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Hello, everyone. Good morning and welcome to the first Bo A and Boto Culture Diversity Day. I am Kate Atkinson and I am the Culture and Diversity representative. I would like to start by thanking the pe synths for sponsoring today and also to meddle who have made today accessible for people all around the world. So when I first took up the post last year, I went to the committee and I said, I'd like to do a Diversity Day. Um We all have to do diversity equity inclusion talks and compulsory e-learning and things at work. But often it's, it's going through guidelines legislation which as important as it is can be quite dry. And I thought, why aren't we actually celebrating the diversity that we have got? Why are we not making it engaging and interesting? And so the committee said, go on then Kate off, you go. So I spent the last few months putting to stay together. So thank you very much for all attending. Um So traditionally, orthopedics has got a bit of a bad rep and we've not always been seen as the most inclusive specialty and the B and voter have been working hard to try and improve the diversity and specialty, make it more inclusive. And I'm hoping that today is one of many things we're doing to work on that. So when the Royal College of Surgeons released the Kennedy report, one of the issues they found was particularly looking at disability and those who are neurodivergent, there wasn't much out there for everybody. We weren't talking about it as much as other protected characteristics. People weren't getting the support that they needed. So you will see today that the first half of the day is purely dedicated to disability and neuro diversity. And then the afternoon, we've got a wide variety of topics. So I myself was one of many people who later on in life got diagnosed as dyslexic and I had a couple of consultant colleagues who said, Kate, I think you might need to get tested. You're sharing a few different signs and I got the diagnosis and I thought now what, I don't know who to talk to, I don't know how to change my life to make it any different. And I started talking to different colleagues and I actually found that there were multiple people in the same position as me. And it wasn't actually until I started talking to people, I realized there is loads of people. And the main issue we have is that we are not talking about things enough. And so once I started to talk to people, we had this fantastic network and everybody was open to talking about it and I'm hoping that today can spur some of that conversation again. But today, the topics that we're talking about, it's not just orthopedics, it's applicable to everything. We've got people online today from five different continents. We've got over 100 people joining online. We've got medical students, we've got consultants, we've got non doctors, we've got nurses, we've got dentists signed up by medical scientists, administration, staff, all sorts of people. And I really hope that you can take something away from today and take it back to your regions, in particular, the champions we've got in the room. I'm hoping that you will find today educational and you'd be able to go back and support your colleagues in your region. I've asked all of the speakers today to also talk a bit about their personal lives. So today is hopefully not just about the topics, but also we can apply some life stories. We can bring the stories to life and we can really celebrate the diversity that we've got. And I just hope it is a fantastic day for you all. So I'm going to pass you over now to the president of the British Orthopedic Association. Thanks Kate. I haven't got used to the fact that I'm supposed to have my phone and my notes on there. So I'm gonna have to do it from memory. I have been really proud to be the president of the bo this year and to work so closely with voter because I think based on the work done previously, we are beginning to make a real step change difference in how we look at each other and how we treat each other. Now, that may just be wishful thinking on my part. But I truly believe that change is happening and that's a credit to all of us here and a real delight that we are working so closely with Bota. I think that's really important. We are all each and every one of us, an individual. It's a common sense statement, isn't it? But it is fact we came out of two years. It seems to me of COVID and Great Ormond Street like me to wear my mask. I think the official thing is I should still wear a mask for every consultation. But we are breaking rules because we are or the pot wearing a mask for all that time really affected how I behaved. It was really miserable wearing that mask. And the longer it went on, the harder I found it actually, it might have been not so itchy as it used to be, but how it hindered my communication and my relationship with my patients was really very difficult for me to cope with personally. So now that we're mask free officially, that's a whole new ball game. Except of course, it makes you remember that we are, we are each and every one of us wearing a mask. Each and every day I started off life being quite shy and you wouldn't really guess that now because I've learned and my mask is not a mask particularly anymore. My mask is me. I can be outgoing and confident when the situation suits me or the circumstances are supportive and if they're not right and they're not supportive, I revert to being the shy teenager, uh who fainted at the sight of blood. So I'd ask you today as you listen to all our speakers to see beyond the mask that each and every one of us is wearing because we all have hidden abilities. My current CT two is a special officer in the police force in his spare time. An ex registrar is a semi professional flamenco dancer in her spare