How To Nap like a Pro

The Nap

Life in the Mediterranean has got a pretty good track record when it comes to health. There’s the celebrated Mediterranean diet (which I definitely battle to achieve), active lifestyles, plenty of red wine – and the siesta. Now the siesta has been around for a while, with its origins dating back to when Latin was not just a GCSE subject. The Spanish translation literally means ‘nap’. Built into a way of life, the siesta is designed to battle the combined heat of the Mediterranean climate and the omnipotent post-lunch energy dip that inflicts the many.


Do they know something we don’t know?

You see, if we put a microscope over our non-Mediterranean lifestyles it will show a very different health landscape – high fat and sugar diets, economically-forced sedentary work-focused lifestyles, about two bottles of red wine too many each week, and definitely not enough sleep. To unpick all of this may see us here a while (and I have some redecorating that needs doing) and so what I’d like to do is chat about the nap and ask the question: is there science in the siesta?

Now it would probably seem a little remiss of me to talk about the nap without talking very briefly about its big brother – sleep. Time for a quick thirty second recap: Sleep is broken into a series of ninety-minute sleep cycles. Each cycle sends you from light non-REM sleep into deeper REM sleep before starting the cycle again. You may therefore have about 4 to 6 cycles each night. Of course, for you and I, these sleep cycles are often seamlessly continuous and form our traditional night of sleep. The reality is that many of us don’t get enough sleep and we’ll go into this more another day. For now, let’s look at how we can repackage that need for sleep – in a nap.

Now, being a doctor, I need to make things very simple because otherwise I will invariably struggle, I assure you. As such, for my benefit – and I hope yours, let’s first establish by what we mean by a nap, by properly defining it. A nap is a short period of sleep that affords you that transient detachment from your conscious mind and body. Like most factors that affect our physical and mental function, the nap has been pretty extensively researched. The research has concluded some key functions of the nap for you:

  1. To enhance your ability to process information and consolidate learning
  2. To reverse a state of information overload that you may be experiencing
  3. To reduce your risk of cardiovascular disease (don’t ask me how – likely multiple factors at play here)
  4. To increase your levels of alertness and your motor (i.e. muscle) skills
  5. To avoid experiencing a ‘burnout’ which presents as frustration, irritation and reduced physical and mental performance

Before we dive into the two different types of naps I am going to drizzle just a little bit more science over our Mediterranean nap plans. You see, during a day your brain constantly absorbs and processes information. That will of course vary depending if you are, for example, in a mentally complex and demanding work state – or sat on the sofa, in your pyjamas at three in the afternoon with a re-heated pizza slice (it’s your workout ‘rest’ day, I know) watching Bargain Hunt. Anyway, we digress – back to the science. Now, a part of your brain called the visual cortex will in turn slowly become saturated with information from your day as it is continuously tested and engaged mentally. Similar to a muscle in your body, it reaches a threshold where it no longer can function effectively. This is your big knocker banging on the burnout door. This burnout threshold however is not all bad, particularly if you can recognise it in time. Just think about that point as the safety mechanism, a way of your body saying “whoa, buddy just take your foot of the peddle for a minute”. In doing so, you’ll allow your brain to process and preserve the information already there and not waste new incoming information that has nowhere to go and cannot be consolidated. That is where sleep, and as a short-term solution, naps come in as a means to cement that final stage of learning and processing.

So how do we get a that necessary mental ‘chill pill’?

The first type of nap is your classic power nap. The power nap is a twenty-minute short sharp nap that is long enough to take you into the early shallower stages of your sleep but not into deep (REM) sleep. It’ll afford you brief physical respite and allow that mental pressure value to be released in order to let off some steam. This way you can wake from a power nap feeling physically and mentally refreshed and ready to tackle the ongoing challenge. Remember though, it won’t be long enough to cement and consolidate any learning – you need deep REM sleep for that – and that’s where your second type of nap comes in.

The second nap is called the consolidation nap. The consolidation nap is a longer nap of around ninety-minutes that potentially takes you through a full sleep cycle via deep REM sleep. The beauty of this longer nap for you is that it allows for your brain to undergo what they call cortical plasticity. This, in a nut shell, means memory and learning is cemented on your brain. Of course, beyond this, the other mental benefit is that while asleep your subconscious continues to process your problems in the absence of all that conscious background noise that fills your life. That’s why you sometimes have those Eureka! moments after a nap. I am of course, still waiting for mine.


