Rachel: (00:00)
Welcome to episode 11 of You Are Not a Frog. The magical art of reading sweary books.

Rachel: (00:08)
Welcome. To You Are Not a Frog, the podcast for GP’s, hospitals, doctors, and other busy people in high stress jobs. Working in today’s high stress environment, you may feel like a frog in boiling water. Things have heated up so slowly that you might not have noticed the extra long days becoming the norm. You’ve got used to feeling constantly busy and are often one crisis away from not coping. Let’s face it, frogs only have two choices: to stay in the pan and get boiled alive, or to hop out and leave. But you are not a frog and that’s where this podcast comes in. You have many more choices than you think you do. There are simple changes that you can make which will make a huge difference to your stress levels and help you enjoy life again. I’m your host Doctor Rachel Morris, GP and Executive Coaching Specialist in resilience at work. I’ll be talking to friends, colleagues, and experts – all who have an interesting take on this – so that together we can take back control to survive and really thrive in our work and lives.

Rachel: (01:11)
I’d like to tell you about our new CPD forms. If you want to learn while you listen and claim CPD points, then go to the link in the show notes and sign up to receive our fully downloadable podcasts, CPD forms. Each one is populated with show notes and links so that you can listen, reflect, and then note down what you’re going to do. A quick, easy and enjoyable way to do your CPD. So I’m really pleased to be joined again this week by Doctor Liz O’Riordan, who’s the breast surgeon who has breast cancer. She’s a TEDx speaker and author, a blogger, a triathlete. She’s an all round superstar. She’s also recently a BMA award winning co-author of ‘The complete guide to breast cancer: how to feel empowered and take control’. Now in the last podcast that she did with us, she was talking about these books that have been really helpful for her and these are the books by Sarah Knight in the fuck it genre.

Rachel: (02:00)
So I wanted to get her back to talk about these books as I’ve read some of them as well, found them really helpful. So in this episode we discuss why they were so helpful to us. How the, uh, the, the, the concept of just having this budget about things that we really care about and things that we don’t care about is really helpful to us. Now, just a warning to our listeners that this episode does contain a little bit of swearing and I think it’s really for a very genuine reason. So I hope you enjoy this episode. I started by asking Liz what she’s been up to recently.

Liz: (02:31)
So one thing that was huge was our book won an award and the BMA popular medicine category, which is just amazing. We didn’t realise we’d been nominated, we weren’t expecting to win, and it’s lovely to know that it’s been recognised by the medical community as a book worth reading, not just for patients. So that’s been lovely.

Rachel: (02:49)
So why do you think it was particularly recognised on this board? What was it about it that people really liked?

Liz: (02:55)
I think because it’s been written by doctors who’ve had cancer, we know what we’re talking about and you kind of know how to push the book at both audiences. I want doctors and nurses to understand what it’s like without baby flying it, without making it sound too simple, just to give them a grasp. And I think a lot of doctors are realising things I knew nothing about, like the collateral damage of treatment or the psychological problems that patients are left with or talking about sex with patients and just little things that they can do to improve the care.

Rachel: (03:29)
I must say that reading the bits of the blog that I have completely opened my eyes to what it’s like going through chemotherapy.

Liz: (03:36)
Yeah, I had no idea and I don’t. I hope no one ever needs to find out what it’s like and I can’t remember what it was like now it’s almost six months after the time your brain just blocks it out. But, it was far worse than I thought. But I coped better than I thought I did. Does that make sense?

Rachel: (03:52)
Yeah, that weird dichotomy.

Liz: (03:55)
Yeah. You just have to go through it, but it’s horrible. But you just somehow get to the other end and yeah, it’s, um, I don’t think anyone, when you, you don’t know what it’s like until you have been through it. And I think you can become quite blahzay about prescribing it or this 4% benefit and she’s 60, but we’ll give her a bit of chemo and it’s not a bit of chemo. It can kill people and it’s very easy to forget just how bad the side effects can be.

Liz: (04:23)
Yeah. And it’s definitely changed some of the conversations that I’ve been having with friends when they’ve said to me, okay, my, my dad or my mum’s got cancer and they’re just about to start chemo. And what do you think? And I’m able to say to them, well, have you really thought through what effect it’s going to have on them? Have they though through the side effects? And you know, it’s not a walk in the park at all. So Liz, would you recommend the doctors read this book even if they don’t themselves have cancer?

