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How to Change Your Life One Tiny Step at a Time
Episode 24826th November 2024 • You Are Not A Frog • Dr Rachel Morris
00:00:00 01:06:05

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How starting with 5 minutes of exercise a day helped a doctor go from liver disease to competing for his country in triathlons – and what small changes you can make now that will compound to improve your long-term quality of life.

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Transcripts

Rachel:

What do you do to unwind after a long and difficult day?

Rachel:

Is it a glass of wine and a takeaway or an hour scrolling Instagram?

Rachel:

When we're pushed to the limit, getting quick dopamine hits.

Rachel:

Seem to be the easiest thing to do.

Rachel:

But we know how small improvements can compound over time.

Rachel:

And my guest this week is living proof.

Rachel:

So in today's episode, I'm speaking with Dr.

Rachel:

Hussain Al-Zubaidi, the RCGP lifestyle and physical activity champion, who went from being diagnosed

Rachel:

with nonalcoholic fatty liver disease in his twenties to losing 30 kilos, to competing as a triathlete.

Rachel:

Hussain shares some really practical tips that will help you find tiny, tiny changes that will help

Rachel:

you to rescue your time, help you practice that necessary care, even if you're stuck in overwhelm

Rachel:

If you're in a high stress, high stakes, still blank medicine, and you're feeling stressed or overwhelmed,

Rachel:

burning out or getting out are not your only options.

Rachel:

I'm Dr.

Rachel:

Rachel Morris, and welcome to You Are Not a Frog

Hussein:

My name's Hussain Al-Zubaidi.

Hussein:

I'm a GP based in Warwickshire and I have a portfolio career including the Royal College of GPs Lifestyle and Physical

Hussein:

Activity Champion, as well as the Lifestyle Medicine course lead at Red Whale and Parkrun's health partnerships lead.

Hussein:

I have a few other roles outside of that, but those are my core ones.

Rachel:

I'm sure we'll get to those, those other roles.

Rachel:

So Hussein, thank you so much for coming on the podcast today.

Rachel:

I'm really interested to explore your story, so I'd love to hear how you got into all of this.

Rachel:

How did you become like the Parkrun lead and the RCGP lifestyle champion?

Rachel:

Have you always been into fitness, healthy living and all that, that sort of thing?

Hussein:

So quite simply, I haven't always been into fitness.

Hussein:

And in fact, when I think about my younger years and going through school and university, you know,

Hussein:

movement, physical activity, the exercise was not only something I didn't do, but I actively hated.

Hussein:

Um, you know, like I, I used to despise people running.

Hussein:

Like I wouldn't even give them way when I'd be driving.

Hussein:

Uh, and it was raining, just 'cause I just didn't understand why they were doing it.

Hussein:

I thought it was a waste of time and energy.

Hussein:

It wasn't until I was, you know, on a hospital bed essentially with an ultrasonographer who had

Hussein:

just told me that I had the, the fattest liver that he had ever seen, that it sort of gave me the

Hussein:

wake up call that at, you know, in my mid twenties to be already diagnosed with non-alcoholic fatty

Hussein:

liver disease, I thought something wasn't right.

Hussein:

And, and I started to explore and try and understand why I'd gotten myself in that situation.

Hussein:

And as part of that journey, movement was a key element to help reverse the changes that were going on there.

Hussein:

And, and although my first priority was correct this issue of non-alcoholic fatty liver disease,

Hussein:

what I learned on that journey and that process was the benefits were far wider than that.

Hussein:

And now, looking back on it, I'm glad I went on that journey.

Hussein:

Not because of improving my liver's health, but just improving my life, you know?

Hussein:

And the way that I enjoy life and, and I get things out of life.

Hussein:

And if I'm being honest, if I didn't have something as, as dramatic as that, I don't

Hussein:

know whether I would've ever made that change.

Hussein:

I think I still wouldn't be letting runners across the road, even in the rain.

Rachel:

What were you doing when you, when you had that scan?

Rachel:

What, what role were you in at that point in your career?

Hussein:

So that was junior doctor role.

Hussein:

So I went straight into medicine.

Hussein:

I didn't do sort of a graduate entry program and like, it really does propel you into life just so quickly.

Hussein:

You know, I, I think in my mind, I, I was still a child.

Hussein:

I think I was still a teenager, probably in my head because I hadn't done anything kind of serious.

Hussein:

And I just found it really stressful, not, not just sort of the latter years of medical school,

Hussein:

but just taking on all this extra responsibility.

Hussein:

I felt quite alone and isolated, and I used a lot of the things that I know now, sort

Hussein:

of certain lifestyle behaviors just to cope.

Hussein:

Whether it was, um, you know, going out with friends and potentially not eating or consuming the right

Hussein:

things there, or just eating takeaways or foods that gave me kind of pleasure in the short term,

Hussein:

but were, were causing harm in the long term.

Hussein:

And, you know, before I knew it, I, I developed certain behaviors and traits over a number of

Hussein:

years, which had completely changed, you know, who I was, not just visually in that I gained

Hussein:

a lot of weight, but just my behavior as well.

Hussein:

You know, when, when I think back and, and a lot of the comments that my friends and families were saying, in a

Hussein:

nice way, they were trying to let me know that, you know, I, I was, I was starting to head in the wrong direction.

Hussein:

But it only took sort of that realization of the diagnosis for me to sort of actually reflect and realize that I'd,

Hussein:

I'd come a long way and I wasn't heading in the right direction, and I needed to make a course correction.

Rachel:

And in terms of your career, were you, were you sort of very, very focused on, on success or were

Rachel:

you not that bothered about career at that point?

Hussein:

I think that was my main priority.

Hussein:

I think everything that I did at university and in my early career was I wanted to seem

Hussein:

successful and I wanted to be successful.

Hussein:

You know, like my, my parents were very academically focused and throughout my, um, schooling, always

Hussein:

pushed me to try and achieve the best, you know, at the real neglect of anything like physical activity.

Hussein:

You know, I remember once when I was in primary school, I think I was year three and I'd, I joined the local football

Hussein:

club 'cause I wanted to try and play a bit of football.

Hussein:

And I've never been in more trouble in my life.

Hussein:

You think, so most kids get in trouble for like, you know, doing something wrong.

Hussein:

You know, like I remember it was days where my parents wouldn't speak to me because they just

Hussein:

thought, you know, he's neglecting his, his studies, he's neglecting his focus that, you know, all

Hussein:

I wanted to do is play a bit of footie with my,

Rachel:

Year

Hussein:

with my friends.

Hussein:

So going through uni, you know, I've really pushed myself and I, I I achieved very well.

Hussein:

You know, if you looked at the results and kind of what I was doing, you know, I was achieving

Hussein:

fantastically, you wouldn't think that this person physically is, you know, slowly falling apart

Hussein:

because of how he's trying to get to that result.

Hussein:

And in fact, going on this journey of, of reducing a lot of the pressure that I was putting on

Hussein:

myself academically, reducing a lot of the key workload and, and responsibilities actually had the

Hussein:

opposite effect than what I was trying to achieve.

Hussein:

I thought I'd have to let go of a lot of those kind of career ambitions and

Hussein:

pushing myself from an academic standpoint.

Hussein:

But it's done the opposite.

Hussein:

In fact, it's, it's just given me the head space to be a lot more creative.

Hussein:

I find that when I'm, I'm trying to apply myself at work, I can do so far more productively and in

Hussein:

far more sort of focused and, and intelligent way.

Hussein:

When before I think I was just, you know, putting absolutely everything just to try to

Hussein:

get that goal and it wasn't very efficient.

Hussein:

Yes, it was getting results in some respects, but it was doing that at the neglect of my

Hussein:

own health and the other priorities of life.

Rachel:

And I know when we spoke before the podcast, you told me that as soon as you focused on, yeah, how

Rachel:

do I make my life easier rather than how do I become very, very successful, that was what actually made

Rachel:

you successful and that was what I'm so fascinated by.

Rachel:

Because we hear, hear all this leadership stuff around, you know, how to be more productive, how to do

Rachel:

this, how to have better conversations and all that.

Rachel:

And, and that's all well and good and we talk about that a lot on this podcast.

Rachel:

But it's something that I have realized pretty recently and pretty late in life, which is really annoying to

Rachel:

myself because I'm now maximizing on the self-care.

Rachel:

And I did a podcast recently about, you know, I was pretty close to burnout earlier on this year.

Rachel:

And since putting the self-care in a, I feel a lot better.