time. So we all have hidden abilities and perhaps many or all of us have hidden disabilities as well. Maybe the reason I'm grumpy at the end of the day is that my back is killing me. I'm certainly more hard of hearing than I'd like to admit to. And my grip strength has gone way down south since I've hit a particular age. So we have all got something that isn't as good as we would like. And everyone you meet is fighting an invisible battle that you know nothing about. So be kind and ask them how they are and listen to the answer because if you don't listen, you won't hear. So, thank you very much, Kate and everyone here and we're on to the next. So we're going to be starting our disability and diversity session. So the first speaker, Mr Mohamed Bala and his talk is on the gift of adversity. So Mr Mo Bial is a consultant urological surgeon at Queen Elizabeth Hospital in Birmingham since 2011 with a special interest in female functional neuro urology and urinary tract reconstruction. He's the current chairman of the bows section of FNU. He is currently working with NHS England representing Bao at the mesh lead. He's recently been elected as the honorary secretary elect while while cycling with a friend, he was struck by a tree resulting in a spinal cord injury and paralysis in February 2021 after multiple operations and eight months in hospital with over 1000 hours of rehabilitation. He has returned to his career as a urological surgeon. He will share his insights from his injury and the journey back to work and the importance of hope in his journey, Mister Brown. Thank you very much for kindly inviting me here today. Um And it's an honor to be here to talk to my colleagues and orthopedic surgeons. We've always had a very soft spot for I was originally going to do orthopedics actually. Yeah, it was one of my favorite things. What happened was every time I did another surgical specialty, I decided that's what I wanted to do so. Then the the council ended at urology, but I have a, I have a soft spot for orthopedics. So thank you very for kindly inviting us. So hopefully today, I want to share my journey and, and see if we can all learn some insights from that journey. Let me see what I'm doing. OK. I don't have any declarations uh for this talk. So my journey begins uh middle of February 2021. I'll take you back to the COVID time. And do you remember during that time of COVID? Um It was a difficult time and we all stepped up and part of that was we weren't allowed outside unless we were exercising unless you were Boris Johnson. That was. And so during that time I, I took up cycling, er, and became what's known as a mammal, a middle aged man in Lyra. It's a very tedious group of individuals. I have to say my wife and kids stopped talking to me. So apparently I'd go out for hours, cycling, come back, ring my friend up, talk about cycling again. So it's a very, very tedious period. According to my wife, I must admit I really enjoyed it. So it was middle of February, it was a cold day and it wasn't raining and it wasn't windy. I rang my friend up and I said, look, let's go out cycling. It was half term as well. So, uh we went out cycling and I live in Birmingham and so Birmingham is really bad for traffic. So we were out in the countryside to cycle, er, as I deemed it to be a lot safer than cycling in Birmingham. Uh, and so we've probably done about 30 miles out in the countryside and there's a place called Merian, which is technically the middle of England. And, uh, we're in the countryside and I still remember and, and this is a picture 30 seconds before. So my friend who's a very good cyclist, he's able to take a selfie and cycle without crashing and that's me behind. And so in cycling, you take it in turns in terms of who's in front, who's in back because it's about wind resistance. And so I was behind him and then I then shortly went forward and literally out of no way, I saw this tree fall. And I remember at the time he was shouting tree and I was going pretty fast. I was going about 40 kilometers now. I must have, I have to have that every time. So I was proud about the, the speed I was going at. Um And the next thing is I remember the time thinking this is going to hurt. And the next thing is I actually remember waking up dreaming, I'm thinking, what am I dreaming for? So as soon as I opened my eyes and trying to get up, it was at that point, I realize I was paralyzed from the waist down. And at that point, I had the weirdest visualization of myself in a wheelchair. And then the second thought was, it's going to be a long journey. It's been like when you stub your toe, you have a half a second delay before the pain kicks in. And indeed, that was the case and the pain was horrendous. I've tore my ACL before and that previously was the worst pain I had. But this was on a, on a different level. And so the tree hit me at the exact moment I went by it. And with cycling, you tend to lean forward and it hit me at the exact point. And so at the time I remember the ambulance man arrived and he, he was very keen and he said, look, I've got you some paracetamol and I'm like, this is really not going to cut it. No. And we actually had a five minute disagreement. He was very insistent that the paracetamol was going to work. And I made it very clear that I don't think the paracetamol was going to help. So eventually I think he got the, the air ambulance out and they gave me some pain relief. And the way this thing was despite all this pain, you know, you'd imagine there'd be panic, but there was actually a degree of serenity. It was, it was a bit weird actually, in a way. And so I made it to the trauma center, which happened to be Coventry and already knew I broke my back, but I broke my ribs and it was clear to me, I needed emergency surgery. And so I just said, look, let, let's just crack on with