1 00:00:00,050 --> 00:00:03,109 When you think about your career now, is it any different to the one 2 00:00:03,109 --> 00:00:07,009 that you imagined when you first started out, or have you started 3 00:00:07,009 --> 00:00:09,334 to feel stuck and maybe even bored? 4 00:00:09,874 --> 00:00:13,504 And more importantly, is your identity so wrapped up in what you 5 00:00:13,504 --> 00:00:17,736 do that it feels uncomfortable even asking yourself those questions? 6 00:00:18,138 --> 00:00:21,591 What we want from the second half of our working lives is often very different 7 00:00:21,801 --> 00:00:23,811 from what we wanted when we started out. 8 00:00:23,991 --> 00:00:26,811 And for me, that's nearly 27 years ago. 9 00:00:27,209 --> 00:00:30,742 When we are younger, we tend to crave recognition and status and often 10 00:00:30,742 --> 00:00:34,552 strive for seniority or leadership roles, but we often find that, 11 00:00:34,552 --> 00:00:38,812 especially within healthcare, that a succession of promotions has led us 12 00:00:38,812 --> 00:00:42,802 further away from the work we were so excited to do in the first place. 13 00:00:43,432 --> 00:00:47,752 This week, Dr. Mark Shrime, author and surgeon, is back on the podcast to 14 00:00:47,752 --> 00:00:50,422 talk about medical careers in midlife. 15 00:00:50,722 --> 00:00:53,902 If you are starting to notice that you're not getting quite the same meaning 16 00:00:53,902 --> 00:00:58,102 from your work as you used to, it might be that you are on what David Brooks 17 00:00:58,102 --> 00:01:02,602 calls the second mountain, where you are no longer chasing status so much, 18 00:01:02,812 --> 00:01:06,352 but looking for a way to help the next generation or do something that offers 19 00:01:06,382 --> 00:01:08,925 purpose and meaning over recognition. 20 00:01:09,285 --> 00:01:12,375 So whether you are at that midpoint in your career or you're starting 21 00:01:12,375 --> 00:01:14,325 to wonder whether what you want now. 22 00:01:14,530 --> 00:01:19,000 Will in fact serve you later in life, Mark has some great advice to get you unstuck, 23 00:01:19,270 --> 00:01:23,380 reconnect with what's really important to you, build a career that's sustainable, 24 00:01:23,584 --> 00:01:25,804 and which offers purpose and meaning. 25 00:01:28,085 --> 00:01:32,135 If you're in a high stress, high stakes, still blank medicine, and you're feeling 26 00:01:32,135 --> 00:01:37,591 stressed or overwhelmed, burning out or getting out are not your only options. 27 00:01:37,821 --> 00:01:41,751 I'm Dr. Rachel Morris, and welcome to You Are Not a Frog. 28 00:01:45,202 --> 00:01:46,312 My name is Mark Shrime. 29 00:01:46,312 --> 00:01:48,442 I am a surgeon by training. 30 00:01:48,472 --> 00:01:51,022 I'm the editor in chief of BMJ Global Health. 31 00:01:51,352 --> 00:01:55,012 I've written a book called Solving for Why, and I'm particularly interested in 32 00:01:55,012 --> 00:02:00,072 how we as healthcare providers, healthcare professionals, make big career decisions. 33 00:02:00,326 --> 00:02:05,494 So, I think this is very pertinent to, to our listeners, uh, either listeners 34 00:02:05,494 --> 00:02:08,374 like me who are in the second half of their lives of their careers, or people 35 00:02:08,374 --> 00:02:12,244 that are maybe coming up to 'em thinking, well, will I always want to be doing this? 36 00:02:12,454 --> 00:02:16,114 But let's start off with, you know, when people come to you, typically what issues 37 00:02:16,114 --> 00:02:17,734 and problems are they, are they bringing? 38 00:02:18,043 --> 00:02:23,773 the majority of my clients, uh, are in healthcare, uh, physicians, nurses, uh, 39 00:02:23,773 --> 00:02:27,123 and other allied health professionals, including, um, including people who 40 00:02:27,123 --> 00:02:31,143 are not officially in healthcare but are carers, uh, for others. 41 00:02:31,726 --> 00:02:34,585 And caring is a. It's a tough job. 42 00:02:34,720 --> 00:02:36,340 it demands a lot out of you. 43 00:02:36,790 --> 00:02:40,480 And so a lot of people end up finding me because they get to a point where 44 00:02:40,480 --> 00:02:43,990 they're burnt out and they get to a point where they're done with, they're, 45 00:02:44,020 --> 00:02:48,137 they're done with what they've been going through on the day-to-day, but they 46 00:02:48,137 --> 00:02:50,912 still have this caring instinct in them. 47 00:02:51,657 --> 00:02:55,887 And they're not exactly sure how to navigate, uh, okay. 48 00:02:55,887 --> 00:02:58,047 I, I, I still love seeing my patients. 49 00:02:58,047 --> 00:03:02,337 I still love being in the operating room, but I kind of hate the day 50 00:03:02,337 --> 00:03:05,187 to day and kind of hate what it's done to me over the last 20 years. 51 00:03:05,547 --> 00:03:09,379 Um, I had a client once say to me, this client was a, is an OR nurse. 52 00:03:09,439 --> 00:03:12,784 Um, the way she framed it was I don't, I don't get it. 53 00:03:12,784 --> 00:03:15,094 I've been an OR nurse for 20 years, so that what? 54 00:03:15,094 --> 00:03:17,254 I can continue to be an OR nurse for another 20 years? 55 00:03:17,494 --> 00:03:20,374 So that kind of, I'm, I'm halfway through. 56 00:03:20,374 --> 00:03:21,604 I'm kind of stuck. 57 00:03:21,687 --> 00:03:24,657 it hasn't been the ride that I was promised. 58 00:03:24,807 --> 00:03:26,127 And what do I do? 59 00:03:26,277 --> 00:03:30,867 How do I balance all of these things, my calling, my identity and also wanting 60 00:03:30,867 --> 00:03:33,473 to live and exist in a non burntout way. 61 00:03:33,751 --> 00:03:37,201 So it's burnout a big reason then why people are coming. 62 00:03:37,359 --> 00:03:38,453 I think burnout, yeah, yes. 63 00:03:38,513 --> 00:03:40,343 Burnout is a big reason why people end up coming. 64 00:03:40,544 --> 00:03:44,429 increasingly I'm thinking obviously that's what people present with, they 65 00:03:44,429 --> 00:03:47,439 say they're burnt out, but it's like saying they come to you with knee pain. 66 00:03:47,652 --> 00:03:50,262 Yeah, there's pain in their knee, but what on earth has caused that? 67 00:03:50,262 --> 00:03:53,292 And unless you start to look at the cause, and that can be caused by all 68 00:03:53,292 --> 00:03:57,202 sorts of things, and so often we're just trying to heal burnout, we're 69 00:03:57,202 --> 00:04:00,202 trying to treat the symptoms, we're not, we're not looking at the cause. 70 00:04:00,772 --> 00:04:07,201 So are people not enjoying the actual sort of meat of their jobs? 71 00:04:07,441 --> 00:04:10,621 Is it everything else that's getting on top of them? 72 00:04:11,251 --> 00:04:13,891 Or do you think it's something a little bit deeper than that? 73 00:04:14,311 --> 00:04:15,511 Well, I think it's both. 74 00:04:15,601 --> 00:04:20,689 I, you definitely have people who will say, and, you know, I'm one of these 75 00:04:20,689 --> 00:04:22,489 people I love being in the operating room. 76 00:04:22,839 --> 00:04:27,729 I really, really like the act of operating and seeing patients and, uh, all that. 77 00:04:27,909 --> 00:04:32,079 I, I personally, I shut down my US practice seven years ago. 78 00:04:32,139 --> 00:04:35,889 I don't see patients in the US anymore because I hated everything else around it. 79 00:04:36,489 --> 00:04:39,279 Um, so there's definitely a, a subset of people, and it's a fairly 80 00:04:39,279 --> 00:04:42,988 large subset of the people that, that I, uh, work with who have that. 81 00:04:43,523 --> 00:04:47,543 Um, who are like, yes, I still want to be a healer in some way. 82 00:04:47,543 --> 00:04:51,953 I still have this, this value in me, I still have this identity, but, 83 00:04:52,237 --> 00:04:54,157 uh, this is not what I was promised. 84 00:04:54,438 --> 00:04:56,508 And then you've got the, you've got another subset of people 85 00:04:56,508 --> 00:04:58,218 who are fully done with it. 86 00:04:58,568 --> 00:05:00,278 All of it is, is over. 87 00:05:00,308 --> 00:05:02,618 Uh, maybe they liked it when they were 26. 88 00:05:02,678 --> 00:05:05,258 Uh, maybe they never liked it, but just put on our front. 89 00:05:05,708 --> 00:05:09,758 Uh, but whatever, now that they're 46, they've decided that that 90 00:05:09,758 --> 00:05:13,058 is not the direction that they want their life to go altogether. 91 00:05:13,358 --> 00:05:14,888 They wanna make a significant shift. 92 00:05:15,293 --> 00:05:16,433 I use this example often. 93 00:05:16,433 --> 00:05:20,147 I, uh, early in my coaching career, talked to somebody who wanted to 94 00:05:20,147 --> 00:05:21,797 leave medicine and open a goat farm. 95 00:05:22,031 --> 00:05:25,901 And so you get, you get all of, all of that, uh, that whole spectrum. 96 00:05:26,241 --> 00:05:30,272 And do you find that the issues that you're dealing with in people sort 97 00:05:30,272 --> 00:05:33,422 of entering the, the second half of their lives and what they're wanting 98 00:05:33,422 --> 00:05:36,152 is very different from, say, if you were doing some career coaching with 99 00:05:36,152 --> 00:05:37,802 some of the, the younger people? 100 00:05:38,297 --> 00:05:40,757 I do think so, uh, I think a couple of reasons. 