Rest first, with Dr. Adam Sandell

0:03Speaker 1:Welcome to Before Breakfast, a production of iHeartRadio.

0:08Speaker 2:Good Morning, This is Laura. Welcome to the Before Breakfast podcast. Today's episode is going to be a slightly longer one part of the series where I interview fascinating people about how they take their days from great to awesome and any advice they have for the rest of us. So today I am delighted to walk up. Welcome doctor Adam Sandal to Before Breakfast. Adam is a physician working in rural Canada. He teaches at the University of British Columbia and writes the Great Work newsletter on Substack. So Adam, welcome to the show.

0:40Speaker 3:Thank you so much. I'm delighted to be here.

0:43Speaker 2:Yeah, I'm decided to have you as well. Why don't you tell our listeners a little bit about yourself.

0:47Speaker 3:Sure, I've had a fairly crazy life, so as anyone sharped can hear. I grew up in the UK with mixed British and American parentage, trained as a doctor and worked as a doctor for about twenty years in the UK before moving to Canada right at the beginning of the pandemic. I've also the craziness, you know, I've spent ten years while working as a doctor, also working as a human rights lawyer. That was in the UK, and I've also spent quite a lot of time in other parts of the world, helping to develop healthcare services in places like Africa and India in the Middle East. But I now I am now in Western Canada and rural Western Canada, where I work on what Americans call a reservation, what Canadians call a reserve with an indigenous population here in British Columbia.

1:42Speaker 1:And you are off on a tiny island, I understand, correct.

1:45Speaker 3:That's right, kind of tucked into Vancouver Island and in fact, and I love telling people this. At the moment, my commute to work involves me getting in a kayak and kayaking across the small channel.

1:57Speaker 2:So that's your company vehicle, that's right, You're exactly right.

2:01Speaker 3:And it's my first company vehicle.

2:02Speaker 1:I was very proud when I bought it. Yeah, so that's true.

2:06Speaker 2:I mean, rural healthcare does not tend to come with company vehicles, I suppose.

2:10Speaker 1:But maybe I can tell people what that's like.

2:12Speaker 2:You know, many of my listeners probably have more the suburban or urban sorts. You know, they think about just going to the doctor or hospital for healthcare? How's that different in rural Canada and especially with indigenous populations.

2:23Speaker 3:You know, it's something that I didn't when I moved from the UK. I didn't even know still existed in high income countries where you've got doctors doing what I think, you know, doctors were doing fifty years ago, in the places where many of us live now, many people live now just doing everything. And in fact, for several years here I worked in an even more remote community than I do now, where we did do everything until things got beyond our expertise, and then if we could, we'd fly them out to a bigger center. But it is.

2:56Speaker 3:It's a kind of medicine, a kind of healthcare that I think in so always people still yearn for, where you have a doctor who deals with pretty much everything for you. They see you in the emergency room, they're the family physician that you see in the clinic, and they're doing everything in between, insofar as you're capable of doing that.

3:17Speaker 2:And now we're going to talk about time management in a minute, because you had told me that you thought you were not so good at time management.

3:24Speaker 1:But it tells me, you know, you're dealing with you never know going into a day what is going to happen.

3:31Speaker 2:I mean, you're dealing with every single ailment that could befall a community or people's regular run of show health needs. So how does one even think about time when a day could bring truly anything.

3:49Speaker 3:It's such a great question that and I think you know some of it. In really reactive jobs like that, all you can do is figure out what the most important thing to do next is and then do that. You know, and there's always the most important thing to do next, and you just do one of those after the other after the other, and you hope that at some point you come up for a and have got through your responsibilities that day or that night or that or that shift. But there's a you know, there's there's a skill to doing that, it seems to me, because you can get so submerged in it that you stop being aware of who you are and how you are doing.

4:31Speaker 3:And you know, when I was a resident, it took me a while to realize that actually you have to go to the bathroom and if you're you know, if you're working really long shifts, you have to have breaks and eat because because otherwise you are going to start work, You're going to feel terrible, and you're going to start working really and effectively, and actually you're going to have a much worse day than you otherwise would be. So there is this thing of kind of maintaining kind of higher out tude view of how you're doing and thinking, no, even though there are still people waiting, I have to stop now, and I need to drink some fluids, and I need to just pause and not think about the next thing I'm worrying about, just for a few minutes so I can get my head straightened out.

5:15Speaker 2:A very important lesson for sure. Well let's talk about time management. Though.

5:19Speaker 1:What if you found hardest about time management?

