Christie Watson: And I got really, got really bored, fed the ducks one day and had a semi-frozen loaf of bread because I hadn't thawed out the bread. And I remember just throwing this bread in the duck pond and it hit a duck. And I thought, I saw the duck's leg kind of move and I didn't stay to see what happened because I thought I've killed a duck, right? I need to go back to work or I need to do something. This is how I got into writing. By killing a duck.
Dr Rupy: Welcome to the Doctor's Kitchen podcast with me Dr Rupy and today I want to introduce this podcast with a quote from my guest's latest book, The Language of Kindness. Come with me on the wards from birth to death. Pass the special care baby unit and the double doors to the medical ward. Run through the corridors to answer the crash bleep. Pass the pharmacy and staff kitchen and to the accident and emergency room. We explore the hospital itself as well as nursing in many of its aspects. What I thought nursing involved when I started, chemistry, biology, physics, pharmacology and anatomy. And what I now know to be the truth of nursing, philosophy, psychology, art, ethics and politics. We will meet people on the way, patients, relatives and staff. People you may recognise already, because we are all nursed at some point in our lives. We are all nurses. Christie Watson is a bestselling author with a specialist interest in nursing and mental health, having spent 20 years working as a nurse in the NHS. She holds an honorary doctor of letters for her contribution to nursing and the arts. She's a patron of the Royal College of Nursing Foundation and her non-fiction work, The Language of Kindness, published in 2018, was a number one Sunday Times bestseller. It was book of the year in the Evening Standard, the New Statesman, The Times, The Guardian, The Sunday Times. It's been translated into 23 languages and spent five months in the Sunday Times top bestseller list with good reason. We're taking a slight turn from our usual chat about nutrition and lifestyle to talk about this fascinating and as important topic that impacts our wellbeing to the very core, kindness. We have a candid chat about stress, burnout, depression, the politics around the NHS. It's a real different chat that we're having today, but I think you will find it absolutely fascinating and useful as well. Christie Watson is a force of nature. I'm so glad our paths crossed and I'm sure they will cross again. She's already doing another piece of non-fiction work that is going to dive deeper into the aspects of social care that are impacting primary and secondary care. And although it does seem a bit doom and gloom sometimes as we're having this conversation, I think people like Christie Watson who don't shy away from the facts are super important for the alleviation of a system that is overburdened at this point in time. You can find the recipe that I cooked for Christie, the aubergine curry on my YouTube channel, The Doctor's Kitchen, and you can subscribe to the newsletter where we give science-based recipes every single week. Give this a five-star rating if you loved it, but for now, on to the podcast. So you said that you like, don't have any dietarys and you like spicy food. So I thought, okay, fine, I'll make you a curry. And I'll make you something inspired by what I try and tell the healthcare staff at my hospital what to eat and big batch foods that you can bring for lunch the next day and that kind of stuff. But then I realised it's 9:30 in the morning and I'm making you a curry, but you don't mind that. So I'm making you an aubergine and lentil curry. We've got fennel seeds, some fenugreek seeds, black mustard seeds and some cumin as well. Some garam masala, some tomato, some tomato puree, sorry, tomato puree here and this is canned tomatoes, coriander. These are some lentils that I've just got from a can, but you can make them yourself just by cooking them for about 20 minutes or so. Just some like standard grey lentil and green speckled lentils. And then this aubergine, all I've done is cube them and then roasted them dry with no oil, just to sort of dry them out for 20 minutes in a hot oven and that's it. And that's a really good hack. I always have like, steamed potatoes in my fridge or cooked butternut squash so you can quickly throw them into curries and dishes just to bulk them up a bit more. We're going to start off with the holy trio, ginger, garlic and onion, Indian cooking and lots of different cuisines actually, even you know, like French and. So we're going to go for that. And yeah, hopefully it's going to be delicious.
Christie Watson: I'm sure it will be. I'm holding you to account.
Dr Rupy: Yeah, yeah, for sure. So this is like an odd question for me to ask you because after having read your book, I feel like I know so much about you and your background and how you grew up and stuff. But just for the listening audience that perhaps haven't come across you before, which is very hard not to because you're a Sunday Times bestselling author and you're incredible. Give us an introduction into you and and how you started on your journey.
Christie Watson: Um, where do I start? So I I I didn't ever want to be a nurse. I was one of those really precocious, flighty teenagers who went through every career idea known to man. I wanted to be a a jazz trumpeter, an astronomer, a lawyer, a dentist at one stage. Everything I could possibly think of. And um, I even went to agricultural school actually to become a farmer. Because I was really interested in, I suppose, animals and farms, even though I grew up on a council estate in Stevenage. I'd never even been to a farm kind of thing. The only animals I'd seen were pigeons. So I had this romantic.
Dr Rupy: How did you think about the farming then?
Christie Watson: I don't know. I think I just romanticised and fantasised about everything. So I imagined sitting in the sunshine and eating cheese and pickle sandwiches and that must be what farming is like, right? Um, so I went off to agricultural college and and uh, and found out it really is not like that at all. So I left within two weeks. And then I, I didn't, I think my parents by that point were so exasperated with me. They'd bought me some quite expensive farming stuff, like rubber-soled boots and stuff like that.
Dr Rupy: Really?
Christie Watson: Yeah, that I'd begged them for because I said, this is it. This is my final decision. I'm definitely going to be a farmer.
Dr Rupy: So expensive wellies and stuff.
Christie Watson: Super expensive coat, super expensive wellies. We didn't have any money. You know, I was really adamant that this is what I was going to do. And so when I left farming after two weeks, I think they they were just so tired of me and I was tired of myself. And I just sort of fell into nursing. I didn't have anything to do. So I went to volunteer. And for the first time ever, I was around these nurses. And I just remember being in total awe of what they were doing. And it was it was really hard to uh, describe in a way how much I admired them because I really did straight away. And I thought, I wonder if that's something I could do. Told my parents and and my dad actually laughed out loud when I said, I think I'm going to be a nurse.
Dr Rupy: Really?
Christie Watson: Yeah, I just don't think he could picture me being a nurse at all.
Dr Rupy: But could he picture you being a farmer?
Christie Watson: I just don't know. I think by then they were just, they'd had enough. They were lovely and they just had enough. But um, so I, yeah, I went off to nursing school at 17. And yeah, I pretty much loved it straight away. I did find out during my first week that I'm scared of the sight of blood, which is not ideal.
Dr Rupy: I remember that in your book. Yeah.
Christie Watson: Yeah. So I fainted when I had a blood test, which is again, but I was so determined by then that this this career would stick.
Dr Rupy: Because you were quite um, you were quite an activist when you were younger, right? You were quite open-minded and you were vegetarian, I think at one point.
Christie Watson: I was vegetarian. Veganism wasn't really in then, but I would have been vegan, no doubt.
Dr Rupy: Yeah, yeah, absolutely.
Christie Watson: Um, so you sort of had that sort of mindset, right? Like, you know, do good and. Yeah, I was really into animals. Really into animals. And I suppose I was quite political. If there was a march, I'd be on it. If there was something going on, then I always wore those badges and I was quite an angry teenager, I suppose, about the world. I mean, if I'd have been around now, I would I'd have been on every march. Yeah, exactly. I'd be outside number 10 today. Um, so I was that sort of person and yeah, it was nursing was really great because I could channel that activism into helping people.
Dr Rupy: Yeah, yeah. That's a really good way of describing it, I think, channeling that activism because you know, they are essentially the unsung heroes of the NHS and I think there's a lot more recognition for them now. And I think your book really heightened that, um, massively because I remember you saying in a couple of interviews, there hasn't been a biographical book written by a nurse since Florence Nightingale.
Christie Watson: Yeah, well, I when I had the idea to write the book, and I'd written two fiction novels before this, um, but it didn't occur to me to write non-fiction and it certainly didn't occur to me to write about nursing at all. And I went to the library to see what kind of books there were out there. And I'd always loved medical narrative non-fiction.