101 00:05:40,757 --> 00:05:45,227 First of all, I, if you've been in healthcare for, you know, 20 years or 102 00:05:45,227 --> 00:05:49,731 so, you've seen basically everything and you've seen the evolution of 103 00:05:49,731 --> 00:05:51,948 the healthcare system in whatever country that you happen to be in. 104 00:05:52,444 --> 00:05:57,164 And then there is a big shift that happens in people around 105 00:05:57,164 --> 00:05:58,484 the middle of their lives. 106 00:05:58,604 --> 00:06:03,286 You know, we, we know it as a midlife crisis, um, which you and I were talking 107 00:06:03,286 --> 00:06:07,666 before we started the recording, that that phrasing is just so harmful also, 108 00:06:07,696 --> 00:06:09,556 that it's a crisis that must be managed. 109 00:06:09,946 --> 00:06:13,426 But there is, I mean, it's, there's, there's research, there's uh, there's 110 00:06:13,426 --> 00:06:17,086 evidence that people go through a big shift in the middle of their lives. 111 00:06:17,573 --> 00:06:20,363 So you get both of those sort of, kind of layered on top of each other. 112 00:06:20,634 --> 00:06:24,377 that the conversations that we have when we're in our forties and fifties, 113 00:06:24,857 --> 00:06:27,857 uh, and, and early sixties are very different than the conversations that we 114 00:06:27,857 --> 00:06:32,027 would've had when we were in our twenties, deciding which specialty do I want to go 115 00:06:32,027 --> 00:06:33,917 into, or do I want to go into medicine? 116 00:06:34,181 --> 00:06:38,111 One of them, do I want to go into medicine versus do I want to stay in medicine? 117 00:06:38,231 --> 00:06:40,901 Very, very different, uh, conversations to have. 118 00:06:41,277 --> 00:06:45,537 I'm very interested in this thing about actually you would've liked to just 119 00:06:45,537 --> 00:06:47,547 do the operating and, and carry on. 120 00:06:48,217 --> 00:06:49,117 Is that really true? 121 00:06:49,117 --> 00:06:52,777 Like, if someone said to you in the US you could work five days a week 122 00:06:52,927 --> 00:06:56,692 purely doing the operating and nothing else, would you not get a bit bored? 123 00:06:57,382 --> 00:06:59,272 yes, undoubtedly I would get a little bit bored. 124 00:06:59,842 --> 00:07:03,622 There are certain people, and one of my, uh, fellowship directors was this sort 125 00:07:03,622 --> 00:07:11,182 of person for whom getting the absolute minutiae of an operation down and slightly 126 00:07:11,182 --> 00:07:14,422 faster every single time, or slightly better, every single time that drives him. 127 00:07:14,662 --> 00:07:16,642 That's not me, that's not my personality. 128 00:07:16,762 --> 00:07:18,682 Uh, so I probably would get a little bit bored. 129 00:07:19,072 --> 00:07:24,262 The problem though, is that what I was offered as a full-time practicing 130 00:07:24,262 --> 00:07:30,412 clinician to, you know, uh, I dunno, add some spice to the boredom was not fun. 131 00:07:30,742 --> 00:07:34,072 That it was the, it was the billing and it was the medical legal and it 132 00:07:34,072 --> 00:07:36,682 was the profit and loss and it was the health insurance interaction. 133 00:07:36,682 --> 00:07:40,984 So yes, I would've gotten a little bit bored, but I don't think the solution 134 00:07:40,984 --> 00:07:44,764 that the American healthcare system presents is all that good either. 135 00:07:44,898 --> 00:07:45,168 Yeah. 136 00:07:45,168 --> 00:07:48,798 I think you've helped me articulate the thing that was ne niggling at me, because 137 00:07:49,151 --> 00:07:50,921 yeah, I had the same issue as a gp. 138 00:07:50,921 --> 00:07:55,841 I, I got really bored just seeing pa the same old, same old, same 139 00:07:55,841 --> 00:07:58,781 old again, although it was, the workload was really high. 140 00:07:58,781 --> 00:08:00,821 So it was this combination of bored and stress. 141 00:08:01,348 --> 00:08:03,478 But I know that I need something else to stimulate me. 142 00:08:03,478 --> 00:08:06,718 And you need to grow and develop, and every human needs to grow and develop, 143 00:08:06,748 --> 00:08:08,218 but then you've got this problem that's. 144 00:08:08,505 --> 00:08:12,315 Growing and developing, so in, in healthcare for example, is often 145 00:08:12,315 --> 00:08:15,555 becoming clinical director, becoming director, and getting these management 146 00:08:15,555 --> 00:08:17,055 and leadership responsibilities. 147 00:08:17,595 --> 00:08:21,525 And then you hit like midlife and you've seen that this career trajectory that 148 00:08:21,525 --> 00:08:24,705 you've been on is, you know, I used to sort run the professionalism course 149 00:08:24,705 --> 00:08:27,165 and then the next step would be to go up here and then the next step here. 150 00:08:27,165 --> 00:08:30,075 But I, I didn't wanna do that, but I still wanted to learn and develop. 151 00:08:30,075 --> 00:08:33,585 So then suddenly I've got the only career path that seemed to be open to me was 152 00:08:33,585 --> 00:08:34,995 like this, but I knew that that was. 153 00:08:35,370 --> 00:08:39,000 Not what I wanted, but nor did I want to just keep seeing patients. 154 00:08:39,030 --> 00:08:40,650 'cause I was finding that boring. 155 00:08:40,989 --> 00:08:43,239 So then I was stuck and that was my conundrum. 156 00:08:43,239 --> 00:08:45,039 Is that familiar to you? 157 00:08:45,654 --> 00:08:47,514 Gosh, yes, a a hundred percent. 158 00:08:48,025 --> 00:08:49,285 Let me say two things here. 159 00:08:49,495 --> 00:08:53,995 I, I've gotten lucky in that I've gotten to construct a life in which my clinical 160 00:08:53,995 --> 00:08:58,531 work is to a large degree, the operating and the taking care of patients without 161 00:08:58,531 --> 00:08:59,971 the other stuff that's around it. 162 00:09:00,481 --> 00:09:04,231 Um, and I do that because I do some global health work and I do that 12 weeks a year. 163 00:09:04,231 --> 00:09:06,901 I'm operating 12 weeks a year, and I get my. 164 00:09:07,381 --> 00:09:10,261 I get my operative numbers, uh, but also I get, I get to be able 165 00:09:10,261 --> 00:09:12,451 to do the thing that I, one of the things that I really love to do, 166 00:09:13,083 --> 00:09:17,871 I was also on a similar path where the only real advancement, so to 167 00:09:17,871 --> 00:09:21,591 speak in, in medicine is to become a director, become a chair of a 168 00:09:21,591 --> 00:09:23,631 department, become a CMO, et cetera. 169 00:09:23,631 --> 00:09:25,131 And I've done all, I was the chair of a department. 170 00:09:25,131 --> 00:09:29,901 I was a chief medical officer, um, and that's basically the only career path 171 00:09:29,901 --> 00:09:33,884 that we are given to broaden ourselves. 172 00:09:34,004 --> 00:09:37,874 Uh, and so we end up people like you and me, we end up doing things that are 173 00:09:37,927 --> 00:09:40,201 outside of medicine, to broaden ourselves. 174 00:09:40,351 --> 00:09:45,222 But at least when our generation was training, that wasn't 175 00:09:45,222 --> 00:09:47,172 necessarily looked upon very well. 176 00:09:47,591 --> 00:09:50,681 You know, you've, you've left medicine in inverted commas 177 00:09:50,921 --> 00:09:52,721 to do this non-medical thing. 178 00:09:53,171 --> 00:09:56,874 Um, are you not a, serious surgeon? 179 00:09:56,874 --> 00:09:58,434 Are you not a serious GP? 180 00:09:58,764 --> 00:10:00,624 Uh, do you not care about your patients? 181 00:10:01,002 --> 00:10:06,942 When I was CMO of the, uh, the charity that I, I work with, um, I was in 182 00:10:06,942 --> 00:10:11,442 that post for about three years and the COO, uh, of the charity, uh, so 183 00:10:11,442 --> 00:10:16,468 one of my colleagues, came from the mobile phone industry first, and then 184 00:10:16,468 --> 00:10:21,838 he moved to aviation and then he moved to be the COO of a medical charity. 185 00:10:22,248 --> 00:10:27,363 And I think about this, his career path a lot because in that sort of world. 186 00:10:27,363 --> 00:10:28,653 He comes from the project management world. 187 00:10:28,653 --> 00:10:32,163 In that sort of world, it's totally normal to take your project management 188 00:10:32,163 --> 00:10:36,513 skills and go from mobile phones to, uh, aviation, to to healthcare. 189 00:10:36,813 --> 00:10:40,263 But for us in medicine, oh my gosh, if you get out of medicine, 190 00:10:40,893 --> 00:10:42,003 there's something wrong with you. 191 00:10:42,003 --> 00:10:44,373 We have this push that you must stay in. 192 00:10:44,433 --> 00:10:46,893 The only path that you can have is in medicine. 193 00:10:47,006 --> 00:10:48,353 That, that really rings a bell. 194 00:10:48,353 --> 00:10:50,063 It's that identity thing, isn't it? 195 00:10:50,063 --> 00:10:53,944 It's that it's very difficult for us to imagine an identity outside of medicine. 196 00:10:53,944 --> 00:10:56,488 And people feel a lot of shame when you think about. 197 00:10:56,488 --> 00:10:57,778 Not even just leaving even. 198 00:10:57,778 --> 00:11:00,598 Just like, well, for a day a week I might do something else. 199 00:11:00,598 --> 00:11:01,288 Is it like. 200 00:11:01,560 --> 00:11:05,670 And I think colleagues shame you as well, or actually nobody can shame you 201 00:11:05,670 --> 00:11:10,050 except yourself, colleagues criticize you and sort of talk about deserting 202 00:11:10,050 --> 00:11:14,010 a sinking ship or being too commercial or, or that, that sort of thing. 