Angus Pringle: And this is the thing, if you’ve ever got someone who is suffering, that’s a mental distress. Even [00:00:05] if you don’t know who they are, it’s just, listen, we spent the time, we spent 30 [00:00:10] or 40 minutes and she could tell me about her journey, [00:00:15] what she’s been through, how she felt worthless and hopeless. There’s [00:00:20] nothing I can say to make it feel better. But the fact is we were there to [00:00:25] listen. And I think that’s something we can all do. We don’t know. Don’t have to give solutions. [00:00:30] And then we followed up with the person. Um, [00:00:35] two days later, I phoned them up and chatted to it, and they were just very grateful. [00:00:40] The fact that we spent the time. I mean, you.

Payman Langroudi: Said yourself something as simple as tomorrow might be different. [00:00:45]

Angus Pringle: Yeah, tomorrow might feel better. You might.

Payman Langroudi: Feel better. Change the way you think about you [00:00:50] thought about your own mental health. Something as simple as that.

[VOICE]: This [00:01:00] is mind movers moving [00:01:05] the conversation forward on mental health and optimisation for dental professionals. [00:01:10] Your hosts Rhona Eskander and Payman [00:01:15] Langroudi.

Payman Langroudi: It gives me great pleasure to welcome [00:01:20] Angus Pringle onto Mind Movers. Angus is a specialist orthodontist [00:01:25] who became a consultant orthodontist and is now working [00:01:30] in a specialist dental practice where six dental specialists. One of the top practices [00:01:35] around Angus has an interest in suicide and [00:01:40] mental health, particularly as it pertains to dentists and to [00:01:45] others. And wearing a jersey from your [00:01:50] cycling. Just what the jersey is. Welcome, welcome. Yeah, thank you very much.

Angus Pringle: And I really appreciate [00:01:55] being invited on to this because it’s such an important issue for all of us, not only [00:02:00] in dentistry but in the general population. So my friend and I just recently [00:02:05] completed our cycle challenge in Belgium called the Flandrian Challenge, and it was to raise awareness [00:02:10] of suicide prevention. And the reason we chose the challenge was it’s [00:02:15] not a race. Just like our mental health isn’t a race. There’s no end point. But it [00:02:20] was an attritional ride where we’re having to ride over cobbles and I’ve [00:02:25] never ridden on cobbles. Neither is my friend. And on day one, after the first set [00:02:30] of cobbles we rolled on, we were shocked how difficult it was and it was an [00:02:35] all encompassing mental battle to keep going. [00:02:40] And that’s like someone who might be struggling with their thoughts, particularly suicidal thoughts. So [00:02:45] we documented our journey on social media, talking through the wellbeing [00:02:50] that we can use to get through these difficult times. And we both had difficult times [00:02:55] with our mental health and those three days. As we were going through, [00:03:00] we had horrendous weather. It was wet. I broke my back wheel, I [00:03:05] got punctures, I had times that this was the last place in the world I wanted to be. [00:03:10] Um, but we were talking about two charities that were really close to my heart, which [00:03:15] is the baton of Hope and the Baton of Hope’s relatively new charities focussed [00:03:20] on suicide prevention. And I took part in the tour last year [00:03:25] in London, where we were walking through London with the baton, [00:03:30] and we’re talking to the general public raising awareness of suicide prevention, and it was [00:03:35] an incredibly powerful and emotional thing for me to do, because I was doing [00:03:40] it on behalf of my brother, who had sadly lost to suicide and had taken a long [00:03:45] time for me to be able to stand up and say, look, we need to do something about it.

Angus Pringle: I want to talk [00:03:50] about it. I want to share our journey and the things that we’ve learned. But [00:03:55] most importantly, show that there’s recovery and that there’s hope. Um, [00:04:00] the other charity that I’m deeply passionate about is the Kanwar Trust, [00:04:05] which isn’t that well known, possibly down in England, but is based in Scotland. [00:04:10] Um, and it’s a dear friend of mine, John Gibson. Tragically, [00:04:15] his son died by suicide. And John Gibson is a professor of oral [00:04:20] medicine who happened to teach me when I was at Glasgow Dental School. And [00:04:25] John’s son was a vet. Um, he had no mental health conditions [00:04:30] and all that John and the family knew was a knock on the door from the police. [00:04:35] And, um, subsequent to that, it was had a devastating effect on their lives [00:04:40] and everything they’ve been through. They then went on [00:04:45] to form the Kanwar Trust. And the point of the Kanwar Trust is creating [00:04:50] safe spaces for lives impacted by suicide. And they’re deeply involved [00:04:55] with dentists, medics and vets because they’ve got a higher [00:05:00] risk of suicide compared to the general population.

Angus Pringle: And I was recently speaking with John [00:05:05] and he they’re involved with supporting people, going through the fitness to practice at the GDC, [00:05:10] which is obviously very important. And there’s a lot [00:05:15] of things that we need to talk about and really move forward with our compassion [00:05:20] when it comes to regulation, not only in dentistry, but medicine and veterinary [00:05:25] surgery. Um, but they also do something that’s incredibly unique [00:05:30] and something that we never have to. We lost my brother Andy, which is Postvention, [00:05:35] which is support to families and individuals who have been bereaved [00:05:40] by suicide because one of the tragic things, when you lose someone to suicide, it’s [00:05:45] very isolating. I didn’t really know anyone who’s ever died by suicide. [00:05:50] I never thought it was going to happen to me. That’s probably where the stigma comes from. [00:05:55] Somehow I thought that we were immune. We were a good family, in inverted commas. [00:06:00] Um, and in that devastation, you know, life changes. It’s never [00:06:05] the same again. But how do you find purpose? And we’ve [00:06:10] had so many impactful conversations, John and I. And I’ve [00:06:15] got purpose certainly in my family and my work. But there was kind of that itch. My [00:06:20] purpose really outwith that protected environment is really discussing [00:06:25] mental health, breaking the taboos, breaking the stigmas, but [00:06:30] also really looking at suicide prevention. It’s such an important thing. We can’t keep [00:06:35] losing our men and women to something where the researchers [00:06:40] will say is preventable. And unless we talk about it, we [00:06:45] can’t stop losing people.

Rhona Eskander: Thank you so much for sharing that. Honestly, you’ve moved [00:06:50] me so much. The whole reason why I started Mind Movers was to open up the conversations. [00:06:55] I think Payman thought I was a little bit crazy a few years ago, and he said, you know, I don’t think anyone wants to be heavy [00:07:00] right now. And then obviously mental health was something that was, I don’t want to use the word trending, [00:07:05] but I think people were opening up to the conversation. Healthcare professionals definitely [00:07:10] feel that it is their duty to show some kind of self-preservation. [00:07:15] I think maybe because we view ourselves as healers in society. So to show vulnerability [00:07:20] is to show weakness. But I would argue and say that to show vulnerability is actually a superpower. [00:07:25] And the more that I’ve opened up the conversations, not only do I feel better, but [00:07:30] I also feel connected to a wider community. So I’m really grateful there are [00:07:35] people like you out there and someone that’s been able to come onto this podcast. I [00:07:40] want to know, though, how old were you when the event actually happened [00:07:45] to your family and yourself?

Angus Pringle: Gosh. So I lost my brother in 2005, [00:07:50] which was that 19 years ago. Okay. And it feels actually like yesterday. And [00:07:55] it just happened to be it was Andy’s birthday on the 10th of September. So [00:08:00] there’s a couple of days ago, which also now is World Suicide Prevention Day. [00:08:05] Wow. And that has it’s got so many mixed emotions, you know, in some way [00:08:10] it’s ironic and cruel, but I’ve started to think it’s actually quite motivating. [00:08:15] You know what is Andrew’s legacy is like we don’t want someone to be [00:08:20] in the position where they feel they need to take their life. And I don’t want people to, [00:08:25] um, uh, have that loss, that [00:08:30] tragic devastation. Um, and after [00:08:35] we lost Andy, you know, I certainly would talk to people and say, you know, Andrew died by [00:08:40] suicide. And for a while, uh, that was fine, but [00:08:45] quite quickly, unfortunately, we quite quickly realised the stigma [00:08:50] surrounding it and there was quite a lot of negativity and not very nice [00:08:55] comments that were being made, and for actually a very long.

Rhona Eskander: Period of the 80s then.