Dr Rupy: You should write some, Rupy.
Christie Watson: Yeah. Um, yeah. Uh, but I've always loved it. And I think my favourite writer of all time is Oliver Sacks. And so I've always read the kind of philosophical musings of doctors about what it means to be a doctor, but never thought, hang on a minute, I could I could do the same about nursing. Yeah, yeah. Um, and I went to the library to look what's out there and there was shelves and shelves and a whole genre of medical fiction written by doctors celebrating what it means to be a doctor, but nothing, nothing by nurses. Except Florence Nightingale's notes on nursing.
Dr Rupy: So was that the catalyst for you to be like, okay, now, because at that point you'd written two books, right? You'd written two novels. How on earth did you get into that first of all?
Christie Watson: Um, so I was on maternity leave actually when I uh, started writing. And I was really bored. I I was so bored. I probably shouldn't say this, because it's not something mothers should say, but I was so bored. And maybe it's because I'd been nursing my whole life. You know, I was a senior sister in in pediatric intensive care. I was used to a really, really busy long day. And my daughter just slept. And I remember I remember taking her.
Dr Rupy: So many mothers are like, I wish my daughter would sleep. I wish my child would sleep.
Christie Watson: She slept all the time, but we I took her to feed the ducks. And and the other thing is that you kind of fantasise, or at least I did when you're on maternity leave that there's going to be this whole gang of really cool mums that you're going to hang around with. And I just didn't know any or find them until much later. And so it was kind of just me and her and and some, you know, people just wandering around the park. And and I got really, got really bored, fed the ducks one day and had a semi-frozen loaf of bread because I hadn't thawed out the bread. And I remember just throwing this bread in the duck pond and it hit a duck. And I thought, I saw the duck's leg kind of move and I didn't stay to see what happened because I thought I've killed a duck, right? I need to go back to work or I need to do something. This is how I got into writing. By killing a duck.
Dr Rupy: I wasn't expecting this.
Christie Watson: I know, I know. Well, I haven't thought about this for a long time, but yeah, it was killing the duck that propelled me to do something. And um, and my poor daughter just needed me to be out of the house, I think. So I went and did a.
Dr Rupy: She was just scarred for life after she witnessed her mother kill a duck.
Christie Watson: She's vegan. Okay, right. Explains a lot. Um, so yeah, I went to do a creative writing course, a short course at the Mary Ward Centre, which is next to Great Ormond Street actually. And it's like an evening class. And it was a beginner's creative writing course, really mixed bag group of people. And I just loved it. I absolutely loved it. And the short story that I wrote was the first creative writing I'd ever done really. And it went and it went on to become Tiny Sunbirds Far Away, which is my novel.
Dr Rupy: Yeah, which I I have to admit, I haven't read actually. Um, but it's definitely on the reading list.
Christie Watson: Yeah. For me. It was fun writing. It was so much fun writing creatively. And I went off and did an MA then at University of East Anglia in creative writing. And I carried on nursing at the same time.
Dr Rupy: Wow.
Christie Watson: So that's how I got into writing by killing a duck. It's a long story. It's true.
Dr Rupy: That's brilliant. No, that's really good. And you were managing your career at that time, um, you know, being a parent, being a nurse, exploring a new career, all simultaneously. How on earth did you keep up with all that kind of stuff? What was your sort of coping mechanism?
Christie Watson: I look back and think I was working silly hours in in all of the things. But I think that was probably the happiest year of my life when I was doing the MA because I just loved everything I was doing so much. And I was passionate about it. And yeah, it just felt, it just felt such a privilege to be able to not only find one job that I completely love, but two jobs that I really love. And then also to parent this this great little girl. So it was it never felt like a hardship. It never felt like, oh gosh, I've got to go to work, the Sunday night blues. I've never had that. And I feel really blessed to be able to not have ever had that.
Dr Rupy: Yeah, yeah.
Christie Watson: You're probably the same.
Dr Rupy: I I'm similar in that I was just going to say one of my one of my best mates from Australia, he loves going to work. He gets there early, he meditates now for like five minutes before going into a shift because he works in A&E, so it's a high pressure environment. And um, he just loves that feeling, that smell as soon as you get onto the ward, the business of it.
Christie Watson: Yeah, the smell.
Dr Rupy: Yeah, the smell. Yeah, like that that sort of um, uh, distinctive clean smell, sometimes not always clean, but um, that that distinctive smell that you have when you walk onto an A&E uh, um, ward. And it's, yeah, I I I I have have that sort of thing now that I'm able to marry my clinical work with all the other stuff I'm doing outside it. But I think I went through a period of time where I just faced, and I'm sure every NHS worker has gone through this, where I just faced complete burnout, where I lost affection for the job. And uh, I kind of lost a bit of empathy, I think, um, simultaneously. I wanted to talk about, we're getting into this a bit early, but I think it's a good point to talk about it now because.
Christie Watson: I'm not crying because you're making me emotional. It's the onions. Although you are making me emotional. And I do feel empathy for you. It was at that moment that small tear came out and I didn't want you to think, wow, she's so empathetic.
Dr Rupy: I mean, you are super empathetic. I wasn't expecting that, Christie, but yeah. Um, I wanted to talk about because uh, at one point in your book, I think you describe something like that where you're working and you had a few issues, I think you were just um, had a few personal issues and you lost the love of the job, which you you reignited a bit later with a beautiful story as well. But yeah.
Christie Watson: No, I am really crying now. I'm not. Um, I think it I think it it's so tricky, isn't it? Because it's such a complicated issue, burnout or compassion fatigue or depression, whatever you want to call it.
Dr Rupy: Compassion fatigue, that's a.
Christie Watson: Yeah. I think I do wonder whether burnout is just a term that we hide behind with language as medical professionals because you because we don't want to say that we're depressed.
Dr Rupy: Yeah, yeah.
Christie Watson: Um, and I think that's a bit problematic. But I certainly felt depressed or burnt out or compassion fatigue, whatever you want to call it. And um, and that was partly because of the job and the pressures of the job and the longevity of it, because you do after so many years start absorbing everyone else's grief and trauma. In the same way that if you work in infectious diseases, for example, you're risking infection every day. If you work in A&E or critical care, you're absorbing some of the most um, significant moments of people's lives and quite often they're horrific. So that accumulates over time. And yeah, I definitely felt that that alongside personal issues is the thing that was the trigger for me. Um, and I spent a good, I suppose, couple of months feeling numb, uh, I remember being unable to cry, which is really worrying. Yeah. It's a real clinical marker of serious issues. Um, and then this little girl that I was looking after called, I've called her Charlotte in the book and everyone's got different names. She came in with sepsis, um, and she was, she had three nurses to look after her, just her, that she was that sick. So she was probably the sickest kid I've ever looked after. She had a meningococcal sepsis and she had a pH of 6.8 or something. I mean, everything, everything was incompatible with life. We didn't, we didn't think she'd have any chance of survival whatsoever. And actually she lost her limbs. Um, but she did survive. And she came back into the hospital some time later on prosthetic limbs with her mum and was, you know, just a normal young child who was laughing and smiling and full of life and full of joy. And I remember thinking at that time, this is, this is for me the thing that prevents or protects me from burnout. It's those moments when you think people's will to survive at all costs, particularly children, I think, they've got this incredible capacity to head to survival no matter what and find joy no matter what. And I, and I sort of, she helped me recover. Yeah. So that was quite a powerful thing. And that you always, I think, get the most from your patients. That they're the people that, because, um, whenever I'm asked about burnout or the job or the pressures of the job, it's never the patients that are the pressures of the job. It's the system, it's the organisation, it's the, it's the staffing, it's the politics, but it's never the patients. The patients are the ones that actually help keep you going, I think.
