Dr Richard Pile, a doctor of more than 20 years, specialises in cardiology and lifestyle medicine. He also provides clinical advice on wellbeing and prevention for multiple organisations across the United Kingdom. He currently works for the NHS and spends most of his time caring for patients in GP surgery.
Richard is passionate about helping people live a life of purpose. Over the past 5 years, he has developed a pragmatic approach to a lifestyle-medicine practice. His first book, Fit for Purpose, delves into ikigai and discusses how to achieve overall wellness and living a meaningful life.
You can find out more about Richard’s work through his website and his podcast, Wellbeing For Real Life. You can also connect with him on Twitter and YouTube.
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Dr Rachel Morris: Do you ever wonder why you keep on doing what you’re doing? Or perhaps you’re so busy with a day job that you haven’t had the chance to stop and really think about this? Does life often seem busy yet empty? If so, then reconnecting with your purpose just might give you the motivation to keep going in difficult circumstances or the courage to change what’s not working.
In this episode, Dr Richard Pile, GP and author, joins me to discuss why connecting with your purpose and meaning in life will increase your happiness and ability to cope and how it can help you feel a lot better. So listen to find out what exactly is a sense of purpose and how can you overdo it. Listen to find out the four different areas of our lives which contribute to our purpose. And we give you a simple tool to work out how to identify what really matters, and then help you make the small changes, which will count in each of these areas.
Welcome to You Are Not A Frog, the podcast for doctors and other busy professionals who want to beat burnout and work happier. I’m Dr Rachel Morris. I’m a GP now working as a coach, speaker, and specialist in teaching resilience. Even before the Coronavirus Crisis, we were facing unprecedented levels of burnout. We have been described as frogs in a pan of slowly boiling water. We hardly notice the extra-long days becoming the norm and have got used to feeling stressed and exhausted.
Let’s face it, folks generally only have two options: stay in the pan and be boiled alive, or jump out of the pan and leave. But you are not a frog, and that’s where this podcast comes in. It is possible to cross your working life so that you can thrive even in difficult circumstances. And if you’re happier at work, you’ll simply do a better job. In this podcast, I’ll be inviting you inside the minds of friends, colleagues, and experts, all who have an interesting take on this. So that together, we can take back control and love what we do again.
I’d like to let you know about a webinar we’ve got coming up all about the three crucial conversations you need to have with your team right now to help them deal with their workload and beat the feelings of stress and overwhelm that many people are feeling at the moment. It’s totally free. And it’s particularly for leaders in health and social care. So if you want to build a robust team through difficult times without burning out yourself, then do join us by clicking on the link in the show notes to register.
It’s fantastic to have with me today on the podcast, Dr Richard Pile. Now, Richard’s a GP partner. He’s an author, and he has a special interest in cardiovascular disease and lifestyle medicine. Welcome, Richard.
Dr Richard Pile: Thank you, Rachel. Thank you very much for having me.
Rachel: It’s great to have you on. Now, most of us in lockdown maybe got a little bit fitter, baked a little bit of sourdough bread, and watched an awful lot of telly. You wrote a book and published it and got it published by HarperCollins.
Richard: Yes, well, the thing is, I’m no good at baking. It was either that or build a Taj Mahal out of matchsticks, so I decided to go for the book instead. In fairness, I’d been planning it for probably about a year and a half. I’d submitted it to publishers a little bit before we went into lockdown, so it all worked out quite well in the end.
Rachel: Okay, all right. I’m not feeling quite so inferior that obviously, I’m planning several books in my head, but none of them have got anywhere near a piece of paper yet or anything like that. So your book is called Fit for Purpose. It’s published by HarperCollins. And it’s all about what the strapline is ‘Your Guide to Better Health, Wellbeing and Living a Meaningful Life.’
Richard: Yeah, I thought I’d keep it really narrow just a couple of areas to play.
Rachel: Yeah, so not much to cover there. What led you to write a book like that?
Richard: It was an accumulation of things, really, Rachel. I think there were two big things, I think, that got me there. One was personal circumstances. And the other was professional experience as well.
And to start with the personal, my son Luke, our oldest boy, he’s 24. and I should start by saying that he is the best person in the world. Obviously, I’m biased, but he is. He is a tremendous gift to us, a blessing, a light in our lives. But looking after him whilst he still lived at home with us was tremendously challenging because of his severe complex epilepsy and his learning disability—well, more the epilepsy than the learning disability—and because of our experiences of family, which I’m happy to go into more detail about, life was very difficult.
We were on call 24/7 as carers for Luke. Obviously, as parents, you expect to be carers for your children, but not necessarily in every day is life and death 24 hours in A&E kind of experience. So that was one big factor that was making me ask some quite big questions about what it was all about, and what it meant to live well, and how we could survive and not even just survive but also thrive as a family despite very difficult circumstances.
