Show Notes

• Dr Shami Barathan website
• The Six Hats Podcast by Dr Shami 
• Unstress Episode with Tabitha Healy on practitioner burnout
• The Taper Clinic – Dr Josef Witt-Doerring
• Unstress Episode with Prof Mark Horowitz on antidepressants
• Unstress Episode with Jodie Lowinger on mental health
• Iristech.co software for reducing blue light for computers

Timestamps

• [00:00:00] – Introduction and Acknowledgement of Traditional Custodians
• [00:01:00] – Discussion on Burnout Among Doctors and Nurses
• [00:03:35] – Introduction of Dr. Shami Barathan
• [00:05:00] – Explanation of Integrative Medicine
• [00:09:42] – Experiences of Burnout and High Workload in the UK
• [00:14:05] – Transition to Integrative Medicine
• [00:18:14] – Discussion on Antidepressants and Mental Health
• [00:20:12] – Reflection on Melbourne’s Lockdown and Its Mental Health Impact
• [00:24:04] – How Stress Manifests in Patients
• [00:33:51] – The Impact of Blue Light on Health
• [00:44:51] – Stress and Its Connection to Cortisol, Sugar, and Health
• [00:46:03] – A Day in the Life of an Integrative Doctor
• [00:49:50] – Challenges of Modern Life and Aligning with Personal Values
• [00:51:08] – Conclusion and Final Thoughts on Integrative Medicine

Dr Shami Barathan: A Doctor’s Journey to Health(care)

Dr Ron Ehrlich [00:00:00] Hello and welcome to Unstress. My name is Doctor Ron Ehrlich. Now, before I start, I would like to acknowledge the traditional custodians of the land on which I am recording this podcast, the Gadigal people of the Euro nation, and pay my respects to their elders, past, present and emerging. Well, we’ve done many programs on doctors health. And, we have, looked at burnout as a problem in health care. Rather soberingly, through the episode we did with, oncologist doctor Tabitha Healy, who is now, a health coach to doctors. She shared with us a rather disturbing statistic that, 44% of doctors and 60% of nurses are suffering from burnout. And, burnout is, characterised by, being disengaged by feeling ineffective and also experiencing exhaustion. And that’s rather sobering when you think that these are the people that are delivering, health service. But then when you think about the, tsunami of preventable chronic degenerative diseases that they are having to contend with, and when you think about the fact that they also would be seeing 30, 40 or 50 patients, a day, or if they’re working in hospitals, they could be doing very long shifts. Then it’s not entirely surprising. And it’s also not surprising that as a result of all of that, we have a pharmaceutical industry worth 1.5 trillion USD, which equates to about 2.5 trillion AUD. Rather sobering. And, the medical profession has facilitated that a very successful industry. But it comes at a price. And practising medicine in one way, is the price that many medical practitioners pay for that. But there is an alternate way, and I’ve highlighted that with many practitioners over the years and many specialists who take an integrative, holistic, functional approach to disease, looking not just at, writing out a prescription and, taking a symptom based approach, but looking at cause. And that happens to be a far more, rewarding, and healthier way for medical practitioners to practice. Well, my guest today has gone through the full gamut of that. My guest is Doctor Shami Barathan. And Shami graduated from the Imperial College, School of Medicine in London in 2000, worked in the United Kingdom and New Zealand before settling in Melbourne, Australia. And she shares that journey with us. She has over 22 years of experience and has specialised now in nutritional and environmental medicine, and has completed a fellowship with the Australasian College of Nutritional and Environmental Medicine. She also has a fellowship from the Royal College of General Practitioners, and in 2021 she was actually vice president of the college acronym. Now, we go through that journey and discuss a whole range of issues with Shami. I hope you enjoy this conversation I had with Doctor Shami Barathan. Welcome to the show, Shami.

Dr Shami Barathan [00:03:36] Thank you. Ron, it’s so awesome to be here. I’m very honoured. By the way.

Dr Ron Ehrlich [00:03:40] Oh, well, it’s a pleasure. Pleasure. I’ve been looking forward to having you on as a guest. I know that you’ve been on a journey. We’ve met through the Australasian College of Nutritional and Environmental Medicine, which we’ve both on the boards of. And, we’ve done all their courses. That is acronym. And I was always really taken by your own professional journey. But I know that you describe yourself as an integrative doctor. Tell tell me when when you say that to people and, like, what’s that? Well, tell us. What’s that?

Dr Shami Barathan [00:04:14] That is awesome. I get that asked all the time from patients and it’s really interesting. So what I normally say is, like when you go to your GP at the moment, you present yourself with a couple of symptoms and more often than not, the solution is in the form of a drug. However, when you come to an integrative doctor, we want to hear all of your symptoms because often it’s all connected with deep dive. We want to find the root cause to get you back to wellness. And we work really holistically, not only from maybe, perhaps nutrient deficiencies, nutrition, lifestyle stress. I’m a big advocate for how stress affects the body. So we work really holistically in a step by step fashion to get you back to wellness. So that’s the key difference.

Dr Ron Ehrlich [00:05:01] And of course, you know, it’s interesting to hear you say that typically a pharmaceutical solution would be found for your problem. And it’s for that very reason that we I think well, I don’t think I know we have a $1.5 trillion pharmaceutical industry, which is supported by that kind of. Listen. But I know you’ve been. You were on a on a professional journey yourself because you once were that doctor. Tell us a little bit. About what? Well, I’m. I’m always intrigued about the trends about why a doctor would would make the transition from, the, the way I think it’s fair to say 80%, at least of the medical profession practice in this fashion to becoming an integrative doctor. I know you’ve gone on that journey yourself. So maybe you could give us you will give us insights into that. Tell us a little bit about your own journey.