Angus Pringle: No, this [00:09:00] was 2005, 2005. Okay. Yeah, yeah. Uh, and we are kind [00:09:05] of in a slightly more modern time now, but still the thing it’s it’s the people that [00:09:10] you might speak to and actually having the right people around you. And for a very long period of time, [00:09:15] I actually didn’t talk about it. I’m really ashamed to say that we had some [00:09:20] circumstances where I might meet new people, and they ask about family, and I wouldn’t acknowledge that I had a [00:09:25] brother because I just didn’t want to get into that conversation. It’s like, what are they going to bring up? [00:09:30] Uh, and for me, it was the end of 2018. [00:09:35] I had a really unpleasant incident with comments about Andrew and also [00:09:40] myself. I then made the decision, you know, I’m going to talk about [00:09:45] it. And if people don’t like it, That’s their problem. But we can’t keep going [00:09:50] on where we’re losing people and also the people who are bereaved. They can’t be [00:09:55] in this isolation because there’s too many people who are in this difficult [00:10:00] position. We’ve got to talk out. We’ve got to support people. Um, yeah. [00:10:05]

Payman Langroudi: Would you say the the grief that a family feels after [00:10:10] someone takes their life by suicide has its own particular [00:10:15] characteristic that’s different to someone passes [00:10:20] away a different way. I think that guilt, a bigger part of it.

Angus Pringle: In the in the [00:10:25] greater scheme of grief, it’s important to acknowledge everyone has a different experience. [00:10:30] And I think what I went through was very different to what Andrew’s, um, [00:10:35] uh, fiancee went through to what was different to what my parents went through. But [00:10:40] there’s two big areas, which is guilt and shame. The [00:10:45] guilt of thinking, what could I have done? And that could really torture [00:10:50] you? Um, and the shame really surrounding the stigma of whether it’s our own [00:10:55] internal stigma or the stigma that other place on you, uh, [00:11:00] and the consequences of living in a family [00:11:05] after a suicide. It can do devastating things to the family network. And the [00:11:10] statistics on marriages that break down after suicide. Uh, it’s [00:11:15] certainly affected my relationships with people. It would put a massive strain [00:11:20] on my own marriage. Um, but, you know, we we [00:11:25] were the fortunate ones that we battled through these difficult times. And [00:11:30] Kevin Hines is a medical mental health campaigner in [00:11:35] America. He’s very famous for surviving a suicide attempt. And one of his expressions is [00:11:40] he’s cracked, but he’s not broken. And I would certainly say that, you know, I’ve [00:11:45] of. I’ve got the scars of what I’ve been through before. I’ve come through it. But because [00:11:50] of what we’ve been through and what we’ve learned, we can certainly talk about [00:11:55] it and help others to avoid these situations happening again. And in the tragic [00:12:00] situation, if someone does lose someone to suicide, being in a better place to [00:12:05] really offer support. Really.

Rhona Eskander: So I got a book in the post [00:12:10] a few months ago when it’s darkest. Me too. And uh, [00:12:15] I didn’t know who it was from and I was really touched. It was very personal to me because I’m very vocal [00:12:20] about my mental health and being gone through those really, really dark times. So I thought maybe a [00:12:25] patient sent it to me, or one of my friends messaged my therapist, my coach, [00:12:30] and I was like, no. And then, lo and behold, we found out today it’s [00:12:35] from you. So. Yeah. And I really, you know, I’m, I’m a very slow reader ad [00:12:40] diagnosed now. So I, I take a long time to read things and I [00:12:45] have found it an incredibly compassionate book. But I think that it’s I’ve [00:12:50] known two people to lose their lives via suicide. So the first one [00:12:55] was a boy at university who was very good looking, very popular, [00:13:00] had a beautiful girlfriend. I think he’d always struggled, had gone on a holiday [00:13:05] in Ibiza with a group of friends, came back to university and [00:13:10] took his own life. He couldn’t cope anymore and I remember we all went [00:13:15] to the funeral. I think one of the most difficult things was as well. He was Jewish and there was a lot of stigma [00:13:20] within religion, and I became very aware of the religious narrative around [00:13:25] his death, and that made me feel a certain way. I had also [00:13:30] gone to school with a girl who became a very famous Bollywood actress, and, [00:13:35] um, she was best friends with my best friend and again led a troubled life [00:13:40] in the limelight, as it were, And had also died by suicide. [00:13:45] But unfortunately, as you’ve already alluded to, her [00:13:50] mother tried to pinpoint it as murder. And I think there was definitely [00:13:55] an element of cognitive dissonance because, as you said, the the people around [00:14:00] you bear this responsibility and guilt and shame. So it’s almost easier to blame [00:14:05] something else, you know. Yeah. And I remember that being extremely heavy because things turned [00:14:10] quite ugly from a legal point of view as well.

Payman Langroudi: Yeah. I mean, it’s crazy that the stigma [00:14:15] of suicide was more than the stigma of murder. Correct? Of course, of course. Well, [00:14:20] it’s mad that there’s a mad situation.

Rhona Eskander: I think that’s that’s the whole problem I have [00:14:25] around the narrative of mental health, and why I’m so grateful that our people like Angus and our industry. [00:14:30] I went to go watch Gabor mate on Monday, and it was I [00:14:35] was it was amazing. But I think what really struck me the most in [00:14:40] the talk was, I mean, he didn’t say anything. That was completely blowing my mind because I’ve read so much of his work, and there were [00:14:45] a lot of people in the audience that had felt very impacted by his life. But what really struck [00:14:50] me about what he said about mental health was he said that a lot of health care professionals will [00:14:55] say that someone that doesn’t suffer from mental health is the absence of disease, [00:15:00] but they don’t actually state what being mentally healthy is. So be not [00:15:05] depressed. Not anxious. Do you see what I mean? But okay. But then what is what is actually [00:15:10] being healthy in mental health terms? And for me, I was really thinking about [00:15:15] that. And we don’t actually know because it’s the absence of some kind of medical disease, but that doesn’t really [00:15:20] mean anything. And for me, I was trying to explain this [00:15:25] to my father yesterday, who was an old school gynaecologist who is [00:15:30] almost 80 years old. And I was also trying to explain to him how so many autoimmune [00:15:35] diseases have now been linked to mental health and so forth. My dad was like, I think [00:15:40] this is rubbish. You know, like he recognises that stress can happen, but he, he [00:15:45] recognises that stress can impact. But he also, you know, [00:15:50] is very much you have an autoimmune disease. You treat it this way, you know, this is the [00:15:55] medical route etc.. And I think that’s a huge problem. I really think it’s a huge problem [00:16:00] in our profession because we are so used to seeing symptoms, giving a diagnosis [00:16:05] and then like trying to alleviate it with a treatment or medicine and not going [00:16:10] back to the body. And I want to say, are we really going to claim that the mind and the body are totally [00:16:15] separate entities? It’s practically impossible.

Angus Pringle: You know, you’ve actually you’ve you’ve [00:16:20] really described it well. And, you know, the, the concept we need to think of is mental fitness, [00:16:25] not mental health, just like physical fitness. And that’s something I’ve worked [00:16:30] out over the years is physical fitness with cycling. And that comes on, [00:16:35] um, it’s on a sliding scale, really. I’m not fit or I’m very fit, but there’s no kind of middle [00:16:40] ground of what is average fitness. And I also think in my own mental health on [00:16:45] that is my where am I mentally fit. And I’ve had better times with mental fitness [00:16:50] and worse times of mental fitness, and changing the rhetoric [00:16:55] around it is probably a better way of understanding it. But you’ve just really described it better than I have, [00:17:00] really.

Rhona Eskander: So I want to ask you, there’s a few things I always claim [00:17:05] this, claim this. And people say back it up with lots of stats and there’s a bit of airy fairy [00:17:10] stats. But does dentistry have one of the highest suicide rates of any profession? My [00:17:15] husband will argue with me and say finance is really up there, etc.. I mean, I don’t know about the finance bros, but [00:17:20] but what are the stats out there, Angus, regarding dentists and doctors and so [00:17:25] forth?

Angus Pringle: Well, it’s the when you actually think about statistics, it’s actually quite difficult. [00:17:30] We know that we’ve had a very sad increase in the number of people who’ve died by [00:17:35] suicide in the UK. We’re about 6600, but we know there’s [00:17:40] certain professions that are higher risk, such as dentistry, medicine, veterinary and nursing, [00:17:45] and medicine is actually slightly higher than dentistry. But [00:17:50] it’s still tragic. But you can also look at the construction industry. They also [00:17:55] have similar issues with a higher suicide rate. Marginalised [00:18:00] people in society like refugees, LGBTQ community, neurodiverse. [00:18:05] Um, but I don’t have the figures on hand. Um, but. [00:18:10] And also, unfortunately, people who have been bereaved by suicide have a higher risk. [00:18:15] So I sadly have a double whammy being a dentist and someone who’s been bereaved. [00:18:20] But just because someone has a higher risk, it’s not a fait accompli. Um, [00:18:25] but I’m just a little bit more mindful of my own wellbeing and understanding how [00:18:30] my own emotions work to make sure that we are [00:18:35] staying as mentally fit as I can. Yeah.