the surgery. Um And so that was where, where the injury was. I broke my scapular ribs and a burs fracture at all points you probably want to know more details about. So it was a burse fracture all the, all the way through. Um And so, so, uh that night I had emergency surgery that night and then after that, what happened was, um, it's weird about spinal shock. Uh You'd think that you, you're in spinal shock, there wouldn't be pain, but there was a lot of pain and that's because pain is perceived in your brain. Um, and also what happens is they turn you every four hours on the broken ribs, off the broken ribs, on the broken ribs, off day and night. And so, so the pain, oh, actually, before I, this is really important, I know the cyclists amongst you want to know what happened to the bike. So the bike survived. It's a steel, high, high grade steel frame, so they're still available to buy for myself. Er, so it's really important but the wheel, I was very fortunate that the carbon wheel collapsed. And so I was entrapped under the, the tree. Now, all of you, those who do exercise is really important that if it's not on strava, then it's not happened. And so this is my last farewell Strava cycling trip. And so for the no cyclist, what you should look at is the power and the average speed, those are the 22 most important parameters. And so I left on a high. Wow. Yes, indeed. So, so I think with the spinal injury, what tends to happen is, and I think it's a bit of a trauma response or you tend to get a crescendo of the pain. And about day five, day seven, the pain became unimaginable. And I still remember the, the, the pain was on the next level despite the, the, the pain relief and they put me on intravenous ketamine me, I still remember this and it's one hell of a drug. And so it gives you the most psychedelic hallucinations. But what it does is it dissociates the pain and resets the pain. And so it's weird as, as a clinician, we, we see patients in pain all the time and, and, and it's weird being on the other side and, and the pain, you know, is on a different level. And sometimes we look at patients in pain, you know, well, they say they're in pain but, but actually I have to say being on the other side give strong pain killers at all times. So that's really important. So that, so then I had these bars put in uh at the time. Um and I was very fortunate that I rang up a friend of mine who worked in the spinal unit in, in London and he, he kind of got me transferred there, my local spinal unit in O Street, but I have a relationship with them in that I do neuro urology. And so I'd get patients to and fro already, then I was thinking about coming back. And so I was like, well, it would be a bit awkward having been a patient there. So, so I wanted to go to a different unit and I was very fortunate I was able to go to the London Spinal Unit which, which happened to be a positive. So, yeah, so that was, that was very, very helpful. Um in terms of, so this is a picture of myself probably about maybe about seven or 10 days after the surgery. And it's amazing, sort of the cata bolic state you go through and I probably lost about 15 kg of muscle in that period of time. It's incredible. You just, you know, it's just incredible how much weight. So I probably went down to about 65 kg for me. My average weight was about 85. And so, you know, um on a positive, I weighed less than my wife. I bet I say this, but she, she'd be very upset. Yeah, she was quite distraught. I never thought I'd actually weigh less than my wife. But she, I hope she's not listening, but uh I'm in deep trouble. So, so, you know, that was one lifetime ambition. So I've, I've achieved that. So that was important. So what is rehab? And so the thing is, you know, as a urologist, we, OK, send them to rehab and we have this sort of genetic idea what rehab is. And so rehab is, is something where you constantly have to push yourself out of that comfort zone. And the way I kind of describe it is is if I was to ask all of you to jump a meter, you jump a meter. If I ask you to jump a meter between two high rise buildings, then actually you have that degree of fear and trepidation. And that's why rehab is constantly doing stuff you don't want to do and pushing that envelope and having that fear of falling. So if I was to fall off the chair, it's a lot more difficult if you were to fall on the floor. And so it's about conquering that fear. And so I think it's really important. Um you know, that the rehab process, you know, is really important and and good rehabilitation makes a huge difference. And I'm sure you all realize it all for pots. So the thing about the spina unit is its purpose is to allow you to be safe at home, you know, learn how to sort your bladder bowels out, be able to transfer safety into the wheelchair out of the wheelchair. Um And so during that period of time, it was in, in COVID and COVID was a difficult time. You weren't allowed any visitors. And so in the spinal unit, eventually, they, they allowed visitors, but that was only once a week and it had to be chaperoned and it was a two m distance. So my wife would drive all the way from Birmingham to, to London, see me for an hour, two m distance with a face mask and with someone sitting behind me. So it was a bit bizarre. Perhaps it gave me an idea of what prison would be like. You know, you, you kind of sort of felt like. And so it was quite challenging not having that and also not being able to see your Children. So, and, and, and you can imagine you're, you're in a bay of four, there's no privacy, you're having bed baths for weeks. And, you know, you can imagine having had showers every single day your entire life. Now you're doing all, all your business on the bed. And so it's a massive change from what you can imagine from, from previously. But nevertheless, I, I pushed