Dr Shami Barathan [00:06:00] Absolutely. So I get it that we are trained to prescribe medicine, because when you really look back at med school, the training is focussed around pharmacology, study of drugs, medication with, with focus on. You’ve got an illness. How do I treat that with a drug? And when I really look back I can’t recall any education on nutrition. Yes, we learn about what happens if you’re really vitamin C deficiency. You’ve got scurvy on the worst case scenarios. But we never learnt what the basics of nutrition that we need to use in order to thrive, or even lifestyle medicine. I can’t remember learning about sleep and movement, I just cannot recall. It was very focussed on pharmacology so I get it. We graduate and this is what we’re trained to do. We’re trained to diagnose. We’re trained to manage with a with medication. So when I started that journey you do come out feeling very overwhelmed. There’s a ton of, you know, information that you’re actually trying to process and learn and stay safe and, you know, follow those protocols, follow those guidelines. Plus, you’re doing so many hours of work. When I graduated in 2000, at that time, this is back in the UK, we would do 48 hour on calls. We would do 36 hour, calls, and perhaps we would sleep for maybe four hours on a 36 hour uncle. It’s almost, almost unheard of. So can you imagine just doing those hours? You’re sleep deprived, you’re exhausted the same time you’re going right. I’ve got a patient in front of me. I need to be alert. I need to stay safe. What do I need to do? And it’s that kind of intensity and pressure most junior doctors are under. So I get it. Why? We’re not thinking differently, I get it. Why? We just want to follow this protocol. We want to stay safe. We want to do the best we can. And the system is designed to do that. However, as we’re both going to talk about, doctors reach burnout very quickly and it makes so much sense. So in my journey, I did do my basic training in the UK, but I needed time out after that. Went to New Zealand for a year and to Australia for six months, went back to the UK and started the journey of training to be a GP. But at so many points in my training I was disillusioned and at Stony Point I needed to take time out. It was a decision that I made so I completed my GP training and again I kind of looked at what I was doing is like home and say I should be really happy. Completed my GP training. Yeah, I’ve got my home, got my car, I’ve got my lifestyle, but why am I not happy? And every day, just to give you an outline of what GP life is in the UK. So when you get a job as a GP in the UK, you’re actually allocated patients. Patients don’t. I’m not allowed to sort of go to a practice, say ten kilometres away. They are allocated practice based on where they live. So doctors are allocated say 1200 patients and that becomes yours to manage. That means you do everything for that group of patients. So they want home visits, they want scripts, they want queries. This is what you’re dealing with. That means just to get you give you an idea on average 40 to 50 consults a day. That’s the interactions that you’re going from one another opening, opening notes, trying to get, you know, gather your ideas for this patient scripting, answering queries. It’s never ending. And until this day, and I hear my colleagues still saying they’re still doing 12 to 14 hour days. And these are.

Dr Ron Ehrlich [00:09:43] And you and you in hospital, I mean, you this rolled off the tongue and I wanted to just you repeat it. You were doing 48 hour or 36 hour on call sessions. So this is rather sobering to think, you know, you rushed into hospital and the very person who you’re putting your face, you know, which I’m very grateful for them, don’t get me wrong, is someone who themselves is incredibly tired and incredibly stressed.

Dr Shami Barathan [00:10:13] Absolutely. And I’m hoping that’s changed. I mean, in the years when I was going up the ranks in medicine, it did change. There was some. It’s a level moving on to shift work and I have a feeling that’s happening in Australia, but that’s what we were dealing with.

Dr Ron Ehrlich [00:10:31] Good bit. You were commenting that you were saying 40 or 50 patients a day, and I can give you an update because we recently did a program with oncologist turned executive coach, a doctor, Tabitha Healy, who quoted a figure current figure 2024, figure the to 40% to 44% of doctors and 60% of nurses suffering from burnout, which is characterised by disengagement, feeling ineffective and being exhausted. That’s what characterises burnout. So that’s the update. Share me. I mean, that’s pretty, you know, 40 or 50 patients a day is mind boggling. Go on, tell us a little bit where we’re at, because that doesn’t leave a lot of time per patient, does it?

Dr Shami Barathan [00:11:24] Absolutely. And that kind of leads me on to just explain. So what does that look like? And then six, seven minutes later, they’re walking out with a script. And when I really look back, we actually celebrated that. We go, wow, you’re keeping to time. You’re getting through all these queries. Patients loved it. They came in, they came out, they got what they wanted, which was a script. But I always stopped and thought, what exactly am I doing? How am I helping them? Because I was literally prescribing. I didn’t get a chance to get to know them. I didn’t get a chance to even say, how’s how’s your life going? Because all of it is impacting the health. And I was literally prescribing day patient after patient. I actually thought I was a robot, I really felt robot. And so around 2010 oh 28 I took some time out, went around the world, I was disillusioned, I need time out for medicine. So I took some time out, travelled, came back, and then the idea of coming back to Australia came into the picture and it was just fortunate. Things led to, one thing led to another and I found a job in Melbourne and it was a GP practice and it was almost like a holiday run coming from the NHS to Australia, because I realised I could give more time to patients and that was incredible. There was this luxury of time which I never had before and all of a sudden my consultation changed, so I was having more time to ask about them and really dive into their lives. Because everything matters. When someone presents in front of you, there’s a story that leads to that presentation. So I was enjoying that. I was enjoying that time. But again, it was all about the solution in a drug. And it was so interesting. Luckily a good friend of mine, a mentor, we went to the same university doctor, Annie Gojo, who many people might know, and another amazing integrative GP introduced me to Akron, the College of Oriental Medicine, and I just started learning the foundation. And when I started doing that, I was blown away. I was thinking, why wasn’t this taught in med school? I felt like I was relearning medicine. This is the kind of medicine I really want to practice, which is about wellness. How do I get a patient from illness to wellness? And this is what the book is meant to and is designed to do. And then you get addicted, as you know, and you get addicted. You never stop studying. You still don’t. And if.