Rhona Eskander: So you talked about prevention. [00:18:40] And in the book they talk about prevention as well. Yeah. So how [00:18:45] in your experience, your view and understanding, do you think it can be prevented? [00:18:50]

Angus Pringle: When we talk about prevention in general [00:18:55] there’s some good concepts. But to prevent just one suicide is very more complicated. [00:19:00] And you’re starting on a societal level of reducing [00:19:05] inequalities, breaking down taboos and stigma around mental health so people [00:19:10] can access the care. Can they then access care over a good long [00:19:15] period of time? Um, I think the other the factors [00:19:20] around prevention is if you think about dentistry as well, [00:19:25] it’s the environment that we’re working in. Uh, if you think about the NHS and [00:19:30] what that’s gone through, and I used to work in the NHS and I knew that it wasn’t good for my mental [00:19:35] health. And I know you’ve talked about the same thing as well, but I’m interested in your [00:19:40] both of your opinions on this, because I appreciate that this isn’t always necessarily [00:19:45] me talking about it, but it’s your feelings and understandings about where we can go with prevention. [00:19:50]

Payman Langroudi: It’s difficult. So off off mic, we were talking about the sort of escalator [00:19:55] of, you know, kind of conversation like this stops someone [00:20:00] who’s decided to take their own lives to not take their own lives. And [00:20:05] I was saying I was a bit sceptical about that. And do you remember we were saying, what do we call this pod? [00:20:10] And we said, call it mind movers as in movement. Yeah. Not just [00:20:15] talking if you remember. But then I spoke to my cousin who’s a psychiatrist, [00:20:20] and she said, well, before someone gets to that point, they’re at a lower point, and at that [00:20:25] lower point you can intervene before someone’s fully decided to take their own lives [00:20:30] and they can find a way out.

Angus Pringle: You know, you’ve just brought something to my mind and [00:20:35] it’s something. And this is actually to do with the media. But also some of this should be [00:20:40] today, which is and I might pronounce this wrong, it’s called the Papageno effect. [00:20:45] Uh, Papageno was in The Magic Flute, uh, one of Mozart’s operas, [00:20:50] and he was feeling suicidal. But his. There’s three characters [00:20:55] that helped to find and give him hope to be able to realise he [00:21:00] could be here tomorrow. So a lot about prevention is the embracing of lived experience. [00:21:05] So people like Kevin Hines, if you ever read his book and he talks [00:21:10] about his experience of his suicide attempts and how the fact he he is [00:21:15] glad that he’s survived and that’s giving hope to others, even in their darkest hour, there might be [00:21:20] hope. Um, and just before we went on camera, I was talking about something [00:21:25] that happened in my life that I didn’t realise had such a massive effect. Um, [00:21:30] After Andy died. There was obviously it was it felt like chaos [00:21:35] and the world was turned upside down. I felt like I was living on [00:21:40] a different planet. Um, and with everything that had gone on, there was naturally there was media [00:21:45] attention, there was police, there was lawyers. And when you’re, you feel [00:21:50] you’re at your lowest. We were kicked down. We’re kicked down again. We kept getting kicked down. [00:21:55] And you think how how low can I go. And I recognised [00:22:00] in myself that I wasn’t in a very good place. So I’d gone to have some [00:22:05] treatment with a psychologist. And having never been to anything [00:22:10] like that and maybe being a man as well, I felt that it was actually quite challenging. [00:22:15]

Angus Pringle: But gradually, as I gained more confidence and opened up, there was one day [00:22:20] where we just had some more bad news coming through, and I, um, and [00:22:25] I was saying to the psychologist, you know, I just don’t feel fulfilled. I don’t feel [00:22:30] happy. I don’t feel like I really need to be here. There’s nothing in life that I’m [00:22:35] gaining from. And the psychologist said to me, you might feel [00:22:40] better tomorrow. And it was. I didn’t really realise the significance of that [00:22:45] comment, but it was very much like a crossroads in my life where there was [00:22:50] actually hope. And someone described hope as hold on, pain ends [00:22:55] just like we’re doing in the cycle, right? As even in the absolute [00:23:00] chaos, it was not going to be forever. And we talked about that a lot. And [00:23:05] even where I was in a really miserable place, I could think, perhaps [00:23:10] this isn’t going to be like the rest of my life like this. Perhaps tomorrow might be something [00:23:15] better. Perhaps tomorrow I might wake up and actually look out the window and think, [00:23:20] do you know what? It’s a nice day. It’s these little glimmers. And the longer [00:23:25] it’s been since then, I realise how important that’s been in my life and [00:23:30] sharing, you know, how different my life could have been if I’d not had [00:23:35] that support and treatment, how different my life had been if I’d not had that [00:23:40] little bit of advice. Which for me was really profound, actually.

Rhona Eskander: I [00:23:45] think that’s really important. And like Payman said, we’re lucky. I mean, I often [00:23:50] seek refuge in podcasts, which is one of the reasons why I brought it up to you. You know, since [00:23:55] the ADHD diagnosis as well, and having a better understanding because I chose [00:24:00] not to medicate it hasn’t affected my professional life, I would say, because I think I’ve always been [00:24:05] able to cope, especially as a high functioning woman, which is quite common for women [00:24:10] to hide neurodivergence behaviour. But I think that my mental health [00:24:15] is like literally up and down. It’s like a constant. It’s a constant up and down. And podcasts [00:24:20] have been a really good way. And as I said, as you had quite correctly described stories [00:24:25] like stories of people making out like, you know, they say the only [00:24:30] way out is through. And I just think, oh my gosh, like, this person’s been through this. [00:24:35] And, you know, it’s really important that we find [00:24:40] help. I think we’re in a more privileged position. Right. Because at the back of my mind, I think sometimes [00:24:45] when I see I live in Notting Hill and it’s super diverse, multicultural area, and sometimes [00:24:50] I see just like Camden, you know, you see drug addicts, crack addicts at like, you know, [00:24:55] 1 p.m. and since reading Gabor Mate’s work, my narrative and my compassionate inquiry [00:25:00] towards those people has completely changed because I’m like, how did they end up that way? We had somebody that was a previous [00:25:05] addict that had come out, you know, he’d been using since he was 12 years old.

Rhona Eskander: Yeah. And but [00:25:10] I think it was it’s also the recognition that a lot of these people don’t have the tools and support. [00:25:15] You know, a lot of them don’t have that. And I think that’s, you know, where the difficulty lies. Dentists [00:25:20] do. And medics will generally have lots of tools available to them. One [00:25:25] thing that you said at the beginning of this talk, which I’m keen to delve into is the GDC [00:25:30] and our governing body, because I think since I graduated, I’m going to go as far [00:25:35] as to say the thought of being ever investigated by the GDC, [00:25:40] which might happen, makes me feel suicidal. And even when I’ve had a patient who’s [00:25:45] who’s complained and wants some kind of, like, financial, um, she has a financial [00:25:50] incentive, they will threaten with the GDC, right? Because they know how scared [00:25:55] it makes us. And that really makes me feel sick to the stomach. You know, whether or [00:26:00] not the GDC finds you guilty is irrelevant. It’s the fact that you have to go through that for [00:26:05] several months and years that for me, I find terrifying. And I don’t know what the answer is. Yeah. [00:26:10]

Angus Pringle: And you’ve raised a very good point where the Cancer Trusts are running a wellbeing conference [00:26:15] in November to address this particular issue with the GDC, the GMC, the [00:26:20] veterinary college, and they’ve invited representatives to speak at that. [00:26:25]

Rhona Eskander: Thing.

