September 18, 2023 • 23 mins
This is a re-release of Season 01 Episode 28: The Pain Whisperer (Lissanthea Taylor, Pain Management Practitioner) Chapters 00:00 - Intro 02:20 - Part 1 17:52 - Part 2 Subscribe to the PREMIUM version, see the visuals, and/or follow the full transcript for this episode at: https://mosaicofchina.com/season-03-rerelease-lissanthea-taylor Join the community: Instagram https://instagram.com/oscology LinkedIn https://www.linkedin.com/company/mosaicofchina Facebook https://facebook.com/mosaicofchina WeChat https://mosaicofchina.com/wechat
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:01):
[Intro]OF: Welcome to Mosaic of China, a podcast
about people who are making their mark inChina. I'm your host, Oscar Fuchs.
Today is the final of three re-releases fromprevious seasons. The first was with Björn
Dalhman, the Swedish Clown from Season 02,which was inspired by our reunion on the streets
(00:24):
of Shanghai on his first time back in Chinafor four years. Then last time was the one
with sea-life conservation specialist EmilyMadge, since I wanted to re-release an episode
with a Brit to coincide with my first timeback in the UK for four years. And today,
I’m re-releasing the episode with LissantheaTaylor, the Australian pain management expert
(00:50):
from Season 01 Episode 28.
The reason I’m releasing Lissanthea’soriginal episode is because of where I’ve
been since my family reunion in London. NoI haven’t been in Australia, I’ve been
on holiday in Malta and now Portugal. If youlistened to Lissanthea’s catch-up episode
(01:11):
in Season 02 - at the end of the interviewwith Seth Harvey - you will know that Lissanthea
found herself in Portugal for a year duringCOVID when she was locked out of returning
to China. Lissanthea has since returned toChina, and then moved with her Portuguese
husband to Australia. So just like with Emilyfrom last week’s re-release episode - who
(01:34):
moved from Shanghai to Thailand to Denmark- Lissanthea has also made two big international
moves since this original recording firstaired in 2020. And I mentioned that I’d
been on holiday to Portugal and Malta, andcoincidentally there’s also a connection
to Malta. I first met Lissanthea when shewas working at Parkway Health in Shanghai,
(01:59):
and I needed her help in my rehabilitationfrom surgery on my ACL. Well the person who
did that surgery was Dr. Derk Rietfeld, whohas since moved from Shanghai to Malta. So
for all these reasons, it just feels rightto be listening to Lissanthea’s voice again
today.
[Part 1]OF: I'm here today with Lissanthea Taylor,
(02:25):
and you're currently a physiotherapist atParkway Health.
LT (02:27):
I am indeed Oscar, thank you for having me.
OF (02:30):
I first got to know you when I was one of your patients.
LT (02:33):
It's a common story, it means I don't really have to have a social life, Oscar,
I mean I can just have a constant stream offabulous people that come to meet me every
day. And of course our conversations startwith a certain context.
OF (02:46):
Right. LT
best days. But yes, that is how you and Icame to be friends.
You had such an easy way of making me feel comfortable, even when I physically wasn't.
You just brought it down to a level whichwas so much more human, and I really appreciated
that. So I'm not surprised that you make alot of friends on that table.
LT (03:07):
I don't know that I could do… I don't think anyone can do the job well - especially
when you do meet people on their worst days- if you can't get to the human underneath
that. And science is important. But the humanstory, and what does this injury mean to someone?
What does this pain mean? What's this painstopping you doing? How are you not yourself,
(03:32):
because of this pain? Because they do sometimeslook at you like you have two heads, because
no-one else has asked them.OF: Right. It’s so fundamental, but there
you go. OK, well we'll get onto that in asecond. But what I want to first of all ask
you - which is what I ask every guest on Mosaicof China - is, what is the object that you've
brought in that in some way typifies yourlife here in China?
(03:53):
Well, if you have a look at my socks, which I'm kicking out from underneath the
table…OF: OK.
I have some fabulous pink socks that I'm wearing, with moustaches on them.
OF (04:05):
Oh that's what they are. LT
I thought they were slugs. LT
to me by a friend. And so they are a giftthat's given out by an organisation called
Pink Socks. And if you go to pinksocks.life,you can find out about them. And it was a
little movement started within healthcarethat talks about compassion and ‘human-centred-ness’
(04:27):
within the practice of either clinical carein healthcare administration, in healthcare
innovation. So I I think that does typifywhat I try to bring to my patients, and bring
to the experience of healthcare in a citylike Shanghai.
You know, that leads us straight into the conversation of course, because you've
(04:48):
been someone who has made pain your mission.LT: Yeah, it's an interesting way to approach
building relationships, when you come fromit from the point of “Tell me about your
pain”. You know, pain is a very difficultarea of healthcare. One in five people globally
are affected by persisting pain. That's 20%of people.
