What you can learn about stress management from an ICU doctor

From keeping a journal to experimenting with meditation, these are the ways to stay grounded amid the chaos. Photo / Getty Images

Welsh medic Dr Matt Morgan, 42, is an intensive care consultant at Royal Perth Hospital in Australia. He shares his tips on how he manages his stress.

Don’t drink coffee after 2pm

I usually just have a big glass of water and a strong coffee in the morning, then a snack mid-morning. Having coffee then not only wakes up my mind, but also stops me eating too many calories at the start of the day. But I can’t go too mad. I did a genetic test a couple of years ago which showed I’m a very slow caffeine metaboliser; it affects me for a long time afterwards. So I can’t drink it after 2pm.

I try to eat some fruit in the morning. Some studies have found that high levels of vitamin C can help reduce stress. Papaya, berries and bananas top up magnesium that is easily depleted with stress.

Remember the things that go well

My work can be super stressful. If I don’t make a decision in seconds somebody may die. Working with those at the brink of life puts the focus on what’s important, and makes you quite stoical. Looking at the worst that can happen makes getting a flat tyre or an unexpected bill feel not as bad.

A lot has been said about doctors burning out, but I’m a big believer in the concept of “burning in” – realising the worth that your role brings to those who are critically ill, as well as to their families. I’ve kept in touch with people, so I’m lucky that I can see the good stuff when it’s there. There’s a danger in medicine of becoming nihilistic, you remember the sad things, not the things that go well. Having this kind of follow-up combats nihilism and shows you that there is worth.

After a difficult day write things down

You have to have a friend or family member to talk to – call it a “failure friend” – when something’s gone wrong, or you have a rubbish day. Everybody needs that person who they can talk to without judgment, and I’m lucky to have a number of those, not only family but also colleagues and friends.

Writing helps. After a difficult day, I write things down. I have a regular column in the BMJ (British Medical Journal) which is cathartic. I keep a notebook of impactful things patients say. One is: “You’re not your worst mistake”. Often we see people in ICU after the worst mistake of their life. For instance, I once cared for a patient who’d been severely injured in a huge meth-lab explosion because he was a dealer. It’s important to remember you’re not your worst mistake, you’re much more than that.

Matt Morgan has strategies in place to stop himself from burning out. Photo / Supplied

Always sit down to eat

Lunch is generally a salad or sandwich. I’ve been mostly vegetarian since writing my book, One Medicine; it felt weird to write about how amazing animals are and then to eat them. My favourite sandwich is a Turkish flatbread with some roasted vegetables. If it’s salad, it will be some leaves, maybe cottage cheese, sweet potatoes, nuts and seeds. Leafy greens contain nutrients that neutralise harmful molecules your body produces when you’re under stress. Seeds and nuts contain B vitamins, which are also important.

There are crazy busy days where I eat whatever I can get my hands on – chips, crisps or chocolate – but a good friend of mine once told me “no matter how busy you are, always make sure you sit down and eat your lunch at a table – with a knife and fork. Like a human being.” Having a salad at least forces you to use a knife and a fork.

Switch off properly at home

I work shifts, including at weekends and on holidays. Today I’m working at night, and before I leave I’ll have lunch with my daughters, who are 11 and 13. I want to see them, and my wife, and do all the normal things.

During night shifts I finish at midnight, but then I’m on call from home with a phone next to the bed that could call me back to the hospital. I really struggle to sleep then. Shift work can make it hard to get enough sleep, and there’s lots of research linking it to weight gain and health problems like heart disease. I try to counter the effects by walking around during any breaks or exercising before work. When I’m home, I don’t have work-email. My phone flips onto a schedule, turning itself off at eight o’clock at night and only letting family and friends through.

Exercise the mind with meditation. Photo / 123rf

Experiment with meditation

I need eight hours of sleep otherwise I’m no good, and I won’t have phones in the bedroom other than when I’m on call. I also use earplugs and an eye mask.

I’ve experimented with a few meditation apps, such as Sam Harris’ Waking Up. I also went to a flotation tank a couple of weeks ago, which is sensory deprivation for an hour.

I struggle for consistency because life is not consistent, but I do feel better when I’ve spent 10 minutes in the morning or evening doing some meditation.