on hard and, you know, they said to me, look, you've done really well, we're going to send you home. But before we go, before we send you home, we'll do a scan just to make sure everything is fine. So they did the follow up scan. And I remember the time seeing this scan, you know, I knew straight away I needed surgery. And so it was a very clear in my mind. As soon as I saw the scan, I saw the malalignment, it was very clear to me that that's why I needed. So it was a difficult time as you can imagine having climbed the first man to have come and realized you've got climbed the second mountain. And I still remember that time, all that pain I had from the first surgery and the trauma all came rushing back. I knew I'd get through it. But, you know, it's that thing that I, I want to get through it, but it's, it is a bit of a pain. But what I did was I reframed it and I said, look, you're a lucky guy. You can have your spine fixed before you go home. And that certainly helped. Um, they gave me some dispensation to allow me to see my Children. And at the time I remember being a bit anxious about showing emotion with my Children, you know, and so what I realized was how I was going to interact with my Children will determine the rest of the relationship. So when they came to see me, we had a laugh and a joke and that's determined how moving forward they've kept dealt with things and we tend to have a laugh and a joke about it and it's not a big deal. And he gave me an idea about leadership, you know, and that gave me an example of leadership if you need, by example, that's a form of leadership. But, you know, so there's lots of valuable lessons to learn. So I was very fortunate because I was at Stanmore, which is the National Spinal Center. So I had three amazing surgeons and neurosurgeon spinal surgeon, a vascular surgeon, take out all the metal work and put all these cages and spaces in. Um And that was another 12 hour surgery, had a bit of fun with some more Ivy ket them in and then it was back to bed rest. So, you know, you, you basically made all these. Um and then you've got to go straight back to bed rest, turn in left, right, every four hours for weeks, weeks on end. So it was about 3 to 4 weeks, bed rest. And the thing I'd say as medics is that if you can have an operation, be prepared for complications. And not surprisingly, as medics, you know, I had a couple of complications. I had a service collection which needed draining, but eventually I kind of made, made it, made it, made it through. And so they gave me a special, I call it body armor, my friend called it Wonder Woman afi And um you know, it keeps, I don't need to explain to you guys. You know, it's a brace that keeps you fixed in a certain position. But actually on other level, the difficulty with the brace is that your, your, your care is much more difficult. So it's very difficult to clean yourself and so on. So, so when I got home, my poor wife did a lot of my caring because I was allowed to only take it off and hold myself in a fixed position while she cleaned me. And I had to wear that for eight months. So it was quite challenging in time. And as you know, you know, redo spinal surgery is fraught with difficulty. So I didn't want a third operation as surgeons, we always know the first time is your best, second time, you might be lucky. But by the time you get to the third time, yeah, you're not hide into nothing. So I was absolutely desperate not to, um, face further surgery. So I actually complied, which was difficult for me, but I did it. Now, there's one thing I want to take for you to take away from. This is really when you see someone in a wheelchair, actually, the inability to walk is the least of their problems. And that's actually only the tip of the iceberg. And so big issues tend to be your bladder, bowel nerve pain, psychological pain. And there's so many other things that are going on. And so when we see patients remember, you know, the, the inability to walk is the least of their problems and, and they have a lot more issues there. So, you know, I think it's really important, especially, I'm sure you will see patients in wheelchairs all the time. So I made it home and it felt like I'd been incarcerated at Her Majesty's Prison and I was very happy, happy to, to leave. And it was, I still remember the first month I came home, I was over the moon. Honestly, it, it was one of the happiest times ever. I was back home with the wife and kids. And what I realized then was inpatient care as we all know is very good. But sadly, outpatient rehab is very poor and they're very limited in Birmingham. But as a surgeon as we always do, I kind of set out a management plan for myself. And I said, look, you know, there's three aspects of this journey. There's a physical mental and spiritual and the physical is something and the mental is very important how to refrain things. And the physical side, I was like, look, that's something I can do something about. And so I set myself a goal um that if I was to come back to work, that I'd have to do certain things. And so as you can imagine, I was on a huge amount of pain killers. Um Neuropathic pain is very difficult pain actually. Uh And the way I describe it is someone's got a red hot sword in the chop in your leg. Uh And so was a lot of gabapentin. Um traMADol uh amitriptyline, amazing drugs. I have to say gabapentin. Very nice. It helps the neuropathic pain. TraMADol is very smooth and then amitriptyline gives you a very nice sleep. So I had to wean off and so I set myself a goal over three months and slowly weaned off all, all, all the painkillers. And so then there's an acceptance of pain, there's a residual pain that you have to accept. And you know, when patients say, oh doctor, I don't want to take pain killers, but it's actually, there's actually, there's an importance