Dr Ron Ehrlich [00:13:55] That’s right.

Dr Shami Barathan [00:13:55] All the way up to fellowship. And that’s when I started shifting my consoles, because, I mean, it was so evident that patients were getting better with this philosophy, this way of consulting.

Dr Ron Ehrlich [00:14:06] It’s interesting because I know well, you said that in the UK, your average consult time for 40 or 50 patients a day would be 6 or 7 minutes. And then you came to Australia and you had, because I know the average console time in Australia is 10 to 15 minutes. Oh my God, what a luxury. It’s interesting, it’s sobering, perhaps for the listener who may not know this, but the regulatory body in Australia is called opera. And, I don’t think there are many, doctors that are brought before opera for prescribing too many medications. But I do know that there are many doctors who are called before the regulatory bodies if their consultations are longer than they should be, which is 10 to 15 minutes. And if they’re ordering tests, God forbid, things like vitamin D testing, that’s, that’s something that the regulatory body would draw. I mean, this is kind of part of the system, isn’t it?

Dr Shami Barathan [00:15:09] Absolute. And I I’ve experienced everything that you’ve said. You’re absolutely right. You can’t do too many consults, a long consults because you will be audited. And I’m aware of doctors being audited because they were offering long.

Dr Ron Ehrlich [00:15:23] Spending too long with your patient. I mean, you might actually find out what the cause is.

Dr Shami Barathan [00:15:28] Absolutely. And also, I was one of the doctors who got the letter about ordering vitamin D. And as a result, I had to change my practice that, you know vitamin D is a private test now. And so you are actually working amongst all of these constraints in the attempt to provide amazing service and well and providing education and wellness. Absolutely.

Dr Ron Ehrlich [00:15:53] Because you talk about the, you know, treating the problem. Whereas really what I think most medications do is manage the problem. And I know that’s just we’re not just talking semantics here. There’s a difference between treating the problem then managing it, isn’t it?

Dr Shami Barathan [00:16:11] Absolutely. And I would love to give an example of just meant yeah go on. And so health and I see this all the time how it’s so quick in our system to go. Right. You’ve come to the doctor. Maybe you’re going through a few life challenges. And the first thing the doctor suggests is an antidepressant. But what exactly is the antidepressant doing? It’s numbing you. It literally is just numbing you from feeling the emotion. However, we know, and there’s a ton of evidence out there how nutrition affects mental health. And I know you’ve had, Georgia lead on when to go.

Dr Ron Ehrlich [00:16:47] Well Julia Rutland. Excellent. Yes. I’m getting oh we’ll get Georgia on. But Julia Rutledge, professor of psychology at Canterbury University in New Zealand. Yes.

Dr Shami Barathan [00:16:58] Yeah. And, so much evidence how important what you’re eating is affecting how you feel. And also, what about movement? What about sleep hygiene? What about blue light toxicity? Now often we this is not addressed, but I go even deeper. What about your social connections? What about your community? Laughter. How you actually, you know, live on a day to day basis, and how that has a massive impact on your mental health. And I’ll always look back and say, wow, I was one of those doctors that I did prescribe and antidepressants without asking about all of these factors. When we know for a fact this has a massive impact and it can never be just about the drug. It can never be because that doesn’t solve. All your other issues when it comes to anxiety and depression. So absolutely wrong in much. It can never be just about the drug. It’s just one tiny, tiny piece of the puzzle.

Dr Ron Ehrlich [00:17:59] And it’s sobering to know, because we’ve done a few programs on anti-depressants, that 1 in 6 Australians are on antidepressants, and they are extremely difficult to come off. If you’ve been on them for any length of time.

Dr Shami Barathan [00:18:14] Absolutely upsetting. I had an amazing chat with Doctor Joseph Wittering, and I don’t know if many people know he’s the founder of the Taper Clinic. He’s actually an Australian psychiatrist, but moved to the States and he was also part of the FDA. He was looking into drug safety and he was always questioned the use of antidepressants, and I think, you know, of listeners should follow him and get the right message, because you’re absolutely right. We don’t talk about the rare side effects of antidepressants which are disabling, which can last many, many, many years. And he’s amazing people.

Dr Ron Ehrlich [00:18:49] What’s his name again?

Dr Shami Barathan [00:18:50] Doctor Joseph Wittering and he’s and he’s the founder of the taper clinic. So on Instagram it’s the taper clinic. Right. And people he’s one of very, very, very few psychiatrist just like Georgia East who are speaking out that mental health is just more than just a pill. And that’s when we’re not getting to the root cause.