Rachel:

But b I'm actually getting more done and I'm, I'm more productive.

Rachel:

But it's this very, very weird, it, it's this paradox, isn't it?

Rachel:

And the way we've been brought up and everything in us, as medics says, work harder, work harder.

Rachel:

That's how you achieve more, that's how you've been more successful.

Rachel:

And like there's a little boy in year three not being allowed to play football.

Rachel:

No wonder that's the mindset that you had.

Rachel:

Right?

Hussein:

A hundred percent.

Rachel:

What else do you think in our training and in the way that we work contributes to that mindset?

Hussein:

You know, like, I think we always feel that if we work harder, we'll get more.

Hussein:

And that's just not the case.

Hussein:

You know, it wasn't the case for me.

Hussein:

In fact, like if we work smarter and actually work on the tool that is going to get us the results,

Hussein:

which is ourselves, then you're gonna get further.

Hussein:

You know, I, I often use the analogy with colleagues and patients of a bicycle in the sense that, you

Hussein:

know, I actually have two bikes in my garage.

Hussein:

One is a bike that I absolutely rag, you know, it's like my commuter bike.

Hussein:

I'll just go anywhere on it.

Hussein:

I give it no love.

Hussein:

I haven't lubricated it for God knows how long.

Hussein:

I haven't changed the tires for God knows how long.

Hussein:

And I have another bike, which is my, my pride and joy.

Hussein:

You know, it's, it's carbon fiber, it, it gets more love than even myself or probably even anyone else.

Hussein:

And if you asked me to ride a hundred kilometers on each of those bikes, same person, same fitness,

Hussein:

I would be able to do it far quicker on the bike that I've given a hell of a lot of love to.

Hussein:

And it's a far more effective tool to get anything done, whether it's climbing a mountain, covering

Hussein:

a hundred kilometers or reaching a top speed.

Hussein:

And that's the same case for ourselves.

Hussein:

You know, I'm more able to complete that project, that task, that busy day.

Hussein:

If I myself am the well-oiled bike rather than the bike that's been absolutely ragged.

Hussein:

Done far more miles, it's done far more miles than the, uh, than the nice bike, but it's not as effective.

Hussein:

And for me, when I was looking and I was making these changes, I didn't do it with that in mind,

Hussein:

but I just quickly realized that the work that I was doing was just to a far higher quality.

Hussein:

I wasn't doing it in two weeks because I just wanted to rush it out and get it done.

Hussein:

I was taking a bit more time, but the quality was far, far better.

Hussein:

And it was starting to get noticed.

Hussein:

It was starting to get rewards and acknowledgements.

Hussein:

And that motivates you, but it also helps with that career progression.

Hussein:

And a number of the roles that I have gotten, and these are dream roles that I absolutely adore doing,

Hussein:

you know, it's in things that I'm really passionate about, they've all come about because of, I've

Hussein:

been noticed with some of the work that I've done.

Hussein:

And if I'm being honest, if I'd done them with the previous mindset, then they just wouldn't have had

Hussein:

the same effect because I just would've done that.

Hussein:

Yes, to try to do my best.

Hussein:

But as we always trying to squeeze it around, not giving it the, the real thought and care that we should give,

Rachel:

I completely agree with that, but I have some yes buts going on in my head.

Rachel:

Because I think, you know, presumably this diagnosis came when you were sort of just finishing up being a junior

Rachel:

doctor and moving into GP training and stuff like that.

Rachel:

There's an awful lot to get done.

Rachel:

You've gotta do a lot of surgeries, you've gotta do your exams, you portfolios, and then you

Rachel:

become a GP and there's a lot of work to do.

Rachel:

And if you're a partner, there's all the extra partnership stuff.

Rachel:

And so it's a bit of a paradox saying, well, you'll perform better if you look after yourself, but there

Rachel:

is so much you're not gonna be successful unless you get that stuff done that you need to do, which

Rachel:

then gives you no time to look after yourself.

Rachel:

So how did you navigate that?

Hussein:

If I'm being honest, it's hard, hard decisions.

Hussein:

You need to start really reflecting on both the small and big decisions when they come upon you.

Hussein:

You know, often we want to be helpful.

Hussein:

We want to look to seem like we are being productive.

Hussein:

But what you need to do is decide what is really important, what's kind of important, and what

Hussein:

potentially can be left to one side regardless of how painful leaving that to one side is.

Hussein:

So there may be some fantastic opportunities that you've had to accept that you're not gonna take it up right now.

Hussein:

And I think it's that constant feeling that another opportunity will never come.

Hussein:

But if we just focus on achieving things that are within our sphere of influence at this time, and really making tough

Hussein:

decisions on potentially leaving really good opportunities that have come at this point in time, to focus on doing

Hussein:

what you can do right now to the best of your ability, I promise you those opportunities will come again.

Hussein:

And one of the key things I did was reduce my sessions.

Hussein:

I'll be totally honest.

Hussein:

I reduced the amount that I was earning quite significantly.

Hussein:

In fact, I, I probably reduced about 40%.

Hussein:

Um, so my paycheck reflected that.

Hussein:

But at the beginning I thought that that just wasn't achievable 'cause I wasn't exactly rolling in money.

Hussein:

You know, I didn't feel like, uh, I, I, I had that much finances to spare, but then as soon as I adapted

Hussein:

my lifestyle to accept that I was gonna be earning less, it didn't negatively impact my quality of life.

Hussein:

Yes, I was buying different things and I was spending my time doing different things.

Hussein:

But just that time, that space to not feel like I have further responsibilities and, and to be able

Hussein:

to focus it on myself, to do things like sleep, to, to do things like spend time with friends and

Hussein:

family, that was worth every pound that I'd lost.

Hussein:

And it enabled me now, whenever I think about how I undertake work, a key part of it is like,

Hussein:

what's gonna be the worth to me of that work?

Hussein:

Not just financially, I want it to ensure that it can allow me to work the hours

Hussein:

that I want to do rather than have to do.

Hussein:

And also the work that I'm doing, does it reward me outside of that financial impact?

Hussein:

Does it make me feel excited?

Hussein:

Does it push me in a certain way?

Hussein:

So I think when it comes down to it is it's really difficult decisions.

Hussein:

You know, I'll be lying to say that it's really easy, you can just reduce this and then you're

Hussein:

suddenly gonna be able to get what you want.

Hussein:

I had to say no to things that I really wanted to do that were financially really great.

Hussein:

And it's by saying no to those things that it enabled me to be able to be on a kind of a platform that allowed me

Hussein:

to feel strong, rather than constantly chasing my tail.

Hussein:

'Cause it was just the worst feeling of constantly having things to do.

Hussein:

Don't get me wrong, we're busy people.

Hussein:

We'll always have things to do, but that list, it needs to feel manageable.

Hussein:

That treadmill speed that you are walking on needs to feel like it's something you can maintain rather

Hussein:

than constantly hoping that it's gonna get better.

Hussein:

'Cause that was the other thing I was doing, you know, I was constantly thinking, oh, do you know what?

Hussein:

It's a busy month.

Hussein:

Let me just smash through this 'cause it's gonna get better.

Hussein:

December's better.

Hussein:

I remember my wife just admitting to me one day going Hussein, december never comes.

Hussein:

It never comes.

Hussein:

You keep saying this and it never comes.

Hussein:

And, and, and she was totally right.

Hussein:

It was, she was totally right.

Hussein:

And unless I make changes right now and say no to things that I desperately wanted to do, it wouldn't change.

Hussein:

And I'm grateful that that's the case.

Hussein:

And it, and as time goes on, you become better at saying no.

Hussein:

Um, you, you just realize that, do you know what another opportunity's gonna come if you

Hussein:

keep applying yourself in the right way and doing what you can do more opportunities come.

Rachel:

So what did you say No to?

Hussein:

I eventually said no to a partnership that I was in.

Hussein:

So a really well-working partnership at a practice, um, that I'm still at, uh, in, in a different role

Hussein:

that I really enjoyed, I enjoyed that partnership.

Hussein:

There were a great set of partners doing fantastic work, but at the end of the day, I just, for me, and

Hussein:

with the position that I was in and the work that I needed to do on myself, I had to say no to that.

Hussein:

I had to move away from that and, uh, allow myself the space.

Hussein:

And it was difficult.

Hussein:

And it probably took about five months of deliberating, of discussing with my closest friends and family.

Hussein:

And even when I sent that email and wrote that letter, I still, a huge part of me did not want to leave.

