Longevity of DoctorsProfessor M Al-Fallouji, PhD, FRCS, FRCSI

We care for patients, but who care for Carers?

Longevity of Doctors

But Satan whispered evil to him: he said, “O Adam! Shall I lead theeBut Satan whispered evil to him: he said, “O Adam! Shall I lead thee to the Tree of Eternity and to a kingdom that never decays?” to the Tree of Eternity and to a kingdom that never decays?”

Surat Ta Ha 20 Verse 120على ) ) أُد�ّل�ك هل آُدم يا قال اّلشيطان إّليه على فوسوس أُد�ّل�ك هل آُدم يا قال اّلشيطان إّليه فوسوس

يبلى ال وُم�لك لد اّلُخ� يبلى شجرة ال وُم�لك لد اّلُخ� ((شجرة

120 طه

Epic of Gilgamish

ANET / | | \ Ancient Near Eastern TextsAncient Near Eastern Texts

Background: Longevity of Nations

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JapanChinaUSAUKIndiaCentral AfricaArabia

Background: Longevity of Doctors

• Doctors’ Longevity:• Greater than General Population

• Stressed Doctors’ Suicide Rate:• higher than General Population• higher than other Academic Occupations• In USA, annual 93 premature doctor deaths

under 40 mainly due to suicide• Smoking doctors over 40 die 3X (45-64) and

2X (65-84) than non smokers• Smoking higher in ethnic groups

Methods: Longevity of Doctors

Retrospective study of 2013 dead doctors (279 dead surgeons) retrieved from the

consecutive obituaries of BMJ over a period of 5 year (Feb 1992 - Jan 1997)

Results: Longevity of DoctorsMean Survival of Doctors in Various

Specialties

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Longevity of Surgical Specialtiesmean survival=75.5 years n=279 SD 12.5

50525456586062646668707274767880

ENT Surgeons

Ophthamologists

General Surgeons

Dental/Faciomaxillary

Orthopaedics

Accident/Emergency

Timing of Retirement Timing of Retirement (279 surgeons)(279 surgeons)

• 52 (19%) died in post (Mean Survival 54 y)

• 21 retired before 65 (M late Survival 14.5 y)

• 22 continued work beyond 65 - (M late Survival 9.1 y)

• 184 retired at 65 (M late Survival 15.5 y)

• Working to 65 is Therapeutic (if stress controlled)

• Early retirement does not prolong the survival

Nationality

• British Doctors Mean Survival 75.8 y

• Irish Doctors Mean Survival 74.6 y

• other Anglo-Saxons Survival 73.5 y

Academic Interests

• Those with academic interests lived slightly longer than those without, with a Mean Survival of 76.2 y and 74.7 y respectively

Outside Activities

• Those with Dynamic activities (sports, travel, gardening) may live longer than those with Sedentary activities (reading literature, listening to music, playing piano), with survivals of 75.8 and 74.1 respectively.

Place of Work

• Contrary to expectation, those working in the cities survived longer (mean 72 y), followed by countryside doctors (71.7 y), and by the sea-side doctors (70.4 y)

Sexual Activity

• Mortality 50% lower in those with higher frequency of orgasm (twice a week or more) than low frequency (less than once a month)

• Celibates (priests and nuns) have lower mortality rate than general population

• Emperor Ching of China / Prophets lives

Feminization of Nature

Other Influencing Factors

• Smoking and/or Alcoholism

• Faith

• Wife

• Diet

• Management Style

• Charity (Sadakah and Zakat)

• Strengthening Ties of kin (silat al-rah’m)

Causes of Death in 153 Surgeons

• Cancer 44%• I H D 23%• Stroke 11%• Chronic Illness 9%• Pulmonary Disease 4%• Accidents 4%• Infections 3%• Ruptured AAA 2%• Suicide 1%

Distribution of 53 Cancers

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bladder/prostatepancreaticcolorectallymphomasleukaemialungmyelomaoesophagealgastrickidneyhepaticnasopharyngealsarcoma

Patterns of Death

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1st Peak(19%)

2nd Peak(81%)

Recommendations1. Balance your Life

2. De-stress yourself Regularly

3. Have an Agenda for Life

1. Balance Your Life1. Home sweet Home: Never make your home an

extension of office, don’t carry briefcase.

2. Maximize privacy (Ex-Directory Telephone)

3. Cultivate friends from outside Hospital.

4. Do not live over the shop!!!

2. De-Stress Yourself Regularly1. Strong Faith

2. Caring Partner

3. Spoil yourself like a child

4. Time management at work only

5. There is always another life

to enjoy beyond the Hospital.

6. Work to live, But

Do not live to work

3. Have an Agenda for Life

Daily

Weekly

Monthly

Quarterly

Yearly

Daily Anti-Cancer Diet

• Onions Family

• Brassicas Family

• Green Vegetables

• Yellow Vegetables (Selenium and Anti-Oxidants)

Daily Exercise

Use Stairs instead of Lifts

Weekly Fish: Essential Fatty Acids• Omega-3 (EPA) is the one. • Omega-6 (GLA)

• Oily (smelly) Fish (100 gm): • Sardines 2.5 gm• Mackerel 2.5 gm• Pilchards 2.5 gm• Sprats 2.5 gm • Huss (Rock Salmon) 2 gm• Salmon (canned) 1.8 gm• Herring 1.6 gm

Daily/Weekly Agenda

1.Use Olive Oil for dressing and/or cooking

2. Eat Honey and Royal Jelly

3. Eat Dates

Monthly

Sex (at least once monthly)

OR

Heavy Physical Exercise (Gym/Swim)

Quarterly

Holiday

Yearly

Health Check (Prostate/Cervix)

AND

Maintain Normal Body Mass Index (BMI)

Secrets of LongevitySuccess different from Happiness

• [Here lies the Great Mr John Smith….He was a Great Man and most Dynamic Chief Executive of the most famous Company ‘Enron’. He divorced his wife and disowned his kids!!!!!…... His managerial style was to continuously downsize his staff and abusing his subordinates. He always fires but never hires!!! Please Piss at his his Grave]!!!!!!!!!!!!!!!!!!!!!

• • Complete Book of Epitaphs

Secrets of Longevity for Doctors Secrets of Longevity for Doctors • To love and to be loved [daily dose of hugs and

kisses, if you get older you need a double-dose]

• Do not recycle ‘Negative Past’

• Be a Gentleman with a silver sweet tongue: Honey attracts more flies than vinegar - This guarantees that no one will piss at your grave!

• Quality of life rather than quantity of years.

Secrets of Longevity for Doctors Secrets of Longevity for Doctors

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Joys of Life are Five:– American Money– British House– Mediterranean/Chinese

Food,– Japanese wife, – French Lover (NOT allowed)

Secrets of Longevity for Doctors Secrets of Longevity for Doctors

Joys of Heaven are in Seven:– American Money– British House– Mediterranean Food,– Iraqi wife, – German Car– Japanese Computer– Mobile Phone (iPhone & Samsung)