(05:12):
And what do you know - maybe even just anecdotally - about how that's dealt with
in China?LT: China is very, very interesting. You know,
you and I, if we go out in the evening, we'llsee the old ladies dancing in the street,
that are actively moving their bodies, andvarious people doing Tai Chi. And there’s
a very active idea around maintaining health.But when people get sick, there's a very passive
(05:41):
idea around pain. The 100 day rule. So ifyou have an injury, the traditional ideas
are, you must stop, you must rest, you mustgo to bed for 100 days, even after childbirth.
And we know in the West, we do lots of rehaband we get people back to doing normal life,
and moving around. And in China, you're noteven allowed to wash your hair.
(06:02):
Wow. LT
is that China is emerging as a place wherethere's a lot more elective surgery, or joint
replacements. Unfortunately, big markets likeChina end up emerging as a new profit centre.
Now the problem from a rehab perspective,is that… Say someone has a hip replacement.
(06:26):
In the West, we get them up day one postoperatively.Like, let's get moving, because we don't want
that nervous system to become sensitive. Andthat's a big part of pain. If you try and
do that in China, you will fight someone'sentire family. Because the idea is, you need
to rest. You need to not move, you need towait, that time for healing. And that means
(06:50):
that people end up severely disabled. It'sa conversation that we have with some of my
colleagues that speak Chinese, that do havethe ability to interface into the local healthcare
system, which I don't have.OF: Right. Can you learn from the Chinese
way? Or is it really only a one-way streetright now?
LT (07:11):
A lot of the problems that we have developed, I think, in the West has come from the way
that we use scans and X-rays, to tell peoplethey're very damaged, which is really more
about normal age-related changes, that willshow up on an X-ray once you're past a certain
(07:31):
age. But if you tell someone that’s there,and they believe that their back is damaged,
it actually sets up a whole cascade of differentoutputs of the brain - protective behaviours,
fear, worry, changes to normal activities- that actually becomes a really interesting
and potent breeding ground for persistingpain. What we're working on in the West now
(07:57):
then is, how do we educate people around “Theback is strong”? How do we educate people
around “These are normal changes, theseare wrinkles on the inside”. Now, it's great
we have scans and X-rays, because they dostop people dying, if there's pathology going
on. But what we do is, we pathologise thingsthat are not things that are wrong or need
(08:19):
to be fixed.OF: It's just the natural wear-and-tear of
an ageing body.LT: Of living a life. Of engaging with the
world, of doing things that are meaningfulto you. Not that you're broken in 10 different
vertebrae, and you've got all these problems.OF: The classic line is “It's just in your
mind,” right? When it comes to pain, whenit comes to pain management.
(08:41):
Yeah. When we get to talk about the science, the worst thing that we should never say is,
“Don't you know, pain is an output of yourbrain. Pain is 100% mediated and related to
your brain”. And what that does is, it shutsdown that person's ability to hear anything
else. Because what you've said to them is“What you're feeling is wrong”. We make
(09:02):
what I call ‘sensory stories’. So if myback hurts, I have to have some way of explaining
that, to myself and to others. The easiestway is usually what my doctor has told me,
that I have three bulging discs. But whatis someone's lived experience? And also what
is another, a new story, that's actually goingto enable them to do something different.
(09:27):
You have to be so careful about helping themto find themselves in a new story. You know,
pain is a little bit like depression, andeven obesity. They all have distributed areas
of the brain that cause that output. You know,so it's never just one thing. Social connections
(09:49):
have a big impact on the way that your brainmight go into that protective state. What
you think and believe; the people you hangaround with; the social messages you get about
pain; whether interest rates have gone up.All of these things that are threat to an
individual can wind up your nervous systemto produce continuing pain.
OF (10:10):
Yeah, that's fascinating. And so what is the new science then?
LT (10:15):
So what they're looking at is pushing back against René Descartes’ very early
model around stimulus and response. So ifI stick my finger in a fire - or something
that I would expect to hurt - that I get asignal from my finger, that goes up to my
brain, that alerts my brain to say “Yourtissue is damaged”. Pain means that you're
(10:41):
damaged. You know? And that's not true. Wehave danger detectors, we don't have pain
detectors. We don't have pain pathways, wehave danger pathways. So the basis of the
science is recognising that pain is an alarmsystem, more so than pain is telling you what's
(11:04):
going on in the tissue. You can be actuallyreally healthy, while you hurt. It's not uncommon
for people that have accidents and injuriesto be absolutely 100% perfectly fine, and
they might go to the site of the injury, andtheir pain comes back.