And the other thing was professional in that I’d been a doctor already for probably for 10 years when I started having these thoughts. And I just felt the way that I was practising medicine, which was the way that I’ve been trained to practise medicine, wasn’t really doing it for the majority of my patients and wasn’t really doing it for me, to be honest. So through a process of personal experience, of exploration, of learning, reading, listening, talking, I was developing all of these thoughts and, ultimately, wanted to share that with other people because I hope that some of the things that I’ve learned to put into practice would benefit a wider audience as well.
Rachel: So I know your book is all about purpose and how purpose can improve wellbeing and life satisfaction. Do you not think that purpose is a given if you’re a doctor?
Richard: You would imagine that, wouldn’t you? I think, as doctors, there is quite a lot of that built in. And I think as I may have referred to in the book, choosing to be a doctor meant I didn’t have to ask myself difficult questions every day about whether what I was doing was worthwhile. And I suspect that drives many of us in medicine, whether we realise it or not when we make our hard career decisions.
But if you look at the challenges that the medical profession faces, particularly at the moment, and the challenges that our patients face and the things that they come to present to us with, it became apparent to me that actually, it wasn’t a given. And anyone, no matter how apparently vocational their job might seem, can benefit from really thinking about their reason for being and what it’s all about. And I think doctors are not exempt from this.
Rachel: That’s a really good point. Because it’s vocational, people that work in health, and social care and maybe other charitable institutions or things that are normally helping other people, it feels vocational; it feels like that is your purpose, then. That is the underlying purpose of your job. It’s the given.
And I do remember years ago when I was really struggling as a junior doctor, really knackered, talking to some friends who are like, ‘Well, you’re so lucky. At least you know what you do makes a difference. We’re just trying to make more money for our company.’ And that, after a while, just gets really, really boring. And it means that you can’t give more and more.
I was reflecting on the fact that yeah, but the problem is, if purpose is just a given, you then neglect it on a daily basis, don’t you? You then neglect it. It can be too far away from you, this whole making difference to helping people. Yeah, being a doctor is a great thing. Does that make any difference to me in my life? And particularly when I didn’t think I really particularly helped that patient over there. Because I don’t seem to solve any of their problems. And they seem to still have a really, really tricky life and finding things difficult.
So actually, do you think it’s a bit of a double-edged sword being in a vocational job where there is a big purpose behind the job? It means that you often neglect it on a personal level?
Richard: I think you’re right, Rachel. I think the personal level is exactly what I was just thinking about as you were describing that. The danger there is that you say, ‘Well, my purpose in life is to be a doctor.’ But actually, that’s not our whole lives. And we’ve got lots of other things going on. And the people that come and see us in our surgeries are people who’ve got whole lives, not just the little bit they talk to us about in 10,15 minutes in a consultation.
I think there was a risk if that becomes all-consuming, and you never stop to ask yourself about the other bits of your life, and what your purpose is there, then I think that can be to your detriment.
Rachel: I guess if your purpose is tied up with your job, and then your job is becoming an absolute nightmare, or you’re being criticised about not doing your job right, then that can be really quite devastating.
Richard: Yeah. Or you don’t like your job anymore. And then you think, ‘Well, hang on a minute. This was giving me purpose before. Even if I’m good at it, what happens if I don’t like it? What am I going to do for the next 20, 30 years?’ So I think it is really important to think about it.
Rachel: I know that Daniel Pink talks in his book, Drive, about the three motivational factors in life being autonomy, mastery, and purpose. To be honest, I’ve really struggled with that last one about purpose because I’m someone who’s just chased off different ideas, perhaps without maybe picking out what’s behind it. I’m just like, ‘Well, that’s interesting. Let me go and do that.’
And actually, now, it’s like, ‘Okay, this thing about purpose.’ I think some people may call that vision, actually, as well. I think in the leadership, which I’m reading a lot about, vision. They seem to be using purpose and vision, sort of interchangeably. How would you define what purpose actually is?
Richard: Well, you make a really good point now. I think it’s really hard to define. You can look it up online, and it will say something like, a reason for being, a reason for doing something. But then I would say, you’ve got to throw other stuff in there like your values in life, the things that you think are important, the things that make life enjoyable and satisfying.
Therefore, are you living life in a meaningful way? I think meaning is a term that’s probably also used quite commonly with purpose. Are you living a life in a meaningful way that’s consistent with those values? Have you even thought about what those actually are? And you made a really good point, actually.
Despite having written a book on the subject, I think we need to be careful that we don’t assume that everybody needs to attend a course or to read a book on purpose—he says, shooting himself in the foot—because actually, your approach that you mentioned, if we’re lucky, we probably could get through life just making decisions about stuff that appeals to us and engages us. And maybe some of us are really good at instinctively knowing what is right for us. But I think, sometimes, some of us aren’t.
And sometimes, if we get stuck, or we reach a crossroads in our life, then that might be a moment to say, ‘I am going to give myself some time to think about this because I haven’t really considered it and given myself the space to contemplate. What it’s all about. Why am I here? What gives life meaning to me? What would I like to do more of? What I’d like to do less of? What makes me happy? That’s another commonly used interchangeable term as well.