Hussein:

And looking back on it now, I'm so glad that I did, you know, not because there was anything wrong with that role.

Hussein:

Because it just wasn't right for me and what I needed to do

Hussein:

. Rachel: I guess it becomes a virtuous cycle, doesn't it?

Hussein:

That once you say no once, and then it feels like it, it really benefited you, it gives you

Hussein:

a bit more permission to say no again, and, and then it like becomes a real, a real habit.

Hussein:

And it sounds like you've really nailed the criteria that you use to say yes or no.

Hussein:

What, what criteria would you say you use to weigh up a decision about, should I do this?

Hussein:

Should, shouldn't I do this?

Hussein:

Yeah, I've definitely massively improved.

Hussein:

I, I, by no means have nailed it though, if I'm being honest.

Hussein:

I don't think anyone can.

Hussein:

And what often happens is I go through cycles where, you know, I've done really well, made those

Hussein:

tough decisions, and then things start seeping in.

Hussein:

And then you start to realize, oh, wait a minute, I'm starting to carry a bit

Hussein:

too much baggage as I like to call it.

Hussein:

And then I then have to do another sort of mini purge.

Hussein:

But I, I luckily, I haven't had to do this sort of major purge that I had, that I did back at the beginning.

Hussein:

But the, the criteria is, is one, when it comes to paid work, like.

Hussein:

Is it financially gonna allow me the space to not work at other times?

Hussein:

Does that make sense?

Hussein:

You know, like we don't often need as much financially than, than we get.

Hussein:

And that was my first lesson in trying to actually lean my lifestyle to a point where I didn't have

Hussein:

to earn huge amounts of money to maintain it.

Hussein:

So I, I very much changed my behaviors to, to mean that, I can reduce the responsibility that financially work brings.

Hussein:

So the work that I do, do I wanna make sure does, is it financially rewarding?

Hussein:

The other element is what I'm taking on, does it fuel me beyond money?

Hussein:

Does it fuel me to keep motivated?

Hussein:

Does it fuel me to push me actually outside of my, my boundaries of, of what I feel I can do?

Hussein:

And then the final, and I think most important element is will this role, will this responsibility,

Hussein:

will this task that you've taken on, is this gonna make a difference in five years time?

Hussein:

So once this, this is done and you've done what you needed to do, or potentially you've maintained

Hussein:

it, how does it change things in five years?

Hussein:

And I think that's been a really important element because as I've seen my career progress to, um, where it

Hussein:

is now, often it's been because I've taken on tasks that actually were completely voluntary, i, I got no money

Hussein:

for, but they've enabled me to get me where I am now.

Hussein:

And I think that's the key because yes, you need to be financially safe.

Hussein:

Yes.

Hussein:

You need to be pushing yourself from a academic or creative standpoint.

Hussein:

But there needs to be thought about where do you wanna get to because you can't make those steps.

Hussein:

For example, the Parkrun role, I couldn't have just walked into that Parkrun job.

Hussein:

I had to make certain steps.

Hussein:

And a lot of them, you know, a hundred percent unpaid in order to get there.

Hussein:

So you need to have that, that, that sort of thought ahead and build those building blocks in early.

Hussein:

So therefore, when you're doing these tasks, they have meaning.

Hussein:

I go, yes, look, you know, this is taking up time at the moment, but it's getting me

Hussein:

to an end goal, which I want to try and do.

Hussein:

And I want that role because I know the influence that it can have on what millions of people essentially.

Hussein:

So I'd really think about those kind of three criteria when you are deciding on taking on responsibilities.

Rachel:

Do you think people use money as an excuse?

Hussein:

Often.

Hussein:

Yes.

Hussein:

Often yes.

Hussein:

And I remember when I was leaving the partnership and I was changing kind of what I was doing, the

Hussein:

work, the amount of my friends that said, you're mad.

Hussein:

Like how are you going to survive off, you know, this massive reduction in your income.

Hussein:

How are you going to, maintain X, Y, Z?

Hussein:

And, and in reality, I think often we, we kind of always live to our means and we often create a

Hussein:

lifestyle which matches the earnings and sometimes potentially even a bit more than what our earnings

Hussein:

are which, which forces us to make decisions that may not be right for our happiness, may not be right,

Hussein:

for our health, may not be right for those around us.

Hussein:

And what I found by reducing my need for a certain set of earning, by trying to live a different lifestyle, that was a

Hussein:

lot leaner from that respect, it just gave me that freedom.

Hussein:

It reduced that pressure that I needed to maintain.

Hussein:

And yes, it means that I moved to a smaller house.

Hussein:

Yes, it means that I sold my Mercedes, uh, for a Mazda, but at the end of the day, I'm, I'm so glad I did.

Hussein:

Those things were giving me short-term reward, but in reality, they weren't making me the person I wanted to be.

Hussein:

They weren't giving me reasons to get up in the morning.

Hussein:

So yes, they're hard decisions and yes, it can seem like you're going backwards.

Hussein:

And I think even to certain members of my family who are kind of just so academic and career focused, they thought,

Hussein:

oh God, Hussain really has gone backwards, you know.

Hussein:

But when I see where I am now.

Hussein:

I'm actually more financially secure than before.

Rachel:

They do say that, um, freedom of time in good health is, is the ultimate wealth, don't they?

Rachel:

And, and what you've illustrated about how you have bought, you've used finances to get freedom of time

Rachel:

or you, you've not tied yourself into getting certain amount of money or you've not exchanged masses

Rachel:

amounts of your time for money, and actually you could have had that free time off, not had the money.

Rachel:

And, and I was listening to podcasts recently about free fun, about actually the, the fun that people

Rachel:

seem to enjoy the most is stuff that comes for free anywhere, like having a laugh with your mates.

Rachel:

That is free, isn't it?

Rachel:

And we, yeah, I've just been on a, a lovely holiday and it was a really nice hotel and stuff, but

Rachel:

I got quite used to it by the end of the week.

Rachel:

You get hedonistic adaption, don't you?

Rachel:

No, not he hedonic adaption.

Rachel:

I think that's the phrase.

Rachel:

Like your Mercedes, you probably loved it for the first month, then it just became like, it's my Mercedes.

Rachel:

And yes, it's nice to have a nice car, but a Mazda does exactly the same job, you know.

Rachel:

And how many extra sessions would you have to work to get the Mercedes versus the other thing?

Rachel:

So I think this, this thing about money, we use it as an excuse and then we can

Rachel:

get ourselves trapped into the lifestyle.

Hussein:

And it's a taboo topic as well.

Hussein:

It is a taboo topic to talk about.

Hussein:

And often, like I'll see friends, uh, and other colleagues and other GPs that, they're making

Hussein:

financial decisions that I just know is gonna tie them into a lot of responsibility and a lot of stress.

Hussein:

But I feel unable to really be able to talk to 'em about it in a, in a just an open and, and, and kind

Hussein:

of honest way and just discuss things, you know.

Hussein:

These things, it just, it's very taboo to talk about and I think that we should speak about it more because

Hussein:

we get no training really on how to finance our life.

Hussein:

Such an important thing.

Hussein:

And, and it is important not just for us, but for those around us and the people that we're responsible for.

Rachel:

And most of us have no idea what we need to live and we have no idea what we spend.

Rachel:

And it's just like the end of the moment.

Rachel:

This is sort of this finger in the air thing.

Rachel:

And Tommy and Ed from Medics Money, they are absolutely brilliant on this.

Rachel:

So we've, I've done some podcasts, so then they've, Tommy's done, some for, for us just about thinking about what's

Rachel:

the value of your time and actually having a budget.

Rachel:

And when you think about it, you actually do need a lot less often than you spend.

Rachel:

And I, I, my one advice for, for sort of, I guess, younger doctors is I, I remember a, a younger doctor talking to

Rachel:

me about, um, deciding what school to send her kids to.

Rachel:

And they had some really good options, like locally, really good state, state school options.

Rachel:

And she thought, well, we might as well 'cause things we've got into the private, might as well do it.

Rachel:

And I'm like, you've got three kids and your other half wasn't in a really high paying job.

Rachel:

Think about what you are now tying yourself into for the next 15 years.

Rachel:

So there are those, there are those things that we, we can, and there's no judgment around this, no judgment

Rachel:

whatsoever, whatever you choose to spend your money on.

Rachel:

But I always come back to freedom of time in good health.

Rachel:

That is, that is the real wealth.

Hussein:

Yeah, I think that's so important.