OF (11:20):
Yeah. LT
myself, which was pretty nasty. And I feellike it started when I was going to yoga.
I finally went back to yoga after a coupleyears, and I developed this pain. And I would
be absolutely fine during the day, until Iwas walking to the yoga studio. No, and I'd
been treating patients all day, I'd been doingperfectly stressful things on my body. And
(11:44):
that's when it started. And so you can't talkyourself out of pain. Absolutely not. And
again, if we’re coming back to what we needto be careful about - with people in the clinic,
giving them an idea that “Well, once youknow about pain, you can kind of…
Overcome it. LT
way out of it” - you have to experienceyour way out of it. Often I would say to someone
(12:06):
“What's something you love doing, that you'renot doing?” And they want to go back to
playing football. And they might not be ready,physically, to play football. But what you'd
start to look at is “Well, what's the contextaround football? Is it social? Is it feeling
included?” And so we would say to them “Right,let's go to football training. You might just
be running water, you might be doing something.”But putting them into something where they
(12:29):
start to feel more like themselves. You geta bit distracted. Distraction’s fabulous.
Once you know that pain is not a damage signal,you can give people the permission to distract
themselves a little bit. And then it's quiteamazing, if you then give them something meaningful
to do, if you can find something that's meaningful,that matters. And you and I both know, most
(12:52):
physio exercises are not things that feellike they matter. And that needs to be an
important transition.OF: So if you think about the general way
that it's dealt with here in China - whichis rest and an isolation, really - that’s
the opposite of what you're talking about.LT: Yeah. That's the big challenge.
You're kind of lifting the lid on how you treated me now. It will make sense. And
(13:14):
I think this is what you and I have talkedabout before. In the past, you've called this
‘Narrative Medicine’?LT: So what Narrative Medicine talks about
is the importance of learning to be a goodreader, a good listener. And we learn that
by engaging with difficult literary texts,with poems.
Oh I see, so it’s literally narrative. LT
(13:40):
does is that builds my ability to understanda difficult story. If I read Jane Eyre, I
go into someone else's life, someone else'sperspective. Because if you sit across from
me in the clinic, you might as well be tellingme a science fiction story, because I don't
live in your life. And unless I've built theskill… And it's a learned skill. Some of
(14:03):
us have a proclivity to be able to do it,but anyone can learn. To be able to sit with…
You know, healthcare stories are hard. I mean,I only deal with pain, I don't deal with cancer
diagnosis, I don't deal with palliative end-of-lifestuff. I never wanted to be a doctor, because
(14:24):
I didn't want to deal with death. But whatI find I deal with a lot of the time - in
dealing with persistent pain - is, you know,a small death of identity. So Narrative Medicine
has been a wonderful practice that now I teacha bit online. I use it in my own practice,
and it also sits behind some of my other onlineprojects.
(14:45):
And is this an expansion of what otherwise you'd call ‘bedside care'? Or you'd call
‘empathy’?LT: Yeah. Yeah, so ‘empathy’ is a really
interesting word to use. I prefer to use theword ‘receptivity’. So empathy says “I
feel what you feel”. What receptivity saysis “I can handle your story. I'm someone
(15:08):
that's safe to tell.” I'm not going to feelwhat you feel, because then if I'm going to
feel everything that every patient is goingto feel when they come into the room…
You'll be exhausted, yeah. LT
interesting.LT: But you've got to be able to not distance
yourself. Yes, my job is to prescribe someexercises, and be a physio - I do some poking
(15:29):
around at people's bodies - but really, myjob is to give a ****. I can read a book,
and it moves me. Maybe I see myself in thatbook, maybe I learn new things, I go to different
worlds. But I don't have to live there. Andthat will be the difference between empathy
and receptivity.OF: Mmm. It actually makes me think about
when I was a headhunter, and having to listento people who were sometimes in between jobs,
(15:54):
which was also a very stressful part of theirlives. But how did you get here then?
LT (15:58):
Well, I never meant to be a physio, to be honest. You know, I grew up in Australia,
I grew up on a farm. I was going to be a veterinarysurgeon, missed out by 0.2 of a mark.
OF (16:07):
Is that right? LT
But you could have re-sat that test. LT
Yeah. LT
ago, I still… For the last time, I wentand looked at it. And it wasn't me. And maybe
it wasn't me at the time, and I wouldn't havedone the life I've done. So my second choice
(16:28):
was was physical therapy. I didn't reallyknow what physios did. But I kind of liked
the idea. My third choice, which is quiteinteresting, was media and communications.
Oh, here you go. LT
a reader, a ‘words nerd’. But I endedup being a physio. And I never loved it. And
it pays the bills, but what is this? Is thisreally fulfilling me? So it made me do other
(16:52):
things. And then I finally threw my handsin the air and said “Not doing this any
more". And I had my own practice at the time,and I closed everything up. And I went and
moved to Silicon Valley. I was lucky, I hada friend there who was the CEO of a tech company.