Rachel: I’ve been thinking about this a lot, particularly with just the overwhelm of work that we’re seeing, particularly, in general practice and in health care. And frankly, I’ve been seeing this in lawyers, in everyone. It just seems to be crazy out there at the moment. And I think it’s so easy to lose our purpose when we’re busy. I came across a quote the other day that ‘The busy life is the empty life.’ That’s so true. Because the busier I get, almost the more I start thinking, ‘What’s life all about? What’s the meaning here? What’s the purpose here?’
I know that a lot of our colleagues in general practice are just running as fast as they can just to stand still. They are going. They’re getting through the work. They’re getting home. They’re collapsing. At the end of the day, they’re going back. They’re doing it again, and again, and again. There maybe isn’t even any room to think about purpose.
Now, what is the consequence of just living like that day after day after day without any time looking at your meaning and purpose?
Richard: So I think there are potentially really quite significant consequences to your health and to your wellbeing. The problem, of course, is that what we don’t have is randomised control trials or meta-analyses, which says: ‘Lack of purpose as a cause for type 2 diabetes.’ But actually, you can flip it around, Rachel. You can look at what the evidence is for the benefits of having a sense of purpose in life. When I say this, I’m not necessarily saying you have to ascribe to any one particular philosophy. Whether you’re a religious person or not a religious person, whether you’ve written it down on a piece of paper or not, a sense of purpose in life is something that we can all have.
For example, there’s associations, obviously, we can’t say the necessary causations, but there are associations between an increased sense of purpose in life and things like reduced risk of having a heart attack if you’ve already got coronary artery disease. There’s an association with a reduced risk of stroke in old age. So you could say that having purpose in life is effectively a form of primary prevention.
There’s reduced rate of cognitive decline, improved recovery rates from cancer, improve longevity, and people with HIV when all other confounding factors are allowed for things like lifestyle and compliance with medication, et cetera, and reduced cardiovascular disease overall, particularly in women. There have been shown to be some associations between regular religious observance and again increased lifespan and better wellbeing.
So it must, therefore, I would think, logically be true that if that’s something that’s lacking in our lives, that does pose as a challenge. If we think about all the different pillars of wellbeing, we talk about all the obvious stuff, so sleep, movement, nutrition, relationships, stress and relaxation. I would say purpose and meaning is a key pillar. Now, you can get by. Will you lead a short and unhappy life if you don’t eat a very healthy diet every day? Well, you might be alright if you’ve got enough other stuff in your life that balances that out. And that’s probably true of purpose as well.
But after 21 years of being a GP and 48 years of being a human and a parent, I would say that purpose in life and connections with other people and meaningful relationships are probably 2 of the biggest pillars. I think if you don’t have those, then you can scramble around trying to fuss over what type of diet you’re eating, whether you’re doing 30 minutes a day of exercise, and whether you’re sleeping for 7, 8 or 9 hours. But I think it’s going to be a lot harder. I think it’s almost a losing battle. That’s why I think it’s really something that I emphasise to people.
Rachel: Do you think that connection and meaningful relationships can be part of your purpose? I slightly struggle with the whole, ‘My family is everything.’ I think that can become… ‘My kids are everything, or my partner is everything.’ I think if you put all your apples in one cart, where are all your eggs? So, eggs in one basket. A.) If things don’t work out how you wanted to, it can be difficult. But B.), that sometimes seems slightly selfish to me. ‘My purpose is just my family and the people near me.’ How does it benefit the rest of the world?
Richard: Absolutely. If you think about Maslow’s hierarchy of needs, it’s often portrayed as a pyramid if you look at images on Google. We’ll start off with the basic stuff like food, shelter, warmth, and intimacy. Those are things that if we don’t have those, we consider ourselves deficient. Then, as you go up the pyramid towards the tip, you get onto things like self-actualisation, self-realisation, becoming all that you can be. And right at the top, there are terms used like transcendency. That’s where we are thinking more broadly.
We’re thinking about not just ourselves and not just our families, but others, society, the bigger picture. That’s often where the spheres of both science and faith can have things to say. So I think you’re right. If you’re always inward-focused, again, you might consider your life to be okay. But maybe you’re only going to ever achieve 75% of what you could have achieved. And if you think more broadly, which is perhaps why some people go into medicine, then your life can be even more fulfilling. So I agree. I agree, not putting all your eggs in one basket, taking time to think about what that bigger picture might mean.
Rachel: In a minute, I’m gonna go on and ask you a little bit more about how we can find purpose in life. So I know you’re very interested in this thing called ikigai, that Japanese concept. But first, I just wanted to ask you. Is there such a thing as having too much purpose?
Richard: I don’t think you can have too much purpose. But I think if your purpose is very single-minded, and you devote all your resources into it, then what you don’t have is balance. I think you need to have balance in your life. We know people, I’m sure, in terms of our families you’ve just described, or perhaps church leaders, or colleagues in general practice, who sacrifice themselves on the altar or whatever they perceive their higher calling to be. And it’s to the exclusion of all other things.
