Jenny part 2

Dave and the speaker are discussing part two of their chat with Jenny. They reflect on the first episode and how it made them feel happier. They talk about Jenny's experiences as a patient and how it has made her a better doctor. They also discuss the importance of empathy and small gestures in healthcare. Jenny shares her journey to becoming a doctor, including her time in the military and as a bicycle mechanic. Dave. We're here. Part two. Welcome back, everyone. Episode eight. We're getting very close to 10 now. It's very exciting. You can almost taste it. Sorry. I think I've had too much caffeine today. If you haven't listened to part one of this chat with Jenny, which I think was an awesome chat, right? Going into part one now, that is mental if you haven't. Yeah, that's an order. Yeah, if you have jumped straight on to part two and fully ignored this, then it's your own fault. Yeah, no sympathy. No. It's not right, is it? I like it. Well, keep going. Quickly, what did you think about that first episode on reflection? On reflection, I think, she's got... On reflection, she makes me feel happy. I came out of that talk, that conversation with Jenny, and I felt happier. That's probably the best way I can describe that. Okay. I don't know what it was. I think some people do just have an aura around them, and from the moment she walked in, stumbled in... Not very nice. Jenny, when you are listening to this back, that's probably the only person listening to the back. I can't make those jokes. I don't know how well enough to say that. I'm very angry with what he just said. You should be. I'm angry at myself. No, she lit up the room, I think, straight away. And she made me feel very comfortable, even though that's my job to do to her, considering she's our guest. So yeah, she's an inspiration from the bottom to the top, and she was the gift that kept on giving, I think. Yeah. There's some interesting and wide-ranging topics in this second part of our chat. I think we started to hallucinate slightly and just get a bit giddy. It got quite late, didn't it? This is the reason we had to split up into two parts. But it got quite late, and we started chatting all sorts of stuff. So yeah. I hope you enjoy. Me or the listeners? Anyone. Anyone that's listening. Okay, everyone. Enjoy part two with Jenny coming up. So I've got a question. I always try and put myself into your shoes. That wasn't meant to be a pun. Jenny's got this new braids on. Just a disclaimer here. My shoes are probably the weirdest pair of shoes in Great Britain right now. But I've got a size 38.5. I don't get UK sizes. I'll do Euro. Sorry, guys. 38.5 on my left foot, and a size 46 on my right foot. I told you the Franken heel was a bit weird. So I always try and put myself into your shoes, and one of them always keeps falling off. No. Let me start again. As a medical professional who's undergone a lot of rehab and treatment and stuff and been in hospital and had operations that obviously you would have never had before, do you think this experience will make you a better doctor and a better clinician? Yeah, 100%. I think there's no way, unless you're made of stone, there's no way it cannot. Yeah, pretty, I don't know the right word, really, but it's pretty humbling to end up, you know, as I say, as the 40-year-old independent woman who all of a sudden cannot take a shit on her own without pressing the call bell for someone she maybe has never even met. Shout out to those amazing people in hospital who do that job, the healthcare assistants and the nurses are just amazing. But yeah, going through that process and the frustrations that come with it, even when the standard of care, like the standard of care I've received here has been exceptionally high, but it doesn't mean there are not frustrations and it doesn't mean there are not people who are amazing clinicians, really well-intentioned who come in, move your bedside table away so they and the team can speak to you and then don't put it back. And you know it's Saturday night and the nurses are so busy and you don't want to ring your bell to ask for your bedside table and it's so near yet so far. You pour coffee on them. I only learnt that trick after discharge day, thanks for the teaching, if only I'd known. But yeah, so things like that and I instantly thought of all of the times that I've done that to some poor patient who can't reach their bedside table or their walker or their, you know, or I'd be, you know, sometimes I'd be on the phone to one of my very dear friends in Ukraine and they were on the front line and tomorrow who knows, maybe I'd be able to speak to them, maybe they wouldn't be there. That's the reality of that, you know, of any war, but of this war, you know, it's obviously horrific and I'd be on the phone to a very dear friend and there'd be someone who'd, you know, be standing there with that facial expression that just says, I'm the clinician, I'm so much more important than whoever you're on the phone to, so put the fucking phone down and speak with me now, patient, you know. Of course they didn't think that, they were all a lot kinder and more considerate than that, but you do feel a little bit like that, you know, and there were certainly times when I walked into somebody's room with that attitude and I have no idea who they were talking, you know, on the phone to. They could have been saying goodbye to, you know, their aunt who was on their last legs somewhere else and it was me barging