And so I went and did a tech startup for awhile. And then I thought “Alright, time
(17:15):
to go back to Australia”. And I lasted twoweeks. And I just went “Nah. It's not time”.
And about the same time, I had a friend herewho had just started a venture capital fund
here, and needed someone to keep him company,more than anything. And that's how I got to
be here. And we have to remember, we’rereally lucky to be here. And I think it is
(17:40):
easy to forget how spoilt we really are. Weget to have the best of everything.
Thank you, Lissanthea. Let's move on to Part 2.
LT (17:50):
Shall we?
[Part 2]OF: So Part 2 is where I asked the same questions
to all of my interviewees. So why don't westart?
Go on. OF
fact?LT: I love the fact that China has one timezone.
The sun doesn't rise till 10am in 新疆 [Xīnjiāng].And I just love the ability to say “We're
(18:12):
just gonna do just one time”.OF: Do you have a favourite word or phrase
in Chinese?LT: Oh I do, I do. 差不多 [Chàbùduō].
I’ll tell you why it's my favourite phrase.OF: Yes.
So I'm Australian. So we have this great saying in Australia like “She'll be right,
mate”.OF: Right.
Which basically means “I don't really care”.
OF (18:30):
Right. LT
enough.OF: Right, right.
LT (18:34):
And to me, that's 差不多 [chàbùduō]. OF
Just doing enough. OF
within China?LT: I haven't travelled much in China. So
I have this unfortunate thing, I work on Sundays.So I don't get to go away for weekends. So
I haven't seen as much of this amazing countryas I'd like to.
OF (18:53):
Right. If you did leave China, what would you miss the most, and what would you miss
the least?LT: Right. Well, I would miss many things.
I would miss the 10pm manicure, any day theweek.
Oh right. LT
delivered. I wouldn't miss the complex algorithmof “Should you leave the house today?”
(19:16):
Which relies on the temperature, the air pollution,is it torrentially raining, and how's the
pollen? So this is specific to you and I inthe French Concession here in Shanghai, Oscar,
but we have these beautiful London plane trees,and this pollen that just… it’s like rain.
(19:36):
And you've got to live here to realise thatthe best alternative probably in that algorithm
is torrential rain. Because it gets rid ofpollution, gets rid of pollen.
And luckily for us in Shanghai, it's wet most of the year round. Yay. Well, thank you
for leaving the house, and coming to me today.Is there anything that still mystifies you
(19:59):
about life in China?LT: I think now I have to be mystified at
my own responses to things. So I'm still mystifiedwhy I can't remember that green toothpaste
tastes like tea. You know, in the West, blueor green are going to be mint. And I still
get it wrong, and I go home with jasmine teaflavoured toothpaste.
(20:19):
Very good. What's your favourite place to go out, to eat to drink or just generally
hang out?LT: So my favourite place is a cafe, it's
on 淮海路 [Huáihǎi Lù], it's calledOn Air. And it's sort of tucked away in the
back of a little lane. But you won't knowit's there.
Nice. LT
There are quite a few of those cafes that would fit that same description, so I'm glad
(20:43):
you found your own. Please take me there nexttime. What is the best or worst purchase you
have made in China?LT: The luxury of the fabric markets means
I get to go and have awful things made onimpulse. When you go, when you look at something
on a model, or you look at a picture, andyou think “Wow, I could have that made in
(21:06):
my size,” you really appreciate why fashion- and fashion models - are certain sizes and
shapes. Because wow, when you get the proportionsdifferent, like “Goodness, that wasn't good".
Oh, that's so funny. I went through a phase where I used to get a lot of things
tailored. And a lot of mistakes happened.And now I've gone back to buying off the rack,
(21:29):
a lot more. Because in you know what you'regetting, and you know what the patterns will
look like on your body, etc, etc.LT: I find, if I find one thing that fits
somewhere else, I bring it back and then Iget it made exactly the same.
Ah right. LT
Right, right. LT
That’s it. What is your favourite WeChat sticker?
LT (21:48):
My favourite WeChat sticker is Tina Fey - Liz Lemon - high-fiving herself.
OF (21:54):
Excellent. I know the one. I must use that one quite a lot as well.
LT (21:59):
It fits our similarly slightly snarky and sarcastic personalities.
OF (22:03):
Yeah, that's right. Because we think we're always right. And there's no one else who
actually believes us. So we might as welljust high-five ourselves.
LT (22:09):
What do you know, we’re not right? OF
Course we are. OF
song?LT: November Rain.
