Lessons from the rainforest

I am a person who needs time alone to recharge. I have always been this way. Social interactions take a lot of energy for me and I get quite frazzled if I am not able to retreat from time to time. A small, un-powered camp-site in the Otways National Park has become my favourite place in the world for this reason and I go there as often as I can, even if it is just for one night. I was so fortunate to be able to spend three weeks in this peaceful paradise earlier this year.

rainforestlessons-3My days are divine. I wake up naturally in my tent to the sound of the resident king parrot mother-daughter pair chattering happily to each other in a nearby tree. A territorial Koala grunts his mating call in the distance and if I sit quietly I can hear the tiny fairy wrens chirping to each other as they hop, impossibly quick, past my tent. The tide won’t be right for surfing for a few hours so I change out of my pajamas, which consist of thermals and thick woolen socks, put on shorts and a t-shirt and drag my yoga mat outside. It is always much cooler in the rainforest but there is a small gap in the trees that provides a warm patch of sunlight and I put my mat down there. Days of surfing and bush walking leave me with sore muscles and I spend 20 minutes or so stretching, enjoying the feeling of the tension leaving my body.

Hungry now, I make some simple oat porridge and boil the kettle which will be used for tea and dish washing water. While breakfast cooks I organise my lunch for the day – a salad wrap – and then settle down with my bowl of oats and cup of earl grey to read for a while. The air is so still up here, even if the tops of the trees are blowing in the wind I rarely feel the breeze. The peacefulness is complete and I feel so lucky.

My little tent home is about a 15 minute drive down dirt roads to the nearest town (and surf spot) so once I am done with breakfast I pack all my belongings into the car except the tent and my bedding and head off, hoping to find the local point breaking. If I’m in luck, I will quickly put my wetsuit on, smother on some sunscreen and zinc and head in. The water is usually cold but I warm up quickly and for the next two hours or so there will be no time for thinking about anything but the waves. It feels good to work my body hard and even though I am still very much a novice surfer it is thrilling to see myself improving incrementally every day. I am coming to know the other local surfers and it’s nice to sit in the water with other people who share my passion. I come in when exhaustion hits me and I can no longer physically paddle fast enough to get on a wave.rainforestlessons-4

The rest of my days usually consist of a nap in the shade, reading, writing or drawing, another surf if conditions are right later on, or a bush walk if not, and then a quiet dinner back at camp. I drink my tea, play music and write or read as the sun goes down.

Living in the rainforest can be challenging. There is no running water, no power, no electricity and no heating. You can’t charge your phone or laptop and there is a whole host of curious forest creatures that are very interested in what you are doing. Living this simple lifestyle made me reflect on the lifestyle I live back home and on the things that I really need to be happy. Hint: Not a lot

1) Sleeping when it is dark

One of the loveliest things about camping has got to be the relief of having your sleep-wake cycles move into synch with the sun. I would find myself getting sleepy at around 8:30 when the sun started to go down and by 9:30 and last light I was well and truly ready for bed. It was a good thing too because I also woke up with the sun (and the absurdly excited birds) around 6:30am. I am not alone in this. In 2013 researchers from the University of Colorado Boulder found that it only took a week of camping with no artificial light to synchronise the internal clocks of all eight participants with sunrise and sunset. I have since discovered that this is because of a tiny region of the hypothalamus called the suprachiasmatic nucleus (SCN) that is located just above the optic nerves in the brain. This region receives signals about the light entering our eyes and controls the production of melatonin, which makes you want to sleep. The SCN can be affected by working night shift, artificial lighting, computers and mobile phones and the disruption caused has been linked to a range of disorders from depression to cardiovascular disease. Having been a shift worker, I really appreciate having my circadian rhythm and sleep-wake cycle in order. We drag our bodies into unnatural rhythms created by the modern world and this causes constant tension. When was the last time you didn’t feel tired? Being away in the bush with no phone reception and no power gives you an excuse to listen to your body instead of living by the clock and snap back into a more natural way – it feels amazing.