Liz: (04:49)
Yeah, I mean we, we talk about, we talk about breast cancer and a surgery, but we then talk about chemotherapy, radiotherapy, how to explain treatments to patients in language they’ll understand. What, we also talk about how to talk to patients, how they can talk to their families, but also the side effects. So sex, exercise, diet, debunking all the crazy snake oil myths, how you help patients understand statistics. Most patients are very visual and they don’t get that if the male says eating bacon doubles your risk of breast cancer, it doesn’t mean you have a one in two chance. We’re very numerically literate as a profession and patients don’t get that. And also talking about telling patients what the symptoms are when cancer does come back, and thinking about death and dying, and warning people and helping them, all that really uncomfortable stuff that you kind of bypass at medical school.

Rachel: (05:45)
So sounds like a really important book and actually most people should be reading it.

Liz: (05:50)
We’re really pleased with it Trish and I. It was just, patients are so many questions and I think you realise how little patient’s take in.

Rachel: (05:57)
Yeah.

Liz: (05:57)
And it’s, I used to tell patients, don’t Google, I’ll tell you everything you know. And that’s just bollocks because it’s the first thing I did, the first thing Trish did; between us, we bought 20 breast cancer books trying to understand what the experience of treatment would be like. We knew what would happen, but not how to cope with it. And I think if doctors can signpost patients to a helpful charity website or a helpful book that can comfort them and their family, it will do far more than you think.

Rachel: (06:25)
Oh, I’m sure it will, and it’s certainly on my mind list of things to read. And I think if doctors need to do some CPD and want some CPD points, it’d be a brilliant thing to read, uh, both for hospital doctors and for GP’s. And it might be good time to mention that we have provided a CPD reflection form. So you just click on the link in the show notes and you can get sort of fully filled in CPD reflection forms after listening to the podcasts.

Rachel: (06:51)
So Liz, we’ve got you back on the podcast. Well firstly because the first one you did with us was incredibly popular with people, but we wanted to talk about books that we’ve been reading around the fuck it genre. So this is a quick warning to people that, that don’t like swearing, that there may be just a little bit of swearing in this episode, but it’s for a genuinely good reason I think. Um, and you know, some of these books have had a real impact on you. I know. So, which are the ones that particularly resonated with you?

Liz: (07:18)
My husband bought me the first book, ‘The life changing magic of not giving a fuck’ by Sarah Knight, and at the same time he bought me the book by Marie Kondo, the joy of tidying, the magic of tidying that book because we have a house of clutter and her principle is only keep things, Mary Kondo, only keep things that give you joy. If you need 20 pairs of black boots and you love them all then that’s fine. And none of us put it away for a year and get rid of it. And I looked and she tells you how to fold and store things and I thought, right, I’m going to start with my husband’s sock drawer because that’s a small thing I can do and it’s good avoidance technique of doing my tax return. And then I dipped into the life changing magic of not giving a fuck.

Liz: (08:00)
And Sarah is an American woman who apologises to her mother for swearing in the book, but she starts the book by saying, I got this Japanese tidying book and I started with doing my husband’s sock drawer. I thought this woman, she’s me, I get where you’re coming from. The flow is surreal. And it’s like for her, if my house is calm then my mind is calm. So for her getting a house in order helped to get her mind in order, but it’s then it’s working out what’s important to you and have you learned to say no. And I’ve always been someone who wants to help people. I’m a people pleaser. I never say no. I always say yes and if you ask me what I want to see at the cinema, I’ll say whatever you want to see that that’s always been my personality. I’m the bottom of the pile and it drives my husband mad because I don’t put myself first.

Liz: (08:54)
And especially after a cancer diagnosis, it was just time to rethink actually who am I and what do I need? And the life changing magic of not giving a fuck was just a way of realizing what is important to me. And she says, there are two main principles. You should only care about things that don’t annoy you and things that make you happy. So she gives an example. I always want to have peanut butter in the fridge and I always want to watch this baseball game on telly, but I don’t give a fuck if I wear the same outfit to pick up the kids on the school run. And it suddenly defining what is important to you, what are your values, and whether that is having a gin and tonic at 10 o’clock every night or lying in bed until three – they’re the things that really matter to you and it shouldn’t matter what other people think. But you can then take that too hard you can start pissing people off and being quite rude and ignoring people.

Liz: (09:48)
And she tells you how to say no to friends and family and people you work with. And one of the things that really hit home to me was, especially when it comes to work, you’ve, we’ve all worked with difficult colleagues. Someone said, you choose your consultant job by the location, the job plan, and the colleagues, and you’re lucky if you get two out of three. And often what you see at an interview isn’t the person you work with. And she said, it’s not your job to make everybody like you, but if you make them respect you for doing your job well, then that’s okay. And it’s just learning how to politely say, no, I don’t want to do that, but could I do this instead? And rather than coming across as a bully.

Rachel: (10:33)
So how exactly do you do that? Because when I’m coaching and talking with my colleagues, with doctors, um, they always say that the biggest thing they struggle to do is actually say no. I mean, we can all do this with patients, can’t we? But, but when it comes to colleagues, it’s really difficult, so how can we say no without coming across as a bully or just plain stroppy or even really, really obstructive.