Hussein:

'Cause like every decision in this, there's no right or wrong.

Hussein:

You know, everyone will have different set of circumstances will mean that a different decision is right for them.

Hussein:

But what they need to also think about is not just the outcome of spending that

Hussein:

money, but what's the outcome of not.

Hussein:

What are the benefits for potential?

Hussein:

For example, let's just use that example of that family of having more time to spend with each other and the growth

Hussein:

and the development that that will have on the child, compared to the child goes to a great school, fantastic.

Hussein:

But do they see their parents or are their parents constantly working?

Hussein:

And when they see their parents, are their parents stressed?

Hussein:

Are they able to give them the time and, and the energy?

Hussein:

So all these kind of things, it's so important.

Hussein:

I remember when I looked at my own finances and I was making cutbacks, I couldn't believe

Hussein:

the stuff that I was paying for, something I didn't even realize I was still paying for it.

Hussein:

And it wasn't until I just brought an Excel sheet, it was like, okay, what are the things that I have to pay for

Hussein:

unless someone's coming to the door to, to sort myself out?

Hussein:

And, and I actually found out that a good chunk of what I was spending were things that I no longer was really using.

Hussein:

And if I was using, I wasn't really getting much from it.

Hussein:

And it's, it's now that whenever I look to spend again, I always go back to this Excel sheet and

Hussein:

just go, okay, look, what am I gonna get out of it?

Hussein:

What do, how do I maximize, if I do spend my money on it, how do I really maximize the outcome from that?

Hussein:

And it's about having that thought process always going through, because I know that it's not just

Hussein:

about spending money, but it's the impact that that does on the time and space in your life.

Hussein:

That is also a commodity that you should measure rather than just the bank account.

Rachel:

The problem is, and I'm gonna challenge you back here, is that it sounds like you

Rachel:

had this wake up call in your late twenties.

Rachel:

And while obviously nobody would, would, would wish health problems on anybody, you say it actually was

Rachel:

good for you in terms of it made you change your life.

Rachel:

What advice would you give to people like me?

Rachel:

I'm about to turn 50 next year.

Rachel:

I can't quite believe that's happening.

Hussein:

can I.

Rachel:

I know.

Rachel:

I'm so young looking.

Rachel:

Okay.

Rachel:

But I've got, you know, three kids and my kids are at, you know, school, university, you know, we've got mortgage.

Rachel:

Um, lots of people my age are in partnerships, maybe leading partnerships.

Rachel:

PCN directors, clinical directors in hospitals.

Rachel:

So, a lot of financial responsibilities.

Rachel:

But even if they got their finances totally sorted out, which I believe that people, that people can do

Rachel:

that with a bit of, a bit of, you know, let's just cut out that skiing holiday, let's not do this, you know.

Rachel:

You can make it work.

Rachel:

So if you've got that sorted out, there are other things stopping you, like the responsibility you

Rachel:

feel to your, to your practice, to your colleagues and just feeling that you, you've got to do it all.

Rachel:

And I guess when you did your change, you were just coming up through that and yet made a decision not

Rachel:

to, not to be the partner, but what can people do who are in that position and who thinks, well, I

Rachel:

would love to do any of that, I'd love to have that mindset, but I just can't 'cause I've got so many

Rachel:

responsibilities to employing all these people, perhaps?

Hussein:

I think first message is that, you know, it doesn't matter what point or what stage you are, I think

Hussein:

focusing and, and refocusing potentially on, on not just your health, but the health of those around you.

Hussein:

It's something you should do at, at, at any age, regardless.

Hussein:

'Cause there are, it's not just the long-term benefits here, there, there are short-term benefits and kind of

Hussein:

relief that you can get by just reducing that burden.

Hussein:

Now, the ability for, from person to person of how much weight you can essentially shed.

Hussein:

I'm not talking about weight on the weighing scales, I'm talking about weight of responsibility.

Hussein:

That varies and I think we have to be totally open and honest with ourselves that for some

Hussein:

of us it can be really challenging to, to, to shed significant bits of responsibility and,

Hussein:

and for others, maybe potentially a bit easier.

Hussein:

I think I was lucky.

Hussein:

I think I was, because I was, I was, I was far younger and I had other options.

Hussein:

It was easier to shed that, but still felt very difficult at the time.

Hussein:

Now if you do feel like you're in that camp where those kind of key responsibilities are very difficult to share

Hussein:

and maybe you don't want to, maybe you want to, uh, stay in, in those kind of high pressure, high stress

Hussein:

roles, then really consider even the small things.

Hussein:

Because it can be even tiny little decisions if stacked up upon each other over time, that can make a difference.

Hussein:

And for many of us, it's about trying to go below a threshold point.

Hussein:

You know, for me, I know that there's a certain threshold that when I go over things start to present

Hussein:

themselves when maybe I'm a bit more irritable, maybe I'm, uh, less compassionate, et cetera.

Hussein:

And so it's about being aware of that fresher point.

Hussein:

So it may be for you that you just need to make lots of little decisions that may seem insignificant, but they help.

Hussein:

And if I could just use an example, I had a friend of mine who has two kids in fact, but one of them's

Hussein:

four, and has joined the football club, unlike me.

Hussein:

But, um, he was asked by his, uh, kids' football team if he would be up for coaching and, and, and, and supporting

Hussein:

them., 'cause he was a pretty decent footballer himself.

Hussein:

And he said yes, and he didn't even think about it.

Hussein:

And he told me later, he goes I'm really annoyed that I'm, I said yes because I have no time.

Hussein:

You know, like I'm, I'm, I'm working eight sessions, I'm doing out of hours.

Hussein:

I'm, you know, doing X, Y, Z and, and I don't have time to do this coaching.

Hussein:

But then, you know, he asked and I wanted to be helpful and it's my kid's club.

Hussein:

And, and I didn't wanna say no.

Hussein:

And so now he, he's doing something that, don't get me wrong, he enjoys, he likes coaching and he

Hussein:

loves obviously doing it where his kid does it.

Hussein:

But actually that was the wrong decision for him.

Hussein:

And it was a discussion that I had with him a few times, and eventually he made the realization that

Hussein:

he had to say no and, and, and give that role back.

Hussein:

And it was the right decision for him because now he's got that space and that bit of time

Hussein:

and, and that just put him over the edge.

Hussein:

So it's little things like that.

Hussein:

And, and it may be that it's about taking decisions going forward rather than cutting things that you've currently

Hussein:

got, if you're finding that really difficult to do.

Hussein:

But where possible, even good decisions, even decisions that seem like it's the thing you wanna do, just

Hussein:

stop for a second and think, how is this going to interact with everything else that I've got going on?

Hussein:

Will this enable me to get my goals and my outcomes?

Hussein:

Because I think we often don't make those priority decisions at the right time, and we're

Hussein:

just thinking about that specific decision.

Hussein:

And at the time it seemed like the right thing.

Hussein:

He loves football, he loves his kid, he loves coaching.

Hussein:

So it seemed like this is a no brainer.

Hussein:

But when you then put it in the context of his life, it was the worst decision.

Rachel:

That's a really interesting example because it's something he really wanted to do.

Rachel:

And I think, you know, when, when we talk about saying no to stuff and, and, and leaving decisions, I'm often

Rachel:

talking about the guilt and the shame of saying no to stuff.

Rachel:

But often that's stuff you don't wanna do.

Rachel:

it, it, it is much, much harder saying no to the stuff that you do want to do, or,

Rachel:

or you do, you do partially want to do.

Rachel:

Uh, and I think one of the problems that a lot of us have is that we're generally pretty competent.

Rachel:

I think medics, people work in healthcare are pretty good at everything.

Rachel:

And, and there are skills that you, you have built up.

Rachel:

So you're quite good at doing this, you're quite good at doing that.

Rachel:

And that, that quite good or that even pretty good is really dangerous because that, that zone of excellence

Rachel:

just detracts from your zone of absolute genius, 'cause you'll just end up doing it and end up doing it.

Rachel:

And the problem is as you go further on and you reach the, my age, you've picked up this role and then that role

Rachel:

and then this role and you're pretty good at doing it.

Rachel:

And then it becomes really, really hard to say no.

Rachel:

So I love that thing about, about going forwards, you know, think about what you're saying yes to going forward.

Rachel:

In the back of my mind though, I'm thinking, what a shame that your friend had to say no to

Rachel:

something that potentially was probably more life affirming than doing an out of hours shift.

