Speaker 1: Apogee Production.
Speaker 2: Hi, my name's beck Woodbine and welcome to Tenderness for Nurses.
Speaker 1: I'm grateful for the person that I have the opportunity
Speaker 1: to be, so I hit it and parked it for
Speaker 1: Nelly four years. We always have free will, We always
Speaker 1: get to choose. We are autonomous.
Speaker 2: Hi everyone, thank you for tuning into Tenderness for Nurses.
Speaker 2: Today we have the lovely doctor Lilli Burteck again who
Speaker 2: is becoming a regular on the podcast. We all can't
Speaker 2: get enough of her information, so thanks Lily for coming
Speaker 2: and joining me.
Speaker 1: Thanks bec It's a worry when you become a frequent flyer,
Speaker 1: isn't it. I tell my patients that all the time.
Speaker 1: Don't become a frequent flyer.
Speaker 2: Well, the feedback of your information that you disseminate has
Speaker 2: been very popular, so people have been asking to hear
Speaker 2: from you again, which is why I keep us send
Speaker 2: your back on and also it's just an opportunity for
Speaker 2: us to catch up, so of course I love that. Also,
Speaker 2: a big congratulations on taking over the presidency of ACEPS.
Speaker 1: Thank you.
Speaker 2: Another feather in the cap.
Speaker 1: I think I think there's so much we can do
Speaker 1: with that, and I'm actually quite excited about the things
Speaker 1: that we can achieve with our apps.
Speaker 2: So can you just explain to our listeners what ACEPS is.
Speaker 1: Yeah, So as is an Australasian Society of Ascetic Plastic Surgeons.
Speaker 1: So it is a Australian New Zealand group which is
Speaker 1: looking after our plastic surgeons who does ascetic surgery, which
Speaker 1: is cosmetic surgery, and our ethos is really actually promoting
Speaker 1: public safety in cosmetic surgery and also making sure that
Speaker 1: the standards required for plastic surgery or plastic cosmetic surgery
Speaker 1: is well made aware in the public and that people
Speaker 1: know that about the risks and they make the right
Speaker 1: decisions about their decision to go ahead with cosmetic plastic
Speaker 1: surgery and they know who they should be looking for.
Speaker 2: So it's all about patient safety and promoting patient safety
Speaker 2: but also promoting who are the right people to see
Speaker 2: for cosmetic procedures.
Speaker 1: Yeah, it's very much about a few things. It's about
Speaker 1: advocacy to advocacy for public safety, advocacy for good safe
Speaker 1: cosmetic surgery and good regulations. It's also about education. As
Speaker 1: APPS is huge on education. Major component of as APPS
Speaker 1: is about educating, upskilling and keeping cosmetic plastic surgeons well
Speaker 1: informed and up to date. So one of our things
Speaker 1: that we talk about is that you know you have
Speaker 1: the qualifications. It takes you up to ten years through
Speaker 1: medical school specialist training to become a qualified and registered
Speaker 1: spaceless plastic surgeon. But that's ten years to get your qualification,
Speaker 1: but there is like ongoing in thirty five plus years
Speaker 1: of ongoing education that's required to keep you in the
Speaker 1: most safest standards and the most up to date standards
Speaker 1: of practice. So that's what we're all about. We're about
Speaker 1: supporting the specialist plastic surgeons in their ongoing education.
Speaker 2: As a plastic and reconstructive surgeon. Do all plastic surgeons
Speaker 2: do reconstructive work or is it some just do cosmetics,
Speaker 2: some just do reconstructive or you do a combination of both.
Speaker 1: Yeah, so it's interesting. I guess it depends on where
Speaker 1: your interest lies. However, what is important is that we
Speaker 1: are trained in both. And part of plastic surgery is
Speaker 1: about reconstructive surgery, which is, you know, reconstructing defects resulting
Speaker 1: from either trauma, cancer, or congenital Also, people are born
Speaker 1: with certain defects and the skills recontracting those and also
Speaker 1: skills of cancer surgery and trauma surgery actually helps us
Speaker 1: and it's also a part of the cosmetic surgery training
Speaker 1: because if you think about porotodectomy, so a perotidectomy is
Speaker 1: surgery that we do for cancer. We'll remove the cancer
Speaker 1: in the parotid gland which lies underneath the facial skin
Speaker 1: over your cheek. The surgery that we do for porotodectomy
Speaker 1: is actually lifting the skin, taking the porotecic gland out,
Speaker 1: and putting everything back down. And that's pretty much a
Speaker 1: face left. The only difference is that you don't take
Speaker 1: the parotid out, but the surgery to expose the parotid
Speaker 1: to do the cancer surgery is very similar to a
Speaker 1: face left. And obviously there's other components of a facelift
Speaker 1: that's in a face left surgery that's not in the
Speaker 1: product surgery, but it is, you know, everything that we
Speaker 1: do there is a component which we use in cosmetic surgery,
Speaker 1: such as you know, we harvest the abdominal flap for
Speaker 1: breast reconstruction, but the harvesting of abdominal flap part of
Speaker 1: that operation is actually a tummy tuck. So people talk about, oh,
Speaker 1: I'm getting a tummy tuck and a new boob at
Speaker 1: the same time. And that's because part of that reconstructive
Speaker 1: procedure is a tummy tuck, So a lot of our
Speaker 1: training is inclusive for both cosmetic and reconstruct surgery. And
Speaker 1: the other thing is that because we know how to
Speaker 1: deal with difficult defects and problems, we also know how
Speaker 1: to look after complications. So if things do go wrong,
Speaker 1: then we are equipped because we know how we don't know.
Speaker 1: You know, we're not just trained in doing the simple
Speaker 1: operation or creating something. We're also taught in how to
Speaker 1: reconstruct difficult defects and also deal with difficult problems. And
Speaker 1: when things do go wrong, we know what we're supposed
Speaker 1: to do and what the potential outcome could be, so
Speaker 1: we can try and prevent it.
Speaker 2: We actually discussed some of that with doctor Samya last
Speaker 2: week when I was chatting with him, and that was
Speaker 2: one of the things and I'll bring it up again
Speaker 2: because I think it's really important. Is that you have
Speaker 2: hospital visiting rights, that's right. And if you go to
Speaker 2: a cosmetic surgeon, can you say surgeon.