Liz: (10:55)
The principles that work. She says that you give too many fucks about fearing the judgement of a boss or someone you work with, what will they say, and the judgement of your coworkers. And we worry too much about things we can’t control. You can only control how well you do your job and you decide how much time, energy, and happiness. So this is what she comes down to. You have fuck budgets. You only are limited, you only have a limited amount of time, energy and money to spend. And you should only spend them on things that don’t annoy you and things that make you happy. And if you’re spending all your time and energy at work into things you don’t like, there’s nothing left outside. And I think it’s, it’s being able to say, I could do that, but I’m not really passionate about could I do something else instead?

Liz: (11:46)
I can’t make that meeting. What about another time? Not just saying no, but maybe giving them an example or an alternative and being completely honest. Um, but it’s really, really hard. It’s not something we’re used to doing. Often we just say yes and then come home and think, oh my God, I had so much to do, and I’m so busy, and I’m stressed, and you’re just going in this awful, awful downhill spiral. Again, stop caring what your colleagues think about you. If you do your job well, they don’t need to like you. And if you, that can make a huge weight go off your shoulders. I come in, I do my job well. I don’t like them. They don’t like me. That’s fine. Accept it. But as long as I do what I’m meant to, they might get off my back.

Rachel: (12:26)
And that’s quite profound isn’t it when you think about it. Because most of the stuff that we’re doing that we don’t really want to do is because we’re worried about what other people are going to think of us if we don’t do it.

Liz: (12:36)
And if you were to say, actually I can’t stay until seven tonight cause I have to go home and pick up the kids. I’m really sorry. I think God, I wish I’d had the balls to say that. And I think it’s being honest and saying so what? After I read this book, I used to tell the juniors I worked with, you should only ever have two projects on the go at once. Cause I was the girl that said yes to everything. The fear of if my CV isn’t full of stuff then I won’t get the job, or they won’t ask me to write something and I’d have 10 abstracts papers on the go and the audits and I’d never finish them and the registrars would move on and they never write them. And after a year you’ve got nothing left. And I used to say you can only do two things at one time.

Liz: (13:13)
One you’re collecting data for and one you’re writing up and if the professor of the male clinic comes and says, can you do this? You have to politely say yes but not until six months cause I don’t have the time or energy to do it properly. And the relief they get of not having to chase you, do that email bounce, and we think, yeah, okay I was honest. I won’t do it. I know I won’t do it. If you really want me then I’ve got a time I can fit it in. And it was the same as a consultant. Um, people ask you to take on projects and I had to learn to say, right, I have one SPA, one thinking session a week that is full for the next two months of me working on this project. CS, I can do your project but I won’t be free to start until December. And then you, you suddenly are aware of what you’re doing with your time.

Liz: (13:57)
And conversely, I think that people will genuinely respect you much more if you’re able to say no to stuff. I mean firstly respecting you for sort of holding your ground and, and being able to say no and they respect you much more than if you say yes to things all the time. Because I guess those people that just say yes to stuff all the time and we all know they’re not really gonna do it, well they come across as really useless and ineffective and I guess it becomes a self fulfilling prophecy, because no one then ask them to do stuff anymore cause you know it’s gone. Not going to happen. You just don’t look good if you’re not producing the stuff you said you would do you.

Liz: (14:32)
No, but no one teaches you how to handle your, your workload as a doctor. You have the clinical workload and then this, everything else, the homework and no one teaches you how to manage that with the on calls and having a life outside of medicine and suddenly you’re up. You know, I remember writing my PhD, I’d come home at six o’clock, I’d sleep until nine I’d write until three in the morning and go to bed for three hours, get up, go to work, come back just to get it done. You find ways of coping, but the older you get, the harder it is. And I think we should be honest and say, actually, when are your nights off in the week? You do this at work, you don’t take this home because you’re not paid to do it. And I want you to do it well and give you the time rather than everyone doing it three o’clock the night before. It’s just a really bad culture of medicine. I think.

Rachel: (15:19)
It is bad. And the other thing I’ve noticed that particularly when I’m coaching people is when I say to them, you know why you doing that? The answer is often well because other people have to. And it’s not necessarily what are other people gonna think of me if I don’t. It’s more about well look that person’s having a bad time and everyone’s having to work like this and just everybody’s stressed. Um, so then I should have to as well.

Liz: (15:42)
Yeah. And I think it’s being brave enough to say I have a limited amount of time and energy and my social life, my home life is just as important as my work life. And at the moment my priority is outside of work and having the confidence to say, I need to look after myself and you may not agree with my decision, but I don’t need to give a fuck about what you think as long as you respect my reasons for that decision rather than just saying no.