2) Natural Resources

When it got dark, all I had was a torch, when it was cold I layered up or boiled the kettle for a hot water bottle and when I needed to wash the dishes all I used was one kettle full of water. Bush wees don’t use any water and showering was minimal because I was swimming so much but when I did shower it was an automated three minutes at the public shower block near the beach. It wasn’t until I got back home that I realised how easily I survived on so little. Comparing this to the length of my showers at home and the amount of water I used to wash the dishes is embarrassing and I can’t come up with a good reason for why it is necessary to use so much. ABS data released in 2014 shows that in the 2012-2013 recording year Australians used just under 20 billion litres of fresh water, with 13 billion litres of this being for agriculture. To try and reduce my water usage I have put the plastic tub I use for dishes whilst camping into my sink at home. I try to fill the tub only once and use a grey water safe washing detergent so when the tub gets full I use it to water my balcony vegetable garden. This means I’m not filling the watering can with fresh water a few times a day. I have also started to keep a bucket in the shower and use the water that collects in it to flush the toilet, saving even more fresh water. In researching ways to reduce water usage I stumbled upon some shocking data. In America one pound of beef requires 2500 gallons of water to produce and one gallon of milk requires 1000 gallons of water to produce. Regardless of your familiarity with imperial measurements (I have no concept of how much this is) the ratios are still impressive! There are no Australian breakdowns of which animals or plants use what but the overwhelming majority of water usage in Australia goes to agriculture. To this end I have stopped eating meat and started avoiding dairy as well but even a small reduction in meat consumption will help! If you would like to contribute to the conservation of water, having one meat free meal a week will be more effective than any personal water saving measures. There is a movement called “Meatless Monday” which you can find out about here, that provides recipes and useful information on reducing the environmental impact of your food choices.

3) Mindfulnessrainforestlessons-2

This is a growing movement and for those who haven’t stumbled upon it yet, practicing mindfulness simply involves being present with whatever it is you are doing. Practically this means doing one thing at a time, paying attention to your senses and slowing right down. When you are living in the bush this is almost enforced. Everything takes a little bit longer and requires a little bit more concentration. You can’t have the TV on while you are cooking and no power means no phone battery or Internet. For more information on mindfulness check out this website, or download the Smiling Mind app.

rainforestlessons-54) ‘Stuff’

For the three weeks I was living in the bush, everything I needed except my tent, bedding and my big esky had to fit in my car. I wanted to have everything with me all the time to avoid trips back to the campsite and unnecessary driving. The incredible thing is that everything did fit, and easily at that. There was even enough room left to pick up the occasional backpackers hitchhiking to the area’s various attractions. I had only basic cooking supplies and I usually made dinner in one pot and then ate it from that pot. I had one cup, one plate and one set of cutlery. Nevertheless I ate very well. I realised about two weeks in that I didn’t miss any of my stuff and it became quite apparent to me which things that I did value. The notion that having less possessions is a good thing is not a new one and it is called Minimalism. I read a blog called Becoming Minimalist and if the thought of de-cluttering your house and giving yourself more time and space to focus on the things that really make you happy is interesting to you I highly recommend having a look. As for me I found that my books, my drawing supplies and my note book were my most used and prized possessions, along with my tea cup, beanie and thick socks. Everything else was forgotten.

5) I have way too much clothing:

In the three weeks I was in the rainforest I wore about three different outfits. I had my sleeping clothes, something for warm weather and something when it got cold. I will concede that I didn’t have many social engagements in the bush and the weather was fairly warm while I was there but I still maintain that I don’t need anywhere near as many articles of clothing as I currently own. I have six pairs of jeans! Six! I am not the only one who has noticed that they could get by on less clothing – there is a challenge called ‘Project 333’ that involves cycling 33 items of clothing (including outer wear, shoes and accessories) for 3 months. This is an intriguing idea and believers tout benefits such as saving time when getting ready, less stress and developing more of a personal style, not to mention saving money. Might be worth giving it a go?

Aside from a wonderfully relaxing holiday, my time in the bush taught me a lot about the simple life, living more in tune with nature and gave me more of an appreciation for the joy of a hot cup of tea and a good book. Not falling back into old habits is difficult but I am certainly going to try and apply the things I have learned here into my every day life. We are the same people whether we are on holidays or whether we are at work and remembering that can help you build a life that you don’t need to get away from.

The straw that broke the camel’s back.

This metaphor has been coming up a lot for me recently. I am a paramedic and have recently suffered a breakdown. I am currently being treated for post traumatic stress disorder (PTSD) and depression.

This metaphor is so relevant. For me, depression crept up, one piece of straw at a time, until it became such a huge burden that I could barely get myself out of bed. When I broke it was not as the result of a big traumatic incident, it was something small. I was already carrying so much weight to begin with that one small incident was all it took to push me over the edge.

I want to dig a bit deeper into what this metaphor means and represents and how this can help us to understand things like depression a bit better.