203 00:11:14,010 --> 00:11:17,580 But, you know, we need commercial people in healthcare, quite frankly, to, you 204 00:11:17,580 --> 00:11:19,290 know, innovate and stuff like that. 205 00:11:19,290 --> 00:11:20,505 But You're right. 206 00:11:20,505 --> 00:11:24,915 Why is it that we encounter the shame and criticism in healthcare yet in any 207 00:11:24,915 --> 00:11:27,998 other industry, but like, yeah, you, you've just moved to a, a different 208 00:11:27,998 --> 00:11:30,158 role, it, there's no dramas about that. 209 00:11:30,219 --> 00:11:33,549 Yeah, and I think you said you, you hit on it in the first thing you said, 210 00:11:33,549 --> 00:11:37,659 which is that there are, I've been calling them the identity professions. 211 00:11:37,869 --> 00:11:41,139 There are professions in which our identity is our profession. 212 00:11:41,379 --> 00:11:46,311 Doctors, lawyers, clergy, you know, you are a priest, you are 213 00:11:46,311 --> 00:11:48,351 a lawyer, uh, you are a doctor. 214 00:11:48,861 --> 00:11:52,857 And that is so much harder to leave. 215 00:11:52,948 --> 00:11:57,208 Uh, a good friend of mine is a, uh, is a ballet dancer here in New York City. 216 00:11:57,388 --> 00:12:03,968 And she wrote a book in which her last chapter kind of meditates on leaving 217 00:12:04,148 --> 00:12:08,318 ballet because, you know, ballet is hard on your body, and so when you hit your 218 00:12:08,378 --> 00:12:12,833 thirties or maybe early forties at some point you no longer dance professionally. 219 00:12:13,373 --> 00:12:18,803 And that chapter is a, is sort of a meditation on who am I without this? 220 00:12:18,923 --> 00:12:22,883 And it's something that I had to go through as I was deciding to shut 221 00:12:22,883 --> 00:12:27,473 down my US practice, is something I used to compete, um, on a, an intense 222 00:12:27,473 --> 00:12:28,913 sport called American Ninja Warrior. 223 00:12:28,913 --> 00:12:31,793 And it's something that as I moved away from Ninja Warrior, 224 00:12:31,793 --> 00:12:34,591 I also had to consider, like, who am I without my white coat? 225 00:12:34,621 --> 00:12:36,337 Who am I without Ninja? 226 00:12:36,480 --> 00:12:40,525 Because those things become your identity, in a way that perhaps 227 00:12:40,525 --> 00:12:44,485 some of the other professions don't necessarily become your identity. 228 00:12:44,725 --> 00:12:49,015 And so then we feel the internal shame that I was called to be a 229 00:12:49,015 --> 00:12:50,425 doctor and now I'm leaving it. 230 00:12:50,425 --> 00:12:51,775 Is there something wrong with me? 231 00:12:52,144 --> 00:12:55,864 And there is the external pressure from our colleagues also that we need to stay 232 00:12:55,924 --> 00:12:59,554 because, oh my gosh, those people who leave, there's something wrong about 233 00:12:59,554 --> 00:13:00,934 their commitment to their patients. 234 00:13:01,407 --> 00:13:04,822 I mean, that's part of what people have to wrestle with in, 235 00:13:04,957 --> 00:13:06,337 in these midlife transitions. 236 00:13:06,337 --> 00:13:07,147 It's what I had to wrestle with. 237 00:13:07,147 --> 00:13:10,507 It's what my clients have to wrestle with is does, does this mean? 238 00:13:10,507 --> 00:13:15,307 Does does moving, does changing mean that I am somehow less impactful in the 239 00:13:15,307 --> 00:13:20,257 world that I somehow, yeah, have have failed what I was put on this earth to do? 240 00:13:20,287 --> 00:13:21,872 These sorts of phrases we hear all the time. 241 00:13:22,653 --> 00:13:25,743 So how do you help people wrestle with that? 242 00:13:25,743 --> 00:13:28,953 And I'm thinking now, not just for people that want to leave, but actually 243 00:13:28,953 --> 00:13:33,153 there might be people that are still working as a doctor, senior, another 244 00:13:33,153 --> 00:13:35,403 senior healthcare professional that aren't gonna leave, but actually they 245 00:13:35,403 --> 00:13:39,003 realize that their identity and their significance is coming from their 246 00:13:39,003 --> 00:13:41,523 role and they realize it'd probably be a bit healthier for them if they 247 00:13:41,763 --> 00:13:44,253 managed to loosen that hold on them. 248 00:13:44,773 --> 00:13:50,197 What I'm gonna say is when I first heard this, like truly, I don't wanna say 249 00:13:50,197 --> 00:13:52,027 depressed, but like truly made me down. 250 00:13:52,166 --> 00:13:52,414 Right. 251 00:13:52,516 --> 00:13:53,156 Brace yourselves, 252 00:13:53,436 --> 00:13:53,596 everyone. 253 00:13:54,194 --> 00:13:56,740 yeah, brace yourselves, but then it was really freeing, uh, 254 00:13:56,740 --> 00:14:01,579 honestly, which is, I do not know my great-great grandfather's name. 255 00:14:01,788 --> 00:14:04,368 I don't think I even know my great-grandfather's name. 256 00:14:04,968 --> 00:14:09,258 A hundred years from now, very likely nobody will remember 257 00:14:09,258 --> 00:14:10,728 Mark Shrime or Rachel Morris. 258 00:14:10,988 --> 00:14:12,008 And that's depressing. 259 00:14:12,008 --> 00:14:15,098 For those of us, especially who feel like we have a calling in this world. 260 00:14:15,518 --> 00:14:19,058 Uh, the likelihood that we will be remembered for the 261 00:14:19,058 --> 00:14:21,458 work that we did is low. 262 00:14:21,785 --> 00:14:27,504 And so coming to grips with the fact that our legacy, so to speak, 263 00:14:27,542 --> 00:14:29,372 is likely to be short-lived. 264 00:14:29,526 --> 00:14:31,806 was depressing, but also becomes really freeing. 265 00:14:31,956 --> 00:14:37,476 That I'm putting this pressure on myself that I must be this amazing, 266 00:14:37,476 --> 00:14:39,246 impactful person in the world. 267 00:14:39,846 --> 00:14:41,286 But really that pressure's coming from me. 268 00:14:41,406 --> 00:14:43,386 The pressure's not necessarily coming from the world. 269 00:14:43,476 --> 00:14:44,976 It may be coming from my colleagues, as we talked about 270 00:14:44,976 --> 00:14:46,416 earlier, but that's also unhealthy. 271 00:14:46,931 --> 00:14:49,809 So How do we then change that? 272 00:14:49,809 --> 00:14:53,139 'Cause presumably these are really deep seated, deep rooted stuff. 273 00:14:53,379 --> 00:14:55,299 You need to spend hours and hours in therapy. 274 00:14:55,704 --> 00:14:57,834 I mean, you can spend hours and hours in therapy, and I'm 275 00:14:57,874 --> 00:14:59,374 a full believer in therapy. 276 00:14:59,505 --> 00:15:05,515 Uh, at the same time, part of what drives us into these things is a value set. 277 00:15:05,515 --> 00:15:12,948 It's a set of values that we had and have, um, when we're 26 and when we're 46 or 56. 278 00:15:13,829 --> 00:15:17,824 What we give ourselves less permission to do than maybe we 279 00:15:17,824 --> 00:15:20,044 should, is for those values to change 280 00:15:20,350 --> 00:15:24,055 Significant evidence that our value sets do change over the course of our lives. 281 00:15:24,770 --> 00:15:30,597 Just as a very specific example, my values around, uh, public health changed. 282 00:15:30,965 --> 00:15:36,927 Because of my experiences working in, uh, west and, uh, and southern Africa, right? 283 00:15:36,927 --> 00:15:40,587 And my experiences have shifted the way that my values, uh, align. 284 00:15:40,802 --> 00:15:42,182 And that's, that's what happens. 285 00:15:42,182 --> 00:15:45,722 I mean, our values are not set in stone to a large degree, they are malleable. 286 00:15:45,722 --> 00:15:50,822 And yet again, as physicians, as healthcare professionals, we feel like 287 00:15:50,822 --> 00:15:54,062 the values that we had at 26 should remain with us for the rest of our lives. 288 00:15:54,482 --> 00:15:55,592 And some of them do. 289 00:15:55,862 --> 00:15:57,182 Like I really do. 290 00:15:57,270 --> 00:16:02,880 Uh, value being able to use these skills to be a healer, but some of them don't. 291 00:16:02,940 --> 00:16:06,624 Some of them completely leave and then the, I use this, this 292 00:16:06,624 --> 00:16:10,524 analogy with my clients of a, a sound board, a sound mixing board. 293 00:16:11,004 --> 00:16:14,124 Um, you know, if you've been to a concert and you've seen the sound person 294 00:16:14,124 --> 00:16:18,474 in the back moving these knobs up and down, that's what our values do too. 295 00:16:18,564 --> 00:16:21,954 They kind of realign themselves and, and one of the knobs maybe turns up 296 00:16:21,954 --> 00:16:27,174 more as your kids are born, uh, perhaps the value of being home more goes up. 297 00:16:27,444 --> 00:16:28,339 Um, and then maybe as they. 298 00:16:28,884 --> 00:16:30,294 Leave for college. 299 00:16:30,354 --> 00:16:33,204 Perhaps the value of, I dunno, travel goes up. 300 00:16:33,625 --> 00:16:35,365 Our internal values change. 301 00:16:35,515 --> 00:16:39,265 Again, we put this pressure on ourselves that that mixing board must stay static 302 00:16:39,475 --> 00:16:43,975 for the entirety of our lives, but it, it actually doesn't, it's allowed to change. 303 00:16:44,421 --> 00:16:47,991 What values typically are changing along the way? 304 00:16:47,991 --> 00:16:51,531 There's that thing about, yeah, wanting to be home or wanting not, not to be home. 305 00:16:51,531 --> 00:16:54,683 Are there any particular values that people tend to really hold onto at 306 00:16:54,713 --> 00:16:59,379 work that are completely different in their late forties, fifties to 307 00:16:59,379 --> 00:17:01,539 when they're in their thirties? 