Rachel: (16:10)
It’s hard though, I guess, isn’t it? Because hey, we don’t have any control over if someone respects us or not. And I guess as long as we’ve acted with integrity and we’re not being a lazy ass and we’re actually doing our job properly, um, even if somebody doesn’t respect the fact that you’re not going to kill yourself for your job, as long as we have acted with our own integrity, we shouldn’t really give a fuck.

Liz: (16:34)
No, you can’t make everyone like you. You don’t like all your family. You don’t like all your friends, you know, you don’t like patients. No doctor is going to have every patient think they’re amazing. There are people you don’t like just because of personality clashes. And it’s the same at work. You’re thrown together with a group of people to function as a team until you move on. These are not people you may choose to work with, they’re where you’re placed and it’s finding your place and you have to be part of the team and you have to act up. But it’s doing it within the limits of what you’ve got the energy to do.

Rachel: (17:06)
So how would this work outside of work? Cause I’m just thinking. Um, there are lots of things that, well they don’t annoy me but they don’t necessarily make me happy, uh, such as feeding the children or doing homework and um, you know, the, the, the things I just have to do and I can’t just decide. I don’t give a fuck about them. Um, cause there’s people relying on me. So what would the book say about that?

Liz: (17:29)
Oh, I think this, that’s when it’s hard and I think there are the things you need to do and the things you want to do. Huh. She lived in America and she wanted to spend a year working freelance in the Dominican Republic. So she realized it would take her three years to save up enough money to do it. So she budgeted, she planned, she didn’t go out, she saved her money to get what she needed. And I think there are things you’ll need to do. You have to feed your children, you have to clean the house. And if you don’t have the time and energy, you might have the money to pay someone to do that. But it’s just remembering that there are lots of things you don’t need to do, you don’t need to worry about. And just I think just realizing you can’t be perfect. I think especially for females, you feel you have to be the perfect doctor and the perfect wife, the perfect mother, the perfect housekeeper, the perfect academic and something has to give.

Liz: (18:22)
And it’s like the saying, I’m going to be an amazing surgeon and an amazing mother, but my house is going to be a filthy hovel and I don’t care. That’s fine. I don’t give a fuck about whether my house is tidy as long as my kids are well fed and looked after and I love my job. And I think it’s finding what you really want to put your time and energy into. And if you’d rather spend a lot of time cooking and cleaning and making the house a funny place, then work may slip. But that’s okay because you’ve decided that’s important to you.

Liz: (18:50)
That’s in your fuck budget, which sounds entirely like something different and all that should be sensible.

Liz: (18:59)
So my husband noticed. That’s the only thing.

Liz: (19:03)
I’m sorry love that’s just not in my book budget.

Liz: (19:05)
No I don’t have the time, energy, or money. Sorry. Different fuck budgets.

Rachel: (19:09)
So how do you actually do this then? Cause there’s one thing saying there are these things that you shouldn’t give a fuck about and there are these things that you should, how do you switch your mindset off? Cause like I’ve spent 40 odd years actually caring about what people think of me. Is it just the case of reading the book and then thinking, okay, fuck it, I’m not going to care. I mean how do you make that shift?

Liz: (19:29)
So I read the book and I act on it and then I slide back into old habits and then I moan to a friend and think, oh God, I must read that book again. I think a big thing for me was when my cancer came back and I went flat and I can’t wear a prosthesis in a bra because of pain. And suddenly I had to go out and about lopsided. And then I remember the first time going into Debenhams crying thinking I can’t find a bra to fit. How am I going to disguise it? And now I don’t care. I don’t give a fuck whether people are staring. Now I’m quite small breasted so there’s not much to see. But it was suddenly, I don’t care what people think that I may look odd or unusual. This is just who I am. And that was a kind of, I don’t care what anyone else thinks.

Liz: (20:13)
As long as I’m happy going outside looking like this, that’s all that matters. Now there are still times when you do think, oh my goodness, I wish I could wear that dress. But it was just, I think it’s getting back to your identity and finding out who you are and what are your principles. And often mine got lost by the wayside because it was doctor job exam, job exam, job exam, consultant carry on the research management and you lose sight of who you are as a person. And I think it’s coming cancer. I had the time of work to think, well, what are my values? What am I really, really passionate about? And when I first retired I was worried I’d have nothing to do. I’d be stuck at home. It might be bored. And I said yes to everything and now I’m thinking, actually I can say no to stuff because I’m not passionate about it and I won’t do it.

Liz: (20:58)
And it’s okay if I let people down, I always try and give them alternatives. I can’t do this, try them, but actually no one expects anything. I don’t owe anything to anybody. And it’s learning to set up barriers to say, right, I need to protect myself. I need to keep something back for me and stop feeling guilty about it.

