Three minutes to stop and breathe: how an app changed my working life

This blog was written for the BMA.

Exhausted, losing weight, looking miserable. This was not how I had imagined my life as a doctor.

As the F1 on acute medicine I struggled to balance treating my patients well and looking after myself. There is no shortcut to learning how to deal with a patient with severe chest pain, an angry family wanting to speak right away and a microbiology consultant on the phone, all at the same time. In the end the skills I learned – such as how to prioritise – still help me to this day. But that came at a cost to my physical and mental health.

I would bend over backwards for my patients but I wouldn’t prioritise myself, my lunch breaks or my right to hand over jobs. And long term, tired doctors aren’t in their optimum state to look after patients.

I did the best I could, but I knew this couldn’t carry on for two years. I made changes, I went to the gym more, made sure I enjoyed all my time off and started meditating.

No junior doctor gets to the end of two years without major highs and lows. It’s a learning curve, and I learnt the hard way just how important it is to look after myself. One day at the end of F2, I was doing nights, and I had to pack up my house and drive my stuff over 200 miles to my parents’ house, pack for a friend’s wedding and sort out accommodation on the opposite side of the country for my new job. I felt acutely stressed and needed something to help.

I remembered my GP teaching – we’d been recapping treatments for depression and our tutor mentioned the Headspace app, recommending we try it. In my moment of panic, I downloaded it and did a three-minute exercise: sitting on a chair and breathing. Easy, right? Well, harder than you might think actually, but that three-minute pause was what I needed. It got me out of my ‘oh my God’ state and into ‘let’s do this’. Thankfully there was no chanting, no annoying music and no great demand on my time.

It helped me when I was feeling stressed, but also when I wasn’t. ‘Prevention is better than cure’: we say this to our patients all the time, in the guise of ‘what’s your diet like?’ or ‘do you smoke?’, but the same can be said about mental health.

When I was on holiday and waiting to start working in radiology, my friend, also a doctor, found it strange that I would continue to meditate every day. But I knew that radiology and moving across the country would have its own challenges, and I wanted to keep up the habit.

I wasn’t wrong. I’m now a few months into training, working and preparing for exams. It’s both the best and worst thing about medicine: you’re never finished. And then you have life’s ups and downs too.

For me, Headspace gives me time away from all of that. Time just for me; sometimes it’s the only time I get. I use it when I can – sometimes on the park and ride into work, on my lunch break or at the end of the day. All you need is a phone and headphones. Half the time people must think I’m napping! And some days I can’t fit it in, and that’s OK too.

Everyone needs a moment to just stop and breathe. I wish I had used Headspace earlier as a doctor. On those busy crazy days, a three-minute ‘time out’ to regroup would have been really beneficial. It’s easy to be sceptical – I know meditation seems hippy and new age to some people – but my advice is, don’t knock it until you’ve tried it.

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social media sabbatical

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Prevention is better than cure. We’ve all heard it. You don’t have to be a doctor or in any way related to the healthcare profession to have gotten that message. You might even be sick of it by now. All the smoking cessation adverts or the constant media scar mongering.

Some of it is a bit overboard I’ll agree but having worker as a doctor for a few years now, I’ve seen my fair share or patents with conditions that were avoidable in some sense. I don’t just mean physical conditions and the obvious culprits such as obesity I’m also talking about mental health.

Whilst I haven’t suffered depression or a mental health condition myself it has alway been something in the back of my mind that I have been conscious of. Working long hours as a junior doctor, initially in a new area with no real social network of friend or family set up for myself, I was a prime target. I use to think looking from the outside it wouldn’t be surprising if I had a patient who was in my shoes who was depressed. Especially after those exhausting on call weeks!

That’s why I’ve tried to make an effort to notice how I was feeling and how different activities made me feel. I had seen patients with depression who were really suffering and whilst I also was fortunate enough to see some at the other end of the tunnel this wasn’t the case for everyone. I didn’t want to risk it.

Oprah once said your life’s constantly talking to you and when you don’t listen that whisper turns into a ton of bricks falling down around you.

They say it’s not wisdom until you actually implement it into your life and recently I listened to the whispers in my life and a made a few changes.

I took a big step back from social media.

Going with my prevention is better than cure, I started to be more conscious of how certain things made me felt and what role they played in my life. I looked at myself as both a consumer and a part of social media. The truth was I didn’t like what I saw.

For any time I would look on Instagram I would ask myself “what value is this adding to my life”. Looking at the super rich in their amazing clothes and holidays added very little value to mine. Then there were some account which one could group as “inspirational”. In fact there are some pretty great doctors out there making pretty big waves on social media from promoting healthy ways to eat to motiving people to work out more.