in, interrupting to tell them the results of their x-ray or whatever else, but I think in general in healthcare we see our time as just so important and we minimise the importance of the patient's time and to my utter horror, because I always thought I was a bit better than that, being a patient, you know, with a pretty serious injury really made me realise that actually I'm not that good and I need to do better. Something I learnt really early on as a physio on the wards, I don't do a lot of wards stuff now, but a really quick one, I learnt the first few weeks that even though I wasn't at the time knowledgeable really, I'd got my degree but didn't really know a lot compared to most of the clinicians around, every time I finished seeing a patient, offer to go and make them a cup of tea and go, I'm willing to do that for you, I'll make you a cup of tea, and they end up thinking you're a better physio or whatever than the doctors who are super knowledgeable and they're like, oh it's you, you're amazing and I'm like, oh, I don't really know what I'm doing from a clinical point of view but I'm willing to make you a cup of tea. 100%. So it's the little things. The little things. It really is, it makes a massive difference and the more incapacitated you are, you know, the less independent you are, the more those little things make a massive difference. Incidentally, everyone was amazing at the big London hospital I was treated at, but my favourite person was the inpatient physio. She was amazing. She was just the person who knew exactly what I needed all the time, knew when I needed space, knew when I needed pushing versus when she needed to back off. She was actually a very experienced physio, but yeah, just that human touch. She was the only person who came round where I was never, I'm the lead consultant, but the only people who came round to my bedside where it didn't matter how grumpy I was, what time of day, what was going on, how much pain I was in, I was just really grateful to see them. Yeah, so I think knowing where I went wrong for all of my career to date. No, it's not quite like that, but you definitely, you cannot put yourself in the shoes of a patient with major trauma or a major illness unless you've actually had it. I'm convinced of that really. You can learn lessons, for sure, but for me anyway, I wasn't perceptive enough ever to really pick up those things until it was me. Now you can truly empathise with how it feels. You've lived that and yeah. Yeah, definitely. To a certain extent, with the caveat that everybody's experience is slightly different and it's no good me bouncing into someone's room trying to sort of G them up and crack the jokes that made me laugh when I couldn't toilet myself or reach my water on the bedside table. You know, somebody else could easily be like, get the hell out of my face, I do not want that approach. Yeah, you have to adapt to that. Yeah, and I think, I don't know about you David, but that's what keeps me going in the health profession because everybody is so different. It's not disease, it's not what people think when they're in school. I never wanted to be a doctor in school, but when people are in school wanting to be a doctor, they're like, the body is fascinating, disease is fascinating, I want this career that makes me think. And you're like, no, no. When did you decide you wanted to be a doctor out of interest? Oh, yeah, that's kind of an interesting question because it's really not a very typical story, but I was in, I'd moved, so I'd spent half my life in the UK, half my life in New Zealand. I like the accent. New Zealand, on a total whim. Yeah, it's sad because in New Zealand they think I'm British, the pony, and in Britain they think I'm Kiwi or Aussie, so I can't win really, truly. And in Ukraine, they definitely know I can't speak Ukrainian very well at all, but I'm trying, I'm trying so hard. Maybe the next time we meet you'll have got a Ukrainian accent. Yeah, Ukraine. Yeah, so I guess it was, so I actually retrained, I did something in the military for a few years and then I retrained as a bicycle mechanic because I was really enjoying my cycling. The sports always didn't matter. I don't know this story. No, no, no, I told you this. Oh my goodness. You can't just go on so fast. So, you know, typical things people do when they come out of the military, you know, do security work, set up their own, you know, business, contracting or whatever, whatever. And I, no, I just really liked mountain biking in particular. Did a bit of road cycling, but, you know, skinny tyres not really my thing and the Lycra definitely not really my thing. But I was big into mountain biking and just really loved bikes, always loved bikes. Sport's been a huge part of my life, you know, my whole life. Probably the biggest challenge of being injured, doesn't come as any surprise to anyone is that, you know, that aspect of missing out on sport and just moving, just physical activity. But anyway, loved mountain biking so I decided, right, I'm going to be a bicycle mechanic for the rest of my life, that's what I'm going to do. So I did a training course. I ended up moving to New Zealand on a whim. That's a whole other massive story, let's not go there, but ended up in New Zealand. New Zealand, really super cool country. It very much is who you know in many ways still and it certainly was back then, you know, quite a few years ago. So I really struggled to get a job initially as a bike mechanic and I started working