Rachel:

And wouldn't that been nice if he'd had the, the head space and the time in his week to be able to do that?

Rachel:

Because like, I think doctors should be able to, to coach a football team, they should be able to, you

Rachel:

know, I mean, don't coach 10 football teams, be a member of the local choir, orchestra and run this

Rachel:

charity as well as being a full-time partner, no.

Rachel:

But you know, we should be able to have a life and do stuff like that.

Rachel:

So, sounds like his life was just at capacity with work, and we actually want to be working a little

Rachel:

bit below capacity, so we've got the time and space is, is that something you'd be advising people to do?

Hussein:

Precisely.

Hussein:

And, and that's what we talked about, in fact.

Hussein:

We said that, look, this was the right decision at the wrong time, and why it's so important that if you're

Hussein:

going to add something, you make sure there's space.

Hussein:

And so hopefully this is gonna trigger him to consider what can he reduce within his capacity

Hussein:

at the moment to take on things like that.

Hussein:

So therefore, when the next opportunity arises for something that he's passionate about, that as you say

Hussein:

is, is is life affirming, that he's able to pop it on.

Hussein:

'Cause at the moment, too often I see people just adding, they'll just add this on, they'll

Hussein:

make it work, they'll make it work, you know, we'll find the time, but you don't find time.

Hussein:

You know, like time is just there.

Hussein:

And so it's really important that when you are thinking about taking on something new,

Hussein:

consider what, where is it gonna replace?

Hussein:

Rather than constantly adding it in.

Hussein:

And so it can be really useful to constantly reflect.

Hussein:

And often I do it like on a six monthly basis.

Hussein:

Every six months I'll just take a moment and I'll look at my kind of calendar and I'll think,

Hussein:

where am I currently spending all my time?

Hussein:

Is it where I want it to be?

Hussein:

Are there things that I can cut back?

Hussein:

And I'm always looking at things where I can cut it back.

Hussein:

Because I know that if I create that bit of capacity, it enables me that when I get that

Hussein:

email, that message, or someone gives me a ring with an opportunity that is fantastic, I've got

Hussein:

the space to go, okay, yeah, let's give that a go.

Hussein:

But if you don't constantly consider and refine and tidy up your time, then it will

Hussein:

always just be added on, added on, added on.

Hussein:

And before you know it, it'll be bursting from the seams.

Hussein:

And then you won't be able to do the things that you really want to do, spend time with your kid teaching the local club

Hussein:

football instead, as you say, you're doing an out of hour shift, which you know, I doubt most people would rather do.

Rachel:

Getting sort of back to practical and reality of people that probably do have too many roles and

Rachel:

they probably can't change it overnight, and as a lifestyle medicine guru yourself, I wanna ask you,

Rachel:

right, if, if I'm that overwhelmed doctor working all hours, and yes, I'm gonna start to say no to

Rachel:

stuff, I'm gonna do a bit of a, a tidy up of my time.

Rachel:

I'm gonna start looking at where I'm spending my time, but what's the low hanging fruit in terms of

Rachel:

making myself feel better and practicing some, well, I don't call it self-care anymore, I call it necessary.

Rachel:

Necessary care.

Rachel:

What would you start with?

Rachel:

When I'm thinking about I need to focus on oiling oiling my bike, making my bike a high

Rachel:

performance bike, where would you start then?

Hussein:

I'm gonna stick to cycling on this one because the best cycling teams in the world, they

Hussein:

use a philosophy called marginal gains, which is the fact that even small, absolutely tiny changes

Hussein:

when stacked up over time, make a big difference.

Hussein:

And when I think about my initial journey, one of the key reasons why I had failed in the past to make

Hussein:

changes was I'd always try to make big sweeping moves, which invariably never got me very far for very long.

Hussein:

And in fact, when I just changed my mindset to going, okay, let me make some tiny changes, little

Hussein:

things that on their own they're gonna do nothing, really, nothing on the grand scale of things.

Hussein:

But when you combine them and, and, and you, you allow yourself to increase with confidence as

Hussein:

you move from goal to goal, they get you far.

Hussein:

And I remember one of the first things I did was I gave myself 15 minutes more time to sleep, 15 minutes.

Hussein:

And it sounds crazy, but what was happening was something that's called rev revenge, revenge procrastinating.

Rachel:

bedtime, revenge, procrastination.

Hussein:

Oh man, I was the best at it.

Hussein:

I was absolutely the best at it.

Hussein:

'cause I was just constantly working, constantly stressing, constantly doing stuff that when it came to it, even when I

Hussein:

could have gone to bed, I was just like, do you know what?

Hussein:

I've had no time to myself.

Hussein:

And I'm now just going to not do actually something that's gonna be useful and feed me.

Hussein:

It was generally just scrolling through Instagram or watching something on Netflix

Hussein:

or whatever and I just decided that okay.

Hussein:

I'm gonna give myself 15 minutes more sleep, and that's where I started.

Hussein:

And I can tell you that just getting better sleep enables you to do that a little bit better

Hussein:

the next day, make little bit better decisions and feel a little bit more like you're coping.

Hussein:

And then I moved from 15 minutes of extra sleep and I said, okay, now I want to spend 10 minutes in my

Hussein:

day doing something I actually really want to do.

Hussein:

And so in fact, those 10 minutes was spending time in my garden.

Hussein:

And at that time reflecting on how terrible it was because I didn't have any time to look after it or prune it.

Hussein:

So then what ended up happening was those 10 minutes was, okay, I'm gonna spend five minutes just sitting in the

Hussein:

garden and five minutes doing something in the garden.

Hussein:

No matter how small it was, 'cause hell, it took more than five minutes.

Hussein:

It would probably take days to sort out that garden at that time.

Hussein:

But just five minutes, I just felt like I could just fix that little bit that's there.

Hussein:

Let me just weed it out, and then I felt like I was accomplishing something in that day.

Hussein:

So at least I've tidied up maybe a half square meter of the vegetable patch.

Hussein:

And so it just, it just, it just snowballed from there.

Hussein:

And then I'll just move on to something else.

Hussein:

And I kept stacking on little things and I kept a little Excel sheet of all the things because, you

Hussein:

know, we're doctors, we like to tick things off.

Rachel:

I would love to see your Excel sheet.

Hussein:

Oh, it is amazing.

Hussein:

And red had various shades of orange as sort of, I felt increased confidence, uh, to eventually green.

Hussein:

And, and I, I just kept stacking them up.

Hussein:

And then when you look back at it, now, what, 10, 12 years later, like those little

Hussein:

things have made a massive difference.

Hussein:

And in fact, there came a point where I had enough small little changes and I got

Hussein:

more confidence to make bigger changes.

Hussein:

And I said, do you know what?

Hussein:

I've, I've created and carved out a bit more energy, a bit more motivation, a bit more time.

Hussein:

I can now take this on.

Hussein:

And then it just slowly, slowly, eventually snowballed.

Hussein:

And it's can seem a bit demoralizing to take on such small things to start off with that on their own, that

Hussein:

15 minutes, it didn't do that much, but it was the start.

Hussein:

And I think that's what's really important is that you make those little changes, not

Hussein:

thinking that they're gonna sort out the world.

Hussein:

But thinking that what will 50 little changes do in six months time if I take on a new thing every, let's say

Hussein:

week or whatever time you wanna have interval between it?

Hussein:

'Cause I promise you, you put them together by God, it makes a massive difference.

Rachel:

and you start getting the rewards quite soon.

Rachel:

I remember coaching a, a GP who, um, was yeah, his senior partner had had no time in the day whatsoever.

Rachel:

And, um, I think at the, the end of one of the coaching sessions, he'd come to the conclusion that he was

Rachel:

so stressed in the afternoon and staying so late and not get anything done, he just said he needed

Rachel:

to get out in a, a lunchtime into the local park.

Rachel:

So we left.

Rachel:

He was gonna go for a walk at lunchtime.

Rachel:

And, and so six months later I got an email from him saying that every day he goes to the park for 45 minutes,

Rachel:

started off 10 minutes, 45 minutes, eats his lunch under a tree, and he was in the afternoon, getting home sooner,

Rachel:

getting more done, and the practice income had gone up.

Rachel:

Amazing.

Rachel:

So you, you think, oh, I haven't got time to do that.

Rachel:

Actually you get that time back.

Rachel:

It's almost like you haven't got time not to do it and I can imagine, yeah, the benefits of the

Rachel:

tiny benefits from a tiny amount extra of sleep actually that probably, that probably balanced.