Dr Ron Ehrlich [00:19:14] Well we have done recently a programme with another psychiatrist, professor Mark Horowitz, who yes, who he’s also very much from his own personal and professional experience about, coming off these medications, which according to the authorities, you know, should take 6 to 8 weeks. But in his his personal experience, it took more like years to come off. You know, and and that is quite a challenge. I know you are. You’ve already mentioned you. You were you based in Melbourne, and Melbourne was really the epicentre of, of of the lockdown mentality. I think there was no city in the world that was locked down more than Melbourne. So you will have seen, you know, what’s your reflection of, of that time as an integrative doctor in, in Melbourne at the time? What’s your reflection on that?

Dr Shami Barathan [00:20:13] Absolutely. Well, I really think background I almost think how did we how do we get through it. How did we survive? It was an unbelievable time. And wow, when I really think back, I almost need to sort of take a moment and say, you know, just reflect and go. It affected us mentally. There was no doubt, no matter how how well you thought you got your mental health together, it affected everyone. You know when you when you really think about, you know, taking away that freedom, that five kilometre, that 8 p.m. rolls, you know, just not seeing other people, that isolation, that being, you know, told to go out only one hour a day for sunlight. That’s everything to make someone anxious and depressed. And I often say to patients, think about what happened during Covid. Everything that you were told not to do is all about human self regulation. And literally that was taken away from me. So you need to connect. You need to hug. You need to see smiles. You need to laugh. You need to experience new things. You need to socialise. It’s unbelievable actually what we went through and I don’t think many times not even many people living in other parts of Australia realised the impact it had on the Melburnians because it was so different to every part of Australia. And almost it makes me really think, is this the same country? Like did we experience where are we in this together? It was definitely Melbourne was on its own, on its own race. The level of restrictions is unbelievable. And as as a GP, I saw it from the other end of mental health. Mental health skyrocket. And I’m talking, you know, my patients were young teenagers who were you got it together. But during that time, all of a sudden eating disorders disorders popped up. Severe depression, suicidal ideation propped up as well. The rates were sky high. Luckily, you know, as a health professional had a level of normality of going to work, going somewhere different. I wasn’t, you know, working just from home. I was able to go to work. I was able to see people. I was able to interact. But so many of my patients were living on their own, suffered the most, and it was just phenomenal. And I actually feel till this day there are still side effects from it. With anxiety. I was hearing, teenagers suffering from anxiety that they never thought they would suffer from, you know, parents. To say, oh, I thought my child was okay. But during Covid the social anxiety skyrocketed and they still feeling the effects because then they had to change schools and they had to get psych psychology for help. And it was actually a lot, a lot more to it than we think.

Dr Ron Ehrlich [00:23:02] Yeah, yeah. I mean, I know that before the pandemic, we’ve done a program with another psychologist, Jodi Low, and Joe from the Sydney Anxiety Clinic. And pre-pandemic, she shared with us that, 1 in 4 teenagers under the age of 18 are diagnosed, diagnosed with anxiety or depression. And that’s a kind of staggering pre-pandemic, you know, statistic. I can only imagine, from your observation where that statistic would sit today.

Dr Shami Barathan [00:23:35] Absolutely, absolutely. And then, you know, he would add it on with staying indoors, lack of sunlight and blue light toxicity. All of that would have just escalated the level of mental health.

Dr Ron Ehrlich [00:23:50] You know stress you mentioned you know stress is something that you see a lot of you obviously I’m interested to know how are you seeing stress manifesting itself in a patient.

Dr Shami Barathan [00:24:04] So interesting you say that because yes I started the journey with Athena and yes we talked about nutrients. We talked about lifestyle, we talked about nutrition. But there was something actually missing in that picture, which I was noticing in my friends. And it was the noticing in my patients was just the impact of stress. So I always wondered, why are you coming to me with these symptoms and not someone else? What was different in your story? And we looked at the stress impact. So that’s great. Yes, there was an element of stress, but also I took it to another level in my research of why some people perceive this as stress and they can get on with it, and why some people take it on. So that’s when I went to another level. I love to chat to you about it. Yeah. So stress affects the body. We know it does. There’s so much research out there. And it when I really observed what I was seeing, 80% of my consults were related to stress. For example, like you’ve got a cold or a cough and you come to see your GP, just think about the days leading up to it. Have you been working hard? Exam stress? Lack of sleep under a lot of pressure. We know, we know the evidence is that immunity is affected by stress. Sleep affects immunity, poor diet affects immunity. So there’s a whole series of events that take place which is due to stress that leads to poor immunity. Then we know stress increases cortisol, which equals sugar. And I would say that to patients cortisol equals sugar. So that’s released. And that means you’re actually leading. It leads to weight gain. And many many patients are suffering from gut disorders such as irritable bowel syndrome. And we know there’s a mind gut connection there. And that’s another stress impact. But we actually see stress affecting the gut in so many different ways. And it’s quite amazing in the integrative world when patients have tried to find a solution to, for example, indigestion or bloating or wind from. So they’ve ruled out all the major causes that most, you know, most of us are worried about, but they still have the symptoms. And that’s when we go back to that stress response. And it’s phenomenal when they’ve addressed it that the symptoms actually go away. So stress appears in so many forms in a normal GP consult.

Dr Ron Ehrlich [00:26:27] I know many people look at stress. So if you stress they almost wear it is a badge of honour. Oh, I’m so stressed. I’m just so stressed. But I mean, I’ve found a very good. You’ve mentioned immune function as one impact of stress. I would add chronic inflammation as well. Any anything anything that you encounter that compromises your immune system or promotes chronic inflammation to me is a stress all spots foreign. Yeah. Yeah. And and so I guess part of it is is awareness, isn’t it? I mean, education.