Speaker 1: Well depends you can. So the difference, I guess is
Speaker 1: a cosmetic plastic surgeon is a registered specialist. Plastic surgeon
Speaker 1: who does cosmetic surgery is you know, we do both.
Speaker 1: A cosmetic surgeon is a surgeon, so they have the
Speaker 1: fellowship or real Australasian College of Surgeons, but they could
Speaker 1: be a general surgeon, n T surgeon, vascular surgeon, any
Speaker 1: type of surgeon, so they can call themselves surgeons, but
Speaker 1: they can also do cosmetic surgery. So they are called
Speaker 1: cosmetic surgeons because the word cosmetic is not a protected title, Okay,
Speaker 1: the word surgeon is.
Speaker 2: So what about the people that GPS that have gone
Speaker 2: and done some extra a little bit of extra study
Speaker 2: and then then performing surgical.
Speaker 1: Well, they can't call themselves surgeons. They call themselves cosmetic doctors,
Speaker 1: cosmetic physicians. Okay, yes, cosurgeons are protected time, Yes, yes
Speaker 1: you can. I think they call themselves also cosmetic practitioners.
Speaker 1: But surgeon became a protected title earlier this year and
Speaker 1: I think w A was the last state to pass
Speaker 1: that legislation. But that's all through and now so throughout
Speaker 1: the whole of Australia. Yeah, that's a protected title. So yeah,
Speaker 1: cosmetic plastic surgeon is somebody who is a specialist plastic
Speaker 1: surgeon registered to such with OPRAH who performs cosmetic surgery.
Speaker 2: Okay, and you have hospital visitation rights yes, cosmetic physicians
Speaker 2: may not.
Speaker 1: No. Yeah, So it's all about admitting rights. So if
Speaker 1: things do go wrong, such as you have bad bleeding
Speaker 1: and required go back to return to operating theater in
Speaker 1: your blood transfusion, or your quite over nice stay and
Speaker 1: things like that, you know, to have hospital visiting and
Speaker 1: admitting rights is important because you want to be able
Speaker 1: to look after your patients in the hospital where you
Speaker 1: have all the support that you require.
Speaker 2: At the conference, did you talk or touch on wellness
Speaker 2: and wellness of self and looking after yourself? Is it
Speaker 2: something that you think people are becoming more aware of.
Speaker 1: Yeah, I think I think we are. I think we're
Speaker 1: recognizing that support for each other is really important. And
Speaker 1: that's one of the things I you know, spoke about
Speaker 1: in my speech about my acceptance of the position. My
Speaker 1: vision is to build and you know, an ethical and
Speaker 1: supportive aesthetic community.
Speaker 2: Absolutely, yeah, for.
Speaker 1: Everybody concerned, for the surgeons, for their staff, for the nurses,
Speaker 1: for the non surgical for the non surgical community, and
Speaker 1: also the industries because I think if the ethos of
Speaker 1: being ethical and supportive instead of just being concentrating on
Speaker 1: being competitive. I think if we can keep the supportive
Speaker 1: and ethical environment in this industry, patient safety I think
Speaker 1: will naturally come because people will do the right thing.
Speaker 1: It also creates a much better space for people to
Speaker 1: share ideas and also listen to each other, and that
Speaker 1: in itself produces the environment that fosters good relationships. You know,
Speaker 1: supportive environment, good mental health, and good practices. I think
Speaker 1: they're all just feeding each other.
Speaker 2: I agree, I totally agree.
Speaker 1: One of the I think what I found was extraordinary
Speaker 1: is about these conferences is every year we have a
Speaker 1: women in Plastic Surgery dinner. And you know, when I
Speaker 1: first started training, there want a lot of us at all,
Speaker 1: and this was back in the early two thousand and
Speaker 1: The women Plastic Surgery Dinner is that something that has
Speaker 1: grown over time or started by doctor Jillian Farrell, and
Speaker 1: now it's become quite a big group. We have about
Speaker 1: twenty four to twenty five people attending the dinner each
Speaker 1: year and there are more than that of plastic surgeons
Speaker 1: female plastic surgeons Australia. But what I love about that
Speaker 1: environment is that females are naturally very competitive. Yeah, it
Speaker 1: is just one of those things because and also like
Speaker 1: if you think about female in plastic surgery or in
Speaker 1: any surgical specialty, more competitive simply because we have to
Speaker 1: be to survive, because it's a very male dominating environment.
Speaker 1: I remember one emergency physician one said to me, which
Speaker 1: is rather nasty, I thought, He said to me, goes,
Speaker 1: So is it that people females will do surgery are
Speaker 1: just naturally nasty or is it and competitive and bitchy
Speaker 1: or is it the specialty that makes them competitive? And vicci?
Speaker 2: Wow?
Speaker 1: Yeah, I thought that was a bit nasty, wasn't it?
Speaker 1: And I thought, well, you know what, that's another here
Speaker 1: or there isn't it's it's actually about us feeling like
Speaker 1: we have to keep fighting to survive in the specialty,
Speaker 1: and we don't. I don't think people mean to be
Speaker 1: such that way, but it's almost it is a competition.
Speaker 1: It's a constant competition of trying to get ahead, and
Speaker 1: we always have to do things twice as good. We
Speaker 1: have to work twice as hard to prove ourselves to
Speaker 1: be heard sometimes even and that just makes us a
Speaker 1: little bit more that as certain, a little bit more
Speaker 1: you know, I guess in your face sometimes maybe.
Speaker 2: But if a man behaved that way that way, they
Speaker 2: would just say they're.
Speaker 1: Competent or oh, that's just being a boy.
Speaker 2: Yeah, Like, why do we as women have to always
Speaker 2: justify ourselves ourselves?
Speaker 1: Yeah, yeah, I don't know. I don't know. To be honest,
Speaker 1: I'm always puzzled by the way women behave, especially in
Speaker 1: positions or leadership. And sometimes even my husband tells me this.
Speaker 1: He says that, you know, sometimes you sound like a man,
Speaker 1: And I say, well, what exactly do you mean by that?
Speaker 1: He goes, well, you're just more aggressive, you know, you
Speaker 1: don't talk like you do at home with me, and really, yes, yes,
Speaker 1: And you know I catch myself that, I catch myself
Speaker 1: do that, And to be very brutally honest, I actually
Speaker 1: am a little bit ashamed that sometimes I do put
Speaker 1: on that front, because that is not who I am.