Angus Pringle: The thing is like, how do we move to compassionate regulation [00:26:30] whereby we aren’t just shamed? Well, yeah. And the thing [00:26:35] is, if you went through the legal system, even the criminal system, you probably would be dealt with in [00:26:40] a more of a compassionate way. Um, and if when I graduated in dentistry, [00:26:45] I think I paid my first year’s registration was like £40. It’s ridiculous. [00:26:50] And the worst thing you’d be doing is if your brass plaque outside the practice was [00:26:55] of a wrong size. And I absolutely agree that patients need [00:27:00] to be protected, but we also have to be compassionate to our healthcare providers [00:27:05] because we are human. And I’ve seen some devastating effects of [00:27:10] people who’ve been through the GDC. Even if they’re cleared, it’s feeling like that. Mud [00:27:15] sticks and it’s it’s there for everyone to see. Um, [00:27:20] and I think that there’s definitely needs to be engagement of understanding the proportionality [00:27:25] of the charges, the proportionality of how they’re dealing with [00:27:30] people and as well as the support, especially now they’re moving to remote [00:27:35] hearings in an attempt to reduce costs. If that happened to me and I’m [00:27:40] sitting at home, they keep my laptop listening to legal terminology [00:27:45] I might not understand, you know, I’d know that would have a devastating effect to my own mental [00:27:50] health. And who’s sitting there to support me, um, and [00:27:55] get me through this difficult time. Because ultimately, the GDC may not have the our [00:28:00] interests at heart. It’s about protecting the public, but we’re still human at the end of the day [00:28:05] and where we spend our time caring for people, we also need to be cared for, too. [00:28:10]

Payman Langroudi: Look, it’s no consolation for someone going through it now, [00:28:15] but one thing that is becoming clear I had a ten day cruise on [00:28:20] the legal That Dental legal expert, and [00:28:25] he said the pendulum is definitely swinging back towards us, really from the [00:28:30] GDC side in that there they may be about to start a [00:28:35] program whereby it’s impossible for a first offence to be struck [00:28:40] off, for instance. Really? Yeah.

Rhona Eskander: That’s so interesting. Yeah.

Payman Langroudi: And, and [00:28:45] and, you know, I guess.

Rhona Eskander: That’s dependent because if it would be something like, of course, MeToo or.

Payman Langroudi: Something. But if [00:28:50] you’ve never had a complaint before and it’s not going to get even get to the GDC. He was telling me about a few [00:28:55] things, and what he was saying was that definitely 2014 to 2015 was sort [00:29:00] of like peak GDC. Yeah. Where where the GDC itself was getting [00:29:05] bigger and it was it was almost like an industry, you know, to to get Dental [00:29:10] they put ads out saying, has the dentist hurt you and all that? Um, but [00:29:15] you know, what I’m trying to say is the fear of the GDC, particularly we get it with younger [00:29:20] dentists That is, it’s it’s it’s not as bad as it was [00:29:25] number one. Yeah. Um, and number two, [00:29:30] as I say, it’s no consolation for someone going through it now. Um, it’s we’re [00:29:35] much less likely to be put in that position. Yeah. Much less likely. Um. [00:29:40]

Angus Pringle: But I think what you’re talking about is the, the expectation versus [00:29:45] the reality. And yeah, there certainly is the catastrophizing of the fear of the GDC. [00:29:50] And that’s affected a lot of people’s careers where, um, all you [00:29:55] have to do is read the GDC Gazette and you see this whole myriad there’s still [00:30:00] names.

Payman Langroudi: Yeah.

Angus Pringle: Um, and that that fear is enough to put off ruining someone’s enjoyment [00:30:05] of their job. And I’ve certainly been fearful, following some complaints, wondering if it’s going [00:30:10] to go to the GDC. Yeah.

Rhona Eskander: Every complaint, if I’m honest with you, every complaint, I’m like, is this going [00:30:15] to end up? And patients know now because they’ll threaten you with it whether they just want money. [00:30:20] They’ll go, well, if you don’t give me money, I’m going to report you to the GDC and it’s going through your head.

Payman Langroudi: What’s going through your head when [00:30:25] you’re when you’re worried about it? It’s shame, the primary emotion.

Rhona Eskander: I think shame is [00:30:30] the primary emotion, because I’ve also had fellow colleagues and healthcare professionals [00:30:35] been through it. And what I find also so disturbing is that the patient is [00:30:40] patient A, and the dentist or doctor has their name dragged through the mud. I find it incredibly [00:30:45] unfair, you know, and I find that is unbelievable. And the fact that people can go just on [00:30:50] the internet and have a look and, you know, people can ridicule you. [00:30:55] And, you know, I just think that since I’ll never forget a year before I graduated, or [00:31:00] was it during, you know, they sat us down Dental protection, came to give us a chat and was like, you will get [00:31:05] sued at least like X times in your life.

Payman Langroudi: Yeah. So Linda Cruz also talked about that, and he said it used to be an opener [00:31:10] that they all used to work at Dental protection, and it used to be an eye opener to every lecture that they [00:31:15] all used to use, and they realised that opener was causing massive [00:31:20] anxiety because they were going around all the dental schools. Yeah, starting with that opener. [00:31:25]

Rhona Eskander: Massive anxiety. And the fact is, look, I’ve been long enough in this game, in the cosmetic game [00:31:30] to actually realise it’s actually part of the job. You know, people some people are going to sue [00:31:35] you whether or not you did your job right. Anika talks about this. You know, Anika in the podcast was like you [00:31:40] put X amount of your money away per year and accept that that’s [00:31:45] going to go like to compensate and something legal or giving the patient money back. You know what I mean? And it’s part [00:31:50] of the game. But they make us operate from a place of fear. And what I don’t [00:31:55] like is in our profession, we are constantly operating from a place of fear. And [00:32:00] I don’t talk about just the GDC or our indemnity. What I [00:32:05] talk about as well is like we operate from fear in the sense that you are here to serve. [00:32:10] You should do X number of years on in a hospital. You should do this in general [00:32:15] practice. You should do this. It’s always this should that is like looming over us. And I think my father’s generation [00:32:20] had it much worse when he talks about his years as well in hospital. So I’ve been operating [00:32:25] from a place of fear for so long, fear that something’s going to go wrong. From the day I was in university. [00:32:30]

Payman Langroudi: And, and, and the other sort of side effect of it is you’re communicating with your patients [00:32:35] from a position of defence.

Rhona Eskander: And you’re almost manifesting things happening. [00:32:40] I know it sounds crazy.

Payman Langroudi: My brother went for a dental check-up. He hadn’t been for a while. Yeah. And [00:32:45] he said it was more like talking to a lawyer than a doctor. Yeah. Yeah. He said the guy was making [00:32:50] me sign stuff left, right and centre. He was saying, did you understand that? Did you understand that? And [00:32:55] I really something. It really hurts when he said that. Yeah. Because you almost [00:33:00] feel like the lawyers have won. Yeah. You know, the legal system has won, and.

Angus Pringle: It’s [00:33:05] taken the human element out of healthcare, and it’s making more risk averse, and [00:33:10] we’re all.

Payman Langroudi: Acting defensively.

Angus Pringle: It’s interesting. I was listening to you speak there, Rona. And, [00:33:15] um, something I was talking about actually, on World Suicide [00:33:20] Prevention Day is listening to understand and then listening to respond. [00:33:25] And you’ve really hit the nail on the head again, in terms of one of the challenges we have [00:33:30] in dentistry, but also medicine is a lot of us have these perfectionism [00:33:35] traits in our personality. And the thing biggest thing around the GDC [00:33:40] is the fear of not only what it’s going [00:33:45] to affect us, but how might we be judged by our colleagues, not just our patients? It’s [00:33:50] like, are we going to be hauled over the coals? Are we going to lose friends? [00:33:55] And unfortunately, the perfectionism trait is one of the contributing factors [00:34:00] to potentially bad mental health and suicide. Sadly, um, [00:34:05] but it’s something that we all kind of have to be mindful of, um, and [00:34:10] be working towards to help to keep our mental fitness as good as [00:34:15] possible.

Rhona Eskander: That goes back to vulnerability. When I was talking to my therapist about my own mental [00:34:20] state and she said that I suffered from something called toxic perfectionism. Yeah. Do you know about it? Yeah. [00:34:25] Yeah. So toxic for section is, you know, the the the self-perpetuating belief [00:34:30] that you’re just never good enough. I might even get my description out that she sent me. And [00:34:35] I constantly live in this, and it’s always like, you know, this thing is going to make me happy [00:34:40] or this or this or this and then this constant, and, you know, it can serve you well, right? Because [00:34:45] if you think about part’s work, I don’t know if you’ve ever done part’s work. So there’s something [00:34:50] called internal family systems. Um, I don’t know if you’re familiar with it, but again, it’s something [00:34:55] I’ve worked on with my therapist and my coach. And, you know, we’re all made up of parts. So if [00:35:00] Payman says, like today, I’m feeling anxious. No part of you is feeling anxious. That’s [00:35:05] just a part of you. It’s not you. Your identity is not anxiety. And it’s really important. And then [00:35:10] when you start to recognise all the different parts of yourself, they can all be in a boardroom together and you’re like, hey, [00:35:15] anxiety.