Dr Shami Barathan [00:27:04] Absolutely. And I think this is a great topic. We’ve normalised it. We love saying stress. It is a badge of honour. You know, for example, in the corporate world you’re working late. Are you staying on late? You’re coming in early. The whole sense of stress is celebrated and almost if you didn’t say it, it’s fine of like, laziness or you’re not, you know, not keeping up to the what everyone else is doing. So it’s in our societal language now. It’s in the narrative. We’ve normalised it. We celebrated it. But no one’s talking about the damage it’s doing internally to you. And you may be walking around with such high blood pressure that you may not know. You may be walking around with saying, great, I’m just going to deal with my gut issues, but and not realising the impact on health. So the problem with stress and and the chronic conditions it has, people are managing. They saying it’s okay then not wanting to say actually I want to thrive, I just don’t want to survive. Actually, I don’t want to deal with bloating. I actually don’t want to deal with poor sleep. I’m tired of feeling tired. And that’s what I hear a lot. Finally, when they come to the journey to an integrative GP, there is a tipping point of saying, I don’t want to feel like this anymore. And that is key. And but it’s a choice. It’s a choice that you take of, deciding like when you want to do something about it. That has to be a pain point for you to take action.

Dr Ron Ehrlich [00:28:37] And I mean, I think the same happens for doctors too in their own lives isn’t it really. I mean I’m still coming back to. Why would you choose to change the way you practised? You know, why wouldn’t you? What would you say to somebody who was in this way you once were and is kind of frustrated with it? What advice would you give for a doctor? You know who’s at that pivotal point in their lives? I’m one of the 44% who are burning, burning out.

Dr Shami Barathan [00:29:06] I always ask that question myself, and I have this discussion with my colleagues. They complain about it. They complain about the long hours. They complain about the pressure. They complain about the admin. But where is the conversation about a solution? And that’s not talked about. And it actually amazes me. And I actually think it’s because they are burnt out. When you’re burnt out, you don’t have capacity to find a solution. You don’t have capacity to think. You’re literally in survival mode. The survival mode is to get up on Monday morning, get to your clinic, see those 30 patients, and you’re on repeat. You’re on repeat for 5 to 6 days because the survival is I need to pay the mortgage. I need to get my, you know, pay my kids private schools. I need to get through this. And you’re in survival mode. There is absolutely no time to stop and think. Can this be done differently? In order to be thinking about solutions, you actually need to have a clear head space. You actually need to have time to think about solutions and actual fact. There is no time in that six day week because you’re so exhausted. So often that’s number one. Number one is that you’re too tired to even think of a solution to get around it. Number two is actually you’ve normalised this. You actually believe that there there is no change. There is no possibility of a change because that’s the way it is. And you kind of see your colleagues doing exactly the same thing, or the clinic’s doing exactly the same. You meet people at conferences, everyone is experiencing stress and you think that’s how it is. I actually have to tell a really quick story here. This is a doctor in the UK and she experienced such high stress. This was years ago that ended up in hospital with chest pain. Luckily nothing nothing was. It was absolutely fine. She was actually fine. But it was a pivoting moment for her in her life. And guess what? She went to her GP and mentioned the stress that she was under. And I remember to this day that her GP said, well, aren’t we all going through it? And I was so shocked that as colleagues, as our peers, we are not doing anything about it. So we think this is the only way of practising. But there but there are so many other solutions. So what advice would I give is there is another way and there’s a way that you can do it. Meeting all the regulations. You know we’ve just got to start having that conversation. But the first thing is you’ve got to stop what you’re doing and you’ve got to look after yourself. Like, self-care is so important. And you’ve got to first take time out for you to suddenly realise that there could be a better way.

Dr Ron Ehrlich [00:31:49] I know you’ve mentioned sleep a few times there and I’m often surprised when I’ve taken a medical history. Of the number of people who were on antidepressants, and yet no one has asked them about the quantity and quality of their sleep. And I and I think this is part of the problem. If the doctor themselves don’t take it seriously, then they won’t include that into their patient assessment.

Dr Shami Barathan [00:32:18] Absolutely. So if you don’t experience what thriving means or living, you know that vitality in, you know, it’s being able to wake up and go, I’m excited about the day. I’m passionate about what I do, and I’m loving the way I’m leading live. If you don’t feel that, you actually don’t feel it’s possible. And if you don’t make the changes of what an amazing night of sleep is and how you feel the next day, you just don’t believe that it’s actually important. So it’s not a priority to ask. And so we keep going down this whole spiral of next mid next medication. Great. Okay. We’ve got side effects. Let’s change it. And you just keep working on that without realising. Once you get the basics and foundation right you can actually feel better and you’re spot on and you’ve got to you’ve got to feel it. You’ve got to feel that difference of lifestyle and nutritional medicine to actually be able to advocate it. And I always get it, actually. A lot of, you know, friends who are not doctors would say, me, I’m not really going to believe a doctor who’s overweight, difficult for them to give me advice. I’m not going to believe a doctor who looks so rundown and burnt out. Give me advice about health. And I go, do you know what, I get that? Because if I’m going to give advice, I have to practice what I preach as well.

