puppy at the most ideal time because I, dogs are true therapy. So I had this puppy that had so much energy and needed walking every day. And that pushed me to get up off the sofa because I definitely was looking back depressed during that phase, or at least I was just totally numb. And yet I was out in nature every day walking this puppy, even when I didn't feel like it. And just spending time with myself and reflecting on my situation and that gave me a lot of compassion. I used to notice that I'd started saying to myself just quietly, you know, in in my head, you are doing so well. Given everything you're going through, you are doing so well. And there's something so soothing and powerful about that compassion, which I don't think I'd had to about like to myself. I don't think I'd expressed that to myself prior to that. And yeah, just walking is so therapeutic as well. Just putting one foot in front of the other, it was a real mindful activity. So there was a few things that just popped into my life around the right time that helped me to just get through that. And then I was so fortunate. It really was divine timing that in the January, I was one of the first patients to receive immunotherapy and yeah, I had an amazing response. I think it really helped that I'd had the four months to focus on my gut health prior to starting treatment. And within four or five months, I was no evidence of disease and I just had a scan two weeks ago and that's so I'm now four years NED, which is just amazing.

Dr Rupy: That is amazing. That is absolutely amazing. And you the the four months of gut health, what what things were you doing there? Because I mean, we can talk about the yoga and and how mindfulness is super important for gut health, but in terms of the food, did you do anything specific or was there

Dr Lauren Macdonald: So I was just, I'd I'd gone away and looked up the prebiotics, the probiotics. So prebiotics, Jerusalem artichokes were a big part of my diet, which if anyone's had, they make you so bloated, but I just I'd eat them really every night. So they were so they were big. Um, just anything containing inulin I was having, anything like asparagus, things like slightly green bananas, anything that could basically feed my gut microbiome. And then on top of that, I was having my kefir and my sauerkraut and taking a probiotic. And of course, obviously because it's the mind-body connection, it doesn't just go one way. So I was trying to reduce my stress levels and I was trying to be mindful and trying to get lots of sleep, which obviously your gut bugs love. So there was a lot of that. By that point, I was just, yeah, just having lots of fibre was was just a big thing. But I've been doing that for years by that point with the juicing and and eating lots of veggies.

Dr Rupy: Yeah, yeah. And so, um, I one of one of the things that I always speak to patients about is, um, how to a, recognise stress and stress is kind of like one of these umbrella terms that I think is just so all encompassing and it doesn't really personalise it to the to the person. Um, but how do you recognise when you are dealing with a whole bunch of emotions that you can't really deal with on a daily basis and how do you take those small steps to improve that bit by bit? Because it's it's easy for someone to say to someone else, you know what, you need to chill out a bit more, you need to, you know, maybe do some breath work and stuff. But what are the steps that you took and what do you what do you feel is quite effective for people?

Dr Lauren Macdonald: Well, first of all, I think the most unhelpful thing you can ever say to a cancer patient is just relax or it'll be fine or, you know, all of these comments that you hear and people have always got the best possible intentions, but actually it causes you just so much extra stress because inside you're thinking, but it might not be okay and I'm feeling really stressed and I don't know what to do about it. And of course, you're sitting there without cancer, you know, tumours in your body. So, so please, anyone listening, don't say that to anyone with cancer. That's just not helpful. Uh, just say something like, I am here for you. If you want to talk, I'm here. What's going through your head? Let's talk. And that in itself really helps reduce stress, just so that you know that you're being seen and heard. That's a powerful way that you there's no better thing you can do for a friend really. And beyond that, I think stress is so personal. We have this kind of window of tolerance and obviously and and you'll have probably seen that arousal curve as well where a little bit of stress is actually quite good for us. And then we can peak and around the middle, we can just about cope and then we go over the other side and that's really it depends on what kind of personality you are. As I said, mine is a real numbness. I know when I'm super, super stressed because I basically stop feeling. It's my coping strategy, it's what I do. For other people, they may be running around like a headless chicken, you know, they they might notice how they're expressing it. And other people might go super introverted. So, I think first of all, self-awareness is the most important place to start. Once you know a little about about your how you respond to stressful situations, and then taking it from there. So it might be that you know that when you're not sleeping well, when you're feeling a bit craggy, when you're snapping at your partner, that it's time to bring in some more practices like the meditation, yoga, maybe just walking outside in nature. And for other people, you might notice you've started to withdraw or to become quite quiet or you're not socialising that much. And that can be your stress response. So it is really, really individual and I think that's why it's so important to get to know yourself because people around you, they might pick up on it, which is helpful, but really only you know yourself, you know what it feels like inside.