Rhona Eskander: Hey, this and sometimes certain parts of you have actually served you well in life. So instead of [00:35:20] shaming it because I think for a lot of dentists, that part of you, that toxic professional perfectionism [00:35:25] part has actually made you be a high achiever. Yeah. Made you do well in your exams, [00:35:30] you know, made you be a provider, organise whatever it is. So actually some parts of us have served [00:35:35] us well, but it doesn’t mean they will continue to serve us well for the rest of our lives. Yeah, I think that [00:35:40] that’s really, really important to recognise because it goes back to the vulnerability vulnerability [00:35:45] argument as well. So many dentists and healthcare professionals are not willing to be vulnerable. [00:35:50] They’re just not willing to have these conversations and be like, do you know what? I feel like [00:35:55] I’ve got imposter syndrome, or I feel like my work’s rubbish, you know, compared to X, Y, and Z online. [00:36:00] Because if we were having these conversations, we’d recognise we’re all in the same boat and we’re actually all connected, [00:36:05] you know?

Angus Pringle: Yeah, yeah. And I often think back to when I started my career, a [00:36:10] lot of the interactions we would have is in person, where you could actually have these heart to hearts [00:36:15] about maybe not feeling so good about things, but things that weren’t going so well. And as we become [00:36:20] a bit more online, especially during Covid, and mindful of the changes [00:36:25] I’ve seen online, and I kind of am mindful of the things that I post about my patients, [00:36:30] whether it’s testimonials or befores and afters and think, am I doing this for me? [00:36:35] And could this have a negative effect because someone might be having a bad day and look at it and think, you [00:36:40] know, I just or in a, in a as an orthodontist thinking I’ve just done a D bond today [00:36:45] and I didn’t really like the occlusion at the end, but Angus has posted something that’s better and [00:36:50] vice versa. I could look at it like that, but we’re not having that discussion to resolve that, [00:36:55] as in to understand the balance in how we’re feeling.

Rhona Eskander: So yeah, I [00:37:00] think also we’ve got to be active in the types of people that we follow online. [00:37:05] And that goes back to the same thing, because comparison is the thief of joy. We know that our [00:37:10] whole social media ecosystem is based on everybody feeling insecure. [00:37:15] Even the people that look like they’re like living their best life. The system would not work unless [00:37:20] every single person felt insecure. That’s the fact.

Payman Langroudi: That you feel insecure just [00:37:25] blows me away. You know, it’s it’s it’s it’s it’s madness to me that someone [00:37:30] like you would feel like you’re not you’re not good enough. But but having been sat [00:37:35] with you through all these conversations that, that that’s an issue you have with you. [00:37:40] You’ve been through so many different parts of our profession. So the hospital system climbing [00:37:45] up to become a consultant now in general? Well, not specialist [00:37:50] practice. You’ve had corporates involved. I [00:37:55] mean, the way we we were introduced was through the people at Bupa. What parts of [00:38:00] our profession can we talked about the GDC part, but what parts of our profession do you think [00:38:05] are the parts that you’ve seen have raised your anxiety levels or [00:38:10] that we could do better.

Angus Pringle: Uh, that’s [00:38:15] a really good question. I think it’s actually a combination of self-compassion, [00:38:20] being aware we’re not superhuman. Uh, and I think unfortunately [00:38:25] in orthodontics, getting in was so competitive. You’re and it’s not being [00:38:30] big headed, but your top of your top of the pile. But to get there, it’s [00:38:35] blood, sweat and tears. You’ve been really going at it. It really is. And then during the training [00:38:40] you’re constantly being pushed to excel, which it is, is admirable, as we should be. [00:38:45] But where’s the kind of middle ground? Where is the enough [00:38:50] is enough? And I remember Annika talking as well on the podcast. I think she’d [00:38:55] had some challenges when she was applying to get into specialist training and also during [00:39:00] specialist training. I think there was an issue in one year. Um, and [00:39:05] I put my hands up when I was a registrar because that’s when I lost my brother Andy and I [00:39:10] said, I’m having a really bad time. I need to have help. And hats [00:39:15] off to the people there, you know. Sue Cunningham, you know, Prof. Cunningham at Eastman. [00:39:20] Lovely lady. A brilliant orthodontist and an academic. You know, [00:39:25] I told her everything that was going on, and she’s hugely supportive. And without [00:39:30] that, you know, where would I have been? They didn’t necessarily always agree with my decisions [00:39:35] because I delayed doing my exams by a period of time, and it didn’t fit [00:39:40] necessarily their schedule. But I did get through my exams. Um, but [00:39:45] I think the hard thing in these training environments is [00:39:50] what do you do when someone struggles? Because the conveyor belt of training continues, [00:39:55] but someone is lagging behind or someone has stepped off. And unfortunately, [00:40:00] more often than not, people leave training. Um, and there has been [00:40:05] some flexibility on a very separate thing about, um, from sort [00:40:10] of, uh, doing part time training, which can help. But [00:40:15] yeah, I, I was lucky I got through it. It was, there was a, [00:40:20] I was bruised and battered, but I got my qualifications. Um, what about what. [00:40:25]

Payman Langroudi: About politics, hospital politics? Like, did that wear you down? Because that’s a big [00:40:30] part of. Well, I.

Angus Pringle: Think there’s politics everywhere. I think that, uh, even [00:40:35] politics where I work. Not in a bad way, I think in a good way. Constructive way. Certainly, [00:40:40] when I left my consultant post, the. It was a period of time when management [00:40:45] were really not very pleasant. And it was a lot of pressure, uh, to see more [00:40:50] patients, to do more hours, to change our contracts, uh, [00:40:55] cutting costs. I was thinking, you know, I trained all these years because I maybe [00:41:00] it was quite naive. I wanted to provide the best possible care. Uh, I [00:41:05] A kid in some respects, but I realise this isn’t for me. I actually want to care for [00:41:10] people. I wasn’t interested really on sitting on committees. Um, I got [00:41:15] the most out of interacting with families, patients, seeing them grow [00:41:20] and develop as I do with staff. And that’s what I’m really fortunate to be able to see now in [00:41:25] the practices that I work in. Um, but I didn’t really get to be heavily [00:41:30] involved in the politics. And you can get sucked in and you have the [00:41:35] different camps for people who’ve got beliefs for this and that. When I always kind of thought [00:41:40] what the big picture is, um, which is looking after people because health care is [00:41:45] just not just about health, it’s actually about caring. And sadly, there’s a lot of people who don’t [00:41:50] actually forget that.

Payman Langroudi: Now that you’re more tuned in [00:41:55] to mental health victims of suicide, families [00:42:00] of victims of suicide, do you think there’s a role for dentists in [00:42:05] intervening, maybe, but in helping in helping, helping [00:42:10] people with their mental health.

Angus Pringle: Yeah, absolutely.

Payman Langroudi: Patients.

Angus Pringle: That’s what we’re doing.

Rhona Eskander: With this as well. [00:42:15]

Payman Langroudi: No, no. But for our patients, I mean, you see the patient every six months, you know, we’re perfectly [00:42:20] placed to spot. But someone like me, I’m not tuned in enough to [00:42:25] to well, I’m not a dentist anymore, but, you know, you’re very sort of empathic [00:42:30] with your patients, and you can tell if they’re going up or down. Have you had a thought about that or have [00:42:35] you noticed with your own patients?

Angus Pringle: Absolutely. And even I think one of the things I’ve loved [00:42:40] in my job is people feeling comfortable to speak to me. Me too. Um, and it’s [00:42:45] like they’re comfortable telling when they’re not happy. And I always say, like, as soon as something doesn’t feel right, [00:42:50] tell me so it doesn’t snowball. So over time, and I think it’s [00:42:55] a privilege that I’ve had parents tell me about the struggles their children are having or their own [00:43:00] struggles. Um, And an orthodontist isn’t really [00:43:05] about moving teeth. It’s about psychology. It’s about coaching people. And that’s something [00:43:10] I’ve really enjoyed.

Rhona Eskander: I had all parts of dentistry, to be fair.