Dr Ron Ehrlich [00:33:36] Yes. Another one you’ve mentioned and we’ve explored, is Blue Light and you mentioned it a couple of times. What are you seeing as the problem with blue light, you know, and how do you advise your patients to deal with that?

Dr Shami Barathan [00:33:51] Yeah, thanks to the work. I’ve got to mention his name. Doctor Max. Go hand. He’s amazing.

Dr Ron Ehrlich [00:33:56] Yes, we’ve had Max on the program.

Dr Shami Barathan [00:33:58] We can all agree. Just highlighting this is another missing piece of the puzzle. So you go on this beautiful, integrative journey. Yes. You’ve learned about nutrients. You learned about gut health, you’ve learned about hormones, stress, lifestyle. And he is absolutely spot on. We’ve missed out light. We missed out the benefits of light. And as human beings, we rely on it to survive. And it’s really interesting. We are missing a massive piece of the puzzle here of illness, and I now advise every single patient who’s got a desk job, who’s sitting in front of screens the whole day. He’s probably spending the evening watching TV or on their screens. The impact of blue light on your health and blue light increases cortisol. It it increases insulin. It affects us. The pituitary gland. You need UV light to produce T3, which is a, thyroid hormone. So just imagine what you’re doing on a daily basis when you’re spending for 12 to 14 hours. You’re also depleting dopamine. So can you imagine what you’re doing without even realising? It looks so harmless. But in fact it’s affecting you health. And it’s really, really interesting is when you’ve explored every other aspect of health, you have got to got to look at blue light and what it’s doing. And when I see patients now and they’ve made those simple changes, they feel amazing. Suddenly sleep is better. Suddenly they’re losing weight. Suddenly they’re less anxious and even less inclined to scroll or look for sugar because they’re not dopamine depleted. So it’s something that we’re not talking about enough. And thanks to thanks to doctors like Max Garland really promoting that. And we need to we need to speak about it because our work is mainly now, you know, when you think about it, majority of my patients working doors, majority are in in front of a computer. At the same time, they’ve got chronic diseases. So we’ve got to connect the dots.

Dr Ron Ehrlich [00:35:55] So so I mean, they’re not going to give up their jobs and probably not going to give up. So what should they be doing. How should they be approaching it.

Dr Shami Barathan [00:36:03] Yeah, absolutely. So I get them to do three three. Things. One of them is it’s actually software that you can download. It’s called Iris techno onto their laptop. Iris to see how Stockholm that actually blocks blue light. It’s very cost effective for lifetime subscription. So it gets gives you this yellowish tinge so on automatically you prevent that. Next thing is blue light blocking glasses. They do work and the next thing is start the morning. The first thing you do in the morning before you pick up. Oh, fantastic. Fantastic.

Dr Ron Ehrlich [00:36:41] For those that are just listening to this, I’ve just put my blue blocker glasses on. That’s okay. I’ll put them off. Now, just for the moment up.

Dr Shami Barathan [00:36:48] We’re doing the first thing you do before you pick any un, do anything. Just open that window. Open that door. Go and sit in the morning sun. That’s the most amount of red light, infrared. And we are deprived. We’re deprived of it. And so that three simple things that can transform how you feel in the day.

Dr Ron Ehrlich [00:37:10] And another public health example of demonising, the sunlight, which I think it is fair to say has given us life. But, the apparent okay, our, our devices are no problem at all. In fact, I think we, we, we were talking, last week, about the fact that, Wi-Fi radiation was classified by the Cho, the World Health Organisation as in 2011, as a class two B carcinogen. Class one means it definitely causes cancer class to be two I means it probably causes cancer and class to be is it possibly causes cancer? And I don’t think we’re ever going to read very much about that in our media, because so much of our media depends on us looking at those devices. It’s not good for the business model, but that’s the fact. I mean, it’s class to be carcinogen. We need to approach it with a good deal of respect. Cautiousness.

Dr Shami Barathan [00:38:16] I’m so glad you brought it up because that’s another thing you really you’ve got to really think about. We’re bathing ourselves in EMF. You know, most people don’t turn off EMF at night. And so we never allowing our body to rest from exposure to EMF. We’re, you know, think about it. You’re in the car, you got Bluetooth on, you go into a building everywhere, has Wi-Fi, you’ve got your phones attached to you all the times. When are you actually allowing your body and mind to not be exposed to EMF? So the key thing is just at night, turn it off. Turn it off at the router, turn your phones into aeroplane mode. No devices around the bedroom. Always keep that sleep. Going back to sleep again. Keeping sleep is the most sacred part of the day and have to share a story with you. Just recently, one of my patients told me the most scary story. She’s thriving in a business. She’s doing really well. She’s so excited. And obviously she came to me with a few symptoms, and then I asked about her sleep and she goes, oh yeah, I go to bed at 11, but I wake up at one in the morning. I’m so alert, so late, and then I work on my computer for five hours, and then maybe I’ll go to sleep at six for an hour and then I’m back again. I’m just so excited about my business, is doing really well, and my jaw dropped. You can imagine how I looked. Okay. You serious? How long have you been doing this for your chronically sleep deprived? Yeah, and guess what? She ended up in hospital with severe vertigo, and then she ended up with another episode of Vertigo that she could not drive, could not move for a couple of hours. And I always say to patients, at some point your body’s going to give sleep is the most important part of the day, therefore a reason to keep you alive and you can’t actually survive without it. And it will come out in other forms until you are listening. And so now she stopped. She can’t work. She has to review that. But you know, it’s amazing how we push ourselves to the limit until something really awful has to happen for you to stop and think, let’s just get our basics right.

