Background: Longevity of Nations

1. Longevity of DoctorsProfessor M Al-Fallouji, PhD, FRCS, FRCSIWe care for patients, but who care for Carers?

2. Longevity of DoctorsBut 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?” Surat Ta Ha 20 Verse 120 (فوسوس إليه الشيطان قال يا آدم هل أدُلّك على شجرة الخُلد ومُلك لا يبلى)طه 120

3. Epic of GilgamishANET / | | \Ancient Near Eastern Texts

4. Background: Longevity of Nations

5. 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

6. Methods: Longevity of DoctorsRetrospective 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)

7. Results: Longevity of Doctors

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

9. Timing of Retirement (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

10. Nationality • British Doctors Mean Survival 75.8 y • Irish Doctors Mean Survival 74.6 y • other Anglo-Saxons Survival 73.5 y

11. 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

12. 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.

13. 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)

14. 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

15. Feminization of Nature

16. Other Influencing Factors • Smoking and/or Alcoholism • Faith • Wife • Diet • Management Style • Charity (Sadakah and Zakat) • Strengthening Ties of kin (silat al-rah’m)

17. 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%

18. Distribution of 53 Cancers

19. Patterns of Death

20. Recommendations 1. Balance your Life 2. De-stress yourself Regularly 3. Have an Agenda for Life

21. 1. Balance Your Life 1. 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!!!

22. 2. De-Stress Yourself Regularly 1. 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

23. 3. Have an Agenda for Life Daily Weekly Monthly Quarterly Yearly

24. Daily Anti-Cancer Diet • Onions Family • Brassicas Family • Green Vegetables • Yellow Vegetables (Selenium and Anti-Oxidants)

25. Daily ExerciseUse Stairs instead of Lifts

26. 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

27. Daily/Weekly Agenda1.Use Olive Oil for dressing and/or cooking 2. Eat Honey and Royal Jelly3. Eat Dates

28. Monthly Sex (at least once monthly) OR Heavy Physical Exercise (Gym/Swim)

29. Quarterly Holiday

30. Yearly Health Check (Prostate/Cervix) AND Maintain Normal Body Mass Index (BMI)

31. 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

32. 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.

33. Secrets of Longevity for Doctors . Joys of Life are Five: • American Money • British House • Mediterranean/Chinese Food, • Japanese wife, • French Lover (NOT allowed)

34. 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)