Rachel:

That's like exercise, isn't it?

Rachel:

We know that the productivity you gain from doing that exercise is, is huge.

Rachel:

I mean, would you be looking to go across all of the, well, five ways away, wellbeing?

Rachel:

I think there's eight ways to wellbeing, but uh, you know, or do you, would you like try and maximize movement

Rachel:

or maximize ice or what would you be focusing on?

Hussein:

I would encourage the person just to consider what they want to do most.

Hussein:

Whether it be they want a bit more sleep and energy, whether it be that they wanna try and focus on their diet,

Hussein:

let their motivation be the trigger to that first goal.

Hussein:

It's so important that we consider all the pillars, absolutely.

Hussein:

But when it comes to those first small goals, just go bare bare where you wanted to go.

Hussein:

For me, I just wanted to wake up in the morning and not feel like I'd been run over by a bus every day.

Hussein:

And so for me, I wanted to start off with that bit more sleep.

Hussein:

And then, you know, my next goal, I wanted to just sometimes feel like my head wasn't constantly going

Hussein:

to explode with thinking and decisions, so that's where the 10 minutes of doing nothing came from.

Hussein:

And so just be guided based on what do you want to try to work on right now?

Hussein:

Create a goal based on that.

Hussein:

And then as time goes on, consider where else you need to move into.

Hussein:

And so I actually got to my nutrition and diet.

Hussein:

Quite late, even though it was probably the biggest problem.

Hussein:

I, you know, my diet was hideous and it was probably, if you were looking at it from an root cause analysis, you'd say

Hussein:

that's where you need to put in most of your effort or work.

Hussein:

But I actually got to it much later on because I knew that I had such a, like a emotive connection with food

Hussein:

and such an unhealthy relationship with it, it needs time.

Hussein:

And I needed to improve my confidence.

Hussein:

I needed to have a bit more energy and head space through the sleep.

Hussein:

I needed to reduce my stress before I even think about tackling on it.

Hussein:

Because in the past I would always just focus on diet and I'd be like, okay, that's it.

Hussein:

Mediterranean diet tomorrow.

Hussein:

Like here we go, you know, no more takeaways.

Hussein:

And I would maintain it for like four weeks and then it would just go, it would just vanish.

Hussein:

And so I knew that I couldn't just keep doing that.

Hussein:

I had to build the space and the time and strengthen all lots of other elements in my lifestyle and resilience, so

Hussein:

therefore when I did approach nutrition, I felt stronger.

Hussein:

And again, I was still still making small changes in nutrition, but I knew that I couldn't make even

Hussein:

small changes in nutrition until I did lots of the other stuff, lots of the accompanying work around it.

Hussein:

Because I'm telling you now, sleep stress, they have huge, huge drivers on the

Hussein:

reasons that we eat the food that we eat.

Hussein:

And it was just creating this sort of cycle of guilt for me, because I would eat something and feel hideous about

Hussein:

myself for doing that and think that I'm useless and, and why am I not doing what I said I was going to do?

Hussein:

But then you realize that there's other strings at play.

Hussein:

You know, the reason I I, I clicked that takeaway was because, you know, work was really stressful and I

Hussein:

didn't have much time and, and my sleep was just awful.

Hussein:

I had no energy.

Hussein:

I just wanted something quick and easy.

Hussein:

I didn't have time to prepare.

Hussein:

So really think about what you can do around a difficult area before you just dive into it.

Hussein:

We often really think about how, let's say if you want to lose weight, people just focus on, okay,

Hussein:

you know, how am I gonna change my diet, how I'm gonna increase my activity, et cetera, et cetera.

Hussein:

But they don't think about why am I here?

Hussein:

And I think that's, it's, once I realized that, look, I gained nearly what, 30 kilos

Hussein:

because, not because of just what I was eating.

Hussein:

Because you have to think about why was I eating that?

Hussein:

You know, why was I not moving my body?

Hussein:

Why was I not getting restorative sleep?

Hussein:

And once I started to focus all my little goals on trying to correct those underlying drivers, the weight came off.

Hussein:

You know, the weight came off not, not quickly, it wasn't like six weeks.

Hussein:

And I was better.

Hussein:

Over six years, just consistently, just slowly lowering the weight to a point where I stopped

Hussein:

weighing myself and instead measured where I was going based on the, that Excel sheet, the outcomes

Hussein:

that I was trying to create, those little goals.

Hussein:

I just said, look, if I focus on that, rather than looking at the weighing scales,

Hussein:

that's where I'm gonna get my reward.

Hussein:

Because not everything we need to do in life needs to be focused on having an external outcome like weight loss.

Hussein:

You know, it could, there's so much more to that.

Hussein:

And so really do consider those kind of surrounding environment that you are putting your body in.

Hussein:

Rather than just what you can do.

Hussein:

Because we always want to do more.

Hussein:

I'm now going to eat more fruit and vegetable, I'm now going to exercise more.

Hussein:

And those are great, but they're also difficult.

Hussein:

So think about what could I do less?

Hussein:

What could I potentially have less of that's going to drive less stress?

Hussein:

And I remember be back 10 years ago, if you left like an entire, let's say 24 multi-pack of crisps,

Hussein:

I'm telling you now, I would eat all of them.

Hussein:

Now, if I go to, let's say, a function, there's crisps out, I don't even touch it.

Hussein:

And it's not because I'm saying, look, you can't have a crisp, oh my God, have one, no, knock yourself out.

Hussein:

But that craving that was so strong before where I would literally be killing myself trying not

Hussein:

to eat them yet, still doing so, now, like it when I look at them, there is no emotion anymore.

Hussein:

And that didn't come through sort of a short term psychological intervention that came through actually

Hussein:

reducing the stress and the pressure, that, that valve just letting it release to a point now where I'm in

Hussein:

better control, you know, I pick the things that I want to eat and don't get me wrong, I eat some crap

Hussein:

sometimes, but I do that now in much better control.

Hussein:

I don't do it because I have to have it because I've been craving for it for days and months.

Hussein:

And so therefore I'm now better able to make those changes on nutrition.

Hussein:

And I just realized I had to just change that environment before I make those changes.

Rachel:

And what I'm realizing, and I think what you're talking about a lot with the goals as well, is

Rachel:

it's, it's much more about process goals, isn't it?

Rachel:

Than outcome goals.

Rachel:

So, you know, I signed up for, I think I've done a podcast or this is, well, I signed up for Cambridge half marathon,

Rachel:

which I hate running, so that wasn't gonna happen.

Rachel:

And, you know, two months before I'm like, mm, this isn't gonna happen.

Rachel:

Whereas if I'd have set the process goal of three times a week, I'm gonna go put my trainers on for 10 minutes,

Rachel:

well, that would've, that would've happened that I'd been more likely to hit the, the outcome goal anyway.

Rachel:

But I think we are quite driven by results and achievement and success, aren't we?

Rachel:

So we just always make that mistake of going for the outcome as opposed to the routine and the process and the habit.

Hussein:

Precisely.

Hussein:

And my top tip is gamifying that process, so therefore it feels like a reward.

Hussein:

So for me, changing those colors, I know it sounds silly, but it was lovely, and I

Hussein:

could see an Excel sheet and I'd look back.

Hussein:

I'd be like, look at all the things that I've managed to do and maintain.

Hussein:

And that is the reward.

Hussein:

And you are absolutely right.

Hussein:

The, the outcomes, they will come as a result of hitting those kind of goals.

Hussein:

And so, you know, when I think about where I started, my first physical activity goal I remember

Hussein:

was just, you know, going for a walk for five minutes after food in the evening with my wife.

Hussein:

Now, that's now stretched to, we probably go for about 30 to 40 minutes.

Hussein:

That sort of happened over time.

Hussein:

'Cause initially I thought I had no more than five minutes.

Hussein:

And it's amazing how, you know, your, um, person that you were coaching, how he's now walking 45 minutes

Hussein:

when initially it was just 10 minutes in the park.

Hussein:

It's amazing how time opens itself up if you change your direction of priorities.

Hussein:

But, you know, that initial goal, that's where it started.

Hussein:

And if I look now this year I've, I've, I've competed in two world championships at long distance triathlon.

Hussein:

And that started with five minutes of walking with my wife after dinner.

Hussein:

Now, if I set the goal of I'm gonna do a marathon, or I'm gonna do a half marathon, then there would've

Hussein:

been so many things that could have stopped me from achieving it, because it's really difficult.