The bubble had to burst some time. Writing this I know for all of us, the above is all well and good – in theory. In the real world, we all often have busy hectic, insatiable lives that don’t afford time for twenty-minute (let alone ninety-minute) naps. We also don’t have a Government (unless you are reading this in the Mediterranean somewhere, in which case you have probably just woken up from a wonderful enforced nap) that endorses the siesta. I for one cannot imagine my medical practice suddenly demanding I nap each day – despite teasing me day in and day out with a patient examination couch that could definitely double as a nap worthy bed. We have 24 hours in our day and still that is not enough time for us to do all what we want to do.

There’s the rub however. We need to be malleable, adaptive and smart in finding ways to go about our days so that we can implement physical and mental performance enhancing measures, like the nap. After-all in the long run it is better for your performance and your health. It is also in theory, more efficient. And anyway, who doesn’t love a nap. So, consider ways in which you can incorporate a nap into your life. Perhaps it will be task and time specific, for example when revising for exams or doing a weekend of interview or meeting preparation. Or if you have the time, add in one long nap a week, perhaps after work mid-week to just re-charge.

The magic bullet? Well, if all that fails, good luck and move to Spain.

See you next week.


@DrNickKnight (Twitter)


Your Life Lesson from a 6 Week Old Baby

Well here we are. Forty-eight hours into being a GP registrar and I still have a licence to practice. TICK. All my patients are still alive. TICK. My colleagues still like me (I think).  TICK. I’m still rolling with the Lycra. TICK. Time to make hay while the sun shines.

Of course you and I know this will only last a certain while. After all, life – real life not Hollywood life – is also about the curve ball, the surprise, the unannounced.

And with that in mind, let me tell you about my youngest patient of the day –  a little man just six weeks old. I mean, Love Island was on for longer than he has been alive. He came with that fresh book smell we all love, and naturally had attached to him a two attentive first-time parents who had bought enough from MotherCare to prop up any ailing economy.

My task of this 15 minute appointment – the six week baby check. It’s a head to toe job where I basically make sure this little man has been put together properly. Thankfully I have done this before; Not quite an ‘old hand’ but not quite a ‘popping to the loo to Google “how to check a baby”‘ situation  (there was a time, yes).

To the tune of my lazily scraping chair (my legs are feeling the cycle ride today), I get up and grandly announce for them to strip their baby down and put him on the examination couch. They get to it like a pair of eager army recruits, peppered only with the under the breath exchanges of short, terse words as dad struggles to negotiate the Panda themed baby grow – fully aware that my judgement of their parenting hangs on the very task. I tap some notes on the computer while quietly enjoying the mini-domestic unfolding. Two minutes later, the little man is prepared and I step up to the mark. Game time.

As I stare down upon him sprawled on the examination couch, all pink, chubby and squirming, I can’t help but think how happy he looks. Not a care in the world.large

How your luck can change, little man.

Like a burst water main his own ‘little man’ suddenly kicks into action and he starts to pee. I have never seen something so remarkable. He has managed to pee in the perfect arc – enough to rival one of Mother Natures rainbows –  launching it over his body and straight onto his face. Instagram would have loved this.

The expression he gave was golden. If I could paraphrase on his behalf, it would have been “W.T.F”. If you don’t know what that means – good on you – that’s clean living.

And so in that moment it reminded me of a valuable life lesson. Sometimes shit just happens. I mean this little man didn’t expect at that moment in time to get a face full of urine – especially his own. But he did. Likewise we don’t expect to fall ill, get dumped, not have the level of fitness we did 10 years ago, or realise one day that we don’t fit into our jeans anymore. But we do.

It is however, what happens next that counts.

Do you stand up, dust yourself off, learn from it and move forward? Or do you bathe and wallow in the fact that something bad happened and fail to even try to move past it? My humble advice – think like my little man in clinic – he took it in the chin (literally), had a bit of a cry,  some milk and then had a nap. By the time he has woken up, he’s shaken off the experience and is onto the next adventure.

Maybe we should all take a leaf out of his book when life urinates on us.

See you next week.