Dr Rupy: Absolutely, yeah. Like purely from a like a managerial point of view, and I I hate to just put everything on the managers and everything else, but the way the system is run is the most frustrating thing about the NHS and the thing that gives me the most anxiety about it as well. Um, and it's the threat to the survival. It's actually, we like to hide behind the fact that, you know, we have an aging population, we have high patient footfall, and yes, all those things are true, but purely if it was run a lot more efficiently, which it has the capacity to do so, we would be able to cope, I think. Um, because we're already coping right now with a broken system. So, yeah. And I think.
Christie Watson: What would you do to?
Dr Rupy: What would I do? So I'm really lucky.
Christie Watson: Before you ask me.
Dr Rupy: No, no, no, don't worry. I'm not, I'm not going to ask you. It's it's an impossible question to answer. And I get asked this a lot. And I'm just like, what do you expect? I'm just cooking food. Like, you know, trying to get people to to think about their self-care a bit more. Um, and I know it's a very emotional uh, topic, which is why you're crying still. But uh. I can cry. Yeah, yeah. So I'm really fortunate to be part of um, the clinical entrepreneurship program, which is run by Innovations, uh, NHS Innovations with Professor Tony Young. And it it really gives me a lot of hope because we are given insight into the most entrepreneurial people in the NHS. We have a a staff of over a million people and there is so much ingenuity in that staff base because these are people on the front line who know exactly what it's like to work in the system, have thought about uh, thought laterally about how it can be improved and actually doing things and coming up with innovations. So a friend of mine has come up with this um, uh, it's an app where it allows you within 15 seconds to take a picture of a non-clinical issue that is slowing down your your clinical um, time. So a broken light bulb or um, the infectious uh, the um, blood culture bottles that have run out again on ward three. You know, those little things, they build up and they're the reason why we're we are slowed down and the reason why we have frustration and all that kind of stuff. Because otherwise, generally what happens is you go and ask the HCA or the nurse, like, where is it? And it's not their responsibility. Whose responsibility is it?
Christie Watson: Yeah. No, I met a nurse recently and speaking of those small innovations that make a massive difference. I mean, they happen all over the NHS. So many people doing such great work despite all the pressures. And she was working in a a homeless hostel. She was a parish nurse in Dundee, working in a homeless hostel. I spent the day with her. And she was described to me as the kindest nurse in Britain. And I totally agree. It's just I just fell in love with her straight away. Um, because those people, she she just, you know, this was a room full of people who had all kinds of issues. Some of them bounced in and out of prison, some of them were on remand. Everyone had substance abuse issues, they had long-term mental health problems. And she just uh, put the karaoke on. Said, said, if you have time, if you're busy judging these people, you don't have time to love them. And she really did love them. But what she'd done in an innovation way is she had made a street map of Dundee and she'd given them an actual physical map and shown the times and the points where they could get dental treatment, where they could get food, where they could get their lunch, whatever, whatever it was, this this hostel will accept you at night on this night. And it was just a map and it had made so much difference to these people's lives. Um, and she was a band five, she's a band five nurse in Dundee that we don't hear about. And what I'd love to see is these things being uh, you know, these people being championed and also the linking up so that that can happen all over the country. So that people's voices are not so quiet that actually listen to rather than the sort of bombastic political voices that we hear. We should be listening to those people like you said, the frontline staff who are on the ground having great ideas.
Dr Rupy: Exactly, yes. And I think that's what you did so well in your book because you married like the brutality and the and the real sort of um, nuts and bolts of of clinical medicine with the softer, as important touch of kindness that is usually on behalf of uh, the nursing staff. And I think it's that kind of marriage of accepting it's not just all, you know, medications and interventions and surgery and all that kind of stuff. There's a huge underside to the NHS that is the reason why we're getting people better. It's and it's and it's kindness.
Christie Watson: Yeah, I think so. And um, this smells amazing, by the way. It's not so good. My eyes have stopped watering now, so don't say anything sad because I'll look mean. Um, it's so, we'll probably talk a lot about the patient population and the state of the world and society really, but the the medical model that we've lived by for so long and revered, it's it's not, it's not cutting it. We know that, right? Because people, because people come in with problems that technology and drugs, not always, but mostly, particularly in uh, primary care, they're coming in with problems that technology and drugs are not going to be able to help at all. And people are suffering with political anxiety, um, all kinds of mental and physical health problems. They've got so many comorbidities. I think the the National Health Service, somebody once described to me as, oh, it's become the national illness service, but I disagree. I think it's the national suffering service now. And how do you alleviate suffering? Well, you don't do it with medicine. Or not the traditional model of medicine that we've seen. You do it with kindness, you do it with food, you do it with information, being able to make people understand their own uh, problems and issues and having having the confidence to be able to do something about it.
Dr Rupy: Absolutely. I I totally agree with that. And I think it's almost like we need to redefine exactly what we mean by medicine. Because I think there's the assumption that when we say medicine, we mean drugs, we mean the hard sort of cold interventions, treatments, um, imaging, uh, surgery, all that kind of stuff. Whereas actually food, uh, exercise, sleep, listening to someone, caring for someone, touch. I remember you talked about skin hunger in your in your book, which I think is a a real interesting um, phenomena that we can improve people's blood pressure, heart rate variability, heart rate, just by giving them a physical touch. Um, it's it's incredible. And I think, yeah, we just need to be a lot more accepting of that. And I think, you know, we we are making small strides, you know, social prescribing is a big sort of um, buzzword at the moment, particularly in the Royal College of GPs. And I think we're we're getting better at recognising that, you know, it has a role in medicine.
Christie Watson: Yeah. But our government's getting better at recognising that.
Dr Rupy: I think so. And I think it's purely, I think it's from like um, patient demand, but also uh, people who work in the NHS demanding it in themselves. And when you experience what it's like to be a patient, you empathise a lot more with the person in front of you. And I think that was my misfortune and fortunate experience when I um, was at Basildon University Hospital and I was um, uh, I got ill myself and I had atrial fibrillation because I I experienced what it was like to be a patient very early on and that sort of experience has never left me. And that's that's probably perhaps why I've ended up cooking people and telling people what to eat for a living.
Christie Watson: That's good though, isn't it?
Dr Rupy: Okay. I've made you uh, this curry. Um, it's a aubergine lentil curry with I've just topped it off with some coriander and um, uh, we've got a whole bunch of spices in there. It'll all be on the show notes. Let me give you a spoon so you can try this. And you can give me your honest opinion as well. Don't worry, I will. There you go. No, it looks amazing. Are you a brutally honest sir? There you go. And there's a little bit of rice there that I've just um, I've made before. So. It's a bit boiling hot, so I might.
Christie Watson: Oh yeah, no worries. No worries. Yeah, yeah. Just take your time. Smells so good. Yeah. I think maybe you should be prescribed on the NHS, Rupy. Just outsourced. You're feeling a bit down. Yeah, yeah. Just come round. Just come round.
Dr Rupy: Yeah. She one of my friends, she was recently um, featured in the Scottish Herald uh, because she started taking patients to the supermarket herself.
Christie Watson: I saw that.
Dr Rupy: You see it?
Christie Watson: Incredible.
Dr Rupy: Yeah, she's great.
Christie Watson: That's what we need more of. This is so good.
Dr Rupy: Good. I hope.
Christie Watson: Do you ever take the nurses food?
Dr Rupy: Uh, I have done. Yeah. So I've got a nurse, her name's Ruth. I hope she doesn't mind me mentioning her. But she always does tea time at 4:00 p.m. always in urgent care. And we always go there and it's usually biscuits and she looks at me and she's like, I'm really sorry, Rupy. I'm really sorry. I'm like, listen, it's fine. You're comforting. It's, you know, it's more than the macronutrient composition of the food that you're giving. It's the fact that you're giving everyone love and you're sharing it. So, yes, we can tweak it. We can add some more nuts and seeds and dried fruits and that kind of stuff. But, you know, the very act of what you're doing and making it regimented, I think is it's more than the food, so.