Speaker 1: It's who I feel like I have to be.
Speaker 2: I've never seen that side of you.
Speaker 1: I mean, you obviously haven't said yet, you obviously haven't
Speaker 1: sat in the board meeting.
Speaker 2: But I don't have an issue with that. I mean,
Speaker 2: it probably was an idiot that said something stupid. Yes,
Speaker 2: you know, I mean, I should probably say that, but
Speaker 2: you know, sometimes you just go, oh my god, did
Speaker 2: you just say that, like seriously if I said that
Speaker 2: as a female.
Speaker 1: Yeah, yeah, I know, I know. But what was was
Speaker 1: lovely about the whole women Plastic Surgery dinner is to
Speaker 1: see a group of women together and we're all like
Speaker 1: incredible right in our own right, we're all leaders in
Speaker 1: our own right, and we were just sitting there having
Speaker 1: a really nice dinner, having a fantastic talk about, you know,
Speaker 1: what we're all up to, and being supportive of each other.
Speaker 1: I mean it was amazing because so there they were
Speaker 1: like council members, vice presidents to vice presidents, do you know,
Speaker 1: And it was just a really nice thing.
Speaker 2: I think it's great.
Speaker 1: Yeah. So I find that that's the most rewarding, the
Speaker 1: most rewarding experience, and you walk away thinking, wow, you know,
Speaker 1: I can do anything. Well.
Speaker 2: Women are really great at holding space for other women,
Speaker 2: and I think when you find your right tribe, women
Speaker 2: uphold women.
Speaker 1: I think being a female is actually a fantastic advantage.
Speaker 1: And the reason is because I think we see things
Speaker 1: differently and we just by nature more caring. Do you know,
Speaker 1: we do it? Actually we worry about other people think.
Speaker 1: You know, we worry about you know, how people are going.
Speaker 1: You know, we naturally will ask questions like you know,
Speaker 1: even with patients, we naturally ask questions, go, so who's
Speaker 1: going to look after your WIFEI are you in hospital?
Speaker 1: Do you know? Things like that that I think as women,
Speaker 1: we just kind of consider because we understand, I guess
Speaker 1: we see a more lot more of a person, more
Speaker 1: than just a person, but also the life around them,
Speaker 1: not just the individual, but the whole you know, the
Speaker 1: whole village that they have a community around them. And
Speaker 1: you know, I find that to be advantage sometimes also
Speaker 1: because I have male colleagues that come up to me
Speaker 1: and talk to me about, you know, their concerns or
Speaker 1: they're having issues, and they probably I would not think
Speaker 1: comfortable talking to their own male colleagues. And I find
Speaker 1: that to be a real privilege. It is a privilege
Speaker 1: because they obviously feel comfortable enough to talk to me,
Speaker 1: but they kind of go, well, what do you think?
Speaker 1: You know, what are your thoughts? And I have male
Speaker 1: colleagues coming up to talk to me about their family, so,
Speaker 1: you know, about their daughters, about their wives, even something
Speaker 1: as simple as oh you know, my daughter's about turned sixteen.
Speaker 1: What do you think will be a good present? You know,
Speaker 1: you're like, oh, okay, so what is she like? They're
Speaker 1: trying to think back when I was sixteen, which is
Speaker 1: a long time ago. It's very thick up for me.
Speaker 1: But I think part of that is also mentally, women
Speaker 1: are a lot more in tune with people's emotions. I
Speaker 1: think we read situations, we have a more more situation awareness,
Speaker 1: and we're able to sort of have better perception what
Speaker 1: people need. I think it's a real intuitive yes, this
Speaker 1: intuitive thing, isn't it?
Speaker 2: Thing as well without a doubt? I mean, how many
Speaker 2: times has your husband told you that you know a
Speaker 2: friend of theirs has just had a baby, and the
Speaker 2: first thing you do is how much.
Speaker 1: Did it weighs?
Speaker 2: The warrior? Is it a girl? How's mum?
Speaker 1: Da?
Speaker 2: Da da? And they look at you blank and go,
Speaker 2: surely he would have asked that question. Now if had
Speaker 2: it been you and I that had found out about
Speaker 2: we would know maybe how mummy is, did you have
Speaker 2: an episiotomy?
Speaker 1: You know exactly exactly, and how long? What's name?
Speaker 2: We would have all that information, But they just it
Speaker 2: just doesn't enter the because it's not it's not that
Speaker 2: it's not important to them. They just don't think about
Speaker 2: asking those questions.
Speaker 1: No, no, But you know, there's things about women's psyche
Speaker 1: which are also not great sometimes, you know, things like
Speaker 1: we tend to internalize things. You worry, worry, We worry.
Speaker 1: If something goes wrong, we think it's our fault. So
Speaker 1: we internalize everything that happens outside. We don't know how
Speaker 1: to let go. Sometimes.
Speaker 2: Do you think women are more praying to burn out
Speaker 2: than men?
Speaker 1: I think so, And I think part of that is
Speaker 1: that compassion fatigue, do you know, I don't know. I
Speaker 1: mean I have met men who are amazingly compassionate and
Speaker 1: amazingly in tuned with their emotions and also in tunes
Speaker 1: with their patients' emotions, and they get quite significant compassion fatigue.
Speaker 1: Are they probably not as good as us in expressing it?
Speaker 1: I think so we forget sometimes that men can all
Speaker 1: also get quite severe compassion fatigue and burnout, And a
Speaker 1: lot of it is also they place a lot of
Speaker 1: pressure on themselves like we do, but their pressure is
Speaker 1: slightly different, you know about I think their pressure is
Speaker 1: a lot on themselves, you know, on wanting to bearing
Speaker 1: a burden of I'm responsible for this, and that our
Speaker 1: pressure on ourselves is more I think expectations or the
Speaker 1: imposter syndrome where we think we're not good enough.
Speaker 2: Imposter syndromes.
Speaker 1: Yeah, yeah, so it's a slightly different kind of I
Speaker 1: think pressure on ourselves and our burnout is slightly different.