Dr Rupy: Was there any sort of like, um, healthy skepticism or reservation when it came to meditation or Vedic mantras or chanting, that that kind of thing? Or were you always sort of open-minded about it given your situation?

Dr Lauren Macdonald: I think I was just open to anything by that point. I just thought whatever, if anything could help me. And I had a really powerful experience when I was on my yoga teacher training. It was during a meditation and we'd actually been asked to lie down. And I don't know how long I've been in that meditation. I definitely wasn't asleep. I knew I wasn't sleeping. But I felt like I was levitating and there was just golden light all around me and flowing through me. And at that moment, I had a really deep knowing that if there was any cancer cells left in my body, that they were being eradicated. It was just this incredible experience. And I actually went and spoke to the meditation teacher afterwards because I'd never had anything vaguely, you know, I'd never experienced anything like that. And he just smiled in his like gorgeous Indian way and said, yeah, this is just meditation, this will happen. So I think from then on, I've never had an experience, you know, since in meditation like that. But it just made me realise there's so much we don't understand about the human experience and the way we interact with not just the world, but the universe and the cosmos. So, yeah, I'm definitely very open-minded. There's been lots of experience that have just made me think, um, there's something more going on than than what's right in front of us.

Dr Rupy: Brilliant. So fast forward, it's been four years since you've you've had that first scan that was clear. Um, what have you been doing and how have you developed more of your interest in integrative medicine, um, environmental medicine, mindfulness-based therapies? Um, what what what has, yeah, what's your journey been like post cancer?

Dr Lauren Macdonald: So I've been exploring lots of different things. Uh, I definitely, I think everything that I read about and learned while I was ill, just there was so much there that I was fascinated by. So I have been obviously practicing yoga. I went off and actually ran some retreats, which is a wonderful experience. I really love bringing people together in community. There's, I think we haven't really touched on that, but there's something so powerful about being in community and sharing experiences and really showing your truth as well, which can happen in a nice kind of ceremony or circle. So I have been doing a little bit of that. I did a bit of coaching online. I tried that for a while. But again, just like we talked about at the beginning, I could feel that my boundaries, my energy was really being zapped by that. And that was because I was speaking with cancer patients and I really wanted to help and support people, but I realised one-on-one that wasn't really going to help me. So I tried that for a while. I have just, as you mentioned, I've been doing my podcast, which has been an amazing experience. I'm having a bit of a break because I've just moved back from Australia. So I've been over in Australia for a year, which is, I mean, that should probably have been the first thing I mentioned. Yeah. I was waiting for when that was going to come up. I should have mentioned that first. I've been over in Australia, which has been lovely. It was so great. I just had such an amazing experience. I know we've got quite a lot of mutual friends over there. And yeah, so then I was doing the podcast and an online group membership, which again was just amazing, lovely way to connect, especially during COVID, connecting online. And I have landed back in the UK in Brighton and I've gone back to work. I'm back in psychiatry. So it's been a bit of a, yeah, lots going on, lots of, I've just put my fingers in lots of pies and I've done lots of trainings and I've just finished a year training with Gabor Maté on compassionate inquiry, which is a therapeutic tool to help people with trauma and just help you get back in your body, which is so important if you've gone through anything, whatever it is, be it a, it can be, you know, a childhood experience, a car accident, a cancer diagnosis. I think we really quite often disconnect from ourselves, from our bodies. And we were talked earlier a little bit about compassion and how important it is. That was an amazing training. And I did an environmental medicine training and that was combined with the nutrition. So that was interesting.