Twitter: @DrNickKnight

First Impressions are Difficult in Lycra

So this is it. Twelve months time and I will be, barring an catastrophic cock-ups on my behalf, a fully qualified GP.  My wife is thrilled – it means we may be able to finally upgrade from the Citroen C2 – which while a spritely 1.1L car – does feel a little bit like forgetting your P.E. kit and having to borrow the cast-offs from the lost property box. Sorry, Citroen.

On the plus side, my final twelve months are in GP surgery within cycling distance. Sorry Citroen – you’re dumped. On the morning of my first ride to work, inspirational thoughts of Sir Chris Hoy, leapt into my mind. He really rocked the lycra. After then staring at the exceptionally pathetic state of my cycling lycra collection, those same thoughts leap out my mind. Replaced was a steely determination that swept over me (last experienced when tacking that stuck ring pessary in clinic), and after a few sharp inspired breathes, conjuring of warm thoughts (for the sake of my own dignity), I wrestled into my lycra.

Thirteen miles later (it’s actually only 11 miles away from home but I got lost – twice), I arrived at my new GP surgery. Home for the next twelve months. I’m excited. The bike locked outside, I took a moment to whisper some inspiration words to myself – “don’t kill anyone on your first day” (extremely difficult given that I just observing this week) – and stepped into the surgery.

Now they say first impressions count.

I really hadn’t thought this through.

A first impression that says professional, diligent, and presentable – are a real stretch when you are standing in front of your new boss, two receptionists and the surgery clinical manager dressed in what can only be described as a gimp suit for wayward cyclists. A fatally placed water splash mark from my (cold) water bottle over the groin is the sucker punch.

Like anyone caught compromised, I realised, on the balance of things, that I had two options; Apologise profusely, trying to explain the series of unfortunate life (and faulty water bottle) choices that led to these lycra choices and regain some impressional ground back – or, pretend like there was absolutely nothing wrong and, that this is just the way I roll.

I, ladies and gentlemen, chose to roll.

Next week I begin to see you – the patients. I cannot wait. Let’s enjoy the next twelve month adventure together, shall we?


@DrNickKnight (Twitter)


THE HEALTH CONVERSATION, Chapter 4: Key Tools To Tame Your Health

Key Tools for the Book

Like any plan of action in life we need a combination of luck, skill and preparation. Thankfully you are just reading a book and so I would hope that the first two are not needed in too much abundance. The final one, preparation, is what this next part of the book is about. In the next few pages I want to tell you about three key tools that I want you to try and apply to yourself as you go about reading this book. These tools are (1) The Knowing-Doing Gap (2) The Cycle of Change and (3) Self-Motivational Interviewing. Now yes, I would like you to digest these three tools applying them to your own life as your browse this book but I also want you to remember that you can apply these to any part of your life – not just your health. Consider how they may be useful in work or with your family and friends. As promised there is no whale music featuring in The Health Conversation so you can blow out the joss sticks and turn off the meditation CD for now.


Tool One: The Knowing-Doing Gap

The “Knowing-Doing” gap is one of my favourite principles. It makes me smile just to think about it and its simplicity actually. Remember, simple is good. Now, I want to share it with you, not just because I clearly have a literary crush on it but because it frames the very ethos of The Health Conversation. In doing so, it help make sense to you as to why some of this book is just so bloody simple and straightforward.

Now I first read about the “Knowing-Doing” gap in a business book. Much to my disappointment and frustration I still cannot remember what the book was called. But anyway, let me still share with you the story within it. Picture a packed, high-profile glossy, no-expense spared conference centre in North America. The conference centre is packed full of high-flying executives, most of whom were at the top of their respective companies – CEOs, CFOs, CMOs, and the ‘Who-knows’. They were all there waiting to receive the invitational key-note speaker of the conference – the executive of executives who conveys an almost God-like presence. Forty-five minutes later this executive deity finished his speech.  Unfortunately for the paying delegates however, he had just spent that 45 minutes telling the packed conference centre of experienced executives exactly what they already knew about running a company and how to behave in business. Naturally the delegates sat there feeling slightly short-changed. It’s like asking for a Sunday Roast Dinner – and getting a corned beef sandwich instead. Disappointing to say the least. Of course being a room of alpha-male and female personalities, someone put their hand up and brazenly asked the question that everyone was thinking: “Thank you