OF (22:18):
No. LT
The whole nine minutes. LT
we have to start at the start.OF: Oh man. There’s a reason why we haven't
done that together, isn't there. OK. And finally,what other China-related media or sources
of information do you rely on?LT: I look at SmartShanghai, because then
(22:39):
I know where not to go with all the otherforeigners.
Great, thank you so much Lissanthea. LT
[Intro]OF: Welcome to Mosaic of China, a podcast
about people who are making their mark inChina. I'm your host, Oscar Fuchs.
Today is the final of three re-releases fromprevious seasons. The first was with Björn
Dalhman, the Swedish Clown from Season 02,which was inspired by our reunion on the streets
(00:24):
of Shanghai on his first time back in Chinafor four years. Then last time was the one
with sea-life conservation specialist EmilyMadge, since I wanted to re-release an episode
with a Brit to coincide with my first timeback in the UK for four years. And today,
I’m re-releasing the episode with LissantheaTaylor, the Australian pain management expert
(00:50):
from Season 01 Episode 28.
The reason I’m releasing Lissanthea’soriginal episode is because of where I’ve
been since my family reunion in London. NoI haven’t been in Australia, I’ve been
on holiday in Malta and now Portugal. If youlistened to Lissanthea’s catch-up episode
(01:11):
in Season 02 - at the end of the interviewwith Seth Harvey - you will know that Lissanthea
found herself in Portugal for a year duringCOVID when she was locked out of returning
to China. Lissanthea has since returned toChina, and then moved with her Portuguese
husband to Australia. So just like with Emilyfrom last week’s re-release episode - who
(01:34):
moved from Shanghai to Thailand to Denmark- Lissanthea has also made two big international
moves since this original recording firstaired in 2020. And I mentioned that I’d
been on holiday to Portugal and Malta, andcoincidentally there’s also a connection
to Malta. I first met Lissanthea when shewas working at Parkway Health in Shanghai,
(01:59):
and I needed her help in my rehabilitationfrom surgery on my ACL. Well the person who
did that surgery was Dr. Derk Rietfeld, whohas since moved from Shanghai to Malta. So
for all these reasons, it just feels rightto be listening to Lissanthea’s voice again
today.
[Part 1]OF: I'm here today with Lissanthea Taylor,
(02:25):
and you're currently a physiotherapist atParkway Health.
LT (02:27):
I am indeed Oscar, thank you for having me.
OF (02:30):
I first got to know you when I was one of your patients.
LT (02:33):
It's a common story, it means I don't really have to have a social life, Oscar,
I mean I can just have a constant stream offabulous people that come to meet me every
day. And of course our conversations startwith a certain context.
OF (02:46):
Right. LT
best days. But yes, that is how you and Icame to be friends.
You had such an easy way of making me feel comfortable, even when I physically wasn't.
You just brought it down to a level whichwas so much more human, and I really appreciated
that. So I'm not surprised that you make alot of friends on that table.
LT (03:07):
I don't know that I could do… I don't think anyone can do the job well - especially
when you do meet people on their worst days- if you can't get to the human underneath
that. And science is important. But the humanstory, and what does this injury mean to someone?
What does this pain mean? What's this painstopping you doing? How are you not yourself,
(03:32):
because of this pain? Because they do sometimeslook at you like you have two heads, because
no-one else has asked them.OF: Right. It’s so fundamental, but there
you go. OK, well we'll get onto that in asecond. But what I want to first of all ask
you - which is what I ask every guest on Mosaicof China - is, what is the object that you've
brought in that in some way typifies yourlife here in China?
(03:53):
Well, if you have a look at my socks, which I'm kicking out from underneath the
table…OF: OK.
I have some fabulous pink socks that I'm wearing, with moustaches on them.
OF (04:05):
Oh that's what they are. LT
I thought they were slugs. LT
to me by a friend. And so they are a giftthat's given out by an organisation called
Pink Socks. And if you go to pinksocks.life,you can find out about them. And it was a
little movement started within healthcarethat talks about compassion and ‘human-centred-ness’
(04:27):
within the practice of either clinical carein healthcare administration, in healthcare
innovation. So I I think that does typifywhat I try to bring to my patients, and bring
to the experience of healthcare in a citylike Shanghai.
You know, that leads us straight into the conversation of course, because you've
(04:48):
been someone who has made pain your mission.LT: Yeah, it's an interesting way to approach
building relationships, when you come fromit from the point of “Tell me about your
pain”. You know, pain is a very difficultarea of healthcare. One in five people globally
are affected by persisting pain. That's 20%of people.