5:22Speaker 3:Yeah, I mean I think there are a bunch of things, and one of them for me was thinking that there was one change that I could make which was going to fix everything. And I'm you know, I love reading, you know, listening to podcasts like this one and reading books about how I can improve my life, and when you do, you have this kind of honeymoon effect of thinking that everything is going to be You've solved the problem and everything's going to get better. And it took me some time and then it does for a little bit, you feel more in control, and then a few weeks later things are not that much different. And it took me some time to realize that this is a life's project.

6:04Speaker 3:You know, you haven't failed by not solving the problem overnight by reading someone's fantastic book. And these are fantastic books and you know, and podcasts and advice advice that people have, but there isn't one solution. This is a you know, this is a process that you learn and you gradually get better at it. And I've been doing this for you know, nearly thirty years now, and I am so much better than I was. But that wasn't That wasn't you know, one big jump that I suddenly made when someone's brain, you know, wonderful idea change transformed my life. It was a series of small, incremental things, you know. So that's one thing. And then another thing I think for me has been recognizing that this isn't it's not just about techniques, it's about perspectives. So you know, you, yeah, you can learn how to time box, and that's great, and that helps you if you're a time boxy kind of person. And I think if you're not a time I am a bit. If you're not a time boxy kind of person, then it's terrifying and awful. But but you need to understand why you're doing that and have have that kind of perspective shift that goes with it,

7:13Speaker 3:and one that you know you You make this point I think in several of your books, including Big Time, which I've just read and I love, which is that you have enough time. The problem is not that you don't have enough time. And I you know, fundamentally agree with you about that, but it took me a long time to learn it that if you're you're fretting about not having enough time, you are fretting about the wrong problem. That that's not that's not how you need to solve your time management problems.

7:43Speaker 2:Well, we're going to take a quick break and then we're going to think about how we do solve our time management problems. Right after this, well, I am back talking with doctor Adam Sandal, who is a physician practice thing in rural Canada.

8:01Speaker 1:He is also the author of the Great Work newsletter on Substack.

8:05Speaker 2:So you mentioned that in your time management journey there had been a lot of small incremental steps that were helpful. I wonder if you can share one or two of those that were helpful for you, and that might be helpful for other people who are listening to this.

8:20Speaker 3:The biggest one for me has been recognizing how important rest is, that how important breaks are, and making sure that I adequately prioritize them, because my instinct always when I feel as though I have too much to do, is to do the stuff that I feel like I need to be doing. And you know, there's a bunch of problems with that, one of which is that there are always more than you can ever possibly do, so you have to prioritize. And the second is that if you don't, if you don't make sure if rest and breaks and things that allow you to feel better and then in fact make life meaningful aren't in there, then they're not going to get done. So so that that that piece of advice, which to me feels like permission to do what I actually want to do, which is to sit on the deck and read a book, or go for a walk, or spend time with my partner or you know, whatever it may be, that that recognition that actually that's at least as important as all of the other things that I'm worrying about getting done. That's been a huge transformative thing for me.

9:40Speaker 2:Well, and that's interesting that you refer to those as rest, because those are activities. The three things you just mentioned that reading a book, yep, going for a walk, spending time with a loved one. Yeah, that's that's not lying on the bed watching TV. I mean, those are all active choices. So I'm curious if you can talk a little bit about this idea of rest as a category that's about rejuvenation and not so much about just doing nothing, if it were even possible to do nothing.

10:09Speaker 3:Yeah, And people use all kinds of terminology for this and distinguish between rest and leisure, and you know, and I think it's easy to get a little bit kind of hung up on that. I guess I'm talking about doing the things that I most want to be doing that don't feel like obligations, you know, because there's a sense much I love my work, and I you know, I love doing stuff like this, but it's it's you know, it keeps me alert and active and having to think hard about it. And I guess the things that are most important to me, and I think to all of us.

10:46Speaker 3:We need to have time to do this are time to allow our minds to wander into daydream or to think the big thoughts, so you know, and that may that definitely does include you know, watching We're watching six feet under It at the moment, which I've never seen before and I'm loving and that, you know, I get a huge amount from that. And that's one of those things for me. Going for a walk, Yeah, is it an activity? I suppose so, but it's not a chore. It's something I just love doing, you know, and or you know, or reading, reading, reading a good book, or you know, even sometimes I can find just doing stuff pottering around in the garden, you know, mowing the lawn that you know, that actually just gets me outside and it's a little bit physical and that feels good. So what it is for you and what it is for me are probably going to be different. Although interestingly, when big surveys are done on this, we they it often boils down to you know, half a dozen or a dozen things that most of us would identify as things that you know, make us feel better. But the key thing is to you know, it's not scrolling Instagram. You know,

11:46Speaker 3:that may be a break. But it isn't. It doesn't leave you feeling invigorated and energized and that the life is good when you finish doing it. You could just kind of feel slightly dirty and ashamed of yourself.