Speaker 1: But as a female, I do have to keep reminding
Speaker 1: myself that, you know, I don't need to prove anything
Speaker 1: to anybody, and that my best is good enough because
Speaker 1: I can't do anything further than what I can do
Speaker 1: my best, and if that's not good enough for them,
Speaker 1: then I'm sorry. That's all I can give. So it's
Speaker 1: not my problem, is their problem, you know.
Speaker 2: So and if you know, if you know you've done
Speaker 2: your best and there's nothing else, I mean, there's nothing
Speaker 2: else to give, is there?
Speaker 1: No, there isn't. And that's the thing. As long as
Speaker 1: I know I've done my best, and at least I
Speaker 1: can say, well, I've done my best and I'm proud
Speaker 1: of myself. And if that's not good enough for them,
Speaker 1: too bad, So sad, I'll move on.
Speaker 2: It's interesting today a client of mine came in and
Speaker 2: she travels down from Rockhampton to see me, and she's
Speaker 2: just delightful and she's just finishing her two more assignments
Speaker 2: to do. And she's a registered nurse and she's a
Speaker 2: mature age becoming a mature agearin she's one on a million.
Speaker 2: She's amazing. And she was talking about imposter syndrome, how
Speaker 2: even though she was really high up in the government
Speaker 2: and decided to go do nursing, she is so nervous
Speaker 2: and anxious about becoming a registered nurse. And she said,
Speaker 2: I really feel like I've got imposter syndrome. She said,
Speaker 2: I just don't feel like I'm prepared enough to actually
Speaker 2: go into the ward. And I said, no, one's prepared
Speaker 2: enough in that first six months. I said, that's you
Speaker 2: know why you're supported and you've got other RNs around you.
Speaker 2: And I said, you know, when I became a nurse practitioner,
Speaker 2: I really had imposter syndrome. I was, well, I'm trained
Speaker 2: with all these alcohol and other drug nurses, eating nurses,
Speaker 2: cancer care, palliative care. Now, those nurses were remarkable, absolutely remarkable,
Speaker 2: and all I could do was compare myself to them
Speaker 2: and go, I don't know any of the stuff they know. Yes,
Speaker 2: you know, so how can I be a nurse practitioner,
Speaker 2: And there really was.
Speaker 1: This yeah inadequacy, absolutely absolutely, and you know I learned
Speaker 1: from that experience. You know, my husband always laughs and
Speaker 1: jokes that my master's in health law is a very
Speaker 1: expensive band aid for my imposter syndrome, because he was expensive.
Speaker 1: But I think the importance is that imposter syndrome is
Speaker 1: in everybody, isn't it. You have that feeling of inadequacy,
Speaker 1: but it's about how much you believe in yourself as well.
Speaker 1: And nobody can actually make you believe in yourself. I mean,
Speaker 1: you can have all the pep talks in the world,
Speaker 1: you know, people can boost you up with you know,
Speaker 1: great messages and all that stuff, but unless you actually
Speaker 1: believe in it, you are never going to surpass it.
Speaker 2: No, No, it is something. It is something I actually
Speaker 2: really had to work on. Yes, that I was adequate
Speaker 2: enough and I knew enough and in my area and
Speaker 2: my specialty, I was okay.
Speaker 1: Yeah, And I mean the fact that I guess some
Speaker 1: of the fact will be that because you are a
Speaker 1: nurse practitioner in cosmetic and dermatology and dermatology, right, and
Speaker 1: you probably don't feel that that is as important as
Speaker 1: cancer care and stuff like that. Right, It's just like,
Speaker 1: you know, I get told every day that he saves
Speaker 1: lives and I make the world pretty. I do remind
Speaker 1: him that ugly people do sue a lot. But it's
Speaker 1: a horrible thing to say, but you know, it is
Speaker 1: one of those things. And that's another thing that I
Speaker 1: find that it's really hard when you say you're a
Speaker 1: plastic surgeon. People kind of give you that look. It's
Speaker 1: really funny and just an example. Right. So a few
Speaker 1: years ago I was in anzac day dawn surfers in
Speaker 1: Melbourne and the man standing next to me this five
Speaker 1: o'clock in the morning collapse next to me, this old gentleman,
Speaker 1: and he just collapsed next to me. And then I
Speaker 1: went down on the grass and I saw how he was,
Speaker 1: and I think he was having a heart attack because
Speaker 1: he was obvious having very heavy chest pain and things.
Speaker 1: And I said, what do you have your GT and spray?
Speaker 1: He goes, yes, I do. I said, where is it?
Speaker 1: So I took it out for him, put two sprays
Speaker 1: under his tongue and then just lie him there and
Speaker 1: just sat with him, tried to calm him down and
Speaker 1: check his polls and then the ambos arrived because somebody
Speaker 1: obviously called when they got the ambulance officers, and the
Speaker 1: ambulance officer goes, oh, what's happened here? I said, oh,
Speaker 1: I think he's just having angina. I've given him two
Speaker 1: sprays with GT and under his tongue. He goes, oh,
Speaker 1: you're a doctor, and I said, yes, I'm a doctor.
Speaker 1: And then Mber goes, so what type of doctor are you?
Speaker 1: And I said, oh, I'm a plastic surgeon. And thember goes, oh, well,
Speaker 1: that's that's all right, will take it over from him,
Speaker 1: So you know, like why yes, And it's interesting. That's
Speaker 1: not just one of the examples. Interesting. The other thing
Speaker 1: is that when I was doing my Masters of Health
Speaker 1: law and we all had to write a thesis on
Speaker 1: regulations and things like that, and then I said, I
Speaker 1: said to my lord professor, as he goes, oh, what's
Speaker 1: your topic? You know, what are you going to talk?
Speaker 1: What are you going to a thesis about, you know,
Speaker 1: in ethics, in bioethics, And I said, oh, I don't know,
Speaker 1: I'm just I'm thinking about my topic. Goes, well are
Speaker 1: you talking? Are you going to write about genetic testing?
Speaker 1: And the ethics of genetic testing of because we were
Speaker 1: talking about topics like, you know, being able to select
Speaker 1: your genes in embryo before you have the baby, so
Speaker 1: they call it eugenics, and that was the topic of
Speaker 1: discussion at the time. And I just said, well, no,
Speaker 1: actually no, I'm not really my field. I said, I'm
Speaker 1: thinking about doing an ethics piece on cosmetic surgery. And
Speaker 1: the look I got like, why would you do that?