But again if I was really honest with myself, how was that beneficial to my life beyond the benefit they have already had? On balance most of the stuff I end up looking at was frivolous and whilst that’s ok at times, these apps are designed to be addictive and 5 minutes here and there soon adds up and that’s time that I wouldn’t choose to use in this way. I would just end up doing so!

Everyone is so happy to show everyone the highlight reel of their life. We all know no ones life is perfect but when you look at those perfectly captures “candid pictures” with Valencia and the perfect amount of brightness and contrast, we forget. Or at least I do. And that I think can be very damaging. Because we compare our reality to someones else perfected squares.

Facebook is the same. For every engagement picture there are triple the heartbreaks and breakups I’m sure. But we don’t hear about that.

And I’m in that group too. I don’t post the crap times of my life either but posting the best bits of my life makes me feel uncomfortable too. I’m not 100% sure why. I guess a part of my feel that it’s a bit dishonest putting one side of the story. Another is I don’t want the world knowing what I’m doing. I guess I don’t find Facebook useful at the moment. I’m not interested in keep up to date with everyone else’s life.

If you’re my friend I already know. We keep in touch in other ways.

Since deactivating my Facebook and getting Instagram off my phone I feel happier. I have noticed my concentration levels have increased and my time feels like my time now. Where I would show off about doing certain thing I don’t have to spend the time to think about which picture to use or which caption. I switch off.

Your mind and your attention are so precious and I don’t want to waste them on things that don’t serve that attention.

I still have my Instagram and my Facebook is deactivated for now. I’m not against social media but I am against wasting time and continuing with old behaviour just because “everyone does it”. I still check Instagram once a day but I’ve taken a backseat to my consumption and uploader status for a while and that’s suiting me just fine.

Whatever your opinion on social media, I hope thing made you think a little. You might love it and get so much out of it in which case carry on! But if you don’t and you don’t find it to be a good thing in your life then perhaps a little sabbatical or just what you need.

Until the next post,

Salma

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

do you boo

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One of the commonest things I notice about people who are lacking confidence is that they don’t realise their own self worth.

Now if this was a trivial things that didn’t really have any life implications I wouldn’t dwell on it but it really isn’t. These past few months I’ve really been struck by a few (mainly female) people I have met who don’t value themselves enough.

The thing that everyone needs to realise in my opinion if that NO ONE can offer what they can and that makes us all unique. And that in itself makes everyone pretty badass in my book. But not considering that and worrying about what Tallula has that you don’t is so disempowering and is the stupidest thing you can do.

Worrying about Tallula won’t help you in any way. If anything it will harm you because you stop focusing on you. It is such an unnecessary distraction and in this social media age we could all do with fewer of those.

So here is my advice. Do what no one else can. Do you boo, and don’t ever worry about anything else.

Until the next post,

Salma xxx

 

Poverty

Not a very sexy title is it? As far as click bait goes, I think that title is probably the opposite.

Anyway, a short post from me on something that made me think this week, hence I’m sharing it on here because it might make you think to. I was recently discussing poverty with a group of colleagues and one made the interesting comment about spiritual poverty.

I’ve never thought about that before. What did that even mean. My colleague went onto give an example. “A lack of hope is a type of spiritual poverty.”

That statement created such a moment of *oh my God* for me. It really is a thing. I’ve seen it so many times but I’ve never labelled it.

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It’s not the poverty I think of but it probably is the worst of them all. Hopelessness is a terrible feeling. It makes you feel powerless and redundant to your circumstances and like you can’t affect any change.

By the way, spirituality is different to religion. I know people get funny about religion.

Take this post a reminder from me to me first and them me to you to check in with yourself spiritually. Hopelessness is just one symptom really.

Poverty apparently come in more shapes and sizes than I first thought.

Until the next post!

Salma

Funny thing we did as med students

Ah to be a medical student. Everything to learn, zero responsibility and a sweet naive attitude that makes every patient interaction so rosy and meaningful.

I miss those days at times and seeing a medical student stand in line the other for coffee the other day made doing something ridiculous we use to do made me smile and made me want to write this blog post. So here it is, my name and shame of the ridiculous thing we use to do as medical students, because I’ve done them all!

1. Making choosing a stethoscope a major life decision

Everyone remembers their first time. First you have to choose which one you want. To go with the urban tribe and get the Classic Littman or risk looking like a douche and getting the cardiology Littman when you probably still wont be able to can’t hear a grade 6 murmur? Then colour selection. To go for what you like or go for how you think people will best perceive you? You might want pink but is pink professional? Will people think you’re a Malibu barbie? But you’re a med student. Black it is then…

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“If we wear black and have black stethoscopes people will think we’re really professional”. GENIUS

2. Wearing your stethoscope everywhere

The day I finally got my stethoscope and the day I graduated were probably the two of the happiest times during medical school. The first time we went into the hospital we were all ridiculous. I’m talking stethoscopes on on the bus to “work” and stethoscopes on during lunch.