(05:12):
And what do you know - maybe even just anecdotally - about how that's dealt with
in China?LT: China is very, very interesting. You know,
you and I, if we go out in the evening, we'llsee the old ladies dancing in the street,
that are actively moving their bodies, andvarious people doing Tai Chi. And there’s
a very active idea around maintaining health.But when people get sick, there's a very passive
(05:41):
idea around pain. The 100 day rule. So ifyou have an injury, the traditional ideas
are, you must stop, you must rest, you mustgo to bed for 100 days, even after childbirth.
And we know in the West, we do lots of rehaband we get people back to doing normal life,
and moving around. And in China, you're noteven allowed to wash your hair.
(06:02):
Wow. LT
is that China is emerging as a place wherethere's a lot more elective surgery, or joint
replacements. Unfortunately, big markets likeChina end up emerging as a new profit centre.
Now the problem from a rehab perspective,is that… Say someone has a hip replacement.
(06:26):
In the West, we get them up day one postoperatively.Like, let's get moving, because we don't want
that nervous system to become sensitive. Andthat's a big part of pain. If you try and
do that in China, you will fight someone'sentire family. Because the idea is, you need
to rest. You need to not move, you need towait, that time for healing. And that means
(06:50):
that people end up severely disabled. It'sa conversation that we have with some of my
colleagues that speak Chinese, that do havethe ability to interface into the local healthcare
system, which I don't have.OF: Right. Can you learn from the Chinese
way? Or is it really only a one-way streetright now?
LT (07:11):
A lot of the problems that we have developed, I think, in the West has come from the way
that we use scans and X-rays, to tell peoplethey're very damaged, which is really more
about normal age-related changes, that willshow up on an X-ray once you're past a certain
(07:31):
age. But if you tell someone that’s there,and they believe that their back is damaged,
it actually sets up a whole cascade of differentoutputs of the brain - protective behaviours,
fear, worry, changes to normal activities- that actually becomes a really interesting
and potent breeding ground for persistingpain. What we're working on in the West now
(07:57):
then is, how do we educate people around “Theback is strong”? How do we educate people
around “These are normal changes, theseare wrinkles on the inside”. Now, it's great
we have scans and X-rays, because they dostop people dying, if there's pathology going
on. But what we do is, we pathologise thingsthat are not things that are wrong or need
(08:19):
to be fixed.OF: It's just the natural wear-and-tear of
an ageing body.LT: Of living a life. Of engaging with the
world, of doing things that are meaningfulto you. Not that you're broken in 10 different
vertebrae, and you've got all these problems.OF: The classic line is “It's just in your
mind,” right? When it comes to pain, whenit comes to pain management.
(08:41):
Yeah. When we get to talk about the science, the worst thing that we should never say is,
“Don't you know, pain is an output of yourbrain. Pain is 100% mediated and related to
your brain”. And what that does is, it shutsdown that person's ability to hear anything
else. Because what you've said to them is“What you're feeling is wrong”. We make
(09:02):
what I call ‘sensory stories’. So if myback hurts, I have to have some way of explaining
that, to myself and to others. The easiestway is usually what my doctor has told me,
that I have three bulging discs. But whatis someone's lived experience? And also what
is another, a new story, that's actually goingto enable them to do something different.
(09:27):
You have to be so careful about helping themto find themselves in a new story. You know,
pain is a little bit like depression, andeven obesity. They all have distributed areas
of the brain that cause that output. You know,so it's never just one thing. Social connections
(09:49):
have a big impact on the way that your brainmight go into that protective state. What
you think and believe; the people you hangaround with; the social messages you get about
pain; whether interest rates have gone up.All of these things that are threat to an
individual can wind up your nervous systemto produce continuing pain.
OF (10:10):
Yeah, that's fascinating. And so what is the new science then?
LT (10:15):
So what they're looking at is pushing back against René Descartes’ very early
model around stimulus and response. So ifI stick my finger in a fire - or something
that I would expect to hurt - that I get asignal from my finger, that goes up to my
brain, that alerts my brain to say “Yourtissue is damaged”. Pain means that you're
(10:41):
damaged. You know? And that's not true. Wehave danger detectors, we don't have pain
detectors. We don't have pain pathways, wehave danger pathways. So the basis of the
science is recognising that pain is an alarmsystem, more so than pain is telling you what's
(11:04):
going on in the tissue. You can be actuallyreally healthy, while you hurt. It's not uncommon
for people that have accidents and injuriesto be absolutely 100% perfectly fine, and
they might go to the site of the injury, andtheir pain comes back.
OF (11:20):
Yeah. LT
myself, which was pretty nasty. And I feellike it started when I was going to yoga.