Dr Ron Ehrlich [00:40:24] Yes, yes. Well, it’s interesting because I think in sleep, the people that sleep, I mean, we 90% of us need 7 to 9 hours, but, you know, people who sleep 3 to 4, five hours a night perform really badly on, on almost every health measure, physical and mental. It’s the group that sleep six hours a night that the most interesting because they think they’re getting enough sleep, but they perform just as badly as the 3 to 5 hour group. And I know that because I was once that person I used to until I took sleep seriously 20 plus years ago, I was that person. Now I get to bed at 12, I get all my best work done between 11 and 1, and my kids are. Asleep. And yes, I’m up at 6:00 and off to work and blah, blah, blah. And then eventually something happens and it alert you to it. It just this again like stress, this normalisation of dysfunctional behaviour absolute.

Dr Shami Barathan [00:41:24] It’s almost like we think, you know, we’re invincible. We can you can push boundaries. But at some point the body will let you know that the boundary has been pushed and you have to do something about it. And it’s just really interesting. Like another patient came to me, she was she was going through a lot of stress in his marriage. And, she was actually quite afraid to come and see a doctor because he was afraid of being judged because the issue was him in the marriage. And he actually came with a different issue. He actually said, oh, no, I’m worried about my kidneys. I’m seeing a specialist. And I go, you know, when was the last time you checked your blood pressure? Ronnie would not believe how high his blood pressure was. It was so high I had to send it into hospital. Well, and he was monitored for a couple of hours, and he was walking around. He was slim. He looked well. He was having this high flying job. He he was functioning. He was happy. He was so-called happy. And he was walking around with such high blood pressure. But it took him at that point to suddenly go, well, actually I am feeling the stress. I actually need to do something about it. I’m not doing something about the level of stress I’m under. So it’s very easy to suppress, really easy to suppress. It’s easy to put on this amazing sort of look and go, I’m looking great, I’m functioning, I’m doing okay at work, but I’m internalising the such level of stress that he could have had a heart attack, he could’ve had a stroke. No.

Dr Ron Ehrlich [00:42:53] How old was he?

Dr Shami Barathan [00:42:55] He was in his late 40s.

Dr Ron Ehrlich [00:42:58] Late 40s? Yeah. Looking fit and healthy. Apart from not a from not being.

Dr Shami Barathan [00:43:05] Absolutely. And it really shocked him. It shocked me because I you walking around with this high blood pressure, how long has this been going on for? And something has to change. And it’s something about a story about community. When I asked him, who would you like to go to the hospital with? He goes, I don’t have anyone. I don’t talk to anyone about stress. I keep this all close together and that’s another issue in society at the moment. The lack of community, the lack of support.

Dr Ron Ehrlich [00:43:34] Yeah. And what would have been some of the things that you, I mean, the, the suggested for him.

Dr Shami Barathan [00:43:41] So funnily enough, the first thing was the level of coffee he was drinking, the amount of coffee he was drinking every day to get through the day, but also just addressing the awareness, what stress was doing to his body. And he wasn’t aware because he was functioning. He was thriving at work. He was getting through, marital issues. He was seeing a marital counsellor. But I go, where are we going to get you the support? And then we talked about deep breathing, nutrition, sleep we get I gave into a couple of strategies. But the key thing is he he needed to be medicated and we were going to work on that as well. But where’s his support? How is he actually going to deal with internalising stress?

Dr Ron Ehrlich [00:44:25] I mean, there’s so many avenues into this out there depending on on your own, on your own focus. So, so in terms of, your experience in, well, stress, you mentioned also about stress impacting on cortisol and sugar and, and a lot of people don’t actually associate stress with diabetes and obesity and share with us a little bit about that.

Dr Shami Barathan [00:44:51] Oh, absolutely. So when you think about stress, what actually is happening to your body, it’s generating a whole series of reactions. But most importantly, it’s releasing that cortisol is that stress hormone. The whole idea is to get you out of a difficult situation. So it’s designed to release a bit of sugar to go right. Got to get you running out of here, get it moving you from a fearful situation. However, in today’s world the fear is very emotional. It could be embarrassment. It could be fear of speaking, fear of a debt, carrying out a meeting. And that triggers the same fight or flight response which releases cortisol, which tells the body to release sugar. So that’s glucose. And so what happens when the body reads it as glucose? It’s as though you’re eating is as though you’ve had a meal and the body process it in the same way. So what happens? Insulin is released and insulin is your home or that tells your body to store fat. So this whole journey happens. So you could be sitting not eating, but at the same time in high stress mode, releasing that cortisol, mimicking as though you’ve just had junk food. That’s how things work.

Dr Ron Ehrlich [00:46:03] Yeah. And what I’m just intrigued. To know what your day as an integrative doctor, because you mentioned 40 or 50 or more patients a day in the old days. What does a typical day in Doctor Sharma’s life look like in terms of patient load? Patient loads.