Dr Rupy: Yeah, tell me a bit more about that, the environmental medicine, um, because I'm fascinated in that subject.

Dr Lauren Macdonald: So that's more, so this is something that I, again, really didn't know anything about before I was ill. And it kept coming up that people were saying, you know, you need to look at the water you're drinking and the air that's in your house and whether you've got mould or toxins and what you're putting on your skin, whether you're using organic products. And before I hadn't even considered this really. And so that was, yeah, that's environmental medicine. It's really looking at beyond the food that we're putting in our body, beyond how we're exercising, how we're sleeping. It really just takes it to that next level because I think so often we're focused on just ourselves and actually we need to look at, it's a bit like an onion, you know, you have those layers and you need to just look, okay, what's going on around me and as a simplest form, the environment is going to be, you know, your home environment, how you're living, what's around you. But really it's also who you're interacting with, your community, which is so important. And environmental medicine, as we know with the climate crisis, I think it's just going to become a more important thing in all areas of medicine really. At the moment with the air pollution and yeah, I'm not going to open up a massive can of worms, but there's there's so much there that I think will will be so important moving forward as healthcare professionals, but also as the general public, just being aware that our planet health, how we treat our planet is how we treat ourselves. And our health is entwined with the health of our planet, whether it's the soil or whether it's plastic pollution. So, yeah, lots, lots there to learn and I'm very much at the beginning of my journey with that.

Dr Rupy: Definitely. And you know, it's funny because I feel like our journeys through lifestyle medicine or integrative medicine, whatever you want to call it, have been fairly on that same sort of trajectory. You start with nutrition, you then go into sort of meditation and and other sort of exercise medicine, and then you you know, you find out about sleep and stuff. Environmental medicine, the impact of us on the soil, different farming methods, all of these are topics that I feel like I really need to educate myself on and get some expert advice. They are seen as quite fringe topics right now. And I think it's because people are scared of scaremongering, I guess. Um, and perhaps there is a lack of evidence about, you know, the impact of pesticides or, you know, inorganic products and that we absorb through our skin. But I think pragmatically speaking, it's quite important to make sure that we're reducing any chance of harm onto our bodies. And and if people can make that choice, then I don't think they should be ridiculed for it. Um, and I see that a lot actually amongst medics like, oh, that's just rubbish or, you know, this is scaremongering or they're just trying to push products or whatever. But I think there are some elements of truth in it that we need to further explore. I don't know, I don't want to open a can of worms, but that's my thought process behind it anyway.

Dr Lauren Macdonald: Yeah, I think it's the natural evolution as well. If you become interested in lifestyle medicine, you realise that actually you just can't stop with the self. It has to evolve, it has to become who's around you, what's around you, how you're living and then ultimately the planet. So I think it will just continue. You know, we're seeing such a growth in lifestyle medicine in the last five years. So I think this is just the way it will go and the more that we learn and find out about it, hopefully the more people will just wake up to the importance of it because that's it, I just didn't know about it. It's definitely nothing, it's not on the curriculum at medical school at the moment at least. And I know you've managed to get culinary medicine on there, so it'll be so amazing to see a planetary medicine module at some point because we just can't ignore it anymore.