308 00:17:01,539 --> 00:17:03,969 I mean, off the top of my head, I'm thinking, you know, probably that 309 00:17:03,969 --> 00:17:06,219 whole having to achieve a a lot. 310 00:17:06,625 --> 00:17:08,905 So this is, this is old, old psychology. 311 00:17:08,905 --> 00:17:13,055 This is Eric Erickson, back in the, uh, I don't know, I wanna say 1950s, but don't 312 00:17:13,055 --> 00:17:18,155 quote me on that, developed this, this, these stages of psychosocial development 313 00:17:18,605 --> 00:17:20,465 over the course of the entire life cycle. 314 00:17:20,645 --> 00:17:23,525 So a lot of the study at that point had been, you know, what are the 315 00:17:23,525 --> 00:17:24,635 phases that babies go through? 316 00:17:24,635 --> 00:17:25,925 What are the phases that children go through? 317 00:17:25,925 --> 00:17:28,235 But he developed this stages of psychosocial development 318 00:17:28,475 --> 00:17:29,765 across the entire life cycle. 319 00:17:30,172 --> 00:17:35,662 And each stage of psychosocial development is characterized by 320 00:17:35,692 --> 00:17:38,242 a crisis that must be managed. 321 00:17:38,512 --> 00:17:43,612 And if that crisis is not managed, then the next stage of psychosocial development 322 00:17:43,612 --> 00:17:45,572 becomes harder to manage, right? 323 00:17:45,572 --> 00:17:52,078 And so in his framing, the crisis that has to be managed in your, uh, 324 00:17:52,108 --> 00:17:56,745 like late teens and early twenties is identity versus confusion. 325 00:17:57,244 --> 00:17:58,174 Who am I? 326 00:17:58,414 --> 00:18:01,594 What am I, I'm, I need to establish who I am in this world. 327 00:18:01,866 --> 00:18:06,766 And then in the forties to sixties, the crisis that you have to manage 328 00:18:06,826 --> 00:18:08,686 is generativity versus stagnation. 329 00:18:08,962 --> 00:18:10,102 Stagnation, we understand. 330 00:18:10,132 --> 00:18:12,742 We know what stag we as healthcare providers sometimes feel. 331 00:18:12,742 --> 00:18:17,367 The stagnation, generativity in the way that he, envisioned it is, 332 00:18:17,567 --> 00:18:19,377 is, is kind of legacy thinking. 333 00:18:19,607 --> 00:18:20,487 What do I do? 334 00:18:20,667 --> 00:18:22,377 How do I leave behind? 335 00:18:22,497 --> 00:18:24,387 How do I train the next generation? 336 00:18:24,387 --> 00:18:25,437 You know, what is the legacy? 337 00:18:25,437 --> 00:18:27,597 I know we talked about our legacies will disappear in a hundred years, 338 00:18:27,597 --> 00:18:31,917 but what am I passing on to the next, uh, the next generation of people? 339 00:18:32,564 --> 00:18:37,074 So already when we're younger, when we're establishing our careers, the thing that's 340 00:18:37,074 --> 00:18:39,474 driving us is establishing our identity. 341 00:18:39,558 --> 00:18:43,038 But then by the time we get to our forties, to fifties to early sixties, 342 00:18:43,275 --> 00:18:45,476 we should have established that. 343 00:18:45,566 --> 00:18:48,806 And it's okay for us to let go of that because we no longer 344 00:18:48,806 --> 00:18:50,186 have that psychosocial crisis. 345 00:18:50,186 --> 00:18:55,438 Our crisis now is we could stagnate or we can build into something else. 346 00:18:55,918 --> 00:19:00,238 And I think this is super important for people who are in our midlife because 347 00:19:00,404 --> 00:19:03,794 again, if you don't manage that crisis in that particular stage well, you have 348 00:19:03,794 --> 00:19:05,594 a harder time managing the next crisis. 349 00:19:05,594 --> 00:19:10,124 And the words that Erickson uses is for the next crisis are a little terrifying. 350 00:19:10,274 --> 00:19:14,084 Uh, the last stage of life he says is, you know, 65 and older. 351 00:19:14,421 --> 00:19:17,901 And the crisis you have to manage there is integrity versus despair. 352 00:19:17,999 --> 00:19:18,419 Wow. 353 00:19:19,280 --> 00:19:19,610 Yeah. 354 00:19:19,660 --> 00:19:19,910 Right. 355 00:19:19,910 --> 00:19:20,270 Wow. 356 00:19:20,270 --> 00:19:23,480 Like despair is a, is a hard one for us to think about ending our lives on. 357 00:19:23,840 --> 00:19:28,267 And so that's why I think this midlife shift is so important to manage, because 358 00:19:28,507 --> 00:19:34,943 we have moved into a different part of our lives than we were in when we went 359 00:19:34,943 --> 00:19:36,953 into medicine or nursing or healthcare. 360 00:19:37,661 --> 00:19:41,801 Uh, it's, it, the, the author Richard Rohr calls it, um, the, 361 00:19:41,981 --> 00:19:44,831 basically calls it the second half of life in his book Falling Upwards. 362 00:19:45,141 --> 00:19:50,795 And what we're trying to do as we become the community elder, so to 363 00:19:50,795 --> 00:19:53,165 speak, is very different than what we were trying to do as we were 364 00:19:53,165 --> 00:19:54,635 trying to establish our identity. 365 00:19:55,138 --> 00:19:58,198 That's interesting cause I was thinking earlier when you came out, thinking, 366 00:19:58,198 --> 00:20:02,008 why is it that so many people do when they make their midlife transition? 367 00:20:02,038 --> 00:20:06,568 Do trainer as coaches and you know, sort of consultants wanna help people. 368 00:20:06,568 --> 00:20:08,608 Is it just because they can't think of anything else to do? 369 00:20:08,608 --> 00:20:11,218 But actually it's not, is it? 370 00:20:11,218 --> 00:20:14,414 'Cause if you look at this generativity, that's all to do with yes. 371 00:20:14,414 --> 00:20:18,892 Supporting other people, helping other people come along, not necessarily 372 00:20:18,952 --> 00:20:21,772 wanting, being about, I've got to leave this long lasting legacy, 373 00:20:21,772 --> 00:20:25,702 but it's actually how can I help other people and share my learning? 374 00:20:25,912 --> 00:20:29,676 And that is really nice to think about that. 375 00:20:29,736 --> 00:20:33,276 So when people are thinking about what else can I do either within my role 376 00:20:33,426 --> 00:20:37,416 within medicine or if I'm gonna leave and do something a bit different, think 377 00:20:37,416 --> 00:20:41,766 you, you would probably enjoy a job where you are more in that sort of wise 378 00:20:41,796 --> 00:20:47,496 elder role as apart from perhaps doing the doing and wanting to achieve a lot, 379 00:20:47,946 --> 00:20:50,856 just to boost your own, you know, ego. 380 00:20:51,201 --> 00:20:55,161 You actually probably will be happier, um, doing the generativity thing. 381 00:20:55,161 --> 00:20:57,891 And maybe that's the way we've been designed actually, yeah, 382 00:20:58,131 --> 00:21:00,861 we don't have very much, you know, oh, I'm so much tighter. 383 00:21:00,861 --> 00:21:04,581 I'm, you know, my 50th is later this year and I really notice 384 00:21:04,581 --> 00:21:06,021 how much less energy I have. 385 00:21:06,021 --> 00:21:07,701 I just can't do as much during the day. 386 00:21:07,701 --> 00:21:08,092 So actually, I'm. 387 00:21:08,429 --> 00:21:11,588 Now I'm much more suited to sort of being like a wise old owl 388 00:21:11,588 --> 00:21:13,088 sitting on a perch advising people. 389 00:21:13,088 --> 00:21:16,268 Although my, my children would fall about laughing if they thought that's how I was 390 00:21:16,268 --> 00:21:20,588 describing myself, than I am just actually getting on and, and, and doing the job. 391 00:21:20,588 --> 00:21:24,374 But I don't know how much we value the, the generativity stuff 392 00:21:24,374 --> 00:21:26,234 versus the, the, the doing bit. 393 00:21:26,319 --> 00:21:26,679 Right. 394 00:21:26,795 --> 00:21:27,069 Right. 395 00:21:27,069 --> 00:21:30,399 And we don't, and I, you know, I will say, you said something in there, um, 396 00:21:30,399 --> 00:21:34,359 about when you're younger, you are, uh, trying to do all the things for your ego. 397 00:21:34,449 --> 00:21:35,199 Uh, uh, yes. 398 00:21:35,199 --> 00:21:38,739 There ego can definitely play in there, but that's also the stage that 399 00:21:38,739 --> 00:21:40,809 you're in, is developing your identity. 400 00:21:40,809 --> 00:21:44,169 Like you are developing your mark in, in the world. 401 00:21:44,799 --> 00:21:48,069 And yes, that shifts and I think you are right, that we 402 00:21:48,069 --> 00:21:50,769 don't necessarily value that. 403 00:21:50,979 --> 00:21:54,939 Um, even, and again, an American, so I'm gonna speak from the American healthcare 404 00:21:54,939 --> 00:22:00,329 system, just the way that doctors are paid does not value that mentorship role. 405 00:22:00,389 --> 00:22:04,979 Like I still need to produce the same number of RVUs as a 55-year-old 406 00:22:04,979 --> 00:22:08,129 surgeon, as I needed to produce as a 30 5-year-old surgeon, if not more, 407 00:22:08,609 --> 00:22:11,429 uh, because otherwise my profit and loss statement is, is off. 408 00:22:11,776 --> 00:22:15,349 And so, no, we don't, we don't pay, really, we don't pay out 409 00:22:15,349 --> 00:22:18,469 people's time to do the mentorship. 410 00:22:18,469 --> 00:22:22,294 We just sort of expect that it happens on top of continuing the thing that you 411 00:22:22,294 --> 00:22:24,094 were doing 20 years, 20 years before. 