Speaker 1: That's not important?
Speaker 2: So important?
Speaker 1: Yes, And I just and I said, well, no, that's
Speaker 1: important because why do people think cosmetic medicine, cosmetic surgery
Speaker 1: is unethical? Why do people think it's not important? It
Speaker 1: is so important it is because it's been so ignored.
Speaker 1: That's how the public safety of cosmetic surgery and the
Speaker 1: standards fallen behind. Because cosmetic surgery is ethical. It is
Speaker 1: part of medicine. And the reason it is is because
Speaker 1: you are helping people. You know, people goes, oh, well
Speaker 1: you don't have a disease, so therefore it's not real medicine.
Speaker 1: That's not true. That's not true. There's this whole concept
Speaker 1: of lucism, right, So leucism is the biggest type of
Speaker 1: discrimination that has not actually been put out there so
Speaker 1: things like sexism racism right, where people are disadvantaged because
Speaker 1: of their sex or their race, but people are also
Speaker 1: disadvantage because of the way they look. So it's a
Speaker 1: real issue. There's been a lot of stuggies to show
Speaker 1: that if you are good looking, you get ahead in life. Absolutely,
Speaker 1: you get better jobs, you get better pays. Right, So
Speaker 1: if you extrapolate lucism right, and then you think about
Speaker 1: what cosmetic surgery does for people, not just you know
Speaker 1: they can get a better job, that's not the point
Speaker 1: of it. Is that they get they feel better about
Speaker 1: themselves so that they have the confidence to go out
Speaker 1: and get better jobs, better pay, better life, better relationships.
Speaker 1: There's even been papers showing that people who think they're
Speaker 1: attractive get better relationships. So cosmetic surgery itself is part
Speaker 1: of medicine because we are making a difference in people,
Speaker 1: even though it's not a disease, but it is something
Speaker 1: that is affecting their overall general health and well being
Speaker 1: and their mental status.
Speaker 2: Absolutely, it impacts strongly on their mental status.
Speaker 1: So there's a lot of bio ethics and cosmetics and
Speaker 1: how it should be practiced and how that space should
Speaker 1: be regulated.
Speaker 2: Without a doubt there when all the forms came in
Speaker 2: and everyone was just discussing about body dysmorphic disorder. Now
Speaker 2: I do have a couple of patients that definitely do.
Speaker 2: The whole conversation has been done, We've gone through the questionnaire.
Speaker 2: They are very aware that they do. But they've now
Speaker 2: chosen to be with me and managed by me because
Speaker 2: of the conversations and because of them doing the forms,
Speaker 2: and they had been elsewhere and they've come back and
Speaker 2: it was like, well, I'm not going to treat you again.
Speaker 2: If you keep going elsewhere, you have to choose to
Speaker 2: provide otherwise we're going to have to refer once A
Speaker 2: psychologists or CEU GP that sort of thing. I have
Speaker 2: been able to really carefully manage those patients that haven't
Speaker 2: gone elsewhere. They've followed what the plans that I have written,
Speaker 2: and their well being has improved, yeah, dramatically, because they
Speaker 2: weren't being gas lit at other places. Me being able
Speaker 2: to manage them now has this amazing continuity of care.
Speaker 2: If that's not managed its people can get really sick.
Speaker 1: It's about the ethical decision to help people because without
Speaker 1: taking advantage of them, because these people are really easy
Speaker 1: to be taken advantage, absolutely, because you know they already
Speaker 1: have a vulnerability that which you know, you know which
Speaker 1: triggers to pull.
Speaker 2: So it's just about making For some people, it's just
Speaker 2: about making.
Speaker 1: Money, yes, And it's about the interests of the patient
Speaker 1: rather than the surgeon or the practitioner or the injector, right,
Speaker 1: And that's where the ethics of cosmetic surgery comes from,
Speaker 1: because cosmetic surgery is verging on commercial without a doubt,
Speaker 1: and commercial is about interest of the business owner, whereas
Speaker 1: medicine is about the interest of the patient. So it's
Speaker 1: a very fine balance. And at the end of the day,
Speaker 1: you were a health care worker foremost, right, so the
Speaker 1: patient interest you come first. And you know, in the
Speaker 1: world of cosmetic, aesthetic medicine and surgery, it is one
Speaker 1: of the things that we need to keep reminding ourselves
Speaker 1: that what we are doing, who's interest isn't in and
Speaker 1: what we're doing is it the right thing to do
Speaker 1: for that particular individual, because not everybody. And that's the
Speaker 1: thing about the other thing about aesthetic medicine surgery is
Speaker 1: that there's usually no one no right answer. One right answer,
Speaker 1: isn't it. There's usually ways of approaching it. And it's
Speaker 1: also a lot of human management, like human holistic management.
Speaker 1: We're not just managing their so called physical deficits or
Speaker 1: deformities or problems. We're actually managing their psychological wellbeing.
Speaker 2: I agree absolutely what you're saying. I suppose that's why
Speaker 2: we focus on skin first and foremost, and then we like,
Speaker 2: if someone's got hips of sun damage, we'll refer them
Speaker 2: on to a lease. There's no way I'm going to
Speaker 2: do any ipl or any laser work unless it's been
Speaker 2: assessed by alist who's our nurse practitioner for.
Speaker 1: Skin cancers and skin damage.
Speaker 2: So they all get referre to her. Then they come back,
Speaker 2: we treat the skin and honestly, probably six times out
Speaker 2: of ten they're happy with that result. They've got a
Speaker 2: lovely glow, the collagen has, you know, started to kick
Speaker 2: back in. Their skin tone is lovely and even and
Speaker 2: they go, oh, I quite like this. So it's not
Speaker 2: just about shoving product in your face. So I suppose
Speaker 2: what I feel in my area is that dermatology and
Speaker 2: cosmetics asthetics go hand in glove. You've got to have
Speaker 2: great skin, yes, and then you know, we can then
Speaker 2: look at doing you know other bits and pieces and
Speaker 2: a bit as jugie as I call it, and it's
Speaker 2: never a huge amount, but when you treat the skin.
Speaker 2: And a good example is a client came in today.