Dr Rupy: Yeah, absolutely. Or on our modules, we've got sustainability as a start. Um, but I think definitely looking at the impact of plastics on our environment and our drinking water and, you know, the impact of microplastics. I think it's becoming a bigger topic that's hard to ignore. Um, and I think yeah, we definitely need to address that, um, particularly with all the associations that may be true. Um, I remember vividly actually, uh, seeing you for the first time, I think it might have been 2016, uh, since Brighton. And honestly, Lauren, you were just so full of life. And I I one of our mutual friends was, um, was saying, you know, oh, she's just come through cancer therapy. And I was like, yeah, I remember hearing about it. And yeah, you were like just so full of energy and it was really refreshing. And then you were interested in what I was doing because I just started the doctor's kitchen. And I remember that that that memory sort of etched into my mind, uh, and so that, you know, I just wanted to say, I really do appreciate what you're doing and uh, and how you're sharing it and in an educated and, you know, informative way. It's it's really inspiring to watch.

Dr Lauren Macdonald: Oh, thank you. It's so, it's so great as well because I remember you were right at the beginning of the doctor's kitchen and it is amazing to see what you've done with it in the last five years really, isn't it?

Dr Rupy: Yeah, it's not even five years. So the feeling is absolutely mutual.

Dr Rupy: Now you're in psychiatry, you just started training.

Dr Lauren Macdonald: Yeah.

Dr Rupy: You've got an interest, yeah, just started. Um, you've got an interest in psychedelics already and the impact it could have on on helping people, um, both I guess with a psychiatric complaint, but also with end of life as well. Can you speak a bit more about that subject or is it quite early?

Dr Lauren Macdonald: No, it's absolutely fine. I think if anything, it's it's important to talk about it, both in terms of a professional level, but also on a personal level because there is such a stigma. You know, we're we're talking about years of hearing about the war on drugs and drugs are bad. And yet all this new research in psychedelics is so promising and my entry point was the John Hopkins now almost famous studies because they looked at psilocybin for end of life or at least stage four cancer patients with anxiety, depression, existential crisis because obviously it's terrifying when you get a cancer diagnosis, especially when you're nearing potentially the end of your life. And we definitely don't talk about death enough at all, you know, it's it's so hidden in most of at least Western culture. And the studies showed that a single dose of psilocybin, and this was done in a very controlled setting with the correct set and setting with a therapist, helped people to, not everybody, but the vast majority of patients to have such deep meaningful experiences that even years later, they were still reporting, because not everybody died, some even went into remission, not obviously because of because of that journey, but they were still reporting very little anxiety, more peace, more kind of ability to look at death through a different lens, knowing that actually this wasn't necessarily the end. This might be the end of your physical body, but actually there's more to to everything, there's more to the to the universe and we're just energetic beings at the end of the day. And when I read this research and I listened to Roland Griffiths, who is just such a lovely man, he was the lead of the study. And yeah, since then, I just been fascinated with it and it's amazing to see places like St Vincent's in Australia, they're currently doing a study with end of life patients, again, looking at anxiety and depression levels. And there's lots of other places in America and obviously we've got Imperial College here, headed by David Nutt and Robin Carhart-Harris. And it's it's my interest is definitely the role it has for people with cancer. And I think not only patients with cancer, active cancer, but actually people afterwards because I think so often that's a forgotten community of people. You know, you go through this such challenging experience where you're potentially preparing your will, as I was, you know, I had a conversation with my dad about how I had to get my will in order. I wrote down all my passwords for various things so I could hand it over to my parents. You go through this huge, essentially trauma, and then you're spat out, if you're fortunate enough to survive, you're spat out the other side with not that much support. So I think there's also a role in my eyes for patients on the other side, if they feel called, you know, I don't think it should be part and parcel of cancer care, you know, everyone's entitled to to their own opinion, but if people, if patients feel that it could help them, if it could be part of their toolbox, their holistic toolbox for healing from cancer on a on a more kind of spiritual, mental, you know, psycho-emotional level, I think it's so powerful. And obviously then there's the whole array of research now looking at the uses for mental health and psychiatry in terms of depression, addiction, there's so much there. So it's just a fascinating field and yeah, I'm really excited to be entering it and just hope that governments will listen to the research because it almost feels more criminal to not have that experience as someone who, I'm going to be really honest here, I have had my own experience. I went off to the Netherlands. I've spoken openly about it on my podcast and had a psychedelic assisted journey with psilocybin just last year and it was so powerful and healing. And this is me, I was already three years in remission by that point, but it's so interesting what you hold on to and what you've buried without even realising. As you mentioned very kindly, I was, I looked very well, I I I did feel really well inside and yet what came up for me during that journey was a lot, you know, I was crying at times, I was really letting go. I actually, it's really difficult to put into words what you see in a journey, what you experience in a journey. And the one thing that I I really want to share with you is that I actually met, so I so I I felt like I was just energy. I'd left my body. I was really peaceful. And while I was in that state of being on another realm, I don't know, I don't know, I can't put it into words properly, but I got to communicate and meet several of the cancer patients who I'd been on the chemo unit with who had since died. And we got to have really beautiful conversations about how they hadn't really, they weren't really gone, they were still here and they told me it's all okay, you don't really leave, you never truly leave, you just you do leave your body, but we're still here. And to have that experience, I have since, it's so mystical and it's so, you can't really put it into words, but it's a deep peace and a deep knowing that you get from having an experience like that, knowing maybe there's something more than what we that we we know to be true right now. So that's why I'm I'm really passionate about helping especially cancer patients get access to this medicine.