11:58Speaker 1:Sometimes we are deer.

12:00Speaker 2:So another topic you talk about, you said, it's the reaction, not the stuff.

12:05Speaker 1:What do you mean by that?

12:08Speaker 3:So I'm unashamed to say that I have often found my work stressful, and I think that goes for many of us, you know, no matter what what your job may be. And and there was a you know, this was one of those perspective shifts that I was talking about a moment ago that was, you know, part of this kind of cumulative life changing, life changing thing that that often when you are getting stressed about something, if you look at your reaction the stress first, it will it turns out that whatever you are getting stressed about is much less of a thing than you were thinking it was. And you know this is you know, there is strains of this in Buddhist and Stoic philosophy. There's that quote from Hamlet, which I think I can get away with because of my accent. There is nothing either good or bad, but thinking makes it. So it's you know, you find it in a lot of modern day thinking about about how we can live our lives better, including cognitive behavioral therapy that you know, that most effective, most evidence based form of psychological therapy that you know, if you are worried that you have done something wrong and

13:35Speaker 3:you are going to get in huge trouble or this is going to have an enormous impact on your career or on the people your work serves, and you're losing sleep over that, Actually unpicking that and figuring out whether that is really accurate and thinking about how helpful to you the reaction that you are having to it is being can often be the most helpful thing you can do in that situation.

14:03Speaker 1:So tell me how you started the great work substack. What led to your decision to try and share your ideas on you know, time and management with other people.

14:13Speaker 3:This crazy career that I have had has taken me to an awful lot of different work settings of one sort or another, in medicine and in law, and in different continents and just very different approaches to doing things. And I, you know, after some years, began to realize that the struggles that I have with my working life are struggles that lots of people have with their working lives and that and I have got this kind of engineering mindset where if I've got a problem, I kind of try and figure out ways to fix it, and I'm interested in evidence based ways that actually do work.

14:55Speaker 3:I'm one of those people who gets put off by wo and pseudoscience, but I want something practical that I can do that makes a difference. And there came a point where I felt that I'd figured out enough of these people and increasingly had enough of these problems, and increasingly had helped enough for other people to figure out solutions to their own problems that I thought there's something here that I want to start sharing with people, And so started the sub stack and working on a book about the same stuff, and have been delighted to discover that this is things. This is information that people really want to hear and seem to find useful if it's practical.

15:33Speaker 2:Absolutely, people always like practical things. We're all about practical here absolutely. And another thing we also like here before breakfast is morning routines. And I understand that you have one.

15:44Speaker 3:Yeah, And I'm slightly obsessive about it and get a little bit stressed if I am unable to follow it and then tell myself, no, it's the reaction, not the stuff. Today is going to be fine. Yeah, I mean, and this is kind of slowly evolved, and it will probably continue to involve to evolve. I get up, and I'm pretty disciplined about not switching on devices or checking anything for a while, just so that I have a little bit of mourning before I start to get consumed. I meditate.

16:13Speaker 3:I do some mindfulness meditation literally for maybe no more than two or three minutes. Sometimes it's significantly longer than that, but two or three minutes makes a huge difference to my day. Recently, because I'm in my fifties now, started doing again just a few minutes of yoga every morning, and that makes me feel way better for the rest of the day too. And two or three times a week we'll lift some weights. All of this is just for a few minutes. The whole thing is just, you know, it's brief, it's easy to fit in there. And then I sit down and I have this quite formulaic process that I go through. I start by writing just a few pages of I don't know, it's a cross between diary and what people call morning pages, just getting stuff out there. And I do find, as people who do morning pages do that if there's something that if there's a decision that I've been struggling with, often just a few sentences on the page and it's figured out for me in my mind. And then you know, I have a task management app on my phone and my computer and I have a look at what's popped up today and sort them out and cross off a bunch of

17:24Speaker 3:things or postpone them and have a think about how my day is going to go. I also look at a list that I keep, just a short bullet point thing of my big priorities in life, and I look at that every morning. And the reason I do that is that it is so easy to get off track, especially during busy or stressful times, and I just find it helpful each morning to look at that list of what is my life, what do I want my life to be about, and make sure that things are as on track as they can be, and if not, think well, what am I going to do about that today? How am I going to fit in an hour of whatever it is that's most important to me today? And that's and By the end of that process, I feel like I'm ready to get going with to.

18:11Speaker 1:Day for sure.

18:13Speaker 2:Well, it's always good to look at our goals and refamiliarize ourselves with them. We're going to take a quick ad break and then I'll be back with more from doctor Adam Sandal. Well, I am back talking with doctor Adam Sandal who is a physician in rural Canada, teaches at the University of British Columbia, and writes the Great Work newsletter on substack.