to that. I think what this is my belief that you can keep on escalating up the pain pain barriers over and over all you do is change your receptors or numbing your receptors. So if you accept a certain degree of pain, then actually you need painkillers. But you have to accept that I'll always have a 3 to 4 out of 10 pain, constant pain in the background. And only when he is a that I take pain killers. So by allowing me to get off the neuroleptics and the traMADol and all the different side effects, I knew that would be crucial for coming back to operate as a surgeon. You can't have be on heavy analgesics and be operating and, and going back to work. The second thing I realized was I had to get you know, be able to drive. Uh And in fact, I'll do, do here today. So, you know, it took a while to fight with the DDVL A, you can't contact them at all. Impossible. But eventually, after multiple letters, written letters complains to the MP, I finally got my license back. So a hand control car, you know, you have a knob on the steering wheel and you have a lever which goes up and down. So up to accelerate down and the difficulty is turning right, because you've got to turn the turn, turn the wheel this way and lift up and it's a bit and Alex to slapping your head on top and doing that on the side. And I don't think my son's forgiven me for the near death experiences. I, I, you know, took, I would regularly take him with me and it took a lot longer than I thought. So the problem is if you've been driving for 30 years, as soon as you want a break, like, oh no, I can't move my feet. Oh, no, this is, that's actually a half a second delay, which is, which is uh but now rest assured I'm very good at driving. Um So I, I created my own regime and I said, look, II I need to create my own regime every day. This is my new job, rehab is, is my new job. Um And also I was very fortunate that I had financial means being a surgeon, you know, compared to some of the other people I was with that had financial means as well. And so I set myself this goal of rehab. And so pretty much for the 1st 18 months, 66 times a week, uh 23 hours a day, I would do my rehab and this would involve muscle stimulation all throughout uh glutes, quads, hamstrings, um anterior tips, gastro eus. And what it does is a bit like a dry thermy machine. It keeps the muscle alive. So it prevents you from getting um the muscle completely dying. So there's a high risk of pressure sores, standing is very important. So there's a standing frame so you, you maintain your bone density. Um and also that prevents you from bone demineralization. And as a urologist, the last thing, one is kidney stones and I, again, your colleagues do deal with that. So, and then there was a motor bike and going to the physio as well. And so, um and so I had this sort of, I mean, by reframing it as my new job and actually, it meant that it wasn't a problem each day as we go to work, we just turn up, I had to grind out three hours a day every single day, six days a week. Even now, I'll probably do it 3 to 4 days a week and that's to maintain my health in order to allow to go to work. Um moving forward. I was very fortunate that I had a further 33 more months of inpatient rehab where I did six hours a day, um, five days a week for three months. And that allowed me to come back to work. It also allowed me to explore all the different equipments. I may potentially need to go back to surgery. And so new rehab, it's not about doing it 10 times. It's not about doing it 100 times. It's about doing 1000 times. It's having that, that, that drive and really, you know, it's that drive as a surgeon, we all have, I just use that drive uh for, for my rehab really. And so that's the muscle stimulator. It's just like being electrocuted. It's a bit like a dither machine. Um You put a lot of power through it and also achieved a couple of further ambitions of my life. One was to have a beard like father Christmas. And so so after about six months, you know, it became a full time job. You had to shampoo air condition it put beard oil in beard straightener, be comb. But the wife and kids refused to be seen with me. So I had to, I had to trim it, trim it down. And the second one was to get a body like an Asian body builder, big arms, big chest, skinny legs. So, you know, it's, it's been good. So a year later, you know, this is the thing, you know, surgeons were very impatient. It actually took it a year from the surgery a year later for my spine to heal. And so at that point, I was able to take the, the the brace off and push hard with the rehab. Um in terms of return to work, actually, some of the most important things really, in terms of return to work are your colleagues and your trust. And I think, I think, you know, having great colleagues makes a huge difference. And then the colleagues supporting you come back to work is really important. And as medics per say, we can be very harsh with our own colleagues when they're off sick, when they're off ill. And I think we need to be more caring and compassionate towards our colleagues. And in a way, in a sense, me having a physical disability is easier because everyone knows what's happened. But when you don't have an invisible disability, then actually people, you know why they're off, oh I've had to do this, I've had to do that. And I think as medics, we really need to be more compassionate. And so the trust allowed me to come back on my own terms and in terms of what I wanted to do, and that was very helpful and, and also my colleagues were very supportive. And so, you know, I've come back and I managed to get rid of the two issues that I always had at work, one was parking, you can't get parking in my hospital at all. And the second was no on call. So I was a very happy guy. I was very happy. So, so I think, I think it's really, really