The other day (the med student who inspired me to write this) I saw a med student who had come out of the pouring rain wearing his stethoscope. The pride! We were so happy to be in the hospital and the stethoscope wearing felt like a big part of that. Finally the biochemistry scars were fading and we could be actually doctors (in our head)! I’ve seen the happy stethoscope wearing crop up in many unusual places including the train station with hand gel and badge on as well….

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The lunch time stethoscope wearing and pride

3. Unique history taking

The first time we practiced history taking we had actor patients and I still remember the level of horrific we were. Genuine questions we asked the actor are below!

A standard history where we were wanting to know about alcohol intake “are you an alcoholic?”

Where we determined to diagnose pigeon fanciers lung “what’s your relationship with birds?”

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From do you have any shortness of breath to ARE YOU AN ALCOHOLIC?

4. Smiling in A and E

I had major issues. My friend use to have to me to fix my face several times because I was just so happy to be there it slipped my mind that many people weren’t, especially on a Friday night.

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Walking into A&E like

5. 15 hour histories and examinations

In my first ever history I remember writing gets short of breath on way to shops. How far these shops were? No idea. But I knew what her fave colour was. Missed that pleural effusion? Probably. But there was always time to pick up that fungal nail infection that everyone else had missed. Time to go and find the busy F1 of your important examination finding.

I hope you can relate and I wasn’t the only one doing those things!

Until the next post,

Salma

Tips on surviving in a new place!

So I’ve had a lot going on recently. But in summary I’ve had a big house move and the starting of a new job in a completely new region. Essentially walking away from all the familiar things in my life. *INSERT INTERNAL FREAKOUT HERE*

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The freakout

I’m writing this blog post at the very start of all of that because I won’t be able to relate to  this in a few weeks time so whilst it’s fresh in my head and I’m living it, I’m writing about it.

Moving to a new region is HUGE especially when it’s far away from family and friends so I’m gonna share some of my top tips with you all.

1 -My biggest tip would be be ok with not being OK. Freakout are allowed. I left a place that I had just about become relatively settled in for an area I knew nothing about and where I knew nobody. What the hell had I done?! I think normalising that thinking is really helpful. Trying to cover it up or force yourself to be OK when you’re really not isn’t helpful. Those feelings won’t go by burying them and burying them makes them harder to deal with.

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Going home my first weekend and surprising my Mum with flowers

2- Get some perspective. Or try to. Chances are you’ve moved away for a great reason. For me it was getting into my dream speciality albeit it my not first choice location. Yes there are things that aren’t ideal but how incredibly lucky I am to be doing a job that I LOVE, get in my first year of applying (which lots of people don’t) and be the youngest person in my year of training. There are people who have the exact same move as me to a different country. Or with children they’ve had to move to a different school. It’s a move, it’s really not that deep.

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3-Keep some sort of routine. When so many things are changing it’s important to hold onto some of continuum. Those things that make you happy, keep doing them. For me it’s going to the gym, talking to my family, meditating, praying, eating well, making sure my eyebrows don’t let the rest of my face down. Whatever it is for you, keep doing it. It’s important anyway but when everything is changing it’s essential.

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Loving my daily meditations from Headspace

4-Use your team. Remember that time when your friend called you crying at 2am because the guy she was in love with got married and you spoke to her for hours. Well this is your time to do that kind of stuff if you need it. I had friends and family offer to come and stay with me and my whatsap was popping with “just making sure you’re ok, let me know if you need anything”. Don’t be too proud to ask for help when you need it. Sometimes a phone call makes all the difference. Whatever you need take it! If you’ve been a good friend to someone else they will have no problem with repaying the favour and would be happy to (if they’re a good friend). Pick your friends wisely so when you go through something hard in life they do overtime for you, I’m very very grateful for mine. If you’re on that team and reading this THANK YOU!

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Basically

5- Don’t go it alone. Chances are if you’ve moved to a new area for work there will be other people in the same boat as you. Talk to them! My sister gave me very strict instructions “don’t be antisocial, make effort with people” and it was effort for me. I already felt like I had my friends and didn’t particularly want any more but you need to make an effort with people. You might not meet a new best friend but having someone close by you can hang out with or go to the gym with is important. And part of that process is being open with people and making an effort.

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Dinner with new friends

6- If you judge a fish by its ability to climb a tree it will spend its whole life thinking its stupid. Equally if you’re in London and you judge it by its lack of beaches you will think it is rubbish. Not every location has everything. Don’t look at is for what it doesn’t have, look at it for what it does. It might sound like a small thing but a small change in perspective can change everything. I don’t have a Zara close to me (I’m slowly getting over this) and my bank balance can breath a sigh of relief, but I do have some of the most beautiful beaches in England a short drive away. What a shame to focus on what is “missing” instead of focusing on what I have around me.