Hussein:

It's another thing that I'm adding rather than thinking about how I can support and remove.

Hussein:

And so don't think always about the reward.

Hussein:

Think about the process.

Hussein:

Think about doing those elements, because I promise you, the rewards will naturally come.

Hussein:

And they will be amazing when they do come.

Hussein:

And you will always be rewarded for work that you do in yourself.

Hussein:

And, and sometimes they'll be in areas that you hadn't even imagined in, in, in subjects that are not even related

Hussein:

to that initial goal that you haven't quite connected.

Rachel:

Oh my goodness.

Rachel:

I just think it's so amazing that you've gone from like this person on that, you know, ultrasound

Rachel:

couch to competing for your country in triathlon.

Rachel:

I mean, that, that's just such an amazing story and I think it's very useful for people to

Rachel:

know you didn't start off like this, did you?

Rachel:

You've, you've, you've had that journey and you've obviously got amazing natural capacity for it.

Rachel:

But it is amazing

Rachel:

'Cause I think when you first start, it just does seem impossible.

Rachel:

And particularly when you are in overwhelm, it seems really difficult.

Rachel:

And I guess this is the same with patients as well.

Rachel:

They, you know, busy lives, working two, three jobs, haven't got much money.

Rachel:

And that's the whole thing about lifestyle medicine, isn't it?

Rachel:

That, we know what a, a big change is for, for people.

Rachel:

But actually I'm thinking, you know, when we are trying to tell patients about it and we are not doing it

Rachel:

ourselves, that's really, that's really hard, isn't it?

Rachel:

What else do you think is stopping us from, from doing this necessary care, from making

Rachel:

these changes from, from working on ourselves?

Rachel:

Is there anything else that you've come across with doctors?

Hussein:

Yeah, the, there's so many reasons why it's really difficult to, to do this and, and

Hussein:

one thing that's the case for not just doctors, but everyone is just the environment we live in.

Hussein:

You know, like whether it be the fact that movement's been engineered out, that we now need to somehow bring it back

Hussein:

in intentionally, that's, that makes it really challenging.

Hussein:

You know, when we think about some of the healthiest places on, in the world, they're active, not because they've

Hussein:

gone to a gym or they've signed up for half marathon.

Hussein:

They're active because it's just, you have to be active to get to the next town.

Hussein:

You have to cycle or walk or to wash your clothes.

Hussein:

It's manual.

Hussein:

And, and don't get me wrong, I'm not going back to manually washing my clothes.

Hussein:

However, we need to realize that look, movement's been engineered out.

Hussein:

And before you take on a new task, like a hit session or you're going spinning or you're gonna go for a run, consider

Hussein:

how can you just engineer movement back into your day?

Hussein:

Maybe it's that walk to work as you described.

Hussein:

Yes, it's 20 minutes extra, but that was 20 minutes that you potentially were gonna need to

Hussein:

do exercising and now you've done two things.

Hussein:

You've got to your destination and walked.

Hussein:

Um, maybe it's around deciding that you are not gonna take a lift or an elevator again.

Hussein:

And that's a rule that I stick to unless you are in New York and you've got like 22 flights

Hussein:

of, of stairs to do that, that I'll allow.

Hussein:

And then think about the things that are advertised.

Hussein:

You know, when, when I'm on my phone in the evening after stressful day of work, what's being pushed to me?

Hussein:

Well, it's, it's takeaways.

Hussein:

It's, you know, fast food.

Hussein:

It's all the things that I crave but don't really need for my health.

Hussein:

And so all these factors is why we're living in, you know, what's called an obesogenic environment.

Hussein:

And we have to be compassionate to ourselves that we are essentially living in a casino.

Hussein:

We're living in a world which wants us to make decisions that are not gonna be helpful for our

Hussein:

long-term health, or even our short-term feeling.

Hussein:

And they're trying to offer us a reward that unfortunately.

Hussein:

Is, is, is lined with a lot of baggage.

Hussein:

And so I think we have to be compassionate to that.

Hussein:

And, and when you look at physical activity levels, when we look at weight levels, we look at nutrition

Hussein:

over the decades, you can see that there's been a huge change in what we eat and how we move.

Hussein:

And that's not be because we've suddenly become lazy and greedy.

Hussein:

Um, we're still the same people, we're just living in a different environment.

Hussein:

And that is the hardest thing to crack because there's no point creating a preventative medicine, um,

Hussein:

revolution that Labour wants to do, which is fantastic.

Hussein:

Not until you've corrected the environment, there's no point doing that unless you look to fix the root causes.

Hussein:

And so what I always tell to patients and to colleagues is be compassionate to that reality that you are not

Hussein:

making bad decisions for the sake of making bad decisions.

Hussein:

You're making it because they are being advertised to you, encouraged to you, you adding

Hussein:

in stress, then you've got a terrible cocktail.

Rachel:

And whatever barriers there are that will just just stop you very, very quickly when you, you know,

Rachel:

our local hospital, there was only a Burger King for years and years, and now there is an M&S Food so you can

Rachel:

get your salad, but it's like hungry doctors on call.

Rachel:

What are they gonna get?

Rachel:

You know, they're not, if they're, if that's all there is, you know, you, you're

Hussein:

Precisely and just, and, and, and, and that's the issue.

Hussein:

And you think about then our people in population that are in our lowest socioeconomic groups,

Hussein:

and you think, what do they have on offer?

Hussein:

Because you know, they can't afford M&S Food for that salad.

Hussein:

And what alternative options do they have to really access that kind of high nutritious food that's affordable?

Hussein:

And I remember, um, so Michael Marmot, uh, had one of his research projects which sort of

Hussein:

outlined the amount that you'd need to spend of your income in order to live a healthy lifestyle.

Hussein:

And for the bottom 20% from an income category, it was nearly 70% of all the

Hussein:

earnings would need to be spent on that.

Hussein:

And you just think this is not an environment, you should not have to be wealthy and affluent to be healthy.

Hussein:

And I, I feel really passionately that as clinicians, we should be advocates for them.

Hussein:

And we have a role, don't get me wrong, like whether it be speaking to your counselor, speaking to your MP,

Hussein:

promoting that because we're not just there to serve appointments, we're there for the health of our communities.

Hussein:

And we need to start really raising our voice and our message that we gotta do better.

Hussein:

We gotta do better for everyone in our society because it's actually a failing to need an appointment.

Hussein:

Don't get me wrong, we always need appointments, but every extra appointment that we need to put on, that's a failing.

Hussein:

And so we need to consider, rather than just constantly going, reduce wait times, increase appointment

Hussein:

numbers, we need to think about how can we actually help our health, our health from the root causes.

Rachel:

And, and it strikes me as well, you know, there is something about leadership as well, because

Rachel:

doctors, yes, they have, they have money to spend on stuff or, or more money maybe than other people.

Rachel:

They don't have the time.

Rachel:

And we do have the time.

Rachel:

It's just we make time for what, for what matters.

Rachel:

You've given me some practical tips, um, before the, the session.

Rachel:

Can you just talk about those three before, just before we wrap up?

Rachel:

'Cause I'm quite interested in, in your top three tips for, you know, making some of these changes.

Hussein:

my first tip would be to speak to those closest to you.

Hussein:

'Cause often they will pick up on signs and on changes that you may have not understood.

Hussein:

And they may also help to identify where you want to focus your initial goals, because you want them

Hussein:

to be as meaningful, as impactful, as possible.

Hussein:

Um, my wife was really helpful in actually, you know, informing me things that I just didn't fully appreciate

Hussein:

and I didn't realize I was doing or not doing.

Hussein:

And so my first tip is speak to those that you trust that are close to you and find out, you

Hussein:

know from them, you know, what's their opinion.

Hussein:

You may not, you may not follow it, you may not agree with it, but you definitely not

Hussein:

gonna lose out in getting that perspective.

Hussein:

My second tip is, I, I, I highlighted a bit before, but is gamifying things, you know, like

Hussein:

gamifying anything just makes it more engaging.

Hussein:

If we think about what has been the most impactful tool to increase physical activity in the world.

Hussein:

It's been Pokemon Go.

Hussein:

There's a really interesting study that was published and it just demonstrated, if you look at the US

Hussein:

population and what they did in that study, there has been no campaign, there has been no intervention, no

Hussein:

matter how well funded, that has been more impactful than Pokemon Go at increasing physical activity levels.

Hussein:

It just shows you the power that gamification has.