I think you’re right in that context. I think that’s unhealthy. And that’s why I think when it comes to life, people probably have different purposes at different times. And you might have different purposes in different areas. What is really important to you for 5 or 10 years might not be the thing that you then move on to, and over the course of your life, you could have many different purposes. So I think it’s good to have purpose, but I do think you need balance.
Rachel: I think, sometimes, having seen lots of GPs, who are also involved in charities, or churches, or other faith groups, or other stuff, that purpose and that sense of, ‘We’ve got to save the world. We’ve got to save our community here.’ It can be really overwhelming. I guess there’s been a little bit of that put on to general practice. ‘We’ve got to vaccinate the whole population. Yeah, we are responsible for this. We are responsible for all our patients. Oh, no, now they’re all criticising us, saying we’ve not been open.’ When we have been open. You’re a partner. Have people been finding things difficult in your practice?
Richard: Yeah, General practice is really intense at the moment. I’ve been a GP for 21 years. I sound very old when I say that, don’t I, 21 years? And it has never been this busy. Never been this busy. And I was trying to come up with an analogy the other day.
I think it’s like going to the annual appraisal for your job, just a generic job, where your boss says to you, ‘Richard, how do you think it’s going?’ And I say, ‘Well, it’s going alright, but it’s really busy.’ And the boss says, ‘Yeah, you’re gonna have to work about 20% harder than you’ve ever worked.’ And I’ll be thinking, ‘Well, I don’t really fancy that because I’d like to spend some time with my wife and kids. How much more will you pay me?’
And they say, ‘Oh, no, we’re not going to pay you any more. We just want you to work 20% harder.’ So I have to think about that. And then they say, ‘Oh, and by the way, whilst you’re working 20% harder, what’s going to happen is large sections of the public are going to believe not only that you’re not working harder, but you’re actually lazy, and that you’re not doing your job. Also, you’re there working as hard as you’ve ever worked with a reduced quality of life, but everyone else will think you’re doing a really bad job, which in turn will make your job harder to do.’
Now, if that was a job that you were selling to an incoming candidate, they’d probably walk out of the room, wouldn’t they? I would think at that stage. So it is all-consuming at the moment. And we’ve had to think very hard in our practice about how we make it sustainable. Because I do firmly believe that the greatest service that any health practitioner can do for their patients is to first look after themselves. Because if they don’t do that, they’re going to collapse. Their surgery is going to collapse. And then suddenly, that patients, in our case, 21 and a half thousand of them, are going to have no service because doctors aren’t practising what they preach.
Rachel: In the book, obviously, you talk about all these different aspects of wellbeing. Would you just suggest that people focus on sleeping, eating, exercising? Or would you say, ‘Actually, this, right now, is when you really have to dig down deep into your purpose’?
Richard: Absolutely, yeah. Now, I’m wary of encouraging people to do too many things at once. Because that can be overwhelming when someone’s thinking about their life and the changes they’d like to make. Having six different goals divided into three different sections is increasingly likely that you will fail. And as a result, you’ll probably beat yourself up and be a bit disheartened.
But I think purpose is worth considering because people need to think about, ‘How am I helping other people? How am I helping myself? Is the balance right? What do I love about my job? What’s really difficult about my job? Could I sustain this so that I can keep going in the next 1, 2, 5, 10 years? Or might I not think about this and just plough on regardless, instinctively knowing that it’s just the right thing to do, and it’s what I’ve always done, and I’m just going to do it anyway?’
And then the risk there is that people just come unglued, dramatically and quickly, and you will have seen that in colleagues and patients. Ultimately, it doesn’t really serve anyone. So I do encourage people to think about that. Because again, saying, ‘My life’s terrible. My working conditions are awful. My mental health’s suffering, but I’ll make sure that I eat a low-carb diet and get seven hours of sleep every night.’ Well, those things will probably help a bit, but they are tinkering at the edges, I would say.
Rachel: So how would someone go about if they are in that situation, reconnecting with their purpose and meaning in their life? I just think it’s quite a difficult thing to even start to do.
Richard: To get around? Yeah, well, this is where it might be useful for us to talk about the concept of ikigai, which I think is helpful. Loosely translated, it’s a Japanese word. And it means ‘reason for being.’ If you type ikigai into Google Images, the most common thing people see is a fairly crude representation. But it’s not a bad place to start, where you look at typically four different interconnecting circles. And those four areas are, if I can remember them, ‘what I love, what I’m good at, what I can get paid for, and what the world needs.’
What the world needs, perhaps touches a bit on the point we were just discussing about the bigger picture. If you were to put it very, very over-simplistically, you could say, well, great, if you’ve got something in your life, if your life basically, you’ve got all of those four circles, not just intersecting but on top of each other, then you have won at life. You can stand up and shout ikigai. That’s great. You love what you do. You get paid for it. You’re brilliant at it, and the world needs it.