in a, I worked in a factory bagging lollies, sweets is the English word, bagging sweets. Yep, really cerebral work. I remember we were not allowed to talk on the production line, but we could eat as much as we wanted. And I remember, yeah, do you remember the manager, she rationalised this by saying, look, we don't like theft, we don't like thieves. If we let you eat your fucking fill of sugary shit all day, you won't steal a bag of it and take it home. I was like, right, okay, that's fine. So really liked the jet planes, that was my favourite, jet planes and jelly beans. If I ever get a listening of weird and wonderful cancers, it'll probably be from those six months. But anyway, I was on a zero hours contract earning minimum wage as a recent immigrant bagging lollies on a production line and other than my colleagues who were pretty cool people, it was fairly miserable. And I think I did a few months of that and I just thought, Jen, like, what are you doing? Like, what is this? You've gone from a successful career that you've thrown the towel into, you know, a zero hours miserable contract. But free sweets. But free jet planes and jelly beans. No. There was even some of that good, you know that chocolate that's never actually seen a cocoa bean in its life? That sort of chocolate. It's the best kind. The stuff that Easter eggs are made of. Yeah, there was that too. But no, one day I just thought, you know, what are you doing? I'd done kind of okay at school until I was about 16, 17, until I could drive. Does that sound familiar? And then all of a sudden you go, you know, you went away and did some other cooler things and some sport and some flying and other bits and bobs. And then I guess I'd always wondered if I could do good at academic stuff. That sounds intelligent, doesn't it? And the answer is no. 100% no. It's taken me maybe 16 years to find out, but the answer was definitely no. Yeah, so I thought, oh, maybe I could go to university. And I was reading, I can't believe I'm admitting this to the world on a podcast. I really hope it is only your grandmother's. You're really overselling this across the world. You might hit four of our mates and our mums. Yeah, where's your mum this week? She might be on the other side of the world in which case. Yeah, so I was reading this trashy novel. I don't like fiction. I was reading this trashy novel about a GP who hated her life and had just got divorced. And there was something in there that made me think, I wonder if I could be a doctor. It's too bizarre, isn't it? But honestly, it's completely true. And I ended up getting into Auckland Medical School. Thank you very much. I'm shaking his head. I love the way you make decisions. It seems so almost flippant, but it works out really well. It just works out. I don't know, would it work out in the financial markets though, Scott? That's the thing. I mean, a lot of people have got rich on luck. Probably. The older day, it's better to be lucky than good. Exactly. So you read a trashy book and decided to become a doctor. That's really embarrassing. I'm admitting this to whoever's listening. But it's completely true. Shout out to Auckland Medical School. Thank you very much for letting me in. With every year, I just realised how lucky I was to effectively trip over and fall on my face into medicine because it just got richer and richer and gave back more and more and sort of more interesting, intriguing career. Probably a couple of times I've almost left just because I'm, you know, sometimes you get a bit bored. The world's a big place, isn't it? There's lots of stuff to do. It's all a bit fascinating. One year, I decided I wanted to race bikes. I went and did that. That was pretty rubbish. It was really good fun though. And eventually... Bicycles or motorbikes? No, no. Bicycles. Bicycles, yeah. And eventually, the dean wrote to me and said, look, you're just about smart enough to take one year off but you're not smart enough to take two years off. So come on back or bugger off. But I'm glad I saw it through. I now work predominantly in rural hospitals, so sort of true generalism really. Do a little bit of everything. Jack of all trades, master of nothing. But there's always... You know, there's always phone a friend with, you know, some amazing specialists. Excuse me, who we can phone up and ask for advice. And it's a wonderful community of colleagues and it's very, very rewarding to, you know, serve these communities that are really in the back of your arms sometimes. Difficult access through to bigger hospitals and all the medical treatment you might need there if you get involved in some terrible trauma on your, you know, your farm or whatever. Often we can send an air ambulance and they maybe bypass, you know, the little hospital I would work in. But sometimes, you know, the place is flooded, the roads close, helicopter can't fly and it becomes really difficult and you end up with some quite challenging cases on your doorstep that nobody would think of that, you know, a rural hospital has to deal with. I don't think you guys really have anything like that over here except maybe in the, you know, the, I don't know, west coast of Scotland or out of Hebrides or something like that. Yeah, certainly not in central London. So you do that all over the world basically? Just New Zealand actually. Oh really? Yeah, so although I did sort of sign up to go practice in Ukraine, I actually haven't really worked as a doctor there because I haven't needed to. Trauma