Rachel: (21:17)
Good.

Liz: (21:17)
And I, I, I’m not, I’m, I’m still learning. I get, I get months where suddenly I’m travelling to London three times a week and I’m doing this and writing that and then I get ill. It’s like, right. Okay. Back to you read the book again. You’re spending your time and your energy on other people and you’re not cycling and you’re not going, and you’re not reading books for fun because you’re doing everything for everybody else. So just stop and recenter and get, and I get better every time, but I’m still a work in progress.

Rachel: (21:44)
Why has it taken a book like this to help us realize that this is, it’s one of the fuck it genres of books, isn’t it? Um, and I, I met recently a guy called John Parkin who wrote the original fuck it book. Um, I think it was called fuck it the ultimate, the ultimate spiritual way. It’s really great. I read it on holiday, much to my children’s disgust cause I’d leave it on the sun lounger and they’d be like, mommy, I can’t believe you’re reading a book with such a rude title. And I’d be saying to them well darlings, you know, it, it’s, you know, it’s much better than it sounds and actually you sort of need to use those words to um, you know, be able to express what you’re feeling. And in fact there’s a whole paragraph in the book talking about that, that say any title they could use really, because those words are just sort of so in most of, it’s such an emotive thing to say, isn’t it? And well his premise in the book is about letting go and letting go for attachment to things. Cause it’s only when we attach meaning to things that we hold onto them. And actually the more you can be free and hold things lightly, the easier things are. And they often come back to you. Do you agree with that?

Liz: (22:47)
I do completely. I mean the tagline for this book is how to stop spending time you don’t have doing things you don’t want to do with people you don’t like.

Rachel: (22:57)
Oh

Liz: (22:59)
Well I wonder whether social media and Instagram has had a negative effect on us all. So many posts are like me. How many likes did they get? Tell me I’m wonderful. Look at me doing something amazing. I’ve got the filter on and I’m touching up the photos. We want to give this perfect image. We care so much about what other people think about us. And this is almost the antithesis to it. You are enough. You don’t have to do that. No one cares if you’re not posting to show how wonderful your bread is or you know, you just, you’re enough. And I think it’s coming back to, again, our real values. What is important to you? And it’s okay if you’re shallow and you need to have Jimmy Choo’s and peanut butter and shop in Harrods. But if that’s what’s really important to you, then that’s fantastic. Don’t feel guilty. Whereas if someone else it’s giving all their spare change to water aid, then that’s fine too. Everybody’s different. But I think it’s stopped trying to be like everybody else and work out what’s important to you. And then you can teach those around you to learn to be a bit selfish maybe, and actually stand up for yourself and say, this is who I am and this is what’s important to me.

Liz: (24:06)
And actually I think it makes you a nicer person because feeling guilty about stuff just makes you behave really badly. And I know that when I get really angry and cross or really defensive, it’s usually because I think I should’ve done something or someone’s thinking badly of me and it’s really bothering me. When I was reading the fuck it book on holiday, um he talks about how the fact is when his children behave badly, he used to get really wound up by that. But actually he’d sort of learned just to go oh fuck it and just let them, let them be themselves, let them be kids. And it really helped me in the restaurant because you know, they started behaving in a slightly, in a way that I wouldn’t have liked them to behave. And because I was reading the book, I just thought, oh, you know what? Fuck it. And it just made me much nicer. I could relax a lot more. And actually they then started behaving better weirdly because it wasn’t bothering me. I was being nicer, I wasn’t getting stress, a bit, it does sort of come back to you in the end.

Rachel: (24:58)
Yeah, I think we just worry too much about offending other people. What will they think? Don’t do that. It’s like we don’t talk to strangers on a train. Everyone’s head down in the phones and it’s just a way of kind of opening up and thinking what’s important to you.

Liz: (25:14)
Hmm. And just trying to loosen our attachment on the outcomes of things as well. Because there’s very little in life that we can completely control and we certainly can’t control other people no matter how much we we try to, and I think a little bit angst in life comes from other people not doing what we want them to do. We need to be able to let go of that and to be able to let go of what their reaction. So what we do is.

Liz: (25:41)
You can’t control what they think but if you, you can’t control what they think and they might not like it when you start acting like this because it’s a change. But I think it’s a really good change.

Rachel: (25:53)
So what advice would you give to doctors, lawyers, accountants, people who are going to go to work tomorrow and they know that there’s a conversation they need to have or maybe a project they need to drop or something they really need to do at work, but they’re just sort of paralyzed by what they think others are going to think of them. What advice would you give them?