I finally went back to yoga after a coupleyears, and I developed this pain. And I would
be absolutely fine during the day, until Iwas walking to the yoga studio. No, and I'd
been treating patients all day, I'd been doingperfectly stressful things on my body. And
(11:44):
that's when it started. And so you can't talkyourself out of pain. Absolutely not. And
again, if we’re coming back to what we needto be careful about - with people in the clinic,
giving them an idea that “Well, once youknow about pain, you can kind of…
Overcome it. LT
way out of it” - you have to experienceyour way out of it. Often I would say to someone
(12:06):
“What's something you love doing, that you'renot doing?” And they want to go back to
playing football. And they might not be ready,physically, to play football. But what you'd
start to look at is “Well, what's the contextaround football? Is it social? Is it feeling
included?” And so we would say to them “Right,let's go to football training. You might just
be running water, you might be doing something.”But putting them into something where they
(12:29):
start to feel more like themselves. You geta bit distracted. Distraction’s fabulous.
Once you know that pain is not a damage signal,you can give people the permission to distract
themselves a little bit. And then it's quiteamazing, if you then give them something meaningful
to do, if you can find something that's meaningful,that matters. And you and I both know, most
(12:52):
physio exercises are not things that feellike they matter. And that needs to be an
important transition.OF: So if you think about the general way
that it's dealt with here in China - whichis rest and an isolation, really - that’s
the opposite of what you're talking about.LT: Yeah. That's the big challenge.
You're kind of lifting the lid on how you treated me now. It will make sense. And
(13:14):
I think this is what you and I have talkedabout before. In the past, you've called this
‘Narrative Medicine’?LT: So what Narrative Medicine talks about
is the importance of learning to be a goodreader, a good listener. And we learn that
by engaging with difficult literary texts,with poems.
Oh I see, so it’s literally narrative. LT
(13:40):
does is that builds my ability to understanda difficult story. If I read Jane Eyre, I
go into someone else's life, someone else'sperspective. Because if you sit across from
me in the clinic, you might as well be tellingme a science fiction story, because I don't
live in your life. And unless I've built theskill… And it's a learned skill. Some of
(14:03):
us have a proclivity to be able to do it,but anyone can learn. To be able to sit with…
You know, healthcare stories are hard. I mean,I only deal with pain, I don't deal with cancer
diagnosis, I don't deal with palliative end-of-lifestuff. I never wanted to be a doctor, because
(14:24):
I didn't want to deal with death. But whatI find I deal with a lot of the time - in
dealing with persistent pain - is, you know,a small death of identity. So Narrative Medicine
has been a wonderful practice that now I teacha bit online. I use it in my own practice,
and it also sits behind some of my other onlineprojects.
(14:45):
And is this an expansion of what otherwise you'd call ‘bedside care'? Or you'd call
‘empathy’?LT: Yeah. Yeah, so ‘empathy’ is a really
interesting word to use. I prefer to use theword ‘receptivity’. So empathy says “I
feel what you feel”. What receptivity saysis “I can handle your story. I'm someone
(15:08):
that's safe to tell.” I'm not going to feelwhat you feel, because then if I'm going to
feel everything that every patient is goingto feel when they come into the room…
You'll be exhausted, yeah. LT
interesting.LT: But you've got to be able to not distance
yourself. Yes, my job is to prescribe someexercises, and be a physio - I do some poking
(15:29):
around at people's bodies - but really, myjob is to give a ****. I can read a book,
and it moves me. Maybe I see myself in thatbook, maybe I learn new things, I go to different
worlds. But I don't have to live there. Andthat will be the difference between empathy
and receptivity.OF: Mmm. It actually makes me think about
when I was a headhunter, and having to listento people who were sometimes in between jobs,
(15:54):
which was also a very stressful part of theirlives. But how did you get here then?
LT (15:58):
Well, I never meant to be a physio, to be honest. You know, I grew up in Australia,
I grew up on a farm. I was going to be a veterinarysurgeon, missed out by 0.2 of a mark.
OF (16:07):
Is that right? LT
But you could have re-sat that test. LT
Yeah. LT
ago, I still… For the last time, I wentand looked at it. And it wasn't me. And maybe
it wasn't me at the time, and I wouldn't havedone the life I've done. So my second choice
(16:28):
was was physical therapy. I didn't reallyknow what physios did. But I kind of liked
the idea. My third choice, which is quiteinteresting, was media and communications.
Oh, here you go. LT
a reader, a ‘words nerd’. But I endedup being a physio. And I never loved it. And
it pays the bills, but what is this? Is thisreally fulfilling me? So it made me do other
(16:52):
things. And then I finally threw my handsin the air and said “Not doing this any
more". And I had my own practice at the time,and I closed everything up. And I went and
moved to Silicon Valley. I was lucky, I hada friend there who was the CEO of a tech company.
And so I went and did a tech startup for awhile. And then I thought “Alright, time
(17:15):
to go back to Australia”. And I lasted twoweeks. And I just went “Nah. It's not time”.