is really quite simple. Horrific, horrible, but, you know, simple and formulaic, especially when you're at the sharp pointy end and you don't have a lot of resources. You know, the typical approach is make sure they don't bleed to death first of all. You know, anyone who's done a basic first aid course will know in the civilian world, apart from checking for danger, you're a doctor at ABC, you check for airway first and then breathing and then circulation. And on the battlefield, in the trauma context, we do things a little bit differently. We use an acronym called MARCH and the first thing is M for Massive Haemorrhage because that's what's going to... Haemorrhage is bleeding, right? So that's what's going to kill you. I quite like that the letter is for massive and then the actual importance is it hasn't got a letter. It's like the acronym is more important. So it's massive. Massive, massive. Anyone else finish that bit? Sorry, go on. You're absolutely right. And this is one reason why I hate acronyms in medicine because they're often complete nonsense. I actually preferred it when we just did eponymous names for things, you know. Random, you know, random disease names made a lot more sense than trying to fit it into, you know, shoehorn it into an acronym. Shoehorns are an interesting thing. Here's a thing I learnt today. So I went to... There's so many directions. So random. Is this too random? No. You don't know because you don't know what I'm going to say. So I went to this marvellous place. The people who made my brace, shout out to... There's a lot of shout outs. Orthopaedics, I know. I've had a lot of people do a lot of things for me, eh? But the people who made this brace, I went there and it does fit into this enormous shoe but you can't really get it into the shoe without a shoehorn. Shoehorns in Ukraine? Ubiquitous. You can't rent an apartment without someone throwing in a shoehorn. That is interesting. Yeah, you get round someone's house and they don't have a shoehorn and it's like not having curtains or not having a sink. Where's your shoehorn? Britain? Not so easy. I never owned a shoehorn. There you go. Do you have a shoehorn, Scott? No, but I under-owned it. There's super long ones as well. Yeah, that's right. When you get a super long shoehorn, that's a great feature. It was so weird seeing my Ukrainian friends, obviously not on the front line, we don't worry about shoehorns in the trenches, but anyway, you sort of go back to Kiev or Lviv and see your friends and they've got, they're young, fit, healthy people but instead of bending over to put their shoe on they've got this massive shoehorn that's like about three and a half feet long. Cultural differences, eh? Yeah, I know that. This segment is going to get cut. Yeah, definitely. Should we go back to the shoehorn segment? Yeah, let's get rid of that. Let's not do that. This episode could be called All About Shoehorns. Let's try and find some normality. Some normality again. So, going back to your injury, I am very interested, how do you, and I guess Dave's going to chime in here, how do you go from start to where you are in terms of the whole physio process from having a hole in your heel, as you said, what do you do? What's the process behind that? Because it must be very baby steps, just lots of baby steps, that's what I can kind of imagine, but I'm interested to hear the process you went through, I guess. Yeah, it really is baby steps, and I knew it would be like that at the beginning. It's kind of logical, and everyone tells you that, but I didn't realise quite how baby the baby steps are. It's like baby cockroach steps, not baby human steps. It's just tiny little jumps, and I guess the first thing, so it hasn't been until recently that I could even stand on the bad leg, so the first thing I ended up doing once they released me from absolute bed rest was getting really good at balancing on my other leg to reach things and hop around and move, and it's all about finding ways to adapt what you would normally do in normal life to, okay, so now, at that stage, I can use my left hand, so I just have my left leg and my right hand to use, and you sort of do as much as you can and change the way you do things, but I think, again, patience is the key thing, and it's just understanding that it's not even incremental gains, because a lot of days, it's losses, right? You win some, you lose some, peaks and troughs of healing and progression, and just being patient when you're actually going backwards is just the normal part of healing. It's not a linear progression, in the same way that the Ukrainian counter-offensive that you guys would hear about on TV, it's not Call of Duty on some games console, it's like, okay, you're going to have good days and bad days, some days you go forward, some days you get pushed back a little bit, and I would say it's more or less the process. Learning to use my hand again and try and grip things and move my fingers, and that was a really slow process, and you see it's still ongoing, I can't really make a fist yet. Learning not to point with my left index finger that's not there anymore. Yeah, just getting used to your new reality really slowly. I think, as you said, I'm definitely going to chime in. You've touched on it there, but what I always try and do with patience is that thing of setting really small goals. If you go almost like a binary, I can or I can't, can I walk on my bad foot? No, that's failure. If you compare yourself to where you