Angus Pringle: If you’ve got the [00:43:15] time, and I think that’s a struggle in the NHS, is you can do a technically good [00:43:20] job on the NHS. But does the patient feel happy? Does they feel listened to? Have you manage their anxiety? [00:43:25] If you’ve not got enough time and that leads to patient dissatisfaction and also dentist dissatisfaction. [00:43:30] And I had a patient last year uh, which [00:43:35] really has stuck in my mind. They just they’d been referred to me to replace a bonded [00:43:40] retainer, which is not a big deal. And I don’t often go into the waiting room, but this time [00:43:45] I thought, I’ll go down. It’s a new patient. It’s nice to get to meet new people. [00:43:50] And as soon as I walk into the waiting room and I said their name, I knew something wasn’t right. They didn’t look [00:43:55] me in the eye. They looked distracted, like the thousand mile stairs. [00:44:00] And so we walked up the stairs. I was making small talk, but they weren’t really saying anything. [00:44:05] And they sat in the chair and I started talking to them and I knew something wasn’t [00:44:10] up. And this is something that’s very important in preventing [00:44:15] suicide is listen to your gut feeling. Something doesn’t feel right. [00:44:20] You generally are on to something. So we forget the bonded [00:44:25] retainer.

Angus Pringle: And I started asking her, you know, how are you feeling? She says, I’m not doing so good. Says, [00:44:30] do you want to talk about it? She says, I don’t really want to talk about it. And do you have any [00:44:35] support at the moment? She says, yeah, I’ve been to a therapist, but it’s not worth it. You [00:44:40] know, I don’t feel like I need to be here, and there’s all these alarm bells that kind of [00:44:45] came up and we just kind of chatted and I let her talk. [00:44:50] Um, and this is the thing. If you’ve ever got someone who is suffering, [00:44:55] that’s a mental distress. Even if you don’t know who they are, it’s just. Listen. We [00:45:00] spent the time, we spent 30 or 40 minutes and she could tell me [00:45:05] about her journey, what she’s been through, how she felt worthless and [00:45:10] hopeless. There’s nothing I can say to make it feel better, but the [00:45:15] fact is we were there to listen, and I think that’s something we can all do. We don’t [00:45:20] know, don’t have to give solutions. And then we followed up [00:45:25] with the person. Um, two days later, I phoned them up and chatted to it, and [00:45:30] they were just very grateful. The fact that we spent the time. I mean, you said.

Payman Langroudi: Yourself something as [00:45:35] simple as tomorrow might be different.

Angus Pringle: Yeah, tomorrow might feel better. You might feel.

Payman Langroudi: Better. Change [00:45:40] the way you think about you thought about your own mental health. Something as simple as that. [00:45:45]

Angus Pringle: But it is. It is. The thing I’ve been talking about is the compassion. And there’s a [00:45:50] lot of fear around about talking about suicide. And if you’re worried about [00:45:55] someone and you’ve got a gut feeling that something isn’t right, A key thing [00:46:00] we know is if you ask someone, are you thinking about taking your own [00:46:05] life? That doesn’t mean you’re seeding the idea. It doesn’t mean that [00:46:10] they’re more likely to die by suicide. They actually might find it’s a way that they [00:46:15] can actually say yes, and it can actually be a huge relief in a lot of respects. [00:46:20] And from that, we can then look to see if we can get them support. Yeah. [00:46:25] But this is where because there’s not been enough of a discussion around suicide prevention, [00:46:30] it’s these conversations that are incredibly important. And I certainly had no skills [00:46:35] in that previously. And I’ve been through some training. I’m certainly not an expert in it, but [00:46:40] I feel in a better place. If I were in the unfortunate situation where I was [00:46:45] to have someone who was worried about, I feel I could possibly handle it slightly better than [00:46:50] I used to.

Rhona Eskander: Yeah, I think it’s really there’s two things based on what you were saying. [00:46:55] First of all, I want to say the listening piece is really important. One of the best questions that [00:47:00] I got asked was, or one of the best proposals that I was given, [00:47:05] was, do you want to be heard or do you want advice? And I think that’s [00:47:10] really important because sometimes when people come to you with a problem, you start giving them a number of [00:47:15] solutions and it actually makes them feel worse. Like there’s definitely times where I’m like, this is overwhelming me and making me feel worse. [00:47:20] Whereas actually, sometimes you just want to be seen, and being seen is incredibly powerful [00:47:25] and you feel that you are not being judged [00:47:30] for what’s being said, and you just need to kind of have that release and that vent. Yeah. So I [00:47:35] think that that’s one of the most important questions I started to ask people, do you want to [00:47:40] be listened to? Or do you want advice? And I think that’s where we really need to start thinking [00:47:45] about that way. The other thing that I wanted to say was, is also the [00:47:50] stigma thing is just so big, because I think that people relate [00:47:55] death by suicide as being mentally unwell. And when I went through a [00:48:00] really dark period of my life, I remember going to quite an old school psychiatrist [00:48:05] telling him about like the suicidal ideation, and [00:48:10] he wanted to put a diagnosis on me straight away for a mental health disorder and put me on, [00:48:15] you know, quetiapine, which is a very strong, um, medication. [00:48:20] And I just said no. And I was like, no, actually, listen to me. I mean, I saw him a few times, but I listened to my [00:48:25] gut and was like, I don’t think he’s the right kind of person because the conversation around those feelings is [00:48:30] something’s wrong with you, and that makes you feel even worse.

Angus Pringle: Yeah, yeah. But you brought up the thing [00:48:35] about stigma. Um, and it’s one of the things how we can change the conversation [00:48:40] is how we use the language around suicide. And something that is [00:48:45] I particularly don’t like was after Andrew died by suicide, people talked about [00:48:50] him committing suicide. And that just it just makes the hair go up on the back of my neck. [00:48:55] And it harks back to really when suicide was a crime implicating, [00:49:00] like there’s a crime where there was a sin that happened. So by it’s nothing to do [00:49:05] with political correctness, but by changing our language about how we talk about [00:49:10] it, it’s so that other people who might be struggling with those thoughts can feel more [00:49:15] able to reach out for help. But if we’re using terminology that is reinforcing [00:49:20] stigma, then they’re the ones who may not be seeking help. And then [00:49:25] we’ve got another tragic death. So there’s a lot that we can do in terms of talking about [00:49:30] it, that we can help others.

Rhona Eskander: I think we have to make them like the media, have to be held accountable. We’ve talked about Caroline [00:49:35] Flack off camera. I’ve talked about her on camera a lot. Uh, you [00:49:40] know, the media’s narrative towards her. And again, it reminds me a little bit of the GDC. [00:49:45] You know, you are like, you are on trial. This person is on trial. It was the same with [00:49:50] Caroline Flack. She was on trial for her behaviour, you know, so that is responsibility. [00:49:55] Like these people, these these institutions, the.

Payman Langroudi: Gdc by design [00:50:00] is a court. Yeah it is. It’s by design. It’s not it’s not like it feels [00:50:05] like it’s a court. It actually it is a court.

Angus Pringle: Yeah.

Payman Langroudi: Yeah. But I think maybe that’s.

Rhona Eskander: Almost medieval to be [00:50:10] different. That’s medieval.

Payman Langroudi: Maybe that needs to be different. Yeah. For sure. I mean, [00:50:15] what should someone do if they have [00:50:20] suicidal ideation?

Angus Pringle: That’s a difficult one. [00:50:25] I think from our point of view, I think that.

Payman Langroudi: Talk [00:50:30] to someone. Right.

Angus Pringle: Well, you know, we’re thinking about men and women here. I think [00:50:35] that anyone who is struggling with their thoughts to begin with, I think [00:50:40] it’s most important for anyone who’s listening today know that help is available. Sometimes [00:50:45] those thoughts can be scary. And this is the issue of if someone had thoughts [00:50:50] of taking their own life, it can be scary if they’ve never had anything like this before, or [00:50:55] heard about it before, or heard that recovery can happen. Yeah, um. [00:51:00] And reach out for help, but reach out for support as well. We’ve [00:51:05] got obviously great charities like Samaritans. We’ve got papyrus, we’ve [00:51:10] Got Minds and Confidential, which is confidential, which is.

Payman Langroudi: Anonymous [00:51:15] for dentists.