412 00:22:24,094 --> 00:22:27,334 So, yeah, I think you're, you're right, we don't necessarily value 413 00:22:27,334 --> 00:22:29,379 that wise old al as you said. 414 00:22:29,601 --> 00:22:32,001 Whereas the leadership thing, you know, if you have a leader who is 415 00:22:32,091 --> 00:22:36,021 really, uh, very skilled at coaching and mentoring and things like that, 416 00:22:36,021 --> 00:22:38,781 you've got the most fantastic leader. 417 00:22:38,995 --> 00:22:42,019 And I think we don't value it ourselves. 418 00:22:42,019 --> 00:22:45,370 You know, we, we seem to think that leadership takes, like, I don't know, 419 00:22:45,490 --> 00:22:50,097 in, in, in the NHS you might get paid like four hours a week to be the clinical 420 00:22:50,367 --> 00:22:53,667 lead for your department and you've got to keep going with your, your day job 421 00:22:53,667 --> 00:22:56,727 or you feel guilty if, well, actually I'm feeling guilty 'cause actually 422 00:22:56,727 --> 00:22:58,467 most of my time is spent on leadership. 423 00:22:58,467 --> 00:23:02,127 But I'm saying I would much rather, you know, you are much more valuable to your 424 00:23:02,127 --> 00:23:05,260 hospital probably now, spending more of your time leading the department and, 425 00:23:05,265 --> 00:23:09,249 and leaving the doing to the younger people because of the experience that 426 00:23:09,249 --> 00:23:12,879 you've amassed and the, you know, the, the time taking to think of it. 427 00:23:13,169 --> 00:23:16,510 Let's also talk about the fact that we, we don't value it enough 428 00:23:16,510 --> 00:23:18,130 to train people in it either. 429 00:23:18,435 --> 00:23:22,436 The number of clinical leaders who are clinical leaders simply because they 430 00:23:22,436 --> 00:23:25,128 were good clinicians, it's massive. 431 00:23:25,128 --> 00:23:28,649 And so we end up putting people in situations in which 432 00:23:28,649 --> 00:23:30,234 they feel under prepared. 433 00:23:30,591 --> 00:23:35,446 Um, but we expect the same high standard of performance as they 434 00:23:35,446 --> 00:23:38,506 had when they were doing the thing they were prepared for, right? 435 00:23:38,536 --> 00:23:41,686 We, we were in training for medicine for whatever it was, a decade 436 00:23:41,686 --> 00:23:45,211 and a half, so we had a lot of preparation for how to cut and sew. 437 00:23:45,255 --> 00:23:48,135 But then you move into leadership and it's just like, okay, go, good luck, 438 00:23:48,165 --> 00:23:50,055 um, you know, improve your department. 439 00:23:50,138 --> 00:23:51,368 And we don't train them for that. 440 00:23:51,368 --> 00:23:54,518 And so that also leads to the burnout because then you've got these high 441 00:23:54,518 --> 00:23:57,431 performers who are thrust into situations that they're not prepared 442 00:23:57,431 --> 00:24:03,487 for, and, they feel themselves, falling down on, on what they're asked to do. 443 00:24:03,916 --> 00:24:07,336 And they also feel guilty for not spending time on the shop floor. 444 00:24:07,366 --> 00:24:10,486 They feel guilty for the leadership time, which is, is madness really, 445 00:24:10,486 --> 00:24:12,149 when it's, they're so, so valuable. 446 00:24:12,522 --> 00:24:16,341 So you've got people coming to you, they're entering the second half 447 00:24:16,341 --> 00:24:19,551 of their life, they're having this sort of identity crisis or whatever. 448 00:24:19,911 --> 00:24:25,041 What else do you do with them that really helps them with this, this transition and, 449 00:24:25,041 --> 00:24:28,011 and work out actually what, what should the second half of my life look like? 450 00:24:28,389 --> 00:24:30,969 So my PhD is in the science of decision making. 451 00:24:31,239 --> 00:24:35,079 And I think the other thing that we struggle with, uh, is that we don't 452 00:24:35,079 --> 00:24:41,739 necessarily have good frameworks, good methods, good, uh, training in how 453 00:24:41,739 --> 00:24:44,319 to make big decisions in our lives. 454 00:24:44,739 --> 00:24:49,089 We're so good as clinicians at making decisions for other people, sometimes 455 00:24:49,089 --> 00:24:50,949 very impactful decisions for other people. 456 00:24:51,249 --> 00:24:58,179 But then to look at ourselves, nobody talks to us about how we can make 457 00:24:58,179 --> 00:25:03,160 these big decisions for our own lives, because big decisions are fraught 458 00:25:03,160 --> 00:25:04,600 with a whole bunch of uncertainty. 459 00:25:05,040 --> 00:25:06,630 I say this all the time to my clients. 460 00:25:06,700 --> 00:25:08,140 No decision is made. 461 00:25:08,190 --> 00:25:09,060 Uncertainty. 462 00:25:09,300 --> 00:25:11,460 Every decision is made under uncertainty because if there was 463 00:25:11,460 --> 00:25:12,750 certainty, it wouldn't be a decision. 464 00:25:13,140 --> 00:25:16,509 So for making these big decisions, small or big for making these big decisions 465 00:25:16,509 --> 00:25:22,179 in our lives, we have zero way really of conceptualizing or taking into account 466 00:25:22,179 --> 00:25:25,659 all this uncertainty that our identity and our values and all the things 467 00:25:25,659 --> 00:25:27,699 we're talking about earlier brings in. 468 00:25:27,969 --> 00:25:32,706 Uh, so I work a lot with my clients on that, on how do we actually 469 00:25:32,757 --> 00:25:34,287 surface all of this uncertainty? 470 00:25:34,287 --> 00:25:36,057 How do we deal with this, uh, this uncertainty? 471 00:25:36,057 --> 00:25:36,837 How do we describe it? 472 00:25:36,837 --> 00:25:41,184 How do we bring it into our decision so that when we're done, we can look back 473 00:25:41,184 --> 00:25:45,474 on it, on that decision and, and say, okay, with everything I knew at the time, 474 00:25:45,864 --> 00:25:47,454 I made the best decision, I, I could. 475 00:25:47,812 --> 00:25:51,772 It's really hard though to make the decisions about your future 476 00:25:51,772 --> 00:25:54,994 self when you're not that self, but also you don't know what it's 477 00:25:54,994 --> 00:25:56,194 gonna be like when you are there. 478 00:25:56,194 --> 00:25:59,464 A really silly example, we are wondering about moving house at the 479 00:25:59,464 --> 00:26:03,201 moment, but we don't know whether we want to move further into town or 480 00:26:03,201 --> 00:26:04,791 whether we want to move out of town. 481 00:26:04,791 --> 00:26:07,851 But it's a really big decision and you're not gonna know we're 482 00:26:07,851 --> 00:26:09,381 there and what made the wrong one? 483 00:26:09,614 --> 00:26:11,699 Well, there were two things I wanna say to that. 484 00:26:11,789 --> 00:26:12,839 Uh, the first is. 485 00:26:13,199 --> 00:26:14,219 Absolutely, you're right. 486 00:26:14,349 --> 00:26:17,642 Transformative experiences lead to personal transformation, but 487 00:26:17,642 --> 00:26:20,012 they lead to something called an epistemic transformation. 488 00:26:20,192 --> 00:26:25,773 You don't know what you don't know, and you cannot know how you will feel after 489 00:26:25,773 --> 00:26:28,391 a big decision on the front side of it. 490 00:26:28,391 --> 00:26:32,261 Like you cannot sitting here, you absolutely cannot know how 491 00:26:32,261 --> 00:26:36,534 you will feel if you decide to move closer into town or out. 492 00:26:36,891 --> 00:26:39,957 So to some degree you're never going to answer that question. 493 00:26:40,527 --> 00:26:43,677 So fixating on trying to answer that question, all it 494 00:26:43,677 --> 00:26:45,777 does is it keeps you stuck. 495 00:26:46,287 --> 00:26:49,857 There are a number of different ways to manage uncertainty. 496 00:26:50,097 --> 00:26:56,067 Um, one of them is to, and, and I, and I think a, a, a maladaptive way to do 497 00:26:56,067 --> 00:26:58,137 it is called, uh, is called reduction. 498 00:26:58,137 --> 00:27:00,387 It's to try to reduce the uncertainty all the way to 499 00:27:00,387 --> 00:27:03,141 zero, and that just never works. 500 00:27:03,378 --> 00:27:08,568 And so people who, um, who have that tendency towards uncertainty, just 501 00:27:08,568 --> 00:27:12,648 continually try to gain more information, more information about the uncertainty 502 00:27:12,648 --> 00:27:17,328 until, until they're satisfied that it's down to zero, but they never act. 503 00:27:17,744 --> 00:27:22,664 Uh, so the other thing I would say to that though is we are, we have a 504 00:27:22,664 --> 00:27:25,223 remarkable psychological immune system. 505 00:27:25,466 --> 00:27:32,034 We are remarkably adaptable to situations that we think are going to be terrible. 506 00:27:32,094 --> 00:27:36,207 There's a fascinating study in which the authors looked at, college 507 00:27:36,207 --> 00:27:41,688 students and asked them how happy they would be in the future if they were 508 00:27:41,688 --> 00:27:47,035 assigned to a, an undesirable dormitory versus to a desirable dormitory. 509 00:27:47,524 --> 00:27:50,335 And the answers were what you'd expect. 510 00:27:50,485 --> 00:27:54,295 The people who were thought they would be assigned to an un undesirable 511 00:27:54,295 --> 00:27:57,445 dormitory thought they would be much less happy than those who, but then 512 00:27:57,445 --> 00:28:01,608 a year in their happiness levels were identical, whether they were assigned 513 00:28:01,608 --> 00:28:03,768 to a, a bad or a good dormitory. 