Speaker 2: Couldn't treat her because she'd gone to see the specialist
Speaker 2: after this spot i'd seen on a brow and I said,
Speaker 2: I don't like it. She's covered in freckles. She went,
Speaker 2: and it's well you should. I think she needs to
Speaker 2: have it revised because honestly, it's a heavy dex it's done,
Speaker 2: is left this massive creator. It was huge. So but
Speaker 2: then we've noticed in a couple of other spots, so
Speaker 2: I've referred it back to see her dermatologists again. And
Speaker 2: that's when I think things that's the ethical way of
Speaker 2: our industry is behaving in that way. I suppose. Another
Speaker 2: example is we don't do the pdo threads anymore. There's
Speaker 2: too much downtime, It costs too much money, there was
Speaker 2: too much bruising, too many complications, too much hand resets,
Speaker 2: and the results really are so minimal for what the downtime,
Speaker 2: it's just not worth it. So we don't offer that anymore.
Speaker 2: But that came from feedback from what i'd seen and
Speaker 2: I suppose we're doing our own research constantly, aren't we
Speaker 2: in our own clinics. It wasn't the information that was
Speaker 2: given to me from the provider, like from the company.
Speaker 2: It was what we saw in clinic, and it was
Speaker 2: not doing that. And I suppose there are things you
Speaker 2: see and do that you've got no not doing that anymore?
Speaker 1: Yeah, I mean, I say, spend more time saying no
Speaker 1: to patients than saying yes. You know, when I feel
Speaker 1: the patient's not suitable for surgery or the surgery is
Speaker 1: not the right thing for them. I actually it takes
Speaker 1: longer to say no that does to say yes, absolutely,
Speaker 1: isn't it, Because what you're trying to do is not
Speaker 1: just telling them that they're not suitable. You need to
Speaker 1: explain to them why they're not suitable and why the
Speaker 1: surgery is not suitable for them, and also you know
Speaker 1: why it is in their best interest sometimes not to
Speaker 1: have the surgery, and so that they don't just leave
Speaker 1: thinking that number one, you've insulted them, number two, you've
Speaker 1: belittled them, and number three you haven't listened to them.
Speaker 1: But number four, they will just go to the the
Speaker 1: highest bidder who will actually do anything for money and
Speaker 1: they end up getting their surgery done that it's not
Speaker 1: right for them and getting a bad result or you know,
Speaker 1: doing some harm. So at the end of the day,
Speaker 1: what I want the patient to understand is that when
Speaker 1: I'm saying I always tell them this. This is my
Speaker 1: usual cliche talk, is that I'm a surgeon, right, so
Speaker 1: I don't get paid unless unless I cut somebody. So
Speaker 1: if I tell you that I don't want to cut you,
Speaker 1: it must mean something absolutely right, So you can go
Speaker 1: and see anybody that you like, and that there will
Speaker 1: be somebody will be willing to cut you for a price,
Speaker 1: so you know. So I have a think about it,
Speaker 1: have a listen to what I have to say, and
Speaker 1: then you can make your own decision.
Speaker 2: Do you go home from certain days consulting exhausted?
Speaker 1: Yeah, I get emotionally exhausted. The breast clinics I find
Speaker 1: extremely exhausting. So the breast clinics are usual, my usual
Speaker 1: reconstructive or implant clinics. So there can be a bit
Speaker 1: mixed of cosmetic and reconstructive surgery. But because a lot
Speaker 1: of my cosmetic practice is revisions rather than primary So
Speaker 1: these are ladies who've had implants before and they've had
Speaker 1: issues with them, you know, other you know, within a
Speaker 1: couple of years or we're talking about years down the track,
Speaker 1: and these patients carry emotional baggage with them about their
Speaker 1: implants usually and they're not ready to not have the
Speaker 1: implants or they're not ready to lose the look they've got.
Speaker 1: And then you have the breast cancer patients who are
Speaker 1: come in from reconstruction, and some of them are just
Speaker 1: being diagnosed with breast cancer, and some of them are
Speaker 1: people who've diagnosed with the genetic propensity to have breast cancer,
Speaker 1: which is a huge implication to their lives. And some
Speaker 1: of them are finished with their cancer journey and they
Speaker 1: are coming back for reconstruction. So they're always different phases
Speaker 1: of their cancer treatment. And it's motional exhausting because I've
Speaker 1: got to constantly adjust myself to where they're at and
Speaker 1: what they're prepared to hear. There's a lot of things
Speaker 1: that we tell patients that they're not quite in the
Speaker 1: right headspace to hear just yet. Or if you say
Speaker 1: it in the wrong way, they will take it in
Speaker 1: the wrong way. You know, they will take it almost
Speaker 1: like a personal in to a personal transgression to their emotions.
Speaker 1: So it's really important with these clinics that I kind
Speaker 1: of constantly watch their reactions, constantly just what I say,
Speaker 1: and constantly trying to work out where they are and
Speaker 1: what they actually understand what they don't, and then get
Speaker 1: a sense of are they suitable so surgery, because it's
Speaker 1: not just where they're physically suitable. Are they in the
Speaker 1: right headspace for surgery? And are their expectations realistic? Because
Speaker 1: if their expectation is not realistic, then I've got to
Speaker 1: spend another fifty minutes telling them why their expectations are
Speaker 1: not realistic and what I can actually deliver for them
Speaker 1: and what, you know, what they're actually going to get
Speaker 1: at the end of the day. I'm a firm believer
Speaker 1: in undersell and overdeliver because I think expectation is one
Speaker 1: of those one of the biggest things that can really
Speaker 1: bring you down afterwards, like consent right with expectation, It's
Speaker 1: like whatever you tell the patients prior to the surgery
Speaker 1: is called consent right and informed consent, but whatever you
Speaker 1: tell them after the surgery is called an excuse. So
Speaker 1: it is so important, and that's that's why with these
Speaker 1: breast clinics I am just emotionally exhausted afterwards.
Speaker 2: So how do you look after yourself?
Speaker 1: Well, one of the things I do is I go
Speaker 1: home and we sit down at dinner and tell my
Speaker 1: husband I've used up all my words for the day.
Speaker 2: Don't talk to me. No, I don't silence.
Speaker 1: Silence is golden. I let him talk. Actually, I just
Speaker 1: listened to him. But what do I do for myself? Well,
Speaker 1: I tend to think about things that make me feel
Speaker 1: good about myself, or tend to do things that makes
Speaker 1: me good about myself. And sometimes the music is great.