Liz: (26:15)
I think come practice what you’re going to say beforehand and say why? Why don’t I want to do this? And it’s either your gut is just saying no, there’s, there’s just something in reason or I either don’t have the time or the energy or the money or I don’t think I’m the right person or I’m scared. You need to push. Just try and think, what is it? Is it, I don’t want to work with this one person or I know I’m not going to finish it. And if you can work out what that is, then I think you talk to the person and say, look, I need to be really honest with you. I’m either scared about doing this. I don’t think I’ve got enough training. I don’t have the time and see what their response is and they may think actually, you’re amazing. You just need a push.

Liz: (26:56)
I remember the first laparoscopic operation I did by myself. There was sweat dripping down my back and my legs. I just didn’t want to do. I hated it, but the consultant was amazing and said, you can do this. I’ve got your back. But by me telling him how terrified I was, he then knew how to coach me through it. So it may be actually you can do it, you’re just a bit scared or it may be I don’t have the time and think , okay great, I’ll do it, do something else. But if you can just think what, dial down to the reason why it doesn’t sit right with you and that might help you find a way out of it. Does that make sense?

Rachel: (27:30)
Yeah, that does make sense. And I think as well, but if you’re not in the fuck it mentality but you’re in the sort of guilt mentality, then you really start making excuses, which makes you seem weaker in a way.

Liz: (27:40)
And I think, know, we’ve all taken stuff on and oh, did that email bounce? Surely it went through. It’s like the new did the doggy eat my homework. And actually if someone would say to me, that’s a great project, but I’ve not got the time to do it. I’m sorry. I think, yeah. Okay. Fair enough. I actually may not want to do either, but I feel I should cause my manager’s told me to and it’s, well I’ll find someone else or, I’ll wait, I think it’s just that honesty of remembering – we have lives outside of medicine and those are important and they need to be cherished and protected as more and more people are getting stressed. But I want to come on to the second. So she wrote four books, Sarah Knight. She’s done the life changing magic of not giving a fuck and the follow, there’s two follow-ons called get your shit together and you do you.

Liz: (28:23)
So once you’ve worked out what you want to spend your time, energy and money on, she tells you how to do it. But it’s the fourth book called calm the fuck down.

Rachel: (28:33)
Ooh, I like it.

Liz: (28:34)
I’m a worrier. I worry about everything. And I will have a conversation with my husband in my head and I will imagine what he said and I will reply to that and make a decision assuming what I think he said. And he comes home and it’s fake to complain or go but I wouldn’t have said that. I worry.

Rachel: (28:51)
Okay.

Liz: (28:52)
And this says it’s all about how to control what you can, how to control what you can and accept what you can’t. So you stop freaking out and get on with your life.

Rachel: (29:03)
Ooh I love it.

Liz: (29:03)
And it’s, it’s just brilliant. And basically I spend my life worrying about things and she says, right. She calls it like a problemeter. Okay. On a scale of one to five, how likely is that thing to happen? So I worry about my mum dying. Well my mum is going to die. That’s five out of five but I can’t do anything about it. So stop worrying about it.

Rachel: (29:28)
Yeah.

Liz: (29:29)
I worry that I might put odd socks on tomorrow and someone will see, well you can do something about that you lay them out the night before. Or I worry that it might rain and my hair will go frizzy. Well it might rain. You could take an umbrella and it, it’s kind of helping you work out how much of your fuck budget, your time, energy and money to spend on the things you’re worrying about. And that really, really helps me. Can, I’m worried my operation might go wrong tomorrow. Well, I can read at the end now to me, I can review the notes, but there’s other things I can’t control. And if it happens then it happens. And it’s that, that fear of that paralysis that can come to you at work can just destroy your day. And this is another really good book about helping you worry about the right things.

Liz: (30:14)
Right? So you work out, is it likely to happen? And then what’s the impact if it happens? So am I likely to put on odd socks? Yes. What’s the impact going to be? Probably quite minor. And then with the operation or is it likely to go wrong? Well, probably not, but what’s the impact of it goes wrong? Well, impact will be high, so you’ll probably spend a little bit more of your fuck budget actually worrying about that.

Liz: (30:38)
And she kind of sums it up, copying a bit from Lord of the Rings. Um, the one question to rule them all, can I control it? If your answer is no, then stop giving a fuck about it.

Rachel: (30:51)
Yeah.

Liz: (30:52)
I find that really, really, really hard to do. But it does, it does really help. I worry that my cancer might come back and you have nights when you’re on the internet looking at metastatic blogs, but I think actually I can, I control that. No, I can exercise, I can eat healthy, but it might still come back, but I should stop worrying about it because there is nothing I can do to stop it happening. And that is where this has really helped me, at those kind of worries and niggles. And what if I don’t pass the exam or, yeah.