The metaphor talks about a camel carrying straw. The camel can carry a limited amount of straw. If you keep adding tiny little pieces of straw one at a time the camel isn’t going to notice each tiny addition. However eventually you will exceed the camel’s strength and endurance and it will fail. One minute the camel will be able to support the weight of the straw. Then you will add a tiny bit more straw and you will exceed its maximum endurance and it will collapse. All you’ve done is add an insignificant amount of weight but that was all it needed. The last straw, so to speak.

People are like this. I have been told that ‘you can handle it until you can’t any more’ several times over my journey this year and this is what they mean. Each little increase in your burden is tiny; it’s insignificant on its own. But when you combine all the little insignificant additions they become too much to bear.

This is particularly relevant to health care professionals and mental health. You hear lots of different advice as a student. Experienced people tell you that for each sad/traumatic/painful thing you see you lose a piece of your soul. They advise you that if you can avoid seeing something particularly distressing, just don’t look because once you get images like that in your head you can’t erase them. I understand where they are coming from but I picture it slightly differently. Unconsciously, and without realising what was happening I took on a small portion of each of my patient’s suffering. I collected these pieces of grief one by one throughout my too short career in an effort to lessen their pain.

I picture myself as a glass. I started off mostly empty, but as I met and treated patients the glass started filling up. The glass empties somewhat when you go on holidays or take time out for yourself and fills up again in proportion to the trauma you are exposed to. Importantly this isn’t just physical trauma and gory scenes, this is mental trauma too, loneliness, hopelessness and grief. Horrific scenes may leave you feeling fine if there was room in your glass, but if you have had a run of bad cases or simply haven’t had enough time to unwind the glass may fill quicker until you end up in my situation.

We were taught how to better empathise with others at university. To listen, put ourselves in their shoes, repeat their problems back to them to make sure we are on the right track and then offer observations based on what emotions they seem to be expressing; ‘that sounds exhausting’, ‘that must be very difficult to deal with’, ‘I can’t imagine what you are going through’, ‘that sounds frustrating’.

This is a great skill to learn and I have seen first hand the relief on a persons face when someone finally listens to them and takes their concerns seriously. The problem arises when you are continually exposed to difficult, negative emotions. Over the course of a day as a paramedic I may have put myself into the shoes of an elderly lady living alone with no relatives. She is lonely and has no stimulation. She is scared of dying alone. Next I might attend a child with a serious illness. At this job I become the parents. I watch their beautiful child suffering as though it is my own. Next up is a middle aged man with chest pain. First I am him, scared I am having a heart attack and worried about what will happen to my family if something happens to me. I also become his wife and children and feel their love and fear. After that we go to a person that has been self harming. I feel their hopelessness, their anger, their feeling of no way out.

I imagine that the health care professionals who last the longest are able to display empathy without actually taking on what people are feeling. They can keep their work and their personal life largely separate. If I had known that this task was near on impossible for me perhaps I would have chosen a different career path, however it is almost impossible to tell until you try it.

If you are a health care professional, whether you are a student just starting out or a seasoned expert, do not underestimate the power of little burdens to bear. What you could handle last week may not be as easy this week and often by the time you realise it is too late. Use your family and friends to gauge how you are going as when it comes to depression the sufferer may not be able to see the forest for the trees. If your organisation offers regular mental health check ups take them. If nothing else they will provide a trend that may pick up something you miss.

Most importantly you need to take care of yourself before you can take care of anyone else. Make sure that you prioritise the things that empty your glass. Be it exercise, spending time in nature, reading, creating art or just sitting on the couch watching a movie. These are not and should not be luxuries, they are essential to your longevity and your patients will benefit in the end.

Grief Sponge

Depression crept up on me slowly. Incrementally. So gradual that I didn’t notice as the colour slowly faded out of my world.

It started with tummy aches that would begin halfway through 10 and 14 hour shifts. Bending over to pick up bags and treat patients caused discomfort and the cause was elusive. They were fairly mild at first but over the course of 6 months they got so bad that I’d end up driving home from work with my belt and pants undone.

At the same time as this was happening I started to get sick. Every bug that went around had me feeling lethargic, coughing and sneezing for weeks. My previously robust immune system was failing. Multiple trips to my GP provided no answers with serial blood tests revealing that I was perfectly healthy.

I would lie in bed on my days off and try and coax myself to get up and do something, but all the sparks were gone from the world. I let my veggie garden succumb to the ceaseless spread of weeds. Shriveled chillies and capsicums rotting on the ground amongst unruly and now inedible baby spinach and coriander, a constant reminder of my neglect.

I no longer had enough energy to leave the house or entertain guests in the few hours between shifts and sleep. For five days in a row I would cook-eat-clean up, cook-eat-clean up, breakfasts, lunches and dinners alone. Getting my washing done is an accomplishment and a necessity. Its completion becomes the main focus of my days off.