Dr Rupy: Definitely. I mean, I can hear it in your voice and I think anyone listening to this would love to have you as their doctor, regardless of whether that's in psychiatry or general practice or whatever else that you end up doing in the future. Um, but honestly, Lauren, thank you so much for sharing your experiences. Uh, I know this is going to be super helpful for people, but even, you know, those who are fortunate to not have a loved one with cancer at this point in time, just sharing those experiences, I think it's it's super inspirational for people to even entertain, you know, spirituality and everything and all the things that we don't know as medical practitioners, um, in the conventional sense of the word. So, so thank you.

Dr Lauren Macdonald: Oh, thank you so much, Rupy. And can I just finally say, I I'm really aware that I'm in such a privileged position to have had stage four cancer and now have no evidence of disease. And and so many people never get to that point. And yet, one of the biggest lessons I've had in the last five years is the difference between healing and curing. And during that period of having active stage four cancer, I was so fortunate to experience what I would now describe as deep healing. You know, a deep inner peace, a calm, which is bizarre to speak out loud, but I remember thinking, wow, compared to when I had, you know, my first diagnosis and I was so frantic and petrified and felt anything but healed, it was amazing to go through that and have that. And then I think equally, you can be cured and not be healed. So I think anyone who who has active cancer right now, who's going through a really tough time, first of all, don't beat yourself up about it. This is, you know, I did everything I could when I between stage three and stage four, I threw the kitchen sink at it and it still came back. So cancer is just one of those things. You don't know how it's going to play out. It's as we know, such a difficult disease to treat, although we are getting some more amazing therapies. So, yeah, just be kind to yourself, be compassionate. And yeah, just just know that you can experience healing even if you aren't cured, which is is quite amazing and I think should be taught more again at medical schools. We don't really talk about healing enough. We talk about maybe healing a broken leg or healing a wound. And yet, we can all heal no matter what we're going through, even if we aren't cured.

Dr Rupy: Yeah, I think that's a the perfect way to end our conversation there. I think and it's the thing that stands out to to me and your website is the first thing. And I love that that that quote that you've got up there about how you can, you know, you can be cured but not healed. And this is actually, you know, part of the journey or part of your journey is actually post what happened. So it's great. Lauren, this has been brilliant. Honestly, it's been really good. I feel like I've got closer to you as well, like learning your story and, you know, yeah, it's been great. Really, really good.

Dr Lauren Macdonald: Thank you so much. And I look forward to finally coming up to see you and maybe having a meal, maybe.

Dr Rupy: Definitely. Some Jerusalem artichokes on the menu.

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