514 00:28:04,248 --> 00:28:06,678 We are so good at this. 515 00:28:06,678 --> 00:28:10,038 We, our psychological immune system is so good, we are so adaptable that you 516 00:28:10,038 --> 00:28:14,866 decide to move closer into town, there are gonna be good and bad things about 517 00:28:14,866 --> 00:28:20,416 it and eventually a year in you're gonna be just as happy as you would've been 518 00:28:20,416 --> 00:28:24,376 had you decided to move further away, uh, from town because the good and 519 00:28:24,376 --> 00:28:25,666 bad will balance them each other out. 520 00:28:26,154 --> 00:28:28,344 That's encouraging, but also quite depressing. 521 00:28:28,344 --> 00:28:31,314 'cause presumably if you get someone coming to you and they're pretty 522 00:28:31,314 --> 00:28:35,187 miserable now, they can also reach the same level of misery in a new 523 00:28:35,187 --> 00:28:37,139 life that they've decided to, to do. 524 00:28:37,421 --> 00:28:38,188 That's such a good point. 525 00:28:38,188 --> 00:28:42,843 I think, what I'm trying to say here is that our, our affective forecasting 526 00:28:42,873 --> 00:28:44,943 is what the, uh, authors call it. 527 00:28:45,183 --> 00:28:47,163 Our affective forecasting is pretty bad. 528 00:28:47,579 --> 00:28:55,621 We are mostly okay knowing whether we will be happier or sadder, uh, with a decision, 529 00:28:55,621 --> 00:29:00,211 we're mostly okay with the direction of the affective positive or negative. 530 00:29:00,451 --> 00:29:08,350 We overestimate, however, how big the, uh, emotion will be and how long it'll last. 531 00:29:08,710 --> 00:29:12,026 Another study of, uh, professors going up for tenure. 532 00:29:12,241 --> 00:29:16,530 Again, pre pre-tenure decision, we're asked, you know, how happy or sad 533 00:29:16,530 --> 00:29:19,020 will you be if you get or don't get tenure, and how long do you think that 534 00:29:19,020 --> 00:29:20,700 happiness or sadness will will last? 535 00:29:21,193 --> 00:29:23,803 And routinely, they overestimated both. 536 00:29:23,893 --> 00:29:27,763 So yes, the professors who got tenure were happier than those that 537 00:29:27,763 --> 00:29:33,343 didn't, but for less time and less intensity than they thought they would. 538 00:29:33,615 --> 00:29:34,995 Gosh, that is really interesting. 539 00:29:35,025 --> 00:29:38,175 Okay, so you are not gonna know unless you try it, but you often 540 00:29:38,175 --> 00:29:42,708 overestimate the effects on your, your happiness or, or sadness as it were. 541 00:29:42,798 --> 00:29:46,188 Okay, so how do people make these decisions and how 542 00:29:46,188 --> 00:29:47,208 do, how do you help them? 543 00:29:47,208 --> 00:29:51,588 You know, what's the techniques that has the biggest value for you that you just 544 00:29:51,588 --> 00:29:53,178 come back to again and again and again? 545 00:29:53,588 --> 00:29:57,458 so broadly in a, in a 50,000 foot view. 546 00:29:57,739 --> 00:30:01,129 We start with the thing that we were talking about in the first half of 547 00:30:01,129 --> 00:30:02,839 this podcast, which is the values. 548 00:30:03,354 --> 00:30:05,574 We actually build someone's mixing board. 549 00:30:05,616 --> 00:30:09,576 We figure out, you know, you pick your five, no, you pick, we like, we go 550 00:30:09,576 --> 00:30:13,446 through exercises in which your five top values get, get kind of surfaced, 551 00:30:13,866 --> 00:30:15,396 and then you build that mixing board. 552 00:30:15,396 --> 00:30:19,754 Which one at this point in my life, do I think is, number one, number 553 00:30:19,754 --> 00:30:20,924 two, all the way down to number five? 554 00:30:21,524 --> 00:30:24,284 Very specifically though, which one do I think? 555 00:30:24,344 --> 00:30:28,904 So I'm trying not to hear what other people think it should be, and at 556 00:30:28,904 --> 00:30:32,204 this point in my life, not when I was 18 and choosing to go into medicine. 557 00:30:32,234 --> 00:30:37,034 So we build that and then there are, uh, I use five different 558 00:30:37,364 --> 00:30:40,962 decision making frameworks, and we match them to the person. 559 00:30:41,258 --> 00:30:44,411 But frameworks that are very um. 560 00:30:44,951 --> 00:30:48,161 Kinda risk taking, uh, frameworks that ask, you know, what's 561 00:30:48,161 --> 00:30:49,151 the best that could happen? 562 00:30:49,511 --> 00:30:51,581 Frameworks that ask, what's the worst that can happen and let's 563 00:30:51,581 --> 00:30:52,871 protect ourselves against that. 564 00:30:53,381 --> 00:30:55,541 Uh, frameworks that, that bring in regret. 565 00:30:55,751 --> 00:30:57,641 Uh, what happens if I make the wrong decision? 566 00:30:57,641 --> 00:30:58,571 How much will I regret it? 567 00:30:58,571 --> 00:30:59,711 And let's minimize that regret. 568 00:30:59,861 --> 00:31:03,461 So we find the framework that is the most, uh, that, that kind of speaks 569 00:31:03,461 --> 00:31:04,871 to the heart of the person the most. 570 00:31:05,261 --> 00:31:09,611 Then we can combine those values that they've elicited with those frameworks 571 00:31:09,611 --> 00:31:13,911 that take into account the uncertainty of how much regret I will have. 572 00:31:14,049 --> 00:31:18,339 And what that does is eventually it, it, there's, there's some math behind 573 00:31:18,339 --> 00:31:19,869 it, but it bubbles to the surface. 574 00:31:20,198 --> 00:31:22,869 What I think the next stage of my, my, the next step should be. 575 00:31:23,708 --> 00:31:27,075 So now that I've put everything together, I, it really is looking 576 00:31:27,075 --> 00:31:29,265 like I should go into cabinet making. 577 00:31:29,634 --> 00:31:32,634 Um, again, this is actually a real example I should go into cabinet making. 578 00:31:33,046 --> 00:31:38,066 Uh, then we take a really important pause and we ask, now I need you to, 579 00:31:38,186 --> 00:31:43,694 to envision yourself at 86, looking back on your life, and I know this 580 00:31:43,694 --> 00:31:46,503 sounds morbid, but I actually have my clients write their obituary. 581 00:31:47,004 --> 00:31:51,624 What do you want your obituary to read and how does this decision fit in with that? 582 00:31:51,891 --> 00:31:55,401 so we've kind of future test their decision and we also 583 00:31:55,401 --> 00:31:56,901 reality test their decision. 584 00:31:56,901 --> 00:31:59,361 So you want to go into cabinet making, let's get you in touch 585 00:31:59,361 --> 00:32:00,201 with some cabinet makers. 586 00:32:00,261 --> 00:32:03,501 Spend a couple days, spend a weekend shadowing some cabinet makers. 587 00:32:03,651 --> 00:32:05,991 What is the of cabinet making feel like? 588 00:32:06,559 --> 00:32:12,019 And then finally the last step that we do is once we have, uh, surfaced 589 00:32:12,019 --> 00:32:14,539 the decision, we've taken into account the values, we've taken into 590 00:32:14,539 --> 00:32:17,629 account, the uncertainty, once we've future tested and reality tested the 591 00:32:17,629 --> 00:32:20,099 assumptions, then it's time to act. 592 00:32:20,339 --> 00:32:24,299 And this is where a lot of people get stuck, is super cool to think about deci 593 00:32:24,569 --> 00:32:30,725 a decision in, in the hypothetical, but okay, now I am gonna be a cabinet maker. 594 00:32:30,963 --> 00:32:32,812 What does it take to do that? 595 00:32:32,902 --> 00:32:34,702 Um, what's my financial runway? 596 00:32:34,822 --> 00:32:37,882 Uh, you know, how long do I have to make this cabinet making a success? 597 00:32:38,242 --> 00:32:41,722 Uh, what are the medical legal consequences of me 598 00:32:41,872 --> 00:32:42,832 shutting down my practice? 599 00:32:42,832 --> 00:32:46,506 You know, how do I brand myself all those, the, that, that actual step by step. 600 00:32:47,201 --> 00:32:50,711 I think one of the reasons that people stay stuck is because making 601 00:32:50,711 --> 00:32:54,011 a big shift seems so insurmountable. 602 00:32:54,311 --> 00:32:58,871 And once you break it down into small steps, you know, in, in May I need to 603 00:32:58,871 --> 00:33:03,761 do this, in June, I need to do this, then it becomes, it's, it's bite-sized. 604 00:33:03,761 --> 00:33:06,791 You know, the, the journey of a thousand miles begins with a single step, you 605 00:33:06,791 --> 00:33:08,441 actually take that, that first step. 606 00:33:08,734 --> 00:33:11,244 I think that's where doctors really struggle is like, it's 607 00:33:11,244 --> 00:33:13,104 such a big field to do this. 608 00:33:13,164 --> 00:33:15,864 Um, so that's really, really practical. 609 00:33:16,584 --> 00:33:20,664 Do you think it really matters what anybody does, if they 610 00:33:20,664 --> 00:33:21,774 get other things right? 611 00:33:22,224 --> 00:33:25,254 Because I've got this theory that there are these sort of core needs 612 00:33:25,254 --> 00:33:28,614 that we all have, and I call it your North star needs, which is to feel 613 00:33:28,614 --> 00:33:32,574 good, to have good deep relationships, find meaning and purpose in life. 614 00:33:33,034 --> 00:33:37,354 But my theory is that if you've got all those things in your life, actually 615 00:33:37,354 --> 00:33:41,404 what you are doing, probably not gonna make huge amounts of difference. 