Christie Watson: This is so good. Good. And yeah, I love Ruth. I I I worked on a neonatal intensive care ward once. And the same thing at at 4:00 in the morning, no matter what was happening, there was a buffet. And a proper buffet, sausage rolls, vol-au-vents. And um, yeah, it it was actually really good for our mental health as a team. And we it didn't do any harm to the patients. It was great for them actually because it meant that we were all ready to go and blood sugar was fine.
Dr Rupy: Yeah, yeah. Probably too high. Yeah, too high.
Christie Watson: I remember this one nurse actually in A&E in um, Monavale in Australia. Oh God, I forget her name now. It was a few years ago. But every, she often worked the night shifts. And every night shift, she would literally come with a cheese platter. And I kid you not, it's 4:00 in the morning, we're sat behind the A&E desk and the doctors and we've got all the little crackers and cheese. It was so like sophisticated.
Dr Rupy: Yeah, it was amazing.
Christie Watson: Yeah.
Dr Rupy: Okay, we're going to enjoy, we're going to take a break. We're going to enjoy this. Um, so not everyone's looking at you while you're eating this.
Christie Watson: Or hearing me crunch.
Dr Rupy: Yeah, hearing me crunch.
Christie Watson: Yeah, there's a lot of food questions I've got for you as well.
Dr Rupy: Oh, yeah, go for it. If you want to ask me food questions, I'm all.
Christie Watson: Yeah, no, it's just because I was thinking earlier, I was thinking about um, particularly when we were talking about the kind of patients that we're seeing in hospital and primary care. Yeah. Um, and people with, for example, really serious long-term mental health conditions. And my fear is that the very people who need your advice the most are the people that are going to be unable to access it. Yeah. They're not going to pick up a cookbook. They're not going to make the lentils. They're not going to be able to do any of that. They're certainly not going to access a device and an app because they won't have one. And so I guess my question is, how do we get, how do we get the the message about food and the importance of it to the people who need that message the most? Because the wellness industry, the people that have taken it on board, it's fantastic and it's great. But these are the people I would suggest who've got mild issues if any and not serious long-term problems that we see day after day.
Dr Rupy: Yeah, totally. And I grapple with that realization all the time. Um, and I suppose I'm still very much on this journey of like, okay, so I started the social media account and that's given me a platform and it allows me to do a bit of TV and sell some books and all the rest of it. And it's slowly filtering out the message that hopefully gets to people who perhaps wouldn't naturally gravitate to looking at uh, an account full of food imagery um, online. However, I think the bigger play for me to get to that exact patient population that you're referring to, I.e. the most vulnerable, the most in need, um, is via culinary medicine, which is the non-profit teaching doctors and medical students. Because in that course, what we do module by module is teach them how they can A, engage patients in front of them who may not even know where they're going to be sleeping in the next couple of weeks, who have a history of abuse, who have um, weight issues that they weren't even have realized is related to whatever other condition they have. Um, that's how we really filter down the information. Um, and uh, taking them on a journey from, okay, so you're having cornflakes and grab and go Greg's bakery items every single day. Can we just change one thing? Can we reduce your Coke consumption from three to two a day? Can we change the amount of crap beef that you put into your lasagna by half and then add maybe some plant-based proteins into it that's just as cheap, if not cheaper than the meat alternative. Yeah. Those little incremental changes uh, are going to be the most effective. And it's something I was I was telling you about earlier about the sort of digital product that I'm in the process of creating. The sole aim of that is to increase the fruit and veg consumption of people, which averages around three to four or five a day. And that that small change at at scale is going to be hopefully grand changing for public health. Yeah. Um, and yeah, so that's what I'm so there's like a bigger plan.
Christie Watson: That's great to hear. It's so good to hear. And and particularly if you can get involved with policy and hospital food and because if you're working on an individual level, it is difficult to to get to the people who are the most vulnerable.
Dr Rupy: Totally.
Christie Watson: But like you said, if you work in a much broader sense, then filtering it out is going to be easier.
Dr Rupy: Yeah, and I think that's kind of um, the way I come about it is that it's all great like having an Instagram account and beautiful images and all the rest of it. Um, and it gets the message out in some way. However, there's 4 million people still using food banks in the UK, which is an abomination. There are people who um, don't have cooking appliances in their home. I.e. a lot of people reliant on microwaves and stuff. So we actually geared a couple of modules in culinary medicine to people who have to rely on canned food. So how can you make a meal with a can of chickpeas or a can of asparagus spears or peas or something like that? And actually you can you can make some healthy alternatives. So it's it's about teaching people that, those like basic skills because otherwise, um, it's incredibly difficult to get to those people.
Christie Watson: And what about getting to nurses and doctors? I feel like you're interviewing me. I love this. I'm fine with this. Go for it. Go for it. Go for it. What about getting because it's really easy. Nurses have got really difficult um, lives at the moment and they're working harder than they've ever worked before. And people are so stressed and the staffing is so horrific that nobody has time to drink water, let alone eat. You know, there's a big campaign, remember to drink water. If you're having to remind someone to drink water, that's a step away from addressing what they've got in their lunch box. Um, how do you support your colleagues with healthy eating decisions? And I mean colleagues sort of not your immediate colleagues, but the whole of the NHS. Broader, yeah.
Dr Rupy: Absolutely. So, I remember that you mentioned um, that in your book, I remember about how people time when they nursing staff in particular, time when they drink according to when they feel that they're going to be able to have a toilet break, which is just crazy, just madness, absolute madness. And I'm lucky I'm not in that situation. I don't think any of the staff at the hospital that I work are in that situation. Um, but so to answer your question, just last week, I did a staff wellbeing um, session, half an hour before work with all the staff. So it was majority nurses, some HCAs and some doctors attended. And we're talking about um, A, the basics of nutrition, which is very hard to cover in about 15 minutes. Um, and then also self-care regimes. So how I, you know, make sure that I've got breakfast ready that's not going to um, be too time-consuming and it's going to allow me to work five, six hours straight without having to rely on snacks and stuff, which I think we're all guilty of doing, like eating on the go and stuff. Um, so like I taught them a whole bunch of recipes like uh, overnight oats, uh, tray bakes, um, things that take less than 20 minutes to cook in a single pan, things that you can have for your lunch the next day. Um, but also combining that with the appreciation that it's beyond just food. It's it's about sense of purpose, it's about community, it's about movement, it's about improving your sleep hygiene. And just the awareness, even if you don't change anything, I think just the awareness actually does change things physiologically in your in your body as well. Um, on the grander scale, hopefully, um, my hospital is is commissioning some videos and stuff that might be able to go into sort of um, uh, will be distributed across like Royal College of Nursing networks and certainly the GP networks and that kind of stuff. Um, and then we're also going to be doing culinary medicine modules online for um, doctors, nurses, dentists, hopefully as far reaching as possible, admin staff, physios, everyone that works in the NHS environment. Um, so there's just grander awareness. And I can imagine there's a time where um, in the future, when you're looking after someone and um, you know, offering them empathy, um, discussing, you know, their livelihoods and and what their aspirations are. You're also feeding them sort of like lifestyle advice as well as that, you know, like what are you going to eat when you go home? Is it going to be tea and toast or you're going to try and get some more nutrient dense uh, vegetables? What things do you like? Like how can we improve your diet incrementally as well?