You could argue that on a good day, actually having a vacation like being a GP, does tick a lot of those boxes, which goes back to your comment about built-in purpose. The challenge is at the moment that I would say, let’s take me as an example. I think I’m quite good at what I do. I do get paid reasonably for it. I don’t love it all the time. And the world does kind of need it. But I’m not sure the world needs medicine as we currently practise it in general practice, which is a very disease-based process, which is a whole other conversation.
So I think that’s where doctors could start to think about those four areas. And in those intersecting areas when you look at it on Google, you’ll therefore end up thinking things about our passion, vocation, mission, and which different bits of your life it ticks. You might say, ‘Well look, I like my job. I don’t mind not getting paid lots of money for it. The world needs it, et cetera.’
But you might say, ‘Well, I do earn plenty of money, but I need to have a better balance in my life. So, I’m good at it, but I won’t do as much of it. I might think about whether there are other things in my life, whether it’s relationships, hobbies, giving, working for charities, doing other vocational things, which may not earn me money but help me to feel, that I feel really passionate about.’ I think it’s about having the right balance.
I’m aware that as I’m having this conversation with you, as a partner, I risk shooting myself in the foot because I can see what you’re thinking. Doctors, partners, and salary doctors might think, ‘Oh yeah, I listened to this episode of You Are Not A Frog. And I decided I’m going to drop from eight sessions a week to four sessions a week.’ But I would argue that it’s better to have an enthusiastic, happy, resilient workforce who give their all to what they do.
And the bigger picture for me is that if it becomes apparent that no one can be a doctor four or five days a week now, certainly not in general practice, because of the working conditions, then that’s bigger pictures that need to be considered by our government, by NHS England, by the BMA, by whoever. Because otherwise, it’s a fiction, isn’t it, where we’re pretending that you can do this all the time, and that that will be exposed for the lie that it is, sooner or later.
Rachel: 100% agree. I’m giving you a massive, great big round of applause there. You’re right. It is such a fine line between, obviously, we desperately, desperately need people to continue to work in general practice, in medicine, in health and social care, and all those other things.
But if it’s a choice between burning out and just leaving, or reducing the sessions a bit so that they can cope, reduce the sessions, because you’re going to be better at what you do. Also, you can then find bits of work that you do love that will complement it because I don’t think that one job can ever give you everything you need, everything that you love.
I think when I’ve been doing career counselling with people, that is part of the problem. They’re like, ‘Right, I want this career that’s going to fulfil me in every single area like that.’ But actually, of course, it’s not gonna do that. So you’ve got to get this balance. What is possible within the framework of what you do and your work?
For starters, I think, yes, the great thing is we can diversify within our jobs. We can do other stuff, can’t we, which then might give us a little bit, maybe more teamwork, more creativity, or something that we need, which we really enjoy and which we really love, or do that outside of work.
Richard: Absolutely. So there are ways. Particularly, if perhaps you work in a larger practice or an organisation where there is that flexibility, none of the partners at my practice spend all their time in general practice. And that’s all they do. No one’s done that for the 20 years, 21 years, I’ve worked there. Some of them are within the general practice area. So they might be trainers.
They might be specialists in certain clinical areas. They might take part in other forms of education. And then, they might do other things outside of general practice on their days off, whether it’s working in other spheres of medicine, or just enjoying running, cycling, painting, doing things that keep them fulfilled, and refreshed, and resilient.
We must practise this as health practitioners because how can we serve our patients who come in, often stressed to the eyeballs, particularly in the last 18 months? And we know there, we know, when we sit and talk to them that, yes, we could end up doing a blood test and referring them to a specialist, and they might even end up having some kind of intervention offered.
But a lot of the time, I would argue probably the majority of the time, it’s the deep, basic life stuff that that really needs getting right. And if we don’t do that in our own lives, or at least understand the importance of it, even if we’re not perfect, even if not perfect, we’re kind of working towards it, then how can we be credible and help other people to really understand what it means to be truly well?
Rachel: Yeah, and I can imagine it’s very hard to ask patients about purpose and meaning in their lives, particularly if you don’t feel you’ve got it yourself. You’re like, ‘Well, I’m just on this treadmill. And yeah, I can see you pretty purposeless. But oh, my goodness, I’m looking at myself.’ I think back to this thing about doing that which we love, sometimes, we don’t actually know what it is we love.
And we don’t actually realise that if we play to our strengths, then we’re probably going to love it a little bit more. Again, I would really encourage people to find out what are your strengths? What are you particularly good at? And do more of it. Because you’re probably going to enjoy that more. I guess then intersects with that ‘what are you good at’ circle with ikigai. I think this is a really useful way of looking at purpose.
It’s stuff you can actually do something about. Because actually, if I’m not particularly good at something, but I really liked doing it, well, I can probably get better at it. But what do I need to do to get better at it? Do I need to go on a course, or get some more experience, or go shadow somebody, or practise? So that’s something really practical you can do.