important, um, that, that had that. Now, the problem is when you come back to work and you need equipment, unfortunately, you have to deal with the department of work and pensions and they're quite challenging department. And what happens is you put your application in and then six months later they say, ok, we've got you, but you've only got one month, four weeks to sort it all out. And at one point, they were going to decline my application because the manager had not emailed them even though she was on annual leave. And so it was rather frustrating. So I think, I think it's interesting. Have you never access any help from the government? It is pretty awful having to deal with them. They do criminalize you make you feel it's not a very pleasant experience. I must add to see it from the other side. Some of the things that patients go through have to deal with government departments and they are very negative, you know, you're on the telephone and make you feel like a criminal that you try to for the department of work and pensions. So it's not the most pleasant experience I have to say. So it's good to get that insight to realize, look, dealing with, with, with, with, with government departments are quite challenging, especially when they assume you line from the onset. Even to get my blue badge, they, they had to keep on um asking me the same question, which was how far can I walk? And I'm like zero m, zero yards, zero kilometers. They repeated about four times maybe because in Asians, in, in, in, in Birmingham, there's a lot of blue black holders who can walk, but they were all quite surprised that, that I couldn't. So, so they kept on asking the same question multiple times. And I'm like, I don't know how I can answer this in any other way apart from, you know, kilometers, miles and meters. So, so, so what I realized was, look, if you're going to come back, if you decide to come back to clinic, they'll leave me in clinic forever. So it's very important for me to come back to theater and not to come back until that's sorted. And so what I did was I organized a simulation day in October. And what we did was we went through the equipment, we went through, I was very fortunate. I had I had an excellent colleague, Tom King, you know, supporting me through my transition back who I work very closely with the OTs, the Physios, the theater staff. And we basically ran through how I was going to get back to theater and achieve the thing. So there's all the different stages. And then I finally made it back last year and that's been in front of the hospital, the outpatient girls happy to see me had a nice cake. And that was when I finished my first procedure, which was an artificial sphincter. So I decided, you know, it was very helpful. I remember speaking to, to one of my trainees, one of our fellows who is now a consultant and she actually gave me some very good advice. She said, look, you know, she's been on multiple maternity leave and she says, actually, it's not that bad coming back and that was very helpful. And so it's always important to ask other people about things and that was, that was really helpful. So, coming back, well, look, I have to say, you know, I'm probably the only person who's really happy to be working in the NHS with a smile because I've been given a second chance. And, and I think it's really important that sometimes when you're in the system and you're working so hard and you get frustrated with the system that you don't see that outside perspective. For me, I see a very different perspective. I see that, that we do an amazing job despite the difficulties we're in. And, and of course, I see it very differently from the patient's point of view. And I have far more interesting conversations with all my colleagues and people than I did previously. And also I realized I finally got balance. I was a workaholic. I'd be working 67 days a week at the expense of the family and friends as well. And so, you know, life is about balance, the surgeons will be very driven and I think it's important to get a degree of balance. And so for me, I feel like I've given a second chance to do it better than I did the first time and make myself a better version of myself. And so a couple of points, I probably like, like to sort of share with you and from from other side that I learned in that journey and that's communication. And so being on the other side, I still remember every single thing that was said to me. And as clinicians, we've got to be very careful how we talk to our patients. Uh You know, it's really, really important that we listen to them and quite often patients will say, oh, this is the problem. They have a gut feeling something's going on going wrong, et cetera. Um And what tends to happen is we ignore them. And I still remember after the second operation about three weeks after um I said, look, something's not right. They, oh, you've just been anxious. I'm not, I'm not the anxious time. So they, they eventually um you did a CT which then showed the so escalation and it made me realize that we, we really do need to listen um to, to our patients in terms of personal learning. What I've learned is gratitude. It's so important to realize how privileged we all are. We in the 0.1% of the world's population with a question of doubt. And, you know, we always should be grateful for what, what, what we have and, and we have an amazing amount of staff and we forget that sometimes. And I think gratitude is really important. That's something something that I I learned, you know, it's very, very important in terms of gratitude that we remember. Remember always looking at not the person above us, the person below us send you other teco messages. I think with pain, I kind of manage pain and accept pain and you always need a positive out of it. And so I reframe the pain that I'm in