Speaker 1: Play music, and I don't know whether people wear, but
Speaker 1: I'm actually musicians. So I played the piano and the flute,
Speaker 1: and so I like music some. I also dance as well.
Speaker 1: I'm not dancing as much now because I got that
Speaker 1: very old a three technee. So but you know, I
Speaker 1: love exercise because exercise is a great way. Walking on
Speaker 1: the treadmill really clears my mind. Sometimes I walk on
Speaker 1: the treadmill just to think through all the things, all
Speaker 1: the things that I've done for the day, or about
Speaker 1: things that are coming up and trying to clarify in
Speaker 1: my head. And because all I need to do is
Speaker 1: walk my head kind of can go on it's own pace,
Speaker 1: so it's very therapeutic. I like to bake.
Speaker 2: Oh you baker.
Speaker 1: I'm a baker. Yeah, yeah, So I love baking, and
Speaker 1: I love the fact of sitting. I'm one of those
Speaker 1: terrible bakers or like, I don't just put the oven
Speaker 1: in and put the cake in the oven and then
Speaker 1: walk away and do something else and one of those
Speaker 1: people comes and back and check it every five minutes.
Speaker 1: But I love the fact that I can just like
Speaker 1: relax for five minutes, do something else, you know, go
Speaker 1: on my phone, look at a few things, or read
Speaker 1: bits of the book, or watch a little bit of TV,
Speaker 1: and then come back and check my cake. But it's
Speaker 1: great because it's just like, so, my husband loves iron right.
Speaker 2: What I know right in military?
Speaker 1: No, No, no, he loves ironing because he even to
Speaker 1: the point where he actually cut down the hours of
Speaker 1: my housekeeper, of our housekeeper who does cleaning, washing, ironing
Speaker 1: and stuff like that, so he's actually half her time
Speaker 1: so that he could do the washing and ironing.
Speaker 2: Right.
Speaker 1: I know it's crazy. You're welcome to hire him, by
Speaker 1: the way, but I'm asking why do you like he irons?
Speaker 1: Bed sheets. So asking why do you like ironing, he goes, well,
Speaker 1: because it's nothing better than crisp, smooth fabric. Once you've
Speaker 1: done it, it's a sense of achievement and you know
Speaker 1: why you're doing it. You can't kill somebody. Yeah, fair enough,
Speaker 1: because he does lung surgery, right, So everything when he
Speaker 1: does lung surgy stressful. But he's worried about doing having
Speaker 1: the wrong move and that can potentially be fatal in
Speaker 1: lung heart and lung surgery. But ironing like he gets
Speaker 1: a result, He gets a sense of achievement without the risk.
Speaker 1: He loves it.
Speaker 2: So does he come home from surgery and that's his
Speaker 2: relax You just get out of the ironing board.
Speaker 1: And no, he does that. He does that on his
Speaker 1: days off. Yeah, he just spends a whole day ironing.
Speaker 1: And he listened to a podcast while he's ironing. And
Speaker 1: I always know when he's been ironing because when I
Speaker 1: get home he's usually very relaxed. True, but he cooks.
Speaker 1: He cooks for after work after he's been operating. I
Speaker 1: think he finds that also another sort of achievement. Sense
Speaker 1: of achievement. The worst thing that can happens is that
Speaker 1: everything goes to pair shape with the cooking and we
Speaker 1: just have to call in foot with eats. But you know,
Speaker 1: to him, that's doing something without catastrophic risk.
Speaker 2: Being a cardiothoracic surgeon, I've never really thought about because
Speaker 2: it was never anything. It wasn't my interest. And to
Speaker 2: be fair, back in the day when it took hours,
Speaker 2: that would be my worst nightmare to spend that amount
Speaker 2: of time in a theater. I liked fast, quick theater,
Speaker 2: fast turnovers. I loved plastics. I loved guy and he
Speaker 2: loved loved it. So I liked getting that vergo with me.
Speaker 2: I loved having a list run on time well and
Speaker 2: keeps moving. It keeps moving, and that would rock my world.
Speaker 2: The thought of standing in a theater orthopedics or cardiac
Speaker 2: or thoracic.
Speaker 1: Where the case goes over hours and hours.
Speaker 2: The worst nightmare. So I've never really put thought into
Speaker 2: the stress levels of those surgeons.
Speaker 1: Yeah, yeah, it's a phenomenal amount of stress. And you know,
Speaker 1: and stresses is interesting is actually a perception of relativity, right,
Speaker 1: I remember, I remember when I took a little bit
Speaker 1: of time off when I was training, about three to
Speaker 1: six months. Actually, I took a research time off. I
Speaker 1: wasn't really researching, I was just being a housewife.
Speaker 2: But it's okay.
Speaker 1: But I remember standing in front of a food counter
Speaker 1: at the supermarket stressing, stressing over the type of sugar
Speaker 1: I should use in a certain cake, and it was
Speaker 1: so stressful. It's the same stress as me standing in
Speaker 1: front of the patient trying to decide what margin to
Speaker 1: take for a certain cancer. Because the scaly stuff around
Speaker 1: the cancer, part of the cancer, is not part of
Speaker 1: the cancer. Is that interesting. It is relative because it
Speaker 1: depends on what's in your life. And so this is
Speaker 1: where gaslighting happens. Right. So patient's coming and they tell you,
Speaker 1: or you know your friend's coming and they tell you
Speaker 1: how stressed they are over a certain thing, and you're like, going, seriously,
Speaker 1: was your stressed about that? That's so minute, that's minutia.
Speaker 1: But to them it is the same caliber of decision
Speaker 1: as you make absolutely every day. So so I think
Speaker 1: I think sometimes, you know, we lose perspective.
Speaker 2: It's limitations we put on ourselves.