Richard: Going back to a comment you just made about giving yourself time to think about it, I think that’s the starting point. Because unless we actually give ourselves this space, this margin, then it doesn’t happen. So, one of the things I recommend to people is that, and it worked differently for different people. Some people might be in a position to take themselves off on a retreat once a year and sit in saffron robes on top of a mountain chanting.
Other people might be able to do half an hour a week or an hour a month or five minutes a day where you just say, ‘I’m just gonna give myself this time to think about—let’s keep it simple—what makes me happy in life? Therefore, what makes me not so happy? What could I do more of? What could I do less of? Which different bits of my life need looking at when it comes to both a personal and professional?’
You need to start by asking yourself those questions, because then when I’m in an appraiser sitting with GPs, we can then talk about how they would go about fulfilling those ambitions that they have, like you say, with a training course, with downloading an app, with learning about mindfulness, whatever. So I think the key is giving yourself that time and valuing yourself enough to do it.
Rachel: Yeah, oh, totally. I would really encourage people to go either retreat, or book a night away by themselves, or with some friends, or just to think about it. In fact, it’s something I’ve been thinking about quite a lot recently, is maybe running a Tuesday You Are Not a Frog, thinking, coaching retreat, where we can just have good conversations, coach each other and do some of this stuff.
Rachel: Just putting feelers out there. If anyone’s listening, and that would be of interest to them, finding somewhere really nice to stay where we can get out into nature and just have some of these conversations, just drop me an email at email@example.com. And if enough people go, ‘Yes, please, I’d be up for that,’ I’ll organise it because it would be lovely. It would be brilliant.
Because the ones I’ve done like that, I went on one thing where we just literally hiked up a mountain. And we said like when you have conversations like this, that and the other, stayed in a hut overnight, hiked down again. Oh, it was brilliant. It was just so good. And we are so busy, we are so busy that unless you’ve actually put some time in your diary, and you can’t get yourself in front of a computer.
So anyway, back to what we’re talking about: the four circles. So you can get good at stuff. You can find out what you love doing by a little bit of reflection, and maybe some coaching or strength areas and stuff like that. The whole thing about what the world pays you for, now that that is an interesting one. I think that is where we are really fortunate, aren’t we, in health and social care? And most people, I think, listen to this podcast, probably in…
Richard: Yes, definitely. There’s the concept, which also mentioned in the book, about income society and the idea that, generally speaking, on average, once you get to a certain amount of money that sort of insulates you as best as it can from the basic deficiencies in life, then you can earn more and more and more, but you don’t tend to get happier and happier and happier.
In fact, there is some evidence to suggest that you might become unhappy, depending on what issues that throws up. So you’re right, that’s maybe one thing most people working as GPs don’t have to worry about as much.
Rachel: And then you’ve got the option of, actually, if you need a bit of extra money, you can always go do extra shifts and extra this and extra that, which not everybody has. I think we’re really fortunate in that sense, as well. The other thing we’re really fortunate about, and I think we forget this sometimes, is that the world always needs healthcare. The world needs healthcare. The world needs compassionate people. The world needs people that are going to listen to them and point them in the right direction of good health, not just fixing people’s disease.
So in terms of finding someone something that the world needs, what we’re not trying to do is create a product, and then try and sell it to people say, ‘No, no, you really, really, really need this.’ People know that they need good health. So we’ve got that going for us already. But I guess it’s narrowing it down to specifically one area, rather than, ‘What does the world need from me?’ ‘Good health.’ That’s a little bit too big. Right?
Richard: Quite broad. So in my case, it could be going back to my earlier comments about the wrong kind of medicine. We don’t have time to go into that in detail today. But we do practice a very disease-based sickness model of medicine. The National Health Service is more of a sickness service than a health service.
And I guess one of the things that I’d like to do, that I think the world might need is to look at how we develop a more wellness-based model. And by that, I mean, looking at how GPs consult, looking at the different models of the consultation. There’s not been any really new ones for many years, and thinking about something that is more focused on wellness.
Now, it’s a challenge because there’s so many competing agendas, and people have got so much that they want help with at the moment. And we’ve got external factors and pressures upon us. But if we don’t do that, then I believe we might be giving the world what they think they want, but it isn’t necessarily what they need. And I know that sounds possibly a little bit paternalistic. But if we keep on doing the same thing, we’re always gonna get the same result.
Rachel: Yeah, yeah, totally. I don’t think that’s paternalistic. I think that showing people the transformation that they need, and then helping them get there isn’t paternalistic. It’s just right. To continue to give somebody something that they want that isn’t necessarily good for them, well, that’s just madness, isn’t it?
Richard: You wouldn’t do it for your child, would you?
Rachel: No, just thinking that… My daughter would quite happily just eat this entire packet of biscuits when she came home from school. But that’s probably not what she needs right at that point. So right, I’m looking at these four circles, which I have drawn. And I’m looking at that intersection in the middle. So it’s the intersection, just to summarise, ‘the things that which I love, the things I’m good at, the things that the world needs, and what I’m what I’m paid for.’ And I guess you could take out the paid-for bits.
