Well I survived my spell of night shifts in the Emergency Department despite being viraemic (flash word for having a bit of a cold). More importantly, so did the patients. While Vitamin C, some anti cold remedies, paracetamol and coffee helped keep me awake and alert so did my COGNITHERAPEUTICALS. These are the therapeutic thoughts that like antibodies I can draw on to fight stressful situations. My software (mind) can generate these thoughts that create a sense of wellness and then stimulate my hardware (brain) to generate neurotransmitters, like dopamine, GABA, serotonin and endorphins, giving me a buzz working (no it wasnt the cold remedies!!).

Once upon I time I would dread going to work in a busy Emergency Department as a doctor on a Saturday night, let alone Easter when it tends to be busier and many friends and family are relaxing. It all came down to what I was telling myself when I walked through the door, saw the full waiting room of patients and thought “Oh no look at all those people!”. Now I have trained my mind to stimulate my brain to get excited when I see a full waiting room, also to feel grateful when I see an empty one. Just like crunches at the gym can strengthen your AB’s, you can strengthen the neural networks in your head that stimulate these chemicals that make you feel good. the advantage of “feeling good” is that your hardware is working well, you are less likely to make mistakes, and people are less likely to complain.

Your concentration and memory improve, you enjoy your shift and look forward to the next one instead of dreading it! Healthy Thinking and COGNITHERAPEUTICS can generate what I like to call a “THOUGHT BUZZ”.

I tell myself when I see the waiting room full and the endless stream of ambulance staff bringing in trauma victims or people having heart attacks, I choose to think, “More People to help” or ” I studied long and hard to have this privilege of working in an Emergency Department” or, “I can use my skills and get more experience in this case” .

It really works, I enjoy the difficult cases, the procedures and volunteer for resus cases, the seemingly mundane cases and the ones no one else wants. Like a druggie looking for their next fix, I ENJOY MY JOB”. I get a THOUGHT BUZZ and energy, just by changing what I think!!”

The trick is to create that same THOUGHT BUZZ, when the shift finishes. Just as much as I enjoy my job, I enjoy coming home to relax, or do something adventurous.

Right now my wife and son are away for a few days holiday visiting our oldest daughter, my youngest daughter is away for the day riding horses, while our middle daughter is about to start her first job as a lawyer tomorrow. Its just me and the cat and the dog at home for a lazy Sunday afternoon. A time to get my spearfishing gear maintained for the next adventure, do some reading, drink coffee and read the paper. Relaxing allows my brain to make more healthy neurotransmiiters.

Another way to stimulate them is extreme adventure. I have just returned from a Black Water Rafting adventure with my 14 year old daughter and her 2 friends. Underground caving, jumping off waterfalls backwards into an abyss several hundred metres underground with your butt in an inflatable tube is full on adventure. My son and wife refused to come due to the thought of being underground going over waterfalls in the pitch black with head torches and having to do it with screaming teenage girls! I wouldn’t have missed it for the world!

One needs alot of Healthy Thinking to cope with the vagaries of the teenage brain and not get stressed at some of their behaviour, but if managed correctly, TEENAGERS can be fun!! But thats the topic of another Blog, if not my next book!

I have just returned from a magnificent 5 days in Western Australia speaking at a Conference on Emergency medicine. I gave a keynote address to about 200 rural doctors on the importance of attitude and how it can affect our health. In the audience was the Deputy Premier for Western Australia, Dr Kim Hames who is both the Minister of Health and Aboriginal Affairs.
Following the conference I had an email from a Paeditrician, Associate Professor Christine Jeffries-Stokes thanking me for my presentation and reinforcing our message of “It’s not necessarily your diabetes that will kill you, but your attitude towards it that will!”
Professor Jeffries-Stokes is based in Kalgoorlie, a Gold town in Western Australia with a high indigenous population. As with most indigenous populations, the incidence of diabetes is huge. Having worked in Fiji I heard a claim that up to 40% of hospital health care costs are related diabetes. The pain, suffering and loss of quality of life is immeasurable.
What Dr Jeffries-Stokes and her amazing team are doing is changing peoples attitudes towards diabetes by using a mix of modern and traditional techniques. Titled Wanti Sugarba it talks about the sugar monster through things like puppet shows for children, and involves practical workshops in growing fruit and vegetables and how our attitudes toward food and nutrition affect our health.
I was so impressed with the program and what they are trying to achieve in a remote and difficult environment that we are looking at a sponsorship arrangement where 50% of our profits from books sales, corporate training and our e-development in Western Australia can go to their mission of raising another $3 million.

We see many of our attitude profiles that relate to lifestyle diseases related to smoking, type 2 diabetes and obesity. The Denialist (I only smoke socially), The Justifier (you have to die of something) and the Extremist (I CANT stop) cause cognitive blocks to behavioural change.
Stress can be a huge part of diabetes and poor sugar control and is backed up by Professor Jeffries-Stokes research. When we feel stressed we secrete cortisol which elevates our blood sugar to cope with the fright and flight response. Our pancreas produces insulin to counter the high blood sugar, putting it under stress and our cells with their pumps and channels are working harder.
Sometimes we eat more in response to stress, thereby fuelling the insulin resistance cycle. It seems fitting that our stress reducing software and e-development can benefit those that need it but dont have computers and access to our Healthy Thinking tools via the web.

Speaking of stress it is Good Friday and I have just returned yesterday from Australia. Hosted by the team at Rural Health West I had a fantastic time 24 hours post conference. I managed to surf epic waves at Yallingup and then free dive for monster crayfish and abalone south of Margaret River with a doctor I met at the conference. Crystal clear warm water with lots of fish it was awesome. I was very impressed with the coastline, the hospitality and the people, not to mention the SEAFOOD. I will be back and have had many offers to work!
Somewhere along the way I sat next to someone sneezing and unwell. Unfortunately its Good Friday, the sun is shining, I feel like crap and am armed with a box of tissues, facing starting work at 10.30pm tonight and a 10 hour shift at Auckland City Hospital Emergency Department, not to mention Saturday and Sunday night as well.
As my sinuses squeak and body aches I hope it passes quickly. Its times like this that one really needs the right attitude. It is not an easy environment to be in, 3am in the morning with a waiting room of intoxicated people, while through another unseen entrance multiple ambulances with multiple trauma, heart attacks and strokes flood the department.

I find it useful to immunize myself (along with Vitamin C and paracetamol) with certain COGNITHERAPEUTICALS or therapeutic thoughts before I go to work. If at any stage I start to feel sorry for myself I can choose to think, At least I only have a minor cold, and am not in that Ambulance.
It is interesting as many people have asked me “What are you doing over Easter?”. When I reply, working nights in the Emergency Department I often get “Poor you” “Rather you than me” or “I couldnt stand that”.
Call me weird but I think its a privilege to do so and actually look forward to it (maybe not so much with a cold). Whats the point of me not? No fun for me, no fun for the staff and no fun for the patients. While fun is probably not the right word, enjoyment of what you do is important. As I often say, if you cant change your attitude, change your job.
Having just had epic waves and diving and then as of Easter Monday I have 5 days off with the family in the school holidays, I cant complain!
Bring on the COGNITHERAPEUTICALS AT 3am as I reach for the tissues!
Lets hope it works, I will keep you posted!