18:37Speaker 1:So you've seen a lot of time management.

18:39Speaker 2:Advice, You've seen you've read a lot of productivity and self help books over the years. I'm curious if you tried something that most definitely did not work for you.

18:48Speaker 3:Oh wow, what a good question. Let me think that through. I mean the things that the things that I find in the hardest are things that just come across to me as too tree hugging and pseudoscientific. And I mean, I'll give you one. I'll give you one example. I was involved in a great team building session led by an external facilitator recently which suddenly dove into the world of polyvagel theory. Now, I don't know if you've heard of polyvagel theory, but it's big out there in in kind of work performance kind of psychology stuff, and it's made up. It's pseudoscience. And what it does is it slaps a fancy sounding scientific, key sounding label on some kind of basically good advice and makes it way more complicated than it needs to be. And I can't stand that because I think it's dishonest. I think it it doesn't actually help people to it to attach labels, and it warps the advice away from what might be the most useful to make it sound like this kind of special, fancy kind of science y thing, and I find it very difficult to engage with that. And goodness me, I had to bite my tongue because actually this was a

20:33Speaker 3:really good session and I didn't want to undermine that or the facilitator, but that that stuff I find really And I know I'm coming at this as a doctor, you know, as someone as someone who is a bit sciencing myself, but that really turns me off.

20:48Speaker 2:Yeah, well, I think the group facilitation right there probably turned me off. I'm really not into any sort of forced group bonding activity, but good.

20:58Speaker 1:For you for being part of it. So Adam.

21:01Speaker 2:I ask, oh, my guests, what is something you have done recently to take a day from great to awesome?

21:06Speaker 1:We know that this.

21:07Speaker 2:Pseudoscience group facilitation stuff was taking a day maybe a little worse. What's something you've had a good day and made it better.

21:15Speaker 3:There's I mean, there's two things I want to say, and one I'm just going to say in passing because any day in which I can walk in nature for the purposes of walking, so I'm not getting somewhere necessarily, but just for the purpose of walking, that is going to be a great day. But from from great to awesome. And I thought about this a little bit because I knew you were going to ask me this. From great too awesome. I think any day where I have spent time with someone else helping them figure something out. I cannot tell you why that gives me the buzz it does, but research tells us that actually that gives all of us a buzz. There's wonderful search on this and I so, you know, I do a bit of coaching and mentoring of other health care providers in British Columbia, and you know, there was a recent day where I spent an hour with someone on Zoom, helping them figure out an approach to clinical problems that they needed to have, and I just felt for days afterwards. I felt good about it because I knew that something, something useful had happened there and we'd done it together.

22:26Speaker 2:Yeah, helping other people and being useful is amazing, and I'm sure one of the upsides of being in a rural physician is you do that every day, right, I mean, you are clearly solving people's problems every.

22:39Speaker 3:Day, and I'm sure that's why I chose that as a career. I didn't know it at the time, but yeah, I get it. I get every every day I go into work, I get energized by that. And it's great. And it's weird for an introvert because actually I really love spending time on my own, but there is something very meaningful about that kind of one on one helping people fix things.

22:57Speaker 1:Absolutely. What are you looking forward to right now?

23:02Speaker 3:I am. I'm loving doing the writing and connecting with people who are interested in this stuff. So that's really that's really exciting for me, and I'm just continuing to enjoy that this time of year for me, you know, part of the reason I'm in British Columbia is it's one of the most beautiful places in the world and this time of year is just fantastic. The nature and the wildlife and the views and the scenery and the outdoors. What else can I tell you that I'm excited about at the moment, I guess the biggest excitement in my life is I'm trying to turn all of this into a book, and that feels like it's going really well, and I'm excited to see how that may unfold.

23:41Speaker 1:Wonderful, absolutely well. Let people know where they can find you.

23:45Speaker 3:So the best place to find me is on my website, which is Adamsandal dot com Adam Sandel l dot com and you can connect with me there. You can also sign up for the substack, and if you prefer that as a podcast, then that's embedded in the substackle. You can find in the emails, or you can find it in all the places where people find podcasts.

24:05Speaker 2:Wonderful well, Adam, thank you so much for joining us, Thank you to everyone for listening. If you have feedback about this or any other episode, you can always reach me at Laura at Laura vandercam dot com.

24:18Speaker 1:In the meantime, this is Laura.

24:20Speaker 2:Thanks for listening, and here's to making the most of our time. Thanks for listening to Before Breakfast. If you've got questions, ideas, or feedback, you can reach me at Laura at Laura vandercam dot com. Before Breakfast is a production of iHeartMedia. For more podcasts from iHeartMedia, please visit the iHeartRadio app, Apple Podcasts, or wherever you listen to your favorite shows.