Richard: Yeah, absolutely. And that’s why, and again, I don’t have the picture right in front of me at the moment. But I do offer a slightly more nuanced model in the book, used with the kind permission of Nicholas Kemp and Professor Hasegawa, which is more, according to Nicholas, is more the Japanese concept of ikigai and not so much the Westernised, Googleised version. And as you’ll see, by looking at that, and you can find it online, it doesn’t emphasise career as much. It is part of it. But it’s not the only thing.
Because for many of us, if we’re at a stage in life where we don’t need paying, or we aren’t in paid employment, to have something that’s a little bit less career-focused, and it’s a bit more about relationships, and hobbies, and creativity and that kind of thing. That can be more helpful. That’s a slightly more nuanced way of looking at it.
Rachel: I like that. And we’ll put a link to that in the show notes. Circle for values, circle for roles and relationships, circle for presence and hope. I love that. It’s one of my core values: hope and inspiration. A circle for work and leisure. And then you’ve got that bit in the middle, which is sort of self-actualisation.
So with all of these interlocking circles, these Venn diagrams, the bit in the middle, right is where we’re aiming for? That is our purpose? Is that right?
Richard: You could say that. That’s what you might crudely call it, the ikigai, the reason for being. Now, you won’t achieve perfection every day. You won’t happily lead a life, necessarily, unless you’re very fortunate, where everything’s in perfect balance, and everything’s in the middle. But I think just having enough different aspects of your life, whether it’s your work, your relationships, et cetera. that just means that overall, you feel you’ve got balance.
I think when it comes to balance and resilience, I tend to look at it as life as standing on a seesaw. And you’ve got the challenges of life on one side, and you’ve got the resources available to you on the other. You’re going to be better resourced if you’ve got a purpose and meaning in life, then you’re better able to cope with whatever life throws at you.
Rachel: Just want to finally touch on another point. I know you do cover this quite a lot in your book. Where does spirituality come into purpose? Because when you ask the question, ‘Why am I here?’ We don’t always go straight to, ‘Well, it’s to do what I love and what I’m good at.’ Sometimes, it’s like, literally, why are we here? The really big picture stuff and something a little bit outside of yourself. Where does that all come in?
Richard: So I think it was in a Terry Pratchett book where there was a philosopher was asked at a party, why are you here? And the answer took three years or something. So again, I’m not promoting any one philosophy or faith. But I think, as human beings, we have physical, mental, and spiritual aspects to our being. I feel that’s undeniable whether we acknowledge it or not, whether we understand it or not. It’s when we attempt to fragment these, to separate them, that things generally end badly in one way or another.
Just as we in general practice would accept that there isn’t really a divide between physical and mental health and that there shouldn’t be but maybe years and years ago, that’s how it was looked at, I think that spirituality is important. But when I say spirituality, again, that doesn’t necessarily mean being signed up to one particular religious faith. But, that is the bit at the top of Maslow’s hierarchy. That’s the transcendency bit.
That’s the, ‘What is the bigger picture? What else is going on beyond me and my immediate surroundings? What is it all about? What should I be doing to contribute to the world, to society?’ That might mean a belief in a higher power. It might not. You might be a humanist or an atheist, who says, ‘I’m very clear about my values in life and the things that I consider to be important. And I will have that at the back of my mind when I’m making my decisions about the job that I do and the way I conduct my relationships.’
Because you want to live a life that’s congruent with those values. And again, if people had never really thought about that, the ‘Why am I here?’ question, that’s something they could start with just having a little bit of time to consider. I think life is so frantic, day-to-day ritual, that unless we actually give ourselves permission to dare to think those big thoughts, it could be a whole area of life that’s just never addressed.
Rachel: Yeah, I think busyness just gets in the way of it. It can be quite a convenient way of covering some uncomfortable stuff that we don’t really want to deal with as well. I had a spiritual director for a while. And that was really, really helpful. And actually, the main thing that came out from my spiritual director was actually me creating time and space in my house, for me, where once a day or once a week, or whenever I could, I would actually go and sit on my own and think.
That was so, so important. Then, there’s so much amazing stuff out there and so many things to connect with, and so many ways to explore all this sort of thing. But yet again, it’s the busyness that just overtakes all this.
Richard: It is. And I think, from our previous conversation, that you and I both read The Ruthless Elimination of Hurry by John Mark Comer. And that is just brilliant, whether you’re a Christian or not, whatever. It’s just that description of the needs to have margin in your life, to have space.
And the idea of Sabbath again, which needn’t be a religious thing, it could just be, this is just like you’ve mentioned, this is the time that I set aside for myself, each day, each week, whatever, just to stop and take stock. I think we all need that as humans.
Rachel: Oh, totally, to rest and restore. There is a reason, isn’t there, why most of the world’s major religions have a day of rest in them or even some time every day of reflection. And I remember one of my colleagues, who I worked with very closely, really, very strictly observed the Muslim call to prayer every time.