Liz: (31:21)
I remember reading something very similar in Stephen Covey’s fantastic book, the seven habits of highly effective people.

Rachel: (31:28)
Oh that’s great book.

Liz: (31:28)
Yeah, it’s brilliant. There’s no swearing in it. However, um, but he talks about the concepts of the circle of control, which is everything that you can control. And then the concept of a, a slightly wider circle circle of influence, which is those things that you can influence. I guess I just prefer the idea there’s things that you can control and there’s those things you can’t control.

Rachel: (31:49)
Yeah.

Liz: (31:49)
I’m factually very black and white. And what I’ve noticed when coaches sort of doctors and professionals in high stress jobs is that we often get very, very upset and stressed about those things that we have absolutely no control over. For example, you know, all those changes going on the NHS and the lack of resources or, or things that other people are doing. Quite often a coachee will say to me, well, if I could just get them to do that, or if they would only think this of me and I’m thinking, well actually there’s absolutely no control over that. Sure we can do things. We can choose to take control of what we do and what we say to try and influence. But actually we have no control over how they’re gonna react. So what’s the answer then? Just literally stop worrying. Are there any methods, stop the worrying.

Liz: (32:36)
I think it’s on a scale one to five, how likely is this to happen and that will help you decide how much time and energy to put into worrying about it. Some people are natural worriers and some aren’t. My husband is very much, everything will be fine. And I’m like, no, but it won’t. You can’t say that. And it’s just can I affect the outcome. And it may be, I’m worried they won’t like my book report, but I haven’t written it yet and it’s midnight and that’s my own fault. So fair call. I have to accept the blame and say, yeah I did a shit job because I didn’t do this properly. I’d take responsibility cause there’s a lot of excuses cause we don’t want to admit that we haven’t done things the way we should have done. I think it’s a really good way of owning up to things that haven’t gone the way they should. We only have a limited amount of time, energy, and money. So here’s a fact, I was reading a great book by Andy Coke called shine about happiness. And he says, I think that’s the name of the title. I’ll, I’ll get it at the end.

Rachel: (33:34)
We’ll put it in the show notes.

Liz: (33:36)
Um, the average person lives for 4,000 weeks and if you tell a five-year-old, they go, wow, that’s amazing 4,000 weeks, what am I going to do? And if you tell an adult, shit, how many have gone, how many have I got left?

Rachel: (33:54)
4,000 weeks uh.

Liz: (33:54)
4,000 weeks on average. That’s if you lived until about 87-90. Now to me that doesn’t sound like a lot. And when you’ve had a cancer diagnosis, you kind of forget everything that went before and you worry about how little time you have rather than just doing stuff and filling them. And I think it’s just that don’t waste the precious amount of time you have worrying about things you can’t control. But again, this is a book I keep rereading because I keep going off on a worrying scale and coming back. But it’s, it’s really sensible advice with an awful lot of swearing.

Liz: (34:29)
I mean, the problem is our brains are just so naturally programmed to worry aren’t there, aren’t they, our amygdala response, our threat detection response and, and they really programmed to detect a threat to the tribe or a group threat. So if the group doesn’t like you when we were living in caves, we would have been thrown out of the tribe and then probably died of exposure or, or eaten by a bear. So actually a threat of people not liking us. That’s a really real thing and we really feel it. So just saying, ooh, you know, don’t worry about what people think of you actually goes against the way that we’re wired, but you have to don’t you. Otherwise you’re constantly living in the past or in the future and you’re never in the present. Sort of enjoying those 4,000 weeks that we have.

Liz: (35:11)
I mean, it may be okay if you want to give a fuck what people think about you then that’s fine. If it’s important to you to always look well presented. And there’s part of looking like a doctor on a job, not looking like someone going to a nightclub, but you don’t need to wear the best suits. You don’t need to have the best things as long as you feel comfortable and you’re dressed appropriately. But it’s okay if that is important to you. For some people it is; having perfect makeup, lipstick, and hair because that makes them feel good and that’s fine and we shouldn’t bitch about women who’ve always got a full face of slap on. It’s just that I think it’s learning to be learning to accept who you are, and I found that really, really hard because you don’t really get life coaching during medical school.

Liz: (35:51)
You come straight out of school where you’re a big fish in a little pond, thrown into university, there’s a dead person go and cut them up for two years. There’s someone vomiting on you and you don’t learn how to deal with the shit that life throws at you. We don’t get taught how to live at school, how to live at university and how to deal with all these problems and I just wonder whether life coaching, like the wheel of life is something I use an awful lot. You’ve must’ve heard about it. Just how balanced is your life. Because when I was a junior doctor every single thing was into work, but I never opened the bills and I didn’t do anything for charity. I had no social life. It was all job exams, but you don’t see how unbalanced things are until you hit a crisis point and are forced to reflect. And I think we need to encourage junior doctors to keep doing the hobbies that they love when they were at school and have that precious time for them. Because I realized I didn’t want people to put on my gravestone, she was an amazing doctor who came in at midnight to see her patients. I don’t want to be remembered for my job as the only thing. And it’s remembering that you should give time, energy and money to yourself because you’re worth it.