Dr Shami Barathan [00:46:21] So at the moment I only need to work three and a half days. I just want to make the point. So I, you know, I’ve always, always prioritised self-care. Some of the things are self-care days. And I’ve got so many other hobbies and, you know, socialising, getting having a connection with friends is so important to me. And on those three and a half days, I’ve split it. So I’ve got two half days and two full days. But in those two full days I see patients in the clinic and it’s half an hour appointments and it’s mixed in with 15 minute appointments. But those are telehealth appointments. So it’s it’s a mix of telehealth, 15 minute telehealth and half an hour inpatient. Because when you think about it, by the time you come in, by the time you have that conversation, it’s never 15 minutes. And it’s pressure on the patient, pressure from the doctor to stay on time. So we’ve made it, a way of consulting. You come in for 30 minutes. So that means you’re actually seeing 13, 14 patients a day maximum. It lots of breaks, you know? So I have mid-morning break, a mid-afternoon break. Always have a good lunch break where I can step out, get some sunlight, go for a walk, get some fresh air. And how we’ve sort of designed it is when you do come in for your first appointment, you’ve already had to go through a nice questionnaire and it’s really long. It’s everything I really need to know and plus more. So sleep, nutrition, everything. I can get an idea of where your health is at, but it’s a beautiful time for patients to self-reflect and go, what do I want to focus on? What do I want to get out from this console? But more importantly, is my mindset ready? So I have mindset questions. So I you respond how you know, are you responsible for your health? Are you willing to work hard? Are you are you ready for change? So you’re already set up to this beautiful concept rather than just walking in off the streets going, this is what I’ve got. What do I need to do? So the doctor’s prepared, you all prepared. And I think that’s important piece of the puzzle when it comes to healthcare. So you come in and so you can get straight into this console. And I always want to get to know the patient, get to know their life. And you’ve got the luxury of time to discuss it. Because I’ve got most of your details. I don’t need to go through medication. And I may clarify past medical history, but I’ve got a lot of your details that I can learn everything about you. So it’s a beautiful time for the doctor, a beautiful time for the patient to feel listened, heard, and then go away with a management plan.

Dr Ron Ehrlich [00:48:49] Yes, I think being heard is kind of, something really an important part of this whole thing. Also, the fact that these questionnaires, you know, it’s quite. Why is the doctor asking me this question? You know, it starts the patient thinking as well beyond I wonder which medication the patient the doctor’s going to. It’s going to prescribe for me. Listen, I wondered, before we finish, I wanted to take a step back from your role as a as a doctor in integrative Doctor, because as you observed, we’re all this we’re all on this health journey through life in this modern world. What do you think the biggest challenge is for us as individuals on that journey.

Dr Shami Barathan [00:49:34] Of integrative medicine, not.

Dr Ron Ehrlich [00:49:35] Just on the journey of life? Oh, okay. In our modern world, that’s what I mean. Taking a step back from, you know, you’re an individual. I’m an individual. We’re all going through life. But what do you think the biggest challenges for us as individuals on that journey?

Dr Shami Barathan [00:49:50] I think that’s a really, really good question. One, I think it’s a beautiful time to self-reflect and go, are we living a life aligned with our values? Oh, we actually do, you know, living our true purpose and meaning, and are we finding meaning of what we’re doing? Or are we being carried away by everyone else’s desires and values? And I think when we just sit and reflect and go, this is what I really, really want to do. This is aligned with my value system. I think that’s when you find true happiness. And, and it’s always okay to say, I didn’t get it right. I’m going to change my route. It’s always a pay to learn and grow and and I my philosophy in life is that there are no regrets. There’s always, always lessons to learn is always experience. And you always look back and go, amazing. Glad I experienced that. What did I learn? What’s my next step? But it’s taking time out to go. Am I in line with where I want to go? And it’s okay to dream how often many people don’t dream and don’t visualise the better life, because that’s what they see is what they feel that you can get. And I always believe, you know, visionaries rule the world, visionaries lead the world. And you can also be your visionary. You can manifest, you can visualise your future. You just need to dream about it.

Dr Ron Ehrlich [00:51:08] Well, show me. That’s a great note for us to finish on. And thank you so much for joining us and sharing your journey with us today and your philosophy of healthcare. Thank you.

Dr Shami Barathan [00:51:18] Amazing. Thank you.

Dr Ron Ehrlich [00:51:19] Well, it’s an interesting journey, isn’t it? One can only ask oneself, why aren’t more doctors making that choice? It would be a win win, win win for them. A win for the patient and a win for the health system in general. But, you know, health care has become an industry. And the pharmaceutical approach is very much part of that industry. Good health may make sense, but it doesn’t make dollars. Now, Shimi, practices in Melbourne and she’s the founder of the Mint Clinic in Collingwood, suburb of Melbourne, Australia. She’s also a podcaster, and her Six Hats podcast is available on all channels. And it’s now. If you didn’t listen to in over 22 countries, I’d also encourage you to join our unstressed health community, where there is a wealth of information about the five stressors emotional, environmental, postural, nutritional and yes, dental stress. And while you’re at reducing, identifying and, reducing the stressors in life that have the potential to compromise our immune system and cause chronic inflammation, the common denominator in all diseases at the same time, you can also build resilience on the website by focusing on the five pillars of health sleep, breathe, nourish, move, and thought. And when we think about thought, our minds can either be our best friends or our worst enemies. And so mindset is another focus. Your is your mindset a thrive mindset or a survivor mindset? Your mind can either be your best friend or your worst enemy. You learn more about that and all about that on in our unstressed health community. I’d encourage you to join us. Until next time, this is Doctor Relic. Be well. This podcast provides general information and discussion about medicine, health, and related subjects. The content is not intended and should not be construed as medical advice, or as a substitute for care by qualified medical practitioner. If you or any other person has a medical concern, he or she should consult with an appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions, experiences and conclusions.