as it's purify my soul. So it's actually there's a positive in that pain and the surgeons we need to let go and embrace uncertainty. And we always want the, you know, of course, we want to control things. But remember most things are out of our control is they need to live with that uncertainty. That is important. So I think whenever people are going through difficult times, um you know, friends, colleagues, whatever, just give them that text message or that phone call, it makes a massive difference, you know, going through what I went through. I remember every single text message, every single phone call, it meant the world to me. And so we need to be a bit more compassionate towards our, our friends and colleagues. You know, just that small text message, how you doing, you know, you're going through a difficult time and that's, that's really important. And finally, I want to talk about, about hope. Hope was probably really important in my journey. And I think hope is not just denial. You know, it's so important that we don't crush patients. Hope. And while, while you an experiment where, where they did a number of years ago, it was an awful experiment that they put rats into water and the rats swam till about 15 minutes sank down and died and they repeated the experiment at 13 minutes. They took the rats out for a couple of minutes, gave them a rest and put them back in and they didn't swim for minutes. They swam for hours. And that's what hope can do. Hope can allow you to push way more than you can imagine. So it's important when we talk to our patients that we don't question, question all hope. Um And so that's, I think that's really important that, that we always try and foster some hope. Final take home messages. Really are all of you guys do an amazing job. Yeah. No one tells you that you do an amazing job. I've been on the other side and, you know, realize how much have a fantastic job, you know, clinicians all do and no one tells you that all you hear is the complaints, the moans and the groans and clearly surgery is definitely the best specialty, you know, without a question of doubt, there's something very special about using your hands, um, to do something and your intellect. And, you know, I'm forever grateful for the surgeons that helped me. I couldn't have come back if my spine wasn't fixed, I couldn't have come back to work. And so I'll probably leave it on this point. Thank you very much. Thank you very much for that talk. Do we have any questions in the room? Use the microphone just so that everybody online can hear? Thank you very much. Very inspiring talk. Can I ask you, were you a positive person before your accident? Is your attitude acquired or was it congenital? Yeah, I, I think I've always been a positive person and, and as a friend of mine says, my positivity is increased by a number of gears and I kind of feel like I've woken up in this light bulb moment. I've realized certain things that I wouldn't realize otherwise. And actually just that gratitude that, you know, I'm so happy. I've still got my hands. I still got my brain, got amazing family, amazing friends, amazing colleagues. What? To not to be grateful for, you know, and actually just focusing on that pos positive is so important it's very easy to focus on the negative and you can fall into the best. And certainly the guys, I was in the spin unit, some of them focus on the negative and it's been quite challenging for them. And, you know, you got to learn to let go what happens happen. You can't change it no matter how upset you get. If only I did this, if only I did that, that's wasted energy. You know, your energy is you only have a limited amount of energy, it's either positive or negative. And so if it's a bit of both, it cancel itself out. And so I think in life it's really important to, to focus on the positive. I think I've always been a, a sort of positive person, but I think it's the experience is, is allowed me to improve that positivity by a number of gears. Do we have any questions online? Iggy. Not yet. OK. Sorry. I the mic first, I'm wondering, have you given any thought of if this had occurred earlier in your life? Would you have been able to achieve what you've gone back to? Yeah, I think there have been different challenges and I, I think I still have ongoing challenges now. And so, you know, I think as a surgeon, it's our mindset problem solving. So whenever there's a problem, I say, how do I don't see it as a negative? I say, look how can I solve this problem? So I remember a year to, I had to go to a dinner which was upstairs up five stairs. No lift. So I was like, ok, it's only a problem. So I crawled up the stairs, got the guys to get the thing, whereas a lot of people would just go home. And so I think that mindset surgeons that we, we problem solved probably would have, would have helped. It would have been different challenges. Definitely more thinking. Say this had happened when you were 16. Do you think it would have been possible to go to med school to do training if it happened in training? Do you think the system would have facilitated you finishing your training? I think now we would do. And, and certainly I, I've met with lots of medics who, who had accidents in different parts of, of their, their career and that they've managed to get through as well. I think we're in a situation we're more adapted to considering diversity. I think it happened now. Definitely if it happened 30 years possible, but there'll be a lot of barriers. And certainly I met a chap who had a rugby injury when he was like year one year two medical school a number of years ago and he managed to graduate, but obviously, it was difficult for him moving forward. Thank you. Uh Gula Abbas, I'm a consultant spinal surgeon in Bedfordshire. So one thing you said in your presentation was about things were