Angus Pringle: But don’t think you have to go through it alone. Um, there. [00:51:20] It’s always amazing to think of the people who are compassionate that can support [00:51:25] you through this journey. And I think that’s what’s really important. And I think that’s the thing for [00:51:30] us. On the other side of things, if you’re worried about someone is having the confidence [00:51:35] to have that chat, and if it’s particularly if it’s a man, if he sees he’s okay, [00:51:40] ask him twice, you know, are you really okay? And if you’re still [00:51:45] getting a no or you say coming back and say, you know, I’m doing fine, if you then say, [00:51:50] well, I’ve have observed this about you like you’ve been a bit withdrawn. [00:51:55] You don’t look yourself. You look quite distant. Um. I’m worried about you. [00:52:00] It’s trying to really extract that information, um, and be persistent. [00:52:05] And we often don’t want to interfere with someone’s private life. Um, but [00:52:10] it’s important in these their life saving conversations. And if you are [00:52:15] worried about changes in their behaviour, that could be that they’re worried that they [00:52:20] might take their own life. Ask the question because it has been shown to be life [00:52:25] saving. It’s not seeding the idea.

Rhona Eskander: Have you seen that, um, amazing [00:52:30] advert? I don’t know which charity it is. Remember it made you cry. There was two older men that were at the football. [00:52:35] And then there’s one that’s really. Yeah. And then there’s one that’s really happy. And the one that looks a bit [00:52:40] more miserable. And the happy ones always trying to make sure the miserable ones are having a really good time. And then, [00:52:45] you know, it says like, mental health doesn’t always look like it. Yeah. And then it was the really happy one [00:52:50] that ended up taking his own life, which I think really labours the point that, you know, you [00:52:55] never know what people are going through, what mask they might be wearing, and [00:53:00] educate like we need to educate ourselves like, don’t shy away [00:53:05] from it. You know, I know it’s not the happiest topic in the world, but when I got the book, I [00:53:10] started reading it, you know, and I think maybe it’s because I’ve been I’ve been I’ve been in dark places. I really, [00:53:15] really have. So for me it was like, oh my God, I feel seen. Someone’s seeing my mental health. [00:53:20] Like that’s what I felt like. And I wanted to understand more. And I think it’s that education that’s really key. [00:53:25] And for some people, particularly in medicine and dentistry, I think it’s really challenging because of cultural and religious, [00:53:30] um, taboos and stigmas around the conversation. And it’s also not [00:53:35] a topic of conversation, which they feel maybe would propel them in their career. But you know, your [00:53:40] mind, you know, mind over matter. That’s what I think.

Payman Langroudi: Something you’ve taught me, Rhona, [00:53:45] and you brought it up today is that, you know, there’s a there’s a spectrum [00:53:50] all the way from mental fitness and optimisation, all [00:53:55] that good stuff, you know, being at the top of your game all [00:54:00] the way to feeling suicidal and you can move along that spectrum and somehow [00:54:05] talking about optimisation is everyone wants to talk about optimisation, but [00:54:10] when we get to the to the suicide side of it, now stigma creeps in. Yeah, it’s just not sexy, [00:54:15] is it? But it’s the same subject we’re talking about is how are you feeling? How is how is your mental health? [00:54:20]

Angus Pringle: Yeah, you’ve just triggered something in my mind. I’ve just remembered. So Mike McCarthy, who’s [00:54:25] the founder of the Baton of Hope, I have had some amazing conversations with him. And he [00:54:30] lives in Sheffield and they’re they’ve got a men’s club called Talk Club, which is very [00:54:35] simple. And when you go to talk club as a man, you’re asked, how [00:54:40] are you feeling out of ten? And can you tell me why? And I’ve used these kind of [00:54:45] skills with patients in terms of how they’re feeling about their smile or their well-being. It’s incredibly [00:54:50] effective. But I actually had the conversations with my kids. So my oldest [00:54:55] boy, Fraser, he is probably a bit like me, a bit introverted, not necessarily [00:55:00] going to volunteer information, whereas Hugo, he’s [00:55:05] amazing. The conversations we have, he will volunteer information, everything. Yeah. So [00:55:10] it was I saw I spoke to Fraser and I said, Fraser, can you tell me how you’re feeling out of [00:55:15] ten? And he gave me a number and then says, can you tell me why? He then talked to me for 20 [00:55:20] minutes and all these things I could hear about. He says, oh, I’m a bit worried about GCSEs, [00:55:25] what subjects are going to do, what the teachers are going to be like, but that’s a few years away. But I [00:55:30] didn’t know that. But sometimes by asking a different question, it opens [00:55:35] up huge, um, avenues of discussion [00:55:40] because it’s in a non-threatening way, rather than how is your day to day? [00:55:45] And it’s a, it’s fine but think it on a different way. And we use [00:55:50] that a lot with our teenage patients in terms of how they’re feeling, how they’re getting on. Because if [00:55:55] you’re asked something directly, it can feel quite threatening. Whereas if you’re having to reflect [00:56:00] upon your thoughts and your feelings, the answers you get are, as [00:56:05] an.

Payman Langroudi: Orthodontist, you get to see a kid go through. I mean, one of my kids went through two and a half years [00:56:10] of ortho, and then right at the end, we sat with the authorities and said, let’s look at the pictures right at the beginning [00:56:15] and right at the end, and the pictures right at the beginning. To hell with the teeth. He was he [00:56:20] was a child at the beginning. And at the end. He’s a teenager, you know, he’s and so you [00:56:25] see a family go through that period and a teenager. I [00:56:30] mean, it’s a difficult time being a teenager. Oh, gosh.

Angus Pringle: Yeah. Yeah.

Payman Langroudi: It’s [00:56:35] kind of a privileged position as an orthodontist. You get to see them. [00:56:40]

Angus Pringle: They’re so different. Yeah, I absolutely love it. And one of the most important [00:56:45] lessons I learned when I was training at the Eastman wasn’t the technical bit, but we had a psychologist who [00:56:50] came in, uh, Sarah Portnoy. I think that’s right. And [00:56:55] she said, when you’re talking to teenagers, don’t just criticise the toothbrushing. Don’t just criticise [00:57:00] their appliance wear because they’re going to switch off. This is where I learned the scale out [00:57:05] of 1 to 10. If you ask them, how are you getting on with your toothbrushing? And [00:57:10] I say to my patients, a ten is I win a gold medal at the Toothbrush Olympics. And [00:57:15] one is I lost it two weeks ago. So there’s no no judgement in that. [00:57:20] And then 99.9% of the time they’re right. They’ll say I’m a five out of ten. And you say, well, [00:57:25] can you tell me why? And they say, well, I brush one time a day and that’s probably for about a minute. [00:57:30] Um, and I don’t say, well, which end of the toothbrush are you using? But [00:57:35] it’s much more engaging. You’re bringing the patient along with you because it can [00:57:40] be so easy to just slap someone down and say, you’re bad at this.

Rhona Eskander: But dentists are really [00:57:45] bad at that, by the way. I’m really shocked because I did a video on TikTok that, [00:57:50] um, got 8 million views. It went really viral, and it was come along with [00:57:55] me as I watched this girl and this girl, uh, basically expressed that she hadn’t brushed her teeth. [00:58:00] Well, she calls it a hot minute. And she says, because every time she brushes her teeth, um, [00:58:05] her teeth crumble and fall apart. And basically you watch her. There’s [00:58:10] a three minute video. Every single tooth is covered in gross calculus. Um, [00:58:15] the girl is panicking. And I did a really compassionate review of the video, [00:58:20] and the amount of positive feedback that I got back was, thank you [00:58:25] so much. Not for judging her. Yeah, you don’t know what people are going through. There have been loads of dentists [00:58:30] that have been really mean to her on this video. There have um, you know, my dentist speaks to [00:58:35] me like I’m trash, but I was actually going through depression. I couldn’t get out of bed. My bodily and [00:58:40] oral hygiene completely Suffered. And I was like, you know, it’s so basic, but I’ve [00:58:45] heard so many patients that have actually been shamed by their own dentist or healthcare [00:58:50] professionals about not brushing their teeth, having good oral hygiene. We don’t know what [00:58:55] people are going through. I’m not saying that I’m giving people a free card to just do what they [00:59:00] want. I’m not telling you to go and like, have a pack of fags for breakfast.

Payman Langroudi: But you’re right, you’re right. You’re [00:59:05] absolutely right that there are some dentists like that. I think number one are dental [00:59:10] education. We’ve talked about this a million times. Right. What bits of the course would you take out and what new [00:59:15] bits would you add in. And definitely something around mental health of yourself [00:59:20] and of your patients.

Rhona Eskander: 100% should be on the curriculum.