were, am I there? No, so this last three months has been completely wasted kind of thing. If you look at it in that way and it just has to be little small, ideally slightly measurable things. Let's talk about how happy you were in the first session or two. With the big toe. Yeah, first session or two when I was trying to move my ankle, move my toe and the toe was just a lump of stone, wouldn't move up or down really. It felt like we would never ever get anywhere, ever. Then you just chip away slowly, slowly. I think the key thing is your goals have to be achievable. Not necessarily achievable today, maybe that's too easy, but you've got to be able to look at a realistic time frame. You've got to have those long-term goals. Yeah, I want to be able to walk on both legs again, preferably normally, preferably with no brace and no support of any kind, no crutches. That may or may not happen. Either way, it's way in the future that I can evaluate that. Yes, it's specific. Yes, it's measurable, but the time frame almost doesn't exist when you're really just living day to day, particularly if you're in a lot of pain. You've also got to have those really short-term goals. It's like, okay, they've left my meal tray over the far side of the room again, but now I know I can get there on one leg, carefully balance and pull it back. Great, that's a first. I've never done that before. Or say with the big toe thing, just get it moving five or ten degrees, which is not nearly enough to walk normally, but it's a start. But it was that functional thing of you couldn't, someone who isn't medical wouldn't know necessarily what this means, but toe touch, weight there with your crutches, you couldn't, your toe was so stiff that you couldn't even put the bottom of the toe on the floor really, could you? Yes. Then after a few sessions, you know, we've got that now. Yes. Yes. You almost have to remind yourself. I think if you generally look at things with a positive mindset, the flip side to that is you forget so quickly where you were. I think maybe the more negative sort of people would easily remember just how hard it was last week, but I just didn't really think about that. I just thought, oh yeah, sure, I've been able to bend my toe like this for, oh no wait, I haven't actually. Actually, that's a really hard-fought win, and you forget just how bad things were and how far you've come. I think you've got to remember that, otherwise you don't feel like you're going forward. Out of interest, do you have a notebook or maybe something digital where you almost note down exactly the small, daily things that you do so you can look back and remember, oh, two weeks ago, I actually couldn't bend my toe X amount, or something to help you remember how far you have come, because I saw you walking down, and I haven't seen anything before, so from my point of view, it's amazing. I know it's been a massive journey to get there, and you just saying it's easy to forget is quite interesting. Yeah, I think I've always been really lazy about journaling. They say you're supposed to journal, show the sign of intelligence or whatever, but it's never really been for me, but a good friend of mine brought me the five-minute journal. That was day one in hospital, pretty much. He visited and dropped that off for me, and I did use that quite a bit, and I think the concept is you just write down three things you're grateful for, you know, one kind of lesson you've learned today or something, and I'd kind of put that stuff, but also little things like, you know, oh, today was my first day that I could do such and such, or just put down interesting things. You know, I'd bled a lot from the original injury, so I'd note down what my haemoglobin was, you know. I'd note down which bacteria were growing in my heel. This week, there were five of them. I only even recognised one from my whole career to date. There were some weird and wonderful things. In fact, the clinical microbiologist came and visited me in person on the ward, so I knew it was quite a big deal. It's like combat wounds are really dirty, so lots of bacteria. So that was another kind of challenge to overcome. But, yeah, tried to note down a few things. Physios, you know, I will always be writing. Illegally, I have to write notes after every session I do with a patient, but we'll try and put some markers in there, and I find myself probably with Jenny, and definitely with everyone I see that, because we're not good history, you know, as humans, we're not good at remembering history, even over a short amount of time. I go, actually, this was here a few weeks ago, and now it's here. Someone who's living with it day by day goes, oh, I didn't realise it has made that progress. You know, we've been using scales, for example, to measure your weight-bearing. Okay, I can get 50% of my weight in that leg. Now I can get 55% of my weight. And objectively going, you go, I don't think it's got any better. Okay, three weeks ago, it was this, and now it's this. So note-taking for video is a little bit like a journal, and we have to remind patients of it, and it's almost like that thing of, like a sculptor every day, if they're just chipping away and chipping away, they don't see those differences, but you take a two-week gap, and you see someone again, or someone loses a load of weight, and you haven't seen them in half a year, and you go, oh my lord, you've lost a load of weight, and they go, oh, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no,