said during your journey. So you heard something? So I heard something as well when I was a little unwell, I was on ventilator for four weeks in the first wave of COVID. So when they were about to put me on ventilator anesthetic od A said no one has survived so far. So did, did you hear something like this? No, I mean, to be honest with you in my journey, there was, I still remember after the, before the second spinal surgery, it was oh, by the way, I've got to men, you, we're going to take your ribs out. So I was right. We've got so, so we may be taking your ribs out as, oh, thanks. So you know, so you do remember, I mean, I was ok, fine. I'm just going to have to suck it up and I woke up then thinking, oh my God, I, I broke my ribs and then they turned up the following day and said, oh yeah, we took your, took your ribs out. Thanks. So that really hurt. So, yeah, so, so I think it would have been nice to tell me before. But then to be honest, I already made my mind up that I need to do the surgery. So I was prepared to take whatever complications. Sure that it would have been nice to have known beforehand. Mentally prepare myself for the severe pain on the other side. I broke my ribs on this side and they took the rib out on the other side. So, so I had pain everywhere. Really? Thank you. Hi. Can I just say just, I'm sure everybody what a phenomenal talk, your positivity, the humor, the compassion that you bring. I'm sure everybody's been really flawed by it. I think as gay has alluded to you have a unique positivity. Maybe it's your predisposition, maybe it's your spirituality. But I think some of the barriers that you faced really admirably come over like logistics where to find help, access that in itself was a separate peak. And how do you think we can help to make that peak more accessible and surmountable for other people who might not have the same, not only resources but mental fortitude and support system that you have. I think, I think it's all possible. I mean, I think when people have achieved it, then, you know, people have done it, it actually makes it easier. And I think one of the things is that, that we have to be compassionate with our colleagues. That's actually one of the biggest barriers if my colleagues were, weren't with me. And I'll give you an example. I heard from one of my orthopedic friends actually, and he works up north that one of his colleagues actually ended up having a transplant and, and, and then they took him off the the on Call Road, but some of his colleagues were very unhappy with that and, and that's what I'm trying to say is that actually, we can achieve a lot of this stuff with us being compassionate to our colleagues. And so I think it also depends on the trust as well and the trust can put a barrier. And I was very fortunate, my trust, despite having a notorious reputation were actually extremely helpful. And so, so that means that it can be achieved. And so, so I think what kind of helps is I'm part of a sort of spinal injuries medics group. And we have a whatsapp group and see how we can collectively work together to help. And so I think a similar sort of group to get like minded individuals together can be helpful to sort of access people with solutions that they may instead of reinventing the wheel. And then perhaps voter can actually have, I've noticed on the website, it's really good, actually got very good website about returning to work and all that stuff. And actually, that's the sort of that it's really, really helpful because, you know, um you could have how to return to work after, after physical illness and, and voted leads on it. Then I'm sure the other organizations will, will, can come together in the Royal College itself can come up with some practical guides of how we can achieve this. This is, it's very achievable. That's a question. Um Thank you very much. That was a really powerful and inspiring talk. Um So thank you for delivering it today. My question was about your positive energy is incredible. But were there times where you felt like you wanted to give up and how did you overcome that? So, so I think it's probably two times were tough. I think it was day two after um the the the accident and, and I kind of, you know, in my mind, I thought, ok, the journey is going to take weeks months, I'll be fine. You know, I'm an internal optimist and then the surgeon neurosurgeon and the spinal surgeon came and they told me that once upon a time story, there was one guy eventually walked off two years and it's very hard because now I realize my journey wasnt weeks months, it was years and it's about managing your own expectation. And that was the time when I I said, look, your journey is going to take years. So it puts less pressure. So what I found is that a surgeon, what we do is if we set ourselves our goals in short term that puts pressure on ourselves, you've got to learn, learn to push those goals out. And so that actually helped by saying to myself, look, your journey is going to take years. Yeah, because you get then obsessed otherwise and you get disappointed. So a lot of it's about managing your own expectations. The second time was ob obviously after the first, you have to go through the second one. And again, it's looking at the positives, whatever situation you're in, there's always positives and what I found is, you know, the day you feel down, that's fine. You embrace it, you accept it but you say tomorrow's a new day. Yeah, I'm not gonna allow, allow it to see on the following day. So you accept those negative feelings or feeling unhappy or sad, you know, and you said that's fine, I'm gonna, I'm upset and sad today. That's, that's ok. But tomorrow is a new day. Yeah. And so when you wake up, you say, ok, it's a new day. Are there any other questions online before we move on again? No. Ok. Thank you very much.