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Not to shabby for an after work walk

7- Go home. This might sound counter intuitive but for me it was so helpful. In the first week of my move I was doing great. Until Thursday. Then I had a little (massive) freakout and wanted to run home so I did. The drive was long but I didn’t care. I was home the whole weekend and planned nothing which is SO not like me but it was exactly what I needed. A little home comfort and some words of encouragement to pick me back up again.

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Halfway home break

8- Give it time. No one settles into a new place in a week so give it time and patient with the place and yourself.

9- Communication is key. Friends and family might be far away but technology is amazing. As I’m typing this I’m also FaceTiming my sister who is folding clothes and talking to her children. I’m not with her, but she feels pretty close. Pick up the phone or use FaceTime.

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Weekend cuddles with my Lana banana

10- I think my last tip would be nothing is the end of the world and there is noting that can’t be undone. If you’re miserable in a place for months (which I doubt will be the case) you can always reevaluate things. There are always options but at the start just give it a chance and go with the flow.

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Mantra for this month: “just keep swimming”

 

If you’ve made it this far, well done! Hope it was helpful.

Until the next post!

Salma.

The one where Romeo was done: the Junior Doctor Years

 

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When I started my first few days as doctor the BMA asked to write about it in a blog for them.

Now on the very last day as my time as junior doctor it only feel natural to reflect on how I was feeling then and how I’m feeling now.

I went to a brilliant medical school but I didn’t feel ready to be a doctor. As a wise friend reassured me, there was no one at that point who was more qualified at that point in their career than me and my other colleagues fresh out of medical school. Even with all the reassurance it felt like a big plunge. 

First day on the job, F1 Aslam in General Surgery. A speedy ward round and then we were on our own. Yes we had seniors around and luckily they were lovely so we could ask them if we needed help but I do remember looking at the other F1’s and thinking “right, so it’s us guys”. 

 

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We made it through our first job. Where we stumbled we helped each other up. A sympathetic ear in the corridor. A text, “I’ve left you a coffee on ward 31”. A reminder to handover and just go home. The struggle was too real but we were in it together. We understood each other.

Then at that magical period when we had all learnt all of the important codes, where the good coffee was and who to go to  if you needed help, we were split up and it and it was a start from the bottom again.

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New job. New people. Unknown Salma.

F1 Aslam Acute Medicine. The weight loss ensued. I literally dropped a dress size and looked dreadful. 

“Don’t eat by the computer, have a proper break” I’m told by one of the consultants.

This job is a lesson in how to look after yourself because I was failing at that on an astronomical level.

Teary on the way home from work. It’s just never enough. I learn by the end that it is is never enough. All you can do if your best and that is good enough. There will always more patients to see and more jobs to do. Self preservation is paramount.

Final job of F1. Reunited with one of my friend and we become team gastro. 

Gastro makes me hangry at time and we stay late a lot. On those really bad days, we get give sympathy chips from the ward hostess and inhale them.

The weight loss is rectified much to my families relief. Punjabi family- no one liked slim Salma. 

We panic less. We’re almost at the end. I’m with my friend. If we have tough days we have each other and cake. Cake is our friend.

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End of the year. Breather for a hot minute and then we’re a back to it.

Something different for me. F2 Aslam Hospice.

This job is an honour to do. The best nursing I have ever seen, the most dedicated staff and I learn some important life lessons.

I start horse riding lessons, there is nothing to wait for and no ones guaranteed anything. I try to be as brave in my own life as the patients around me and go after what I want. I try to appreciate more the everyday. One of my patients sits out in a chair with the help of the physio before I go on leave. It makes my week.

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The first job I have been sad to leave but onto Radiology.

The supernumerary life is sweet and I get to learn. Ironically work usually get in the way of learning. Here I am a sponge. I am jealous of the Radiologists eyes and brain. Apparently we can see the same thing but really they’re the only ones seeing the images. I play envious spectator, go the MDT meetings and get to help with interventions. I go to ITU and see ultrasound at the bedside. I get time to use the ultrasound probe. People know my name. They encourage me. I’m in a happy radiology bubble and decide to apply so that one day I can sit in the lower GI MDT and feel really smart too.

I get into Radiology and it’s a win for hard work and being brave.

Last job F2 Aslam the GP.

I left my heart in Radiology. It’s a different world and I realise early on that it’s not for me. Long days with no other juniors around me.

Never ending tea and tasks.

Done.

One months funployment until Radiology starts.

Do I feel ready for that? Well just like Salma at the end of medical school, no, but I’m as ready as I’ll ever be.

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Until the next post xxx