616 00:33:41,821 --> 00:33:43,291 I, yes, I agree with you. 617 00:33:43,471 --> 00:33:48,841 Um, and I, I think it's su super interesting that you split out 618 00:33:49,411 --> 00:33:51,691 meaning and purpose and work. 619 00:33:52,926 --> 00:33:57,396 Because that's another thing that we, as, as healthcare professionals tend 620 00:33:57,396 --> 00:34:02,736 to, uh, we tend to combine those two, that we must find our meaning in our 621 00:34:02,736 --> 00:34:05,256 work, and that's not actually true. 622 00:34:05,256 --> 00:34:07,686 The number of people who don't find their meaning in their work 623 00:34:07,686 --> 00:34:09,576 far outnumbers the people who do. 624 00:34:10,144 --> 00:34:15,375 And we, I think, need to really come to grips with the fact that it's okay 625 00:34:15,375 --> 00:34:17,025 that your meaning is something else. 626 00:34:17,025 --> 00:34:20,655 It is okay that taking care of patients is a job that you do on Tuesdays and 627 00:34:20,655 --> 00:34:24,105 Thursdays from eight to five, and then you find your meaning in your cabinet 628 00:34:24,105 --> 00:34:26,955 making totally okay to do that as well. 629 00:34:27,222 --> 00:34:29,232 I think it's a, it's a double-edged sword, isn't it? 630 00:34:29,232 --> 00:34:33,192 Because I know that a lot of the burnout research shows that purpose is 631 00:34:33,192 --> 00:34:35,871 a really powerful antidote to burnout. 632 00:34:35,901 --> 00:34:40,041 However, I have, and I think we talked about this in the last podcast, Mark, is 633 00:34:40,041 --> 00:34:44,834 that I've, I've looked at people that find a lot of their meaning and purpose through 634 00:34:44,834 --> 00:34:48,876 their work, or put all their meaning and meaning and purpose into their work, and 635 00:34:49,206 --> 00:34:51,306 they get burnt out even even quicker. 636 00:34:51,336 --> 00:34:54,546 'Cause if you genuinely think your job is to save the world and you do that 637 00:34:54,546 --> 00:34:58,926 through being a doctor or a priest or this or that, then actually when you're 638 00:34:58,926 --> 00:35:02,286 not doing it, you are not fulfilling your, not just your purpose, but you are 639 00:35:02,736 --> 00:35:07,086 poor, all these souls that are unsaved or whatever, that's a, a huge amount of 640 00:35:07,086 --> 00:35:11,196 pressure that just feeds into the whole identity and significance thing as well. 641 00:35:11,421 --> 00:35:11,661 Yeah. 642 00:35:11,661 --> 00:35:13,671 And I, I do think we talked about this last time, the intersection 643 00:35:13,671 --> 00:35:17,961 between purpose and burnout is not, it's not a clean straight line. 644 00:35:17,961 --> 00:35:21,528 It's not that finding your purpose leads to less burnout, because 645 00:35:21,528 --> 00:35:22,368 it might actually lead to more 646 00:35:22,518 --> 00:35:25,908 Yeah, I think sometimes it really, really does, particularly in healthcare. 647 00:35:25,944 --> 00:35:28,824 And so, yeah, no, I, I really love the concept of the, the zone of 648 00:35:28,914 --> 00:35:31,674 genius and Michael Hyatt describes that where you are doing what you 649 00:35:31,674 --> 00:35:33,234 love and also what you're good at. 650 00:35:33,234 --> 00:35:34,854 So it's finding something where you've got your skills, 651 00:35:34,854 --> 00:35:36,394 but you also enjoy doing that. 652 00:35:36,847 --> 00:35:39,642 And that can be in paid work or out of paid work. 653 00:35:39,642 --> 00:35:43,782 And I was listening to a, a brilliant audio book by one of 654 00:35:43,782 --> 00:35:46,752 my, my favorite people, Rob Rob Bell, who does the Rob cast. 655 00:35:46,752 --> 00:35:49,962 And I'm sure you, you've come across Rob Bell before and he was just talking 656 00:35:49,962 --> 00:35:52,842 about the fact that, you know, if you find something here that's no one's 657 00:35:52,842 --> 00:35:55,182 really gonna pay you to do, but it really gives you a lot of meaning and 658 00:35:55,182 --> 00:35:58,032 purpose and you love doing it, then great, find some work that's gonna pay 659 00:35:58,032 --> 00:36:00,192 your bills to enable you to do that. 660 00:36:00,192 --> 00:36:03,552 But we always think, oh, work has to have all this meaning 661 00:36:03,552 --> 00:36:04,752 and be really significant. 662 00:36:04,752 --> 00:36:07,992 Actually, if you've got enough money to exist, then go do that other thing. 663 00:36:08,115 --> 00:36:08,385 Yeah. 664 00:36:08,385 --> 00:36:10,635 There's, there's a concept, and actually I have it at the end of my book. 665 00:36:10,635 --> 00:36:12,615 And the more I've, I've thought about it, the more, I think 666 00:36:12,615 --> 00:36:13,725 it's an incomplete concept. 667 00:36:13,725 --> 00:36:16,839 But there's a concept that had a lot of, cachet in the public discourse, 668 00:36:16,839 --> 00:36:20,379 maybe five, 10 years ago, called Ikigai, the Japanese concept that what you 669 00:36:20,379 --> 00:36:23,348 should be doing is what you're good at, what you can get paid for, what 670 00:36:23,348 --> 00:36:24,578 the world needs and what you love. 671 00:36:24,885 --> 00:36:30,765 But I think what you're saying here, which I agree with, is that, uh, we have this, 672 00:36:30,825 --> 00:36:35,966 uh, presupposition that one thing has to do all four of those things, but it's 673 00:36:35,966 --> 00:36:39,296 not, you need to have all four of those things in your life, but they don't all 674 00:36:39,296 --> 00:36:41,276 necessarily have to come from one thing. 675 00:36:41,681 --> 00:36:41,921 Yeah. 676 00:36:41,921 --> 00:36:43,511 I think people get very hung up on the. 677 00:36:43,573 --> 00:36:46,153 what the world's gonna pay you for and what the world needs. 678 00:36:46,303 --> 00:36:49,753 Um, I mean, you know, in an ideal world, we'd all be contributing greatly and 679 00:36:49,753 --> 00:36:51,613 everyone would pay us well for doing that. 680 00:36:51,613 --> 00:36:54,223 But in, in a, in a real world, it doesn't. 681 00:36:54,253 --> 00:36:57,133 And then you see other people doing absolute crap and 682 00:36:57,133 --> 00:36:58,333 getting paid loads for it. 683 00:36:58,333 --> 00:37:01,153 You know, you just look at the, the influencers who like, you 684 00:37:01,153 --> 00:37:03,943 know, what are they doing that's not meaningful or worthwhile, but 685 00:37:03,943 --> 00:37:05,053 they're getting paid so much money. 686 00:37:05,053 --> 00:37:07,660 So if you know, then you get your worth from what you get paid. 687 00:37:07,660 --> 00:37:09,280 It's just, it's just ridiculous. 688 00:37:09,280 --> 00:37:13,833 And then, or we try and bend what we really enjoy doing into 689 00:37:13,833 --> 00:37:15,903 what people are gonna pay for. 690 00:37:16,023 --> 00:37:19,533 So the market forces or, or people even don't know that they need it 691 00:37:19,533 --> 00:37:22,563 and, and that's when I think you then start to feel like a failure. 692 00:37:23,013 --> 00:37:24,213 'cause people won't pay for it. 693 00:37:24,213 --> 00:37:26,553 Or maybe people don't need it, but you still love doing it. 694 00:37:26,553 --> 00:37:27,513 Doesn't mean you shouldn't do it. 695 00:37:27,582 --> 00:37:28,271 Right, right. 696 00:37:28,271 --> 00:37:32,771 We're aligned here, that we don't necessarily need to bend, uh, what 697 00:37:32,771 --> 00:37:34,391 we're doing to what the world pays for. 698 00:37:34,391 --> 00:37:40,023 We need to find a, an overall portfolio of our lives that 699 00:37:40,023 --> 00:37:41,523 addresses all four of those things. 700 00:37:41,523 --> 00:37:44,853 Or in your, in, in your analogy, all five of the, of the core 701 00:37:44,853 --> 00:37:46,173 needs, the North star needs. 702 00:37:46,593 --> 00:37:50,201 And that, When we, when we look at romantic relationships, we feel like 703 00:37:50,201 --> 00:37:55,001 one person has to provide every single need in our lives, and that leads 704 00:37:55,001 --> 00:37:56,531 to a lot of stress in relationships. 705 00:37:56,981 --> 00:37:58,451 We're doing the same thing with jobs. 706 00:37:58,511 --> 00:38:02,261 That one job or one thing that we do has to provide all of the North Star 707 00:38:02,261 --> 00:38:03,251 needs that you're talking about here. 708 00:38:03,251 --> 00:38:05,021 And that puts too much stress on the job too. 709 00:38:05,410 --> 00:38:08,290 I don't really know any job that can really do all of that. 710 00:38:08,927 --> 00:38:13,457 and it takes it away from, you know, I, I once did a, it was called a performance 711 00:38:13,457 --> 00:38:16,397 site diamond with a, a senior consultant. 712 00:38:16,457 --> 00:38:19,307 Um, and it was a way of marking how well your job was doing in 713 00:38:19,307 --> 00:38:24,767 terms of purpose, achievement, recognition and growth or something. 714 00:38:24,767 --> 00:38:26,747 And, uh, so he marked himself. 715 00:38:26,927 --> 00:38:30,407 a, a lot of achievement, a lot of recognition, a lot of purpose, 716 00:38:30,407 --> 00:38:32,087 but enjoyment pretty low. 717 00:38:32,327 --> 00:38:34,187 And then I said, well, what, what would you want it to be? 718 00:38:34,187 --> 00:38:36,107 And he put his achievement of recognition. 719 00:38:36,107 --> 00:38:38,087 He actually reduced the amount. 720 00:38:38,087 --> 00:38:41,027 So I said, well, well, you, you want less recognition and achievement? 721 00:38:41,027 --> 00:38:43,907 He said, yes, because look how much it's pulling down my enjoyment. 722 00:38:44,478 --> 00:38:47,808 And this goes back to the conversation we were having before about Richard Rohr 723 00:38:47,808 --> 00:38:51,810 and Eric Erickson, that when you're in your twenties and your thirties, uh, 724 00:38:51,810 --> 00:38:55,290 achievement and recognition is something that drives you because you are trying 725 00:38:55,290 --> 00:38:57,930 to figure out that identity crisis. 