Prior to this I would have been the kind of person described as ‘bubbly’, ‘confident’ or ‘outgoing’. I was always doing something, always full of energy and giving my all to whatever challenge was in front of me.

When I finally broke it was like a dam wall burst. I had been collecting tiny pieces of grief, loneliness and pain from each of my patients over the course of two and a half years and it all poured out of me in a torrent of tears and hopelessness.

The most prominent feeling was an overwhelming sense of failure. When you are a paramedic you are told over and over again that ‘it takes a special person to do what you do’. What happens when you can’t do it any more?

A cup of tea and a chat could be more beneficial for your health than another blood test.

In June an article entitled “How stress can clog your arteries” was published by the American Association for the Advancement of Science. A group of scientists have investigated why people who are suffering from chronic stress are more likely to have increased atherosclerosis (a build-up of plaque in their artery walls that can lead to heart attack, amongst other things). Blood samples from stressed-out medical students revealed they had increased levels of immune cells in their blood. Subsequent laboratory testing successfully duplicated these findings.1 The poor stressed-out mice had increased levels of neutrophils and monocytes as well as increased incidence of risky atherosclerotic plaques at danger of rupturing and causing life threatening blockages. The findings were conclusive; stressed-out mice are at greater risk of heart disease.

This is incredible news! They found a definite link between stress and cardiovascular disease. Alternative medicine has long emphasised the importance of reducing stress but conventional medicine has not explored the possibility of a direct connection in much detail before this study. It is well recognised that stress is contributing to the majority of illnesses such as high blood pressure, Irritable Bowel Syndrome (IBS), and susceptibility to seasonal infections. Despite this, little is taught of how to reduce stress and it is rare to find a GP who would suggest mediTation to a patient before, or even in conjunction with, mediCation. That is why the results of this study are exciting. A definite link means that this very important aspect of wellness may start to be recognised as a major player in overall health in the conventional medical model.

But in true conventional medicine style, the article then mentions some possible outcomes of this research including a pharmaceutical drug to block the excess production of the offending immune cells, and then this telling quote from Alan Tall, a physician and atherosclerosis researcher at Columbia University:

“Rather than asking four questions about stress levels, we could use their [patient’s] white blood cell counts to monitor psychosocial stress,”

A blood test for stress!? Is this a step forward or a step backwards? Increased diagnostic powers can have definite advantages, and sometimes patients might not know when they are stressed, particularly if it is chronic stress but Tall specifically refers to saving time. Why talk when you can test instead? This is concerning in an age of disconnect, where people are feeling more isolated and helpless. Over the past few decades the world of medicine and pharmaceuticals has become increasingly advanced and often beyond the comprehension of most people without specialist knowledge. The result is that patients lose their agency and ability to make their own informed decisions. Complicated, multifactorial conditions such as hypertension (high blood pressure), Parkinson’s disease and cancer can require this specialist medical knowledge, but reducing stress definitely does not. A blood test for stress would ‘medicalise’ it, taking it out of patients’ hands where it belongs, and putting the responsibility on the doctors and the health care system. Research should focus on how to best communicate the importance of stress reduction to patients, and diet too while they are at it.

There is a long way to go for our health system before GP appointments can be long enough for good conversation. Regardless, the results of this study could provide a fantastic stepping-stone in the path towards involving the patient back in their own health. It would be fantastic to see these results encouraging doctors to talk to their patients again and to build relationships with them. To find out about their lives, whether they are happy or unhappy, and what stresses are impacting on them. Engage patients, educate them, and encourage them to be partners in their own healing.

Reducing chronic stress is one area of health care where the patient has the ability to prescribe and initiate their own treatment. The link between stress and atherosclerosis paves the way for GPs and cardiologists to take a look at the sources of chronic stress in their patients’ lives and start referring them to psychologists, counsellors, massage therapists, yoga and meditation classes and suggesting long baths, cups of tea, and more convenient working hours. Give the power back to the patients!

  1. Here is the full reference for the paper. Unfortunately I cannot access it as it is behind a pay wall.

Heidt T, Sager HB, Courties G, Dutta P, Iwamoto Y, Zaltsman A, von Zur Muhlen C, Bode C, Fricchione GL, Denninger J, Lin CP, Vinegoni C, Libby P, Swirski FK, Weissleder R, Nahrendorf M
Chronic variable stress activates hematopoietic stem cells
Nature Med. 2014;20(7):754-758 – PMID: 24952646 – PMCID: PMC4087061