And about the same time, I had a friend herewho had just started a venture capital fund
here, and needed someone to keep him company,more than anything. And that's how I got to
be here. And we have to remember, we’rereally lucky to be here. And I think it is
(17:40):
easy to forget how spoilt we really are. Weget to have the best of everything.
Thank you, Lissanthea. Let's move on to Part 2.
LT (17:50):
Shall we?
[Part 2]OF: So Part 2 is where I asked the same questions
to all of my interviewees. So why don't westart?
Go on. OF
fact?LT: I love the fact that China has one timezone.
The sun doesn't rise till 10am in 新疆 [Xīnjiāng].And I just love the ability to say “We're
(18:12):
just gonna do just one time”.OF: Do you have a favourite word or phrase
in Chinese?LT: Oh I do, I do. 差不多 [Chàbùduō].
I’ll tell you why it's my favourite phrase.OF: Yes.
So I'm Australian. So we have this great saying in Australia like “She'll be right,
mate”.OF: Right.
Which basically means “I don't really care”.
OF (18:30):
Right. LT
enough.OF: Right, right.
LT (18:34):
And to me, that's 差不多 [chàbùduō]. OF
Just doing enough. OF
within China?LT: I haven't travelled much in China. So
I have this unfortunate thing, I work on Sundays.So I don't get to go away for weekends. So
I haven't seen as much of this amazing countryas I'd like to.
OF (18:53):
Right. If you did leave China, what would you miss the most, and what would you miss
the least?LT: Right. Well, I would miss many things.
I would miss the 10pm manicure, any day theweek.
Oh right. LT
delivered. I wouldn't miss the complex algorithmof “Should you leave the house today?”
(19:16):
Which relies on the temperature, the air pollution,is it torrentially raining, and how's the
pollen? So this is specific to you and I inthe French Concession here in Shanghai, Oscar,
but we have these beautiful London plane trees,and this pollen that just… it’s like rain.
(19:36):
And you've got to live here to realise thatthe best alternative probably in that algorithm
is torrential rain. Because it gets rid ofpollution, gets rid of pollen.
And luckily for us in Shanghai, it's wet most of the year round. Yay. Well, thank you
for leaving the house, and coming to me today.Is there anything that still mystifies you
(19:59):
about life in China?LT: I think now I have to be mystified at
my own responses to things. So I'm still mystifiedwhy I can't remember that green toothpaste
tastes like tea. You know, in the West, blueor green are going to be mint. And I still
get it wrong, and I go home with jasmine teaflavoured toothpaste.
(20:19):
Very good. What's your favourite place to go out, to eat to drink or just generally
hang out?LT: So my favourite place is a cafe, it's
on 淮海路 [Huáihǎi Lù], it's calledOn Air. And it's sort of tucked away in the
back of a little lane. But you won't knowit's there.
Nice. LT
There are quite a few of those cafes that would fit that same description, so I'm glad
(20:43):
you found your own. Please take me there nexttime. What is the best or worst purchase you
have made in China?LT: The luxury of the fabric markets means
I get to go and have awful things made onimpulse. When you go, when you look at something
on a model, or you look at a picture, andyou think “Wow, I could have that made in
(21:06):
my size,” you really appreciate why fashion- and fashion models - are certain sizes and
shapes. Because wow, when you get the proportionsdifferent, like “Goodness, that wasn't good".
Oh, that's so funny. I went through a phase where I used to get a lot of things
tailored. And a lot of mistakes happened.And now I've gone back to buying off the rack,
(21:29):
a lot more. Because in you know what you'regetting, and you know what the patterns will
look like on your body, etc, etc.LT: I find, if I find one thing that fits
somewhere else, I bring it back and then Iget it made exactly the same.
Ah right. LT
Right, right. LT
That’s it. What is your favourite WeChat sticker?
LT (21:48):
My favourite WeChat sticker is Tina Fey - Liz Lemon - high-fiving herself.
OF (21:54):
Excellent. I know the one. I must use that one quite a lot as well.
LT (21:59):
It fits our similarly slightly snarky and sarcastic personalities.
OF (22:03):
Yeah, that's right. Because we think we're always right. And there's no one else who
actually believes us. So we might as welljust high-five ourselves.
LT (22:09):
What do you know, we’re not right? OF
Course we are. OF
song?LT: November Rain.
OF (22:18):
No. LT
The whole nine minutes. LT
we have to start at the start.OF: Oh man. There’s a reason why we haven't
done that together, isn't there. OK. And finally,what other China-related media or sources
of information do you rely on?LT: I look at SmartShanghai, because then
(22:39):
I know where not to go with all the otherforeigners.
Great, thank you so much Lissanthea. LT
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