Christie Watson: I think nurses have always done that and health promotion has always been such a huge part of nursing, whether you're in a third-level PICU or whether you're in primary care, whatever. But people are so stretched. And I do wonder whether academically, intellectually, the people that you're teaching in terms of the nurses and doctors know all of this. And absolutely want to take it on board. But I remember myself many days when it's 5:00 p.m. and I realize I haven't eaten at all. And so I just dive into the Quality Street box. And there's only the red ones left ever. Yeah, yeah. Um, but it is really difficult and I think it's great what you're doing, but I do think that, you know, sometimes it's the political system behind it that's causing the issues, not necessarily people's knowledge.
Dr Rupy: Yeah.
Christie Watson: And it's that time.
Dr Rupy: I appreciate that definitely. I would also take the opinion that a lot of people, certainly from my personal experience, in healthcare positions haven't got the faintest clue about nutrition.
Christie Watson: Really?
Dr Rupy: Yeah.
Christie Watson: Oh, that's interesting.
Dr Rupy: Yeah. So not necessarily my experience is mainly from general practitioners and doctors. Um, but man, some of the stuff I've come across from other physicians, yeah, it's just like, no, no, no, you can't be telling patients that or you can't be, you know, telling everyone to go low carb or you can't be saying that, you know, just eat whatever you want, it doesn't have any impact on your health outcomes. So I think there's like extremes and I think perhaps it's my own bias that, you know, not I wasn't taught nutrition at at medical school and, you know, we get on average less than five hours at medical school.
Christie Watson: Really?
Dr Rupy: Yeah.
Christie Watson: Goodness.
Dr Rupy: Yeah. And that's like a a verified fact. Um, I think that was distributed by the GMC or the MSC, the Medical School Council. Um, and they recognise that the variability in nutrition training goes from uh, I think a maximum of eight to 10 hours to zero. Like it's literally in the paper. Like some medical schools give zero. And so that has to change. And I think that explains a lot of what I see at least anecdotally on the front line of people's um, nutritional knowledge.
Christie Watson: Is there a generational aspect to this?
Dr Rupy: I think so.
Christie Watson: Because I'm I'm thinking particularly of a of an older doctor who I know who I won't name who was having a sort of mini stroke. So a transient ischemic attack. And and said, pass me the decent Chianti, I'll just drink my way through it. Ended up fine and it's all a happy tale and a happy ending, but I don't imagine a younger person would have tried to drink their way through a stroke, particularly a doctor. Um, and I think there is, I think there is this kind of old school and I sit between them, I guess, because I'm 42, so I'm kind of on the peripheries of both. But I there is this old school attitude in a way that it's almost um, it's almost not as important as people think.
Dr Rupy: Yes, yeah.
Christie Watson: And and that's going to change, I suppose, as the next generation of doctors and nurses come through.
Dr Rupy: Yeah.
Christie Watson: Who are much more interested in holistic health, I think, in terms of medicine.
Dr Rupy: I think so. Yeah. And I think that's either like we said earlier, based on the fact that more and more people are experiencing getting sick themselves or close family members. Yeah. Um, and patient voices as well. Patients are demanding more than the medicines, I say that quote unquote. Um, that we have traditionally offered and they're demanding more because it's beyond just pills and surgical interventions, I think.
Christie Watson: Yeah. And it's something there is something philosophical about the control that you're giving somebody. Because people are so out of control, feel so out of control with the state of the world and the level of hatred that we're all suffering and the division and the isolationism and the loneliness and the lack of community, lack of kindness and all those things, that if you say to somebody, well, there's no tablet for this, but I'm going to teach you how to do the food and that's going to make you feel so much better. And they believe that it will make them feel better. That's such a powerful thing because then they have some control into their illness or their state, might not even be their illness, their state of living, I suppose. And having that thought that you can do something yourself that's going to help yourself, then I think at the moment that's a really powerful force.
Dr Rupy: I think it's it's incredibly powerful giving someone the acknowledgement that this is within your locus of control is very, very, it's a very interesting psychological state and it's something that I experienced when I was having my paroxysmal atrial fibrillation episodes. Being a 24-year-old with no triggers, with no pre-existing history, it was so frustrating to not understand why this was happening. All the electrophysiology studies were negative, all my blood tests were negative. There was nothing that modern medicine could explain to me, let alone treatment, it's one side. There was definitely a treatment for it. But explaining the root cause of it was so, so frustrating. And then when I started taking a step back and looking at, okay, what are the other factors that could be impacting my symptoms? Stress, poor sleep, poor diet, uh, my psychological state at that point in time, being thrust into a junior doctor environment, you know, being uh, in a constant state of like imposter syndrome, I felt at the time when I was, you know, junior doctor not having that much clinical experience. You know, all these things had an impact and they clearly had an impact because now I've been able to put myself in remission using a whole bunch of other um, uh, lifestyle techniques. And yeah, and that is very powerful in itself, just knowing that, okay, there's something inside me that I can control.
Christie Watson: And maybe it's the feeling of control that's put you in remission.
Dr Rupy: Perhaps. Yeah. Yeah. There's loads of ways in which I try and retrospectively figure out what exactly happened, you know, was it my microbiota? Did I change some electrolyte imbalance that wasn't picked up by traditional blood tests? Was it omega-3? Was it my stress state? The reality of it is that it's a holistic um, sort of change that has changed multiple different things. And this is, it's very hard to put that into a sound bite, right? It's uh, and it's it's not something I try and attempt to do because um, it's trivializing what is a very complex picture of.
Christie Watson: Yeah, definitely.
Dr Rupy: And whatever happens, you will live a much better and longer life because of it. So it's going to have a great outcome, great side effect.
Christie Watson: Yeah, exactly. Yeah. What's the downside? Wonderful side effect.
Dr Rupy: Yeah. Let's talk about you. So, uh, I, when I was reading it, I um, The Language of Kindness, um, I thought it was a heart-wrenching, honest account of what it's like to be an NHS worker with the right smattering of political insight and the right tone as well that kind of gave us a hint of like, oh, look at the bigger picture here and look at what this story is on the front line. Was that intentional? Was that something that you intended to do or did it just come out in your writing where you're trying to do a story and then actually, you know, let me just give people some insight here into why this might be happening.
Christie Watson: Um, I wanted it to be story and storytelling. And you can't tell stories about the NHS without politics. They just happen naturally. So I didn't go in heavy-handed and think I want to write a political non-fiction book. I wrote a book about a nurse, about me nursing. But of course, the politics is the backdrop for that. So you don't need to add any because it's just there. You can't, it's impossible to not be political when you're writing about the NHS. Um, I think that and I'm I'm writing another book at the moment, which is probably even more political because again, it's impossible to be less political at the moment. We're becoming more and more political.
Dr Rupy: Everyone is being shoved into that. Everyone is in that state, whether you want to be or not.
Christie Watson: Yeah. Um, but no, I I wanted it to be about story and storytelling and not just my own, but other people's experience of illness and health and what it means to be human, I guess.
Dr Rupy: And I did notice that you didn't stray away from some pretty hard-hitting, brutal topics that I think unless you were like a a hardened NHS nurse, no one else would have had the confidence to talk about. So, in particular, I remember your story about um, the patient you named Derek and how that um, how you weaved in statistics about schizophrenia and those who are more likely at risk of mental health issues, those who are more likely to be institutionalized are from the minority ethnic groups and how you started realizing when you're in a fast food restaurant or who the cleaner is at the British library and stuff like that. And I thought that was really brave of you to to talk about that because I and like I said, I don't think anyone else would have had the confidence unless having had the experience as an NHS nurse in a city of London.
Christie Watson: I think it was my experiences as an NHS nurse and the NHS is one of those brilliant organizations that the the staff members reflect the population. So it's so diverse within the NHS. And when you go into other organizations, you're like, oh my gosh, everyone's a straight white man. What's going on? Um, so that's beautiful. That's a really beautiful thing about the NHS. But I felt a responsibility as a nurse to be able to highlight inequalities, astounding inequalities in healthcare. But also, I have two children and my children are black. So I'm raising a black son in this society. And so I suppose that in the background of my own personal life was a huge factor to start thinking about these really important issues that we should all be talking about and not shying away from. And we will get it wrong talking about it. But that doesn't mean we shouldn't talk about it.