Hussein:

You know, it increased, I think it was somewhere between two to 3000 steps a day

Hussein:

compared to what the user was doing before.

Hussein:

That is huge.

Hussein:

And so gamifying things, whether it be your goals in that Excel sheet with the different colors or whether you are

Hussein:

gonna build in certain rewards based on achieving certain of those goals or whatever that may be, there's lots of apps

Hussein:

out there that can help you to gamify movement or nutrition.

Hussein:

Just do that.

Hussein:

Don't consider it being silly.

Hussein:

Actually, you'll, you'll get engaged with it and you'll find it funny and you'll find it much more rewarding.

Hussein:

And then the third and final tip is accept that you are going to fail at a number of the goals that you set.

Hussein:

My Excel sheet is not full of green.

Hussein:

There are a number of, of dead goals on there that I've tried over and over again to do, and I still can't do them.

Hussein:

And you just have to accept that.

Hussein:

There are some things that we will be able to do, some things that we'll partially manage

Hussein:

and some things that we'll be successful in.

Hussein:

And that's, that's just life.

Hussein:

And it doesn't mean that you're just gonna leave it.

Hussein:

You may return like I have and try it again.

Hussein:

And some of the things that I've returned to, I've managed.

Hussein:

Some I've still not managed to do, but it's appreciating that it's not a straight line.

Hussein:

It's this sort of constant spiral and fall down and spiral and fall down.

Hussein:

And eventually you will get forward progress over time.

Hussein:

And what it can often do is when you fail at things, it can help you maybe reshape

Hussein:

your future goals to be more achievable.

Hussein:

But don't be hard on yourself.

Hussein:

And even actually now when I think about my, um, sporting career, it's the races that I have failed at that,

Hussein:

that have truly enabled me to progress and to grow.

Hussein:

And in fact, the races, which I've absolutely nailed, when I think about what have I

Hussein:

learned from them, not really that much.

Hussein:

So, you know, those failures, cherish them.

Hussein:

Don't think of them negatively and use them positively.

Rachel:

Oh, such, such brilliant tips.

Rachel:

Thank you.

Rachel:

The one thing that's made the difference to me is actually planning.

Rachel:

So, you know, actually sitting down at the beginning of the week and going, right, when am I gonna do my self-care?

Rachel:

When am I gonna do my exercise?

Rachel:

What am I gonna eat?

Rachel:

That's probably made the biggest difference.

Rachel:

'Cause then, then it's in, and I've thought about it rather than just being reactive when I'm, when I'm

Rachel:

hungry, or when I'm tired and then not doing anything.

Rachel:

So that's really

Hussein:

And plan, like for me, like includes actually popping it in my calendar.

Hussein:

So in the days that I have blocks where I've popped in, I still do my 10 minute garden.

Hussein:

So for example, that's actually in the calendar and it stops me from putting a Teams call or

Hussein:

putting in a meeting or whatever over it because it's there and I find it difficult to replace it.

Hussein:

I don't like deleting it.

Hussein:

'cause then it feels like actually I'm not prioritizing that.

Hussein:

I'm not giving it the time.

Hussein:

I'll move it around sometimes 'cause I'll be like, well, okay, I need to move around.

Hussein:

But it always needs to be in there between nine to five at some point.

Hussein:

Whether it be walking outside of, of the practice or whether it be, uh, when I'm working from home,

Hussein:

you know, going out into the garden, whatever that may be, think and prioritize in the same way.

Hussein:

So whether it be a calendar, whether it be a diary, whether it be you write it down, you know, be intentional,

Rachel:

Now I know you obviously the RCGP lead for lifestyle medicine.

Rachel:

You do the course for Read, well, you run the course for, for, for healthcare professionals

Rachel:

who, who deliver lifestyle medicine for patients.

Rachel:

And presumably it's, it's this sort of advice that you've been giving us now, is

Rachel:

it, is there anything that extra in that.

Hussein:

Yeah.

Hussein:

yeah.

Hussein:

Because I think what's beautiful about Lifestyle medicine is that when you train in that you

Hussein:

develop so many skills for your patient, but these skills are 100% transferable for yourself.

Hussein:

And I'd really, really recommend anyone working in healthcare to consider doing the lifestyle medicine

Hussein:

course because it just, it enables you to get a better understanding on topics that are so fundamental and

Hussein:

so core for health, but when you think back on it, how much time have you had to train yourself up on it?

Hussein:

And in fact, one survey asked patients, where did they get the lifestyle advice from?

Hussein:

Would they get it from their GP or from another healthcare professional?

Hussein:

80% put Instagram.

Hussein:

And come on.

Hussein:

You know when the World Health Organization says that 7% of the content on there is actually accurate?

Rachel:

Seven.

Rachel:

Oh, I thought you was gonna say 7% is inaccurate.

Rachel:

7%

Hussein:

7% is accurate, okay.

Hussein:

You know, we, we can't accept that.

Hussein:

And, and can you blame them for accessing it there?

Hussein:

Because we don't have the knowledge, the confidence, or the skills.

Hussein:

So it's really important that we consider doing it.

Hussein:

And in particular for GPs, um, in April this year, I co co-authored the role for

Hussein:

an extended role in lifestyle medicine.

Hussein:

And I really recommend going on the college website, having a look at that framework.

Hussein:

It details really kind of what the role involves, what training's required, et cetera.

Hussein:

And.

Hussein:

I really feel passionately that all GPS should have that lifestyle bow in their hat.

Hussein:

And the more we can get, the more we can show within healthcare and within primary care

Hussein:

that we care about it, that it's important.

Hussein:

And that can be such a important message when it comes to policy makers and decisions.

Hussein:

If healthcare is taking lifestyle seriously, then hopefully we can have the policies that impacts our

Hussein:

environment, and not only for ourselves, but our patients.

Rachel:

And I can imagine, um, for doctors and nurses and other healthcare professionals that train in lifestyle

Rachel:

medicine, it's a, it's a really rewarding field to be in.

Rachel:

You probably get a bit more time with the patients.

Rachel:

Actually, it's something that you probably could say hell yes to in your day.

Hussein:

Really enjoyable, and it just feels.

Hussein:

Like it feels like compound interest often.

Hussein:

Because when you make lifestyle changes with patients, often it's to try and remedy something specific.

Hussein:

But what the patient and both the clinician realizes is that you get compound benefits.

Hussein:

So for example, when you support a patient to join a community walking group because they wanna improve their

Hussein:

fitness, for example, yes the fitness will improve, but they'll also improve the connection with community.

Hussein:

They'll also have a space to improve their mental health.

Hussein:

They'll also be able to sleep better because they're being active regularly through the day.

Hussein:

It just compounds.

Hussein:

So instead, unlike with medication where you have negative side effects that compound the benefit that you're treating,

Hussein:

the side effects in lifestyle interventions are positive.

Hussein:

They're often things that the, the clinician or the patient hadn't really focused on, but come about.

Rachel:

Yeah.

Rachel:

And we are right back to where we started this podcast with you saying you make the lifestyle change, actually, you

Rachel:

find yourself more successful, more productive, happier.

Rachel:

You are not just thinner and fitter and more relaxed, but there's all that other stuff there.

Rachel:

So, thank you so much.

Rachel:

That has been so, so inspiring to me.

Rachel:

There's loads of stuff I'm gonna do.

Rachel:

Um, we'll have to have you back another time if that's okay.

Rachel:

There's loads more to talk about.

Rachel:

How can we find out more about you and your work and all that sort of stuff.

Hussein:

I have a kind of, uh, an Instagram account which is focused on trying to promote healthy lifestyles, give

Hussein:

factual and important information, try to boost up that 7%, and the account is Iron Doctor HAZ, which is my initials.

Hussein:

And on LinkedIn is where I share a lot of the kind of professional developments in terms of

Hussein:

what the college is doing, and so just search that through my name, Hussain Al-Zubaidi,

Rachel:

Thank you so much and hopefully we'll speak again soon.

Hussein:

Take care.

Rachel:

Thanks for listening.

Rachel:

Don't forget, we provide a self-coaching CPD workbook for every episode.

Rachel:

You can sign up for it via the link in the show notes, and if this episode was

Rachel:

helpful, then please share it with a friend.

Rachel:

Get in touch with any comments or suggestions at hello@unnotterfrog.com.

Rachel:

I love to hear from you.

Rachel:

And finally, if you are enjoying the podcast, please rate it and leave a review wherever you are listening.

Rachel:

It really helps.

Rachel:

Bye for now.

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