Payman Langroudi: And then and then what you’re saying here empathy. Not sure if it’s [00:59:25] teachable as much, but something you should bear in mind here is that some people [00:59:30] were treated by a dentist who told them off. Yeah. And [00:59:35] they see that’s the dentists job to tell you off. Yeah. And it’s so interesting because [00:59:40] what the dentistry that you had as yourself as a child kind of defines [00:59:45] what you think is normal. Yeah. As dentistry, whatever that was. So [00:59:50] I was treated by the guy. Same guy who treated us in Iran before we came. And he [00:59:55] he happened to go to Harley Street. So I thought Harley Street was normal. [01:00:00] Then I go into my practice saying, what the hell is this? Yeah. The next person had a bossy [01:00:05] dentist. He thinks that’s the normal.

Rhona Eskander: I think it’s I think it’s different. I mean, I had a horrible orthodontist. [01:00:10] Horrible. And it was the worst experience ever. But also, I [01:00:15] wasn’t super compliant, but also, like, my parents couldn’t afford to be around and make [01:00:20] sure that I could go to appointments. So there was complexity in my social environment at the time, [01:00:25] which meant that I was in braces for six and a half years and my six and a half years. So [01:00:30] my orthodontist was like, not great. And he obviously was resentful of being on the [01:00:35] NHS. I still wanted to be a dentist, and I was like, I want to be a very different dentist to him. Do you see what I mean?

Payman Langroudi: So [01:00:40] sometimes you want to be the.

Rhona Eskander: Opposite, but it’s the same as when you look at people that grow up in abused homes or [01:00:45] addict homes. Either they follow in the footsteps or they become the complete opposite. You know, that’s quite [01:00:50] common. So I think that’s. But I think that what’s lacking in the education system and perhaps [01:00:55] in the selection process, a lot of people will choose dentists [01:01:00] based on certain accolades without actually assessing whether they are [01:01:05] right to be a healthcare professional. I was deemed to be not [01:01:10] desirable to get into dental school, and pretty much rejected from every [01:01:15] part of my dental education, not the A-level GCSE part because [01:01:20] I was deemed to be too airy fairy to this, to that because the character I am, and actually [01:01:25] that’s served me. That’s my superpower. My patients are my superpower because I have [01:01:30] that understanding. But in dental school, they didn’t see that.

Payman Langroudi: People misjudge you. [01:01:35]

Rhona Eskander: They do, they do, they do misjudge.

Payman Langroudi: It’s part of it’s part, it’s it’s part of the feature of of [01:01:40] being loud and proud that people get get you wrong. It’s one it’s one of the it’s [01:01:45] your biggest it’s your biggest strength and your biggest weakness at the same time.

Rhona Eskander: But why? But why? Why is dental [01:01:50] care professionals, health care professionals? Do we want somebody to be quiet in the corner and slaving [01:01:55] around? And just like writing academic papers or doing research studies, why is that [01:02:00] considered within the community? Not my patient community. Within the medical health care professional [01:02:05] community, the more quiet you are, but doing research and ticking those academic boxes, [01:02:10] the more we’re going to look up to you.

Angus Pringle: People like us do things like us, [01:02:15] and no one wants anyone to rock the boat and change things.

Payman Langroudi: It’s a conservative.

Angus Pringle: Profession. [01:02:20] And, uh, and I think even in orthodontics is a very small [01:02:25] world. And you think of everything I had to do. I was a kind of a chameleon. I, I changed [01:02:30] myself to be the person they’re looking for rather than the person who I am. So I did, [01:02:35] and hence why I’m in a much better place myself, because I’m doing [01:02:40] my authentic self now in terms of caring for my patients and [01:02:45] feeling fulfilled. But to come back to when we think how we speak to our patients, [01:02:50] this perfectionism trait that is detrimental to our own mental health is [01:02:55] why we sometimes struggle with relationships with patients or with staff members. [01:03:00] If I think of staff members, um, who when [01:03:05] I was younger because of my drive and determination, if they weren’t as driven [01:03:10] and determined and hard working as me, I would kind of judge them internally. I might not [01:03:15] express that, but they’re still doing their job. But at the same with our patients. A [01:03:20] really difficult thing with orthodontics is compliance. But no one is a perfectionist [01:03:25] like the orthodontist might be. How do you get them through wearing their aligners? [01:03:30] It’s a very good point. Their elastics are wearing are brushing their teeth. Not everyone [01:03:35] can be at the very top end of that curve. And how do you handle that and still maintain a good relationship? [01:03:40]

Payman Langroudi: Yeah, yeah. By the way, you think we have egos and dentistry orthodontists. [01:03:45] I was going to sell a product to orthodontists and looking to sell [01:03:50] a product to orthodontists. And I wanted just to talk to some orthodontists, just to see what they thought of the [01:03:55] idea before going ahead with it. So I called Tracy and Tracy Posner. Yeah, yeah. She used to run the [01:04:00] British Orthodontics Boss event. Yeah. So I said to her, look, who are the top 3040 orthodontists [01:04:05] in the country? Let me just go see all of them. My God, the egos, my God, the egos. [01:04:10] It surprised me having, you know, having been with dentists continuously. [01:04:15] There were egos and disagreements. You know, that old thing [01:04:20] about six orthodontists? Seven opinions. It was like six orthodontists, [01:04:25] 23 opinions. You know that so many different ways. And it’s so weird because [01:04:30] as a dentist, you think you kind of know what’s going on in that world. Yeah, yeah. But so many different [01:04:35] ways of moving teeth and different opinions and strong opinions. Strong opinions on [01:04:40] how things should be done.

Angus Pringle: But yeah, this orthodontics is science, but also art. Yeah, yeah. [01:04:45] And it’s the art that we really there’s there’s huge arguments [01:04:50] about, you know, what’s right and wrong. And, and I often say to patients, there’s so many different ways I [01:04:55] can get you to the end point of treatment, but what is going to be the right thing for you? And often they’re [01:05:00] more of the judge than I am. Um, and I’ve sat in the periphery of a lot of online [01:05:05] debates regarding things like Myofunctional appliances, [01:05:10] six month smiles, GDPR, GDPR. So et cetera, et cetera. [01:05:15] And it can get incredibly toxic. But if you step back and say, look, [01:05:20] at the end of the day, we just want to look after our patients. A lot of it is kind of semantics between [01:05:25] different things, but it is about caring about people. But there’s a the [01:05:30] keyboard warriors can really oh my.

Rhona Eskander: God, they’re terrible. They’re literally I mean, they create pages about [01:05:35] colleagues.

Payman Langroudi: Like, I had a guy here sitting where you’re sitting. Uh ex-goldman. [01:05:40] Sachs. He’s now owns 14 dental practices. And and I said to him, what [01:05:45] surprised you the most about dentistry? And he said, the egos. And I was really I was like, I said, what the bigger [01:05:50] egos in dentistry than in banking. And he was like 100%. Yeah. Yeah. It was really surprised [01:05:55] me.

Rhona Eskander: I think it is really difficult. Um, Angus, [01:06:00] it’s.

Payman Langroudi: Been a massive pleasure.

Rhona Eskander: Yeah. You are amazing. And thank you so much for the work that you’re doing and coming [01:06:05] on here and talking about a topic that’s incredibly close to my heart. Uh, I [01:06:10] would love people to be able to connect. If they need more help, could you perhaps give some [01:06:15] information about where they can find any more information with regards to all of this?

Angus Pringle: So I think the [01:06:20] first place is like education. And just like when I gave you the book that in what’s [01:06:25] the when it is darkest like I my I’m really someone [01:06:30] talking through lived experience. I’m not a therapist. I’m not a psychologist. But to actually [01:06:35] understand the backgrounds to mental health and suicide awareness is incredibly [01:06:40] important. I think, in the Dental community, engaging with the charities, [01:06:45] particularly the Canmore Trust, where they’re doing a huge amount of work supporting dentists [01:06:50] in difficulties, but also looking to see can we get a more compassionate regulation. [01:06:55] Um, and there’s a lot of stuff that’s going on online. And if you look at my Instagram, [01:07:00] I’ve done a lot of posts regarding mental health, different wellbeing things, but [01:07:05] I think it’s the collective voice that we all speak together as most important. Um, [01:07:10] from that point of view.

Payman Langroudi: What’s your Instagram? Yes.

Angus Pringle: Uh, Angus Pringle Orthodontics [01:07:15] and or Angus Pringle as well. So. Perfect.

Rhona Eskander: Thank you so much Angus. That’s amazing.

Angus Pringle: Well [01:07:20] thank you for having this conversation. It’s it’s it can be life changing for people and life saving. [01:07:25] So thank you for taking the opportunity to invite me.

Rhona Eskander: Thank you so much.