He said, ‘It makes my day run better. Because I stop, and I reset myself, and I reflect.’ He said, ‘I would never be without it. It’s so helpful. And it’s so important.’ Just that time when you stop and that is built-in, isn’t it, to a lot of our major world religions. And there’s a reason for that.
Richard: There is, absolutely. These ancient wisdoms, these things that have been around for thousands of years, I think we potentially ignore them at our peril. It’s great that we live in a world of evidence-based medicine or mostly evidence-based medicine. But more and more, as I’ve learned more in life as a doctor, it is interesting.
There are many things that in my early years I would have said, ‘Well, where’s the evidence for that? That’s just what some philosophy that’s been handed down or some religious belief.’ But those common principles, I think that just reflects the fact that as human beings we instinctively know what’s good for us. And those principles are shared to some degree or another by probably the majority of people on the face of this planet. So yeah, it’s worth remembering that.
Rachel: I think we need to get a little bit more comfortable with embracing mystery, stuff that we can’t explain, but we know it’s happening and we know is working. Oh, well on that note, I think we’re gonna have to stop because we’re out of time. In a minute, Richard, I’m going to ask you for your three top tips for busy people to reconnect with the purpose in their life. But before I ask you for that, if people wanted to find out more about your book or about ikigai or any of this stuff, how can they reach you?
Richard: So you can find me on all the usual social media channels. I’m mainly on Twitter, @DrRichardPile, I’ve got a YouTube channel and a blog, which is called Wellbeing for Real Life, which is also the title of my podcast, which I’ve now done series one. Nowhere near as many episodes as you, but just seven episodes so far. My book Fit for Purpose is available from HarperCollins.
Rachel: Brilliant, so yeah, I encourage you to check that all out. So what would your top three tips be?
Richard: I’ve listened to so many podcasts over the years where people are put on the spot with their top three tips. And I often think, ‘I’m glad I’m not there.’ And here I am.
Number one would go back to what I’ve mentioned a couple of times already, which is you need to give yourself time to take stock. So just think about how that is achievable for you. You might be very busy. Your life circumstances might be really challenging personally or professionally, I absolutely get that.
But I would argue that the most of us, for example, could probably afford five minutes a day of just giving ourselves a bit of time to think about these things, and ideally, maybe, something even just once a week or once a month could be a bit more meaningful because then you could devote a bit more time to it—half an hour, an hour, whatever. So taking stock, I think, is really important.
Then, number two is perhaps thinking about the ikigai concept. So thinking about what you are good at or enjoy, what you are passionate about, what you get paid for, what the world needs. Because I think it’s a simplistic way of looking at. But it’s not a bad way to start off the thought process.
Number three is, when you’ve identified, possibly, the things that you either do or would like to do that would give your life more meaning and purpose, think practically about how you’re going to achieve that and what are the steps that you’re going to take. Does it mean learning a new skill? Does it mean increasing your work, maybe? Does it mean reducing your work commitments? Does it mean focusing more on your relationships?
And a little bit like I do, as a professional development plan with appraisees. You might want to write it down. ‘This is what my goal is. This is what I’d like to do. This is how I’m going to do it. How will I know when I’ve done it? Will it be something I can measure? Well, I have achieved, I’ve finished a course, finished an app, crossed some kind of line that will help me know that I’ve achieved that goal.’
And then I guess, it’s kind of rinse and repeat. So you’ve given yourself the time to think about it. You’ve broken it down into few areas. You’ve come up with a plan for what you’d like to happen and how you’re going to make happen. And then, ask yourself the question at some point again, ‘How’s it going? Have I achieved what I wanted to do? What went well? What didn’t go quite so well? What didn’t I think about that maybe I came a bit unstuck? But next time, I could get rounded by doing it differently.’ Those would be my tips.
Rachel: That’s brilliant. Thank you so much, Richard. That has been really, really helpful. I think some really practical ways of actually reconnecting with your purpose in life. So I think there’s lots more we can talk about. Will you come back in the podcast at some point?
Richard: I’ll be delighted. Thank you, Rachel.
Rachel: That’d be great. And I encourage people to have a look at Richard’s book as well. Check out all those resources. And if anyone is interested in a You Are Not A Frog gathering, then just email firstname.lastname@example.org. Just say, ‘I’m interested.’ You’re not committed to anything.
But if I have more than 10 people email me, I will set something up, and we’ll go do it. We’ll have a gathering where we eat lovely food, maybe sit around a campfire and think about this sort of stuff and just reconnect with our purpose and our vision. So that’s brilliant.
Thank you, Richard! We’ll speak soon.
Richard: Thank you, Rachel. Take care.
Thanks for listening. If you’ve enjoyed this episode, then please share it with your friends and colleagues. Please subscribe to my You Are Not A Frog email list and subscribe to the podcast. And if you have enjoyed it, then please leave me a rating wherever you listen to your podcasts. So, keep well, everyone. You’re doing a great job. You got this.