Speaker 1: I think. So I think we think that we have
Speaker 1: no how do you say, no choices? You know, we
Speaker 1: think that something catastrophic is going to happen when that's
Speaker 1: not the case. If you step back and think about it,
Speaker 1: what's the worst thing that could happen? And that's what
Speaker 1: I actually ask myself all the time, what's the worst
Speaker 1: thing that could happen? That's one thing. Number two is
Speaker 1: what's your plan B. It's always to know that you've
Speaker 1: got to plan be. And number three is hoo can
Speaker 1: I call? Because I think that's really important to have
Speaker 1: somebody that you know around you that can support you
Speaker 1: behen you need them the most. And I think all
Speaker 1: those three things essential for you know, really good mental
Speaker 1: health support about the way you think about things right,
Speaker 1: because I get told this right. So you have two choices,
Speaker 1: two things in life that you must do right. So
Speaker 1: one you must die, everybody dies. But two you must
Speaker 1: choose Okay, So you have the choice. You have the
Speaker 1: choice to go around and mop and see all the
Speaker 1: bad things, see all the bad choices, see all the
Speaker 1: bad options, or feel bad about things. Or you have
Speaker 1: the choice to see things in the different light or
Speaker 1: to just stand up and deal with it, or be
Speaker 1: excited about stuff. You can be you can be moppy
Speaker 1: about stuff, or you can be excited about things. Right,
Speaker 1: And it just changes your frame of mind.
Speaker 2: And it changes the neural pathways of your brain as well.
Speaker 2: If you choose positive that is now being researched. It's
Speaker 2: really quite remarkable.
Speaker 1: And do you know what else it changes? It changes
Speaker 1: the people around you. Absolutely try I mean, and it's
Speaker 1: almost like a positive feedback loop. Right. So you turn
Speaker 1: up to work grumpy. You choose to be grumpy, basically,
Speaker 1: you do. You choose to think that the coffee is
Speaker 1: crapy instead of Oh I got a.
Speaker 2: Cup of coffee today, How blessed am I?
Speaker 1: How clessed am I? So you know, it's it's one
Speaker 1: of the things that rather people and and you know,
Speaker 1: I don't know whether you're weare, but I used I
Speaker 1: had a really severe depression when I was a medical student,
Speaker 1: and there were a few things that stopped me from
Speaker 1: getting better. So Number one, I didn't recognize I had
Speaker 1: a problem because my father just my parents actually my
Speaker 1: parents just all told me, goes, you're not depressed, You're
Speaker 1: just weak, right, you need to be stronger and to
Speaker 1: deal with problems and just get over yourself. So I
Speaker 1: didn't recognize I had a problem. So obviously I didn't
Speaker 1: seek help. And when I seek help help. I wasn't
Speaker 1: convinced I had a problem, and that's you know, all
Speaker 1: I did. All I needed to do was take drugs.
Speaker 1: Then I had a terrible psychiatrist because one of my
Speaker 1: best friend actually trying to commit suicide. And my psychiatrist
Speaker 1: told me that was my fault, that she tried to
Speaker 1: commit suicide. Yeah, horrific. So I fell down deeper into
Speaker 1: a ditch. And then I met a really good psychiatrist
Speaker 1: who just realized that whatever was happening wasn't getting through
Speaker 1: to me. And then so he goes, okay, so you
Speaker 1: want to do surgery. I say yes, I do. And
Speaker 1: this time, at this time, I was a junior doctor.
Speaker 1: He goes, so you're applying for surgery. I say yes,
Speaker 1: I am. He goes, okay, well you will understand this.
Speaker 1: So having depression is that having a broken arm? Right,
Speaker 1: what do you do when you have a broken arm? Okay,
Speaker 1: we'll fix it. He goes, yeah, but before you fix it,
Speaker 1: what do you have to do before? I said, well,
Speaker 1: you have to go to ED, get an emergent, get
Speaker 1: a next ray. And he goes, yes, so you got
Speaker 1: to recognize you got a broken up and get a
Speaker 1: next ray. To diagnose your broken out, right, and then
Speaker 1: you got to accept the treatment to fix it. So
Speaker 1: what do you do to fix it? I said, we'll
Speaker 1: put it in a plasta cast, will put plates and
Speaker 1: screws in them. I go yeah. He goes yeah. So
Speaker 1: you put plays and screesing them. What does that do
Speaker 1: to your arm? I said, well makes it strong enough.
Speaker 1: He goes good, and it makes it stronger because it
Speaker 1: got work in it, right, I go yeah yeah. And
Speaker 1: then he's like going, well, that's what you do with depression.
Speaker 1: You got to recognize it, diagnose it, you got to
Speaker 1: treat it. You've got to be willing to accept the
Speaker 1: treatment that's required, and then you become stronger because of it.
Speaker 1: And so what happens when you hit it again? I said,
Speaker 1: it was less likely to break because he's got a
Speaker 1: plate on it. He goes, yes, that's what happens. So
Speaker 1: that's how he got through to me and make me
Speaker 1: acknowledge the fact that, you know, I needed to do
Speaker 1: something for myself. It's not just the drugs. I got
Speaker 1: to accept the treatments, and that's not just drugs, but
Speaker 1: I accept to change the way as I was thinking
Speaker 1: and actually do the psychotherapy and should be engaged my
Speaker 1: phsychotherapy to be able to get better, and he goes.
Speaker 1: What you're building is your mental resilience so that in
Speaker 1: the future something similar happens, or something that triggers you
Speaker 1: to go back into depression, you pick yourself up before
Speaker 1: you get that bad and you'll recognize it. Yeah, you're
Speaker 1: recognize it and you go and get help before it
Speaker 1: gets bad. I think that's so important, do you know,
Speaker 1: And that's part of insight, I think.
Speaker 2: Yes, and insight it's one of those things that the
Speaker 2: first time I think you have quite significant depression.
Speaker 1: You lack a lot of money.
Speaker 2: Oh yes, I think then if you work on yourself
Speaker 2: and you spend the time in the f and surround
Speaker 2: yourself with the right people, that insight develops and you
Speaker 2: start to I recognize now when I'm starting.
Speaker 1: To yeahel, don't you Yeah, you know.
Speaker 2: I know I don't want to go out and you know,
Speaker 2: just little there are little things, but I wouldn't have
Speaker 2: recognized that initially. So Lily, we have to wrap this.
Speaker 2: That's her right, Thank you so much.
Speaker 1: That's okay, pleasure.
Speaker 2: I'll be booking the next time you come back. Thank you.
Speaker 2: And thanks guys for listening and I'll see you all
Speaker 2: next week.
Speaker 1: Thank you, thanks for having me, M