Rachel: (36:59)
Yeah.

Liz: (36:59)
In the word of a L’Oreal ad, was it L’Oreal?

Liz: (37:01)
We’re all worth it.

Rachel: (37:05)
Particularly if we have great hair. Um, so, so what other books has she written?

Liz: (37:10)
So Sarah Knight, the first one is the life changing magic of not giving a fuck.

Rachel: (37:14)
Yeah.

Liz: (37:14)
And then she did get your shit together.

Rachel: (37:17)
Yes. I’ve read that one.

Liz: (37:18)
Worrying about what you should do so you can finish it and do what you want to do and then you do you. So that’s kind of, you’ve sorted your life out now sort yourself out. And then a separate one is calm the fuck down. And that’s the one that resonates with me more. You worry about things. What if this happens? What if I get wrong? Well what if it doesn’t?

Rachel: (37:38)
I mean they’re basically a really clever way of expressing some really important truths and some of those sort of models that psychologists talk about all the time. Aren’t they a guess a really good way of doing therapy?

Liz: (37:50)
I think politely learning how to say no to people without coming across like an arsehole or asshole cause she’s American. Cause you don’t, you don’t wanna be rude. You don’t want people to not like you, but it’s just making them respect that you’ve made a decision and that’s okay.

Liz: (38:05)
So really worth reading. If you can get over the swearing and you haven’t got prudish children like I have.

Liz: (38:12)
I think she says there is about 273 fucks in the first book and she does apologize to her mum, but they’re really lighthearted and it’s just, yeah, I get what she’s saying.

Rachel: (38:21)
Yeah. Yeah they are. You know, really worth reading. They’re really funny and I think they’re really needed cause they’re really helpful and certainly when I’m running my training and I’m talking about the neuroscience of this all it’s a real eye opener for people cause it certainly isn’t what we’re taught about at medical school.

Liz: (38:38)
No.

Rachel: (38:38)
No, we’re certainly not taught about, um, you know, our reactions to stuff and our response and the tribe not liking us and why this is and why we worry about group threat, etc etc. Um, but you know, I guess when I was at medical school, I wonder whether I wouldn’t have been that interested in this anyway. I don’t know.

Liz: (38:57)
Yeah, no, I’m sure I would’ve. Is there an exam on that? No, then I don’t care.

Rachel: (39:02)
Yeah, exactly. So Liz, um, what else are you up to at the moment?

Liz: (39:07)
So I want to write a book.

Rachel: (39:09)
Oh, you’ve already written one.

Liz: (39:11)
I know. I’ve, I’ve written like a cancer manual. I kind of want to write my own story. Maybe my own self help book. I think I’ve been through a lot of shit in my life and I’d like to kind of tell people how to cope. But there being a woman going through surgical training and the sexual harassment and the bullying that went on and, and the whole imposter syndrome and how you just kind of find your feet and keep going.

Rachel: (39:36)
Wow.

Liz: (39:37)
Um, so it’s trying to find the time to do that as well as getting back on the triathlon again.

Rachel: (39:42)
Wow. And I’d really love to speak to you, um, another time about all your sports training, your triathlon and as well as some of the other stuff about the bullying about the sexual harassments and you know, you’re expected to react differently as a woman aren’t you at work. Um, and that can be really, really frustrating. So we’ll definitely get you back on the podcast to talk all about that. So Liz, Liz, how can people contact you?

Liz: (40:05)
So on Twitter, I’m @Liz_ORiordan. I have a website Liz.ORiordan.co.uk or if you Google the breast surgeon with breast cancer, my name comes up. The book is the complete guide to breast cancer, and I’m always talking here, there and everywhere. So, and I’m happy to come and talk. I talked to seven year old school kids to medical students to international conferences, so if you’d like me to come and talk about cancer, IT, self-help, leadership. Drop me a line.

Rachel: (40:33)
Well, thank you so much, Liz. It’s been so great to have you on and we’ll speak to you again soon.

Liz: (40:38)
Thanks a lot, Rachel. Bye.

Rachel: (40:42)
Thanks for listening. If you’ve enjoyed this episode, then please do subscribe to the podcast and also please rate it on iTunes so that other people can find it too. Do follow me on Twitter @DrRachelMorrison. You can find out more about the face to face and online courses which I run on the youarenotafrog.co.uk website. Bye for now.