726 00:38:57,930 --> 00:39:03,748 But once you've figured out that crisis, it's so, so common for people to retreat 727 00:39:03,928 --> 00:39:06,328 and to say, I don't need this anymore. 728 00:39:06,388 --> 00:39:07,078 I've done it. 729 00:39:07,138 --> 00:39:08,398 You know, I've done the thing. 730 00:39:08,398 --> 00:39:11,818 I've, I you, in your example, I've become the clinical director, 731 00:39:12,005 --> 00:39:15,080 and it wasn't what I wanted to do and I don't need it anymore. 732 00:39:15,710 --> 00:39:20,000 So Mark, what else do you think needs to be present in the second half of 733 00:39:20,000 --> 00:39:23,600 life for people to sort of really enjoy themselves and have sort of fulfilling 734 00:39:23,990 --> 00:39:25,670 life that we haven't mentioned already? 735 00:39:26,285 --> 00:39:30,691 Often, when you're at the second half of life, you are making a decision. 736 00:39:30,721 --> 00:39:36,799 You know, you're making a decision for, I have 15 years, whatever left of my career. 737 00:39:37,238 --> 00:39:40,578 Do I want to spend it the way I've spent the last 15? 738 00:39:41,094 --> 00:39:44,994 And I think the people who navigate that the best are the people who are able 739 00:39:44,994 --> 00:39:50,150 to answer that question the best, give themselves permission to actually ask that 740 00:39:50,150 --> 00:39:54,500 question and if the answer is yes, great, but not assume that the answer is yes. 741 00:39:54,693 --> 00:39:57,423 And actually, even if the answer is yes, probably in five years time 742 00:39:57,513 --> 00:39:59,283 the answer's gonna be probably not. 743 00:39:59,343 --> 00:40:00,543 Let's keep changing. 744 00:40:00,618 --> 00:40:00,968 Yeah. 745 00:40:00,968 --> 00:40:01,628 Uh, yes. 746 00:40:01,628 --> 00:40:05,288 And, and that growth that's in your North Star, uh, yes. 747 00:40:05,318 --> 00:40:07,838 The fact that we, we need to allow ourselves to change. 748 00:40:07,838 --> 00:40:10,808 We need to allow ourselves to reinvent ourselves, um, throughout 749 00:40:10,808 --> 00:40:11,289 the course of our lives. 750 00:40:11,983 --> 00:40:14,803 So Mark, if you've got people that are, they're not yet, they're not sort of 751 00:40:14,803 --> 00:40:17,233 wanting to do a full blown career change, but they want to put sort of some of 752 00:40:17,233 --> 00:40:20,623 this into, into action 'cause they, they know something not quite right and they 753 00:40:20,623 --> 00:40:24,506 need to shift things around a bit, what would your three top quick actions be 754 00:40:24,892 --> 00:40:29,993 So I think the first thing that one really need to do is, is that I'm 755 00:40:29,993 --> 00:40:33,473 a surgeon, so you'll forgive the, the phrasing I use for this, but 756 00:40:33,533 --> 00:40:35,363 is that dissection of their values. 757 00:40:35,697 --> 00:40:40,317 Really take a good look at what you're assuming your values are and ask if 758 00:40:40,317 --> 00:40:42,027 that's really what, what they still are. 759 00:40:42,597 --> 00:40:45,987 Uh, so you dissect your value, you dissect out your values, number one. 760 00:40:46,017 --> 00:40:47,667 These are not quick, unfortunately, these are hard. 761 00:40:47,787 --> 00:40:50,547 Uh, but I do think people need to do that. 762 00:40:50,637 --> 00:40:54,177 Uh, I think the second thing that, the second, there's a big mindset shift that 763 00:40:54,177 --> 00:40:59,063 we also need to make, which we didn't get time to talk about here, which is we 764 00:40:59,063 --> 00:41:05,153 assume that we have no other marketable skills besides medicine, which is 765 00:41:05,243 --> 00:41:10,343 incorrect because to be a good doctor, you have to be a good communicator. 766 00:41:10,343 --> 00:41:14,513 You have to be, uh, you know, at least somewhat good with people. 767 00:41:14,513 --> 00:41:15,323 You have to, et cetera. 768 00:41:15,323 --> 00:41:17,183 You have to be a good systems thinker, et cetera, et cetera. 769 00:41:17,213 --> 00:41:21,083 So, uh, the second thing that I would tell people to do is to figure out 770 00:41:21,083 --> 00:41:24,413 what are the skills that I have that I've learned because I'm a doctor, 771 00:41:24,473 --> 00:41:28,123 but I've kind of devalued because they aren't specific to doctoring? 772 00:41:28,536 --> 00:41:34,865 And then combine those two and start asking the question, if I want to design 773 00:41:34,865 --> 00:41:38,495 for myself more of a portfolio career, so I don't wanna leave altogether, but I 774 00:41:38,495 --> 00:41:40,415 don't want to do this full-time either. 775 00:41:40,415 --> 00:41:45,125 If I wanna design a more of a portfolio career to address the other needs 776 00:41:45,125 --> 00:41:48,737 in my North Star, uh, five, what things should I start looking at? 777 00:41:49,091 --> 00:41:50,011 And think broadly. 778 00:41:50,011 --> 00:41:51,431 I mean, honestly, think broadly. 779 00:41:51,521 --> 00:41:54,221 Uh, I've given two examples already of a cabinet maker and somebody 780 00:41:54,221 --> 00:41:55,421 who wants to open a goat farm. 781 00:41:55,421 --> 00:42:01,091 Like we can think we, uh, as clinicians have a lot of skills, we can think 782 00:42:01,091 --> 00:42:02,861 really broadly, uh, around those things. 783 00:42:03,059 --> 00:42:03,809 I love that. 784 00:42:03,809 --> 00:42:07,139 And I think also if you sort of add in that thinking of, well, when I'm designing 785 00:42:07,139 --> 00:42:11,279 my portfolio career, maybe I'm gonna go for the stuff that's more pointing 786 00:42:11,279 --> 00:42:15,599 towards that generativity, rather than the, the achievement and the recognition. 787 00:42:15,659 --> 00:42:20,189 And yeah, you can do anything and, and sometimes just doing something different 788 00:42:20,279 --> 00:42:22,645 one day a week is enough isn't it? 789 00:42:22,645 --> 00:42:25,165 Is enough of a change to get you outta burnout or even just dropping one 790 00:42:25,165 --> 00:42:29,455 particular role in your clinical role that's just gonna give you a bit more 791 00:42:29,515 --> 00:42:33,394 breathing space and head space to be able to, to do that stuff that you really 792 00:42:33,394 --> 00:42:36,214 love and that will bring you some of that meaning and purpose and stuff, even, 793 00:42:36,274 --> 00:42:37,654 even if you're not paid for it, right? 794 00:42:37,846 --> 00:42:38,414 Totally agreed. 795 00:42:38,414 --> 00:42:38,894 Totally agreed. 796 00:42:38,894 --> 00:42:42,219 And, and you know, that portfolio career, again, we all do 797 00:42:42,219 --> 00:42:43,419 actually have portfolio careers. 798 00:42:43,419 --> 00:42:46,149 If we're in the middle of our lives and we're clinicians, we have built 799 00:42:46,149 --> 00:42:49,539 a portfolio, but that portfolio is all clinical or all like medical. 800 00:42:49,959 --> 00:42:53,019 You can start to add things to that that are not as well. 801 00:42:53,362 --> 00:42:55,222 Mark, that's been so interesting, thank you so much. 802 00:42:55,222 --> 00:42:57,832 If people wanna find out more about your work or get hold 803 00:42:57,832 --> 00:42:58,586 of you, where can they go? 804 00:42:58,837 --> 00:43:01,907 So I have a personal website, which is markshrime.com. 805 00:43:02,047 --> 00:43:05,857 Uh, I also have a website for the coaching work that I do around specifically this. 806 00:43:05,857 --> 00:43:10,297 And there's a, there's a free masterclass on that website and that's solving 807 00:43:10,297 --> 00:43:14,047 for why, uh, WHY, so solvingforwhy.co. 808 00:43:14,599 --> 00:43:19,339 Or you can, uh, yeah, find me on the usual social media, uh, apps. 809 00:43:19,339 --> 00:43:20,899 My handle is the same everywhere. 810 00:43:20,899 --> 00:43:22,039 It's just my name, mark Shrine. 811 00:43:22,464 --> 00:43:22,964 Wonderful. 812 00:43:22,964 --> 00:43:25,779 Thank you so much, and I'm sure there's loads more stuff we need to talk about, 813 00:43:25,779 --> 00:43:29,474 so we'll have to get you back another time just to go down this route even more. 814 00:43:29,474 --> 00:43:30,944 And if anyone's got any questions, uh. 815 00:43:31,345 --> 00:43:33,715 Write in email Earth, let us know. 816 00:43:33,715 --> 00:43:36,475 And yeah, I do check out all of Mark's resources. 817 00:43:36,475 --> 00:43:37,555 And you've done Ted Talk as well. 818 00:43:37,555 --> 00:43:39,895 I think Mark Avenue, you, which people can, can watch this. 819 00:43:39,895 --> 00:43:41,095 We'll put all that in the show notes. 820 00:43:41,275 --> 00:43:43,735 Thank you so much for being here, and we'll speak again soon. 821 00:43:43,923 --> 00:43:44,373 Thanks, Rachel. 822 00:43:44,373 --> 00:43:45,093 Thanks for having me. 823 00:43:46,686 --> 00:43:47,616 Thanks for listening. 824 00:43:47,716 --> 00:43:52,176 Don't forget, you can get extra bonus episodes and audio courses along with 825 00:43:52,266 --> 00:43:57,096 unlimited access to our library of videos and CPD workbooks by joining 826 00:43:57,176 --> 00:44:01,636 FrogXtra and FrogXtra Gold, our memberships to help busy professionals 827 00:44:01,636 --> 00:44:04,606 like you beat burnout and work happier. 828 00:44:04,980 --> 00:44:08,500 Find out more at youarenotafrog.com/members.