Dr Rupy: I really commend you because I think that appreciation for the fact that you will be called out. Some people will say something, some people will have a willful misinterpretation of the point of view you're trying to paint.
Christie Watson: Absolutely. And it's about being aware of my own privilege. It's about constantly questioning my own privilege. And then a willingness to be vulnerable and to say, I will get things wrong. Um, and and I need to listen and learn every time I do, but it doesn't mean I'm going to stop talking.
Dr Rupy: Yeah, absolutely. And there was there was a bit in the book and we talked about this a little bit earlier about where you felt like you lost empathy and you talked about Charlotte, um, the little girl who comes back after her meningococcal sepsis episode. What other things do you think that people have in their um, toolbox of self-care, particularly nurses that they can use to sort of support them on that journey? Because I think everyone has that burnout or stress or really hiding a word hiding um, anxiety and depression and low mood. Um.
Christie Watson: Um, I think the main thing that helps nurses and I'm sure doctors are the same and other healthcare professionals is the team and your colleagues because they really truly understand in a way that maybe your friends outside medicine don't, what a bad day looks like. So if you say I've had a bad day at the office to someone who you work with, they really know what you mean. And just having that understanding and that teamwork and that framework around you is just crucial for your own mental health and getting through those really difficult times. I think for me, that's the most important thing. Um, obviously having the support of friends and family, but I think the teamwork is the thing.
Dr Rupy: Yeah. Do you think um, and this is me playing devil's advocate here because I have a lot of friends who are not in medicine and when they describe to me what a bad day at work looks like for them, I'm in my head and I don't vocalize this anymore because I know not to. But um, you know, we're at risk of like putting the sort of morbidity of our day-to-day lives at the forefront without really recognizing that stress is relative to the person in front of you.
Christie Watson: It's really important thing that I'm constantly aware of. Um, I used to be really bad at it and like you, I've learned to keep my mouth shut. Um, a couple of things about that. So I I remember when friends were starting to have babies and they were really so anxious and calling me all the time because the baby was crying. And I remember saying to one friend, if the baby's crying, then they're fine. Because if they're really sick, they won't cry. And she was so traumatized by that information. And of course, for me, that was just a natural thing to say. Really sick babies don't cry. And she was just so, so anxious. So I really didn't help that situation. And it is relative. Um, the other thing is that my children, uh, their dad is a consultant intensivist. I'm a PICU nurse. Um, they have never been to the GP. They desperately want to go to the GP. They see it as this sort of mythical land of unicorns. If I'd said to them, I'm spending the morning with a a doctor who's a GP trained doctor, they would just be wanting to come.
Dr Rupy: No way. I should have brought them along.
Christie Watson: They are desperate. And so they are never ill because my definition of illness is very different from a lay person's definition of illness. So and and their dad's even more so. No, if their pupils react, they're probably fine. Um, so the children of nurses and the children of medics, I think, um, are a special, special tough lot because they have to be. And they are certainly, they certainly seem to be, touch wood, never properly, never really ill. They don't have coughs, colds, anything like that. And if they do, they don't mention it. Because there's no sympathy.
Dr Rupy: Well, they'll probably be sharing microbes within that you've essentially developed over the last like 20 years of being a nurse. So, yeah, I can imagine.
Christie Watson: But I know what you mean about the sympathy and it's really, now I try and take a step back and realize that everything is completely relative and people's worries are completely legitimate and they don't understand and most people don't want to know really what happens in an accident and emergency department or in hospital with really, really sick people because why would you want to live with that knowledge every day of our vulnerability and our frailty as human beings, knowing what could happen is a is a terrible gift as well as a great one.
Dr Rupy: Yeah, absolutely. I think we were talking about earlier about like everyone living in this existential crisis where um, I feel certainly that what I'm seeing coming in both primary care and uh, to an extent A&E as well, are manifestations of uh, our poor mental health.
Christie Watson: Yes.
Dr Rupy: And stress is a very, I don't like using the word stress because I think it's just too broad a term. But for want of a better term, stress is certainly something that's underlying a lot of what I see.
Christie Watson: Yeah, absolutely. And I think that if you really want to see the state of the nation in 2019, go and visit a pediatric ward. Because when I started as a pediatric nurse in 1998, whatever it was, a long time ago, it was uh, babies who'd come in with asthma, happy wheezers, give them a nebulizer, pretty much they go home. And then someone might come in with one comorbidity, one. Treat them with technology or medicine and then they go home. Now, pediatric wards are are absolutely choco full of children who've self-harmed, suffering their first psychotic episode, um, who have tried to take their life and who've also got 17 physical comorbidities at the same time. And it's just unbelievable. And this is the spillover from the fact that we don't have enough mental health beds a million miles. And so we and and everybody now is is increasingly, I think, suffering so so many serious mental health problems, particularly young people, that we're only just at the beginning of recognizing and understanding it. And when I say mental health problems, I think that we've we're in a great movement of anti-stigma and talking, we've got some great celebrity endorsers of the wellness movement and all these things which are incredible. But the mental health disorders that I've seen are catatonic patients who've spent 20 years unable to use the toilet because they cannot move or who are um, jumping off the roof of buildings. Um, so I mean, properly serious stuff that we don't really highlight. And the money from the mental health pot is all the same pot. And so I do worry a little bit about the ethics of where we are in terms of mental health care in the country.
Dr Rupy: Absolutely. I feel like an investment in mental health services is an investment in our ability to look after our societies. The investment in people, even just the act of listening to people's worries and concerns or, you know, exploring their history of whatever that might be, a very colorful history. Um, that is something that I've noticed in general practice is hugely, hugely lacking. The number of people that I've tried to refer to CAMHS, the number of people that are waiting to speak to a counselor, the number of people, you know, that I know have a stress-related issue, but are just, you know, don't have a psychologist to get them to to speak to. And then, you know, the GP becomes a Swiss army knife of everything, dealing with the back pain, we're dealing with uh, psychiatry issues, we're dealing with, you know, people that should perhaps be uh, in hospital, but we're dealing with them in the community because we just can't send them.
Christie Watson: And that person's at risk. And so the stress of that on the doctor knowing that that person is at risk, you're going home and not sleeping and thinking that is a that is someone that could take their own life tonight. And they're on a waiting list for 18 months. So it's really, we're in a really bad state. And this is not just UK, this is across the world. This is a global issue now in the West.
Dr Rupy: In the West.
Christie Watson: In the West, interestingly. So, um, yeah, this is a this is a much wider talk.
Dr Rupy: It's almost like what I'm seeing in um, uh, in developing nations or developed nations like India and China is the double burden of disease. So you're getting the um, affluent middle classes that are now suffering from diseases of Western living because we aspire to have our KFC and McDonald's and all the rest of it. Yeah, and you know, driving cars and working sedentary lifestyles. Um, but it's interesting just to segue into how in your book you actually bring up a whole bunch of, it was like reading a history book at some points. No, honestly, no, no, it was brilliant. It was just the right amount of historical, sort of, you know, you talked about Florence Nightingale, you talked about the inception of nursing, but you also talk about Ayurvedic traditions, you talk about Chinese medicine. Is that something that you took an interest in at an early stage or was it something that you realized after having been a nurse for so long that it was kind of instilled in your profession without labeling it as something like ancient medicine?
Christie Watson: I think my my thinking has shifted with with the patients that we're seeing. So we need something else now. We need something new. So, um, we're not necessarily suffering just with Western problems anymore. We're suffering with world issues. And so our thinking needs to change. And and we've been so focused on our own system of what we think is right and what we think is helpful that we're living in this multicultural society and we're saying we're going to impose our system on you. It might not work for that particular person. Um, I had a a patient once who was suffering with very severe depression and and kept talking about the ants crawling in his head because he had no word for depression in his in his language. There wasn't a word for it. So I think we do need to start thinking about much more globally about uh, medicine that potentially can help our human condition and not necessarily medicine that's going to cure traditional diseases. Because we don't suffer so much with traditional disease or we do, but it's changing and it's shifting.
Dr Rupy: Yeah, one of the things I look out for in A&E, um, obviously excluding organic causes, all over body pain. And it's usually that, you know, matriarchal uh, Indian mother who comes in who's had all over body pain for so long and it's got worse. And you dig a little bit deeper, hopefully without the family in the room and stuff, and then you realize there's a lot of stuff. There's definitely like, you know, type two diabetes and I hate to generalize, but high blood pressure and all the all the rest of the things in their medical history. But there's a there's so many other things, so many other layers of psychological involvement going on in that presentation.
Christie Watson: Yeah. Do you ask, have you got all over body pain?
Dr Rupy: No.
Christie Watson: If someone hasn't. Yeah, that's it's almost like asking a child, does your tummy hurt? But does your head hurt? And they say yes. Yes, it's.
Dr Rupy: And and so it's it's you sometimes put ideas into people's psyche.
Christie Watson: Yeah.
Dr Rupy: So I'm very careful about the the language I use because I know people can latch on to symptoms.
Christie Watson: And is that why GPs now say, well, what do you think the problem is? And patients say, well, you're the doctor. Surely you can tell me. But is that why?
Dr Rupy: It's such a loaded question. I mean, like, I I ask that question, but I I'm becoming and I'm very, I feel like I'm very junior. I've only been a general practitioner now fully qualified for five years. And I'm learning every step of the way as I'm sure everyone is, even my bosses have been consultants for for decades. Um, which patients to ask certain questions to. So, uh, there are certain patients that I wouldn't even think to ask that question to because it's kind of like, well, they're coming from a a cultural background that expects the doctor to prescribe them a pill or prescribe them something. Whereas other people would enjoy the inquisition about what they think is going on. And sometimes very powerful questions um, and very powerful answers that can be delivered to that as well. Like, I think it's a lot of people admit it's probably stress-related. I'm going through a really bad time. I'm going through a divorce or I'm going through financial issues and that kind of stuff. And then it allows me to explore a lot of things within the eight-minute period that I have with them.
Christie Watson: I know, it's shocking, isn't it?
Dr Rupy: But yeah.
Christie Watson: Yeah.
Dr Rupy: Yeah.
Christie Watson: And do people who know they've got bigger issues book triple appointments and things like that? Can I have a quadruple appointment?
Dr Rupy: Uh, so depending on which practice you work at, yes and no. So I, when I'm in A&E and I'm working, let's say in urgent care, uh, I will and I know that there's some other issues that they need to, I will request that they ask the um, receptionist to book a double appointment. Um, but it yeah, it can be, I mean, we're all just super stretched. We only have like 15 slots per morning. And then if you're taking two or three, then that's two less patients you can see in that short time.
Christie Watson: And do you find as a GP that you're absorbing all the sadness of everyone that must be coming in? Because generally people are sad now, right?
Dr Rupy: To an extent, yes. Um, however, because I work part-time, so two to three clinical days per week, I feel I have the right balance to not get too overwhelmed. Whereas when I was training and when I was fully qualified doing five days a week, huge, huge burden. Uh, you know, I'd go back, being a junior as well, having, you know, um, not diagnosed anything and ask them to come back and like put a treatment plan in order, was that the right thing? Should I have done this? Should I send them to A&E? Should I have, you know, got them to come in the next day and that kind of stuff. Safety netting is a is a big thing, but in some cases, you can't safety net enough. Um, so yeah, no, it's hugely worrying. And it's something that my colleagues who work full-time in general practice, I don't think I could do that now if I'm honest. Um, and I don't know whether it's something that we should be doing either with the number of patients that we see per day. And then they're not to uh, trivialize what um, specialists do. But if you're seeing a urologist and all they see every single day is um, uh, the post-prostatectomy patients or the renal colic patients, it's all very specialized. They can pattern recognize. With a GP, you're seeing 30 patients, 30 to 40 patients a day physically with a multitude of different issues that can extend across different specialties. So that is another level of sort of um, mental burden to take home with you at night. And then put onto that, you know, the managerial issues, the bureaucratic issues, the QOF things and, you know.
Christie Watson: Do you think uh, doctors' mental health is suffering like never before?
Dr Rupy: Oh, massively.
Christie Watson: Yeah, nurses as well. And female nurses have now got the highest occupational suicide rate.
Dr Rupy: Really?
Christie Watson: Yeah.
Dr Rupy: Oh, I didn't realize that.
Christie Watson: Because it used to be. That's the Office of National Statistics.
Dr Rupy: Yeah.
Christie Watson: Um, yeah.
Dr Rupy: Wow. When did that?
Christie Watson: It's terrifying.
Dr Rupy: That is terrifying.
Christie Watson: It's terrifying. Um, and I think the doctors must be a similar, particularly GPs, I hear.
Dr Rupy: Yeah. Not to think too morbidly about it, but it's kind of like to be expected, right? If you put.
Christie Watson: It shouldn't be.
Dr Rupy: It shouldn't be, no. But like, if you put people in a in a situation where they're working plus 12 hours a day, multiple times per week and with the amount of stress that they have to deal with as well and all the occupational pressure.
Christie Watson: And and the society stress, the patient, the type of patients that people are seeing. Because it is it the loneliness and the suffering is just beyond anything.
Dr Rupy: And the PTSD and, you know. I um, I was chatting to a colleague of mine who works in Australia and uh, I don't mean to sort of like um, uh, not, what's the opposite of catastrophize? To sort of like glorify.
Christie Watson: Glorify.
Dr Rupy: Yeah, that's the one. You can tell you've done that English speaking creative writing course. Um, yeah, and I don't mean to glorify like the Australian healthcare system and they've definitely got issues and they're actually, I think they're they're seeing issues related to increasing patient footfall with an inadequate um, system to cater for it because they still have inefficiencies that parallel the NHS. But a friend of mine did a really, really bad shift overnight where they had multiple traumas coming in, a couple of junior doctors overnight. And that morning, the hospital had arranged for three trained psychologists to come and actually give them a little bit of a debrief. And the consultant was on the phone at 7:00 a.m. speaking to individuals as well that were like, you know, he just like, can I just speak to this person? Can I speak to this person? Because they were dealing with multiple traumas and like young people and it was horrific, horrific. But just that realization that people need.
Christie Watson: It's a massive difference.
Dr Rupy: It's huge.
Christie Watson: And I think that's going back to what you what I was asking you about earlier in terms of what helps you not have burnout. And particularly, I I I hate uh, nostalgia because half of the time the things that were good never existed anyway. But um, there's a brilliant Welsh word called Hiraeth that means looking back to something that never actually existed with with joy or whatever. Yeah. Um, but but we used to all of us go out regularly. And there was such a huge diverse multicultural, multi-system, lack of hierarchy support network. We'd all go to the pub after a terrible day from the chaplain to the cleaner, to the consultant, to the nurses. And having that was really amazing. And of course, people don't do that now because they've got no money and nobody's got any time and nurses are working other jobs and everyone's exhausted. And the other thing is the lack of firms for for medics and not having those mentors and not having the seniority that you can go to and say, look, I've just done this terrible thing and them saying, it's okay, it's not as bad as you think or whatever. But that that doesn't happen. That's kind of infrastructure and the support system doesn't really happen so much anymore. So you might be going from somewhere every six months and new faces and yeah, it's really tricky.
Dr Rupy: Do you think that is a particular issue when it comes to hospital environments in inner city environments like uh, Birmingham or uh, Manchester and London in particular? And it happens less so and there's more of that sort of sense of community in DGHS around the UK.
Christie Watson: I think so. I think so. I think it's um, there is such a fast high turnover of staff. But people don't have money. Student nurses now, they don't have a bursary at all. So they're working, they're working maybe three jobs on top of their studies. So nobody's socializing really. Nobody's got time or energy or money.
Dr Rupy: You need to incentivize um, the occupation that really looks after the most vulnerable. In fact, that brings me back to a quote that you talked about in your book, uh, the Mahatma Gandhi quote, uh, the way we treat our most vulnerable is a measure of society. And if that is so, then you add the act of nursing itself is a measure of our humanity.
Christie Watson: And how we treat our nurses is a measure of our humanity, surely. We've got homeless nurses who are going to food banks and we're in dire straits. That's crazy. Yeah, we've got a high, a highest occupational suicide rate is female nurses. And we're in big trouble. And we know we're in big trouble. Um, and while all this braying is going on in Westminster and all this political maneuvering, people are dying. We know that we see it every day.
Dr Rupy: Tell me a bit more about your new book. I'm fascinated by what you're working on right now because if there's anything as impactful as your last one, it's going to be incredible.
Christie Watson: So it's it's a way off. It's not going to be coming out for a while because I've only just written a first draft and as you know from first drafts, it's pretty rough around the edges. 80% rewrite. 100 rewrites later. Um, but it's very much um, it's more stories about being a nurse and more stories from my own life. But also I wanted to come outside the hospital doors because most of the NHS is outside the hospital doors and it's nursing, a lot of nursing is done outside uniform, outside the hospital. And it's maybe what people don't really understand about about nursing and medicine. And people look at the NHS and they imagine a city hospital. And of course that's not it at all. And so I wanted to describe the cobweb of of healthcare that runs through the country and how it works and I've been traveling in the country but also outside the country just to look at nursing particularly in different places like prisons, um, hostels, homeless care centres, school nursing, district nursing, everything that I can imagine that's outside because I think that by talking about those things, it gives us a lens into where we are as a society. Because those are the people who are working with quite often our most vulnerable people. So it's back to the quote. Well, if we, if how we measure our society is by how we treat our most vulnerable, and our most vulnerable don't have a voice at all, and we only hear from those people who are shouting and who are powerful, then how can we measure our society? So in order to do that, I hope I've given a voice to people that maybe didn't have a voice.
Dr Rupy: Absolutely. And when are you going to make a TV program out of this?
Christie Watson: So. Yeah.
Dr Rupy: Because I can so see this as a TV program. Like I I I want to visualize it as well as read it, obviously. I want to visualize it.
Christie Watson: Yeah, well, kindness is, kindness is, I'm working with Mammoth Productions, um, uh, on making a TV program for kindness. And that's just ongoing. And it's really, um, TV world is quite, I mean, you you've got links with TV world. You know about this.
Dr Rupy: Yeah.
Christie Watson: It's a very strange place. It's very odd. It's very exciting.
Dr Rupy: It's very exciting. It's flaky. It's. Oh. I didn't say that. I I my experience has definitely been that. Um, it's very fast-paced. Um, it's under threat, I would say, um, with the likes of, yeah, I would say with the like with traditional sort of channel. I think it's under threat. But they they're finding like more innovative ways of um, of promoting content. I mean, I still I I've started, I never used to watch TV, right? Um, I don't have a TV in my flat. I, but given that I have a laptop, you know, I can watch TV. And so I've I've started watching Netflix a lot more than I used to and stuff. Um, in the name of research sometimes when I'm watching like medical programs. Nutrition stuff.
Christie Watson: Yeah. No, it's very addictive and I think so many teenagers now, we worry about young people's mental health and and then they sit in their room for 12 hours binging Netflix every day with the curtains shut and we wonder why things are bad. Um, but Netflix is a drug for sure. As I'm signed up, you know, I love it as well. It's very addictive. And it's very isolating because you're just there on your own watching a TV show and then when you do see other people, you talk about the TV show that you've watched because you've not done anything else. Um, but yeah, I love it. I do love it, but I do worry about um, I do worry about how much TV everyone's watching. And also, like you said, we don't the people watch on their laptops and YouTube as well. YouTube or Netflix is what people tend to watch. My kids will wait till something comes to Netflix rather than watch it on traditional channels, even if they can get it on iPlayer. They will wait till it comes to Netflix. It's like a branding thing for them as well.
Dr Rupy: Oh, wow. Okay.
Christie Watson: It's really strange.
Dr Rupy: Yeah, yeah. Oh, very interesting.
Christie Watson: Yeah.
Dr Rupy: I I've noticed actually over the last like uh, 10 years, um, that the staff common room has completely changed to one where there used to be a lot more interaction verbally to one where you go on your break and you're looking at your screen and you're eating and you're watching your screen. And I'm I'm making more of a conscious effort to put my phone away because I'm guilty of that just as much as anyone else. And then to strike up a conversation with random people, whether it be, you know, the cleaning staff or the HCAs or other doctors and that kind of stuff.
Christie Watson: Yeah, that's different, isn't it?
Dr Rupy: Yeah. You must have witnessed that over the.
Christie Watson: Oh, when I started, we had a smoking room.
Dr Rupy: Oh.
Christie Watson: I swear to God, this place was yellow.
Dr Rupy: Not just in the mental health units.
Christie Watson: No, for staff.
Dr Rupy: Wow.
Christie Watson: So, and I'm not that old. And it was it was at the back of the canteen and you go in and it was like Ronnie Scott's late at night. And the staff used to sit there, the relatives, the patients, and the walls, if you'd got a knife on the walls, you would have scraped off some nicotine.
Dr Rupy: Oh my God.
Christie Watson: Actually scraped it off. So I mean, that's not that long ago. And so we chatted because we were just in the smoking room. And then that changed and then I suppose the the staff room was always, wherever I've worked, the staff room hasn't been great, I have to say. Like really shabby and quite dirty and like cups left everywhere and always in industrial sized fridges with do not touch my food. I know who you are. But yeah, it's um, it would be, I I suppose again, it's about investing in staff and investing in people and it's about time and money and where do those priorities go? But I think you cannot care for people unless you're cared for yourself. And so in so those investments and not just uh, kind of random things. Like I saw, I saw recently on a on a staff room wall, it said, uh, sign wellness uh, plan, sign up for yoga on Tuesday afternoons. And it was a sign up sheet for all the staff. And somebody had written, I didn't pee for 12 hours yesterday. Namaste. And I was like, yeah, there are bigger, you know, and unless you address the big issues, you can't get to the small things. But um, yeah, I'm glad the smoking room's not.
Dr Rupy: Yeah, yeah, definitely.
Christie Watson: You'd have died. I'd have died. It was bad.
Dr Rupy: I thoroughly enjoyed chatting to Christie and the rawness and the passion which she brings to her writing as well as how she speaks. I just think is so commendable. Uh, please do pick up a copy of the book, The Language of Kindness. Check out Christie online at Tiny Sunbird, that's on Twitter, Instagram, it's Christie Watson writer, and check out the website Christie Watson author.co.uk. I know she's going to have loads of TV and media stuff coming up, so keep an eye out for her. I can't wait for Language of Kindness to be uh, a motion picture or at least a series online because I just think it's going to be so, so hard hitting and it and it just tells the truth of what it's like to be a healthcare practitioner in the NHS, particularly in inner city areas. You can find all of this information and more at thedoctorskitchen.com. Subscribe to the newsletter for weekly based recipes, content and much more to help you live the healthiest, happiest life. Give us a five-star rating if you love this podcast. It really helps spread and share the message. Tweet us at doctors_kitchen, check out the Instagram, YouTube, and of course, don't forget to order a copy of either of my two books, The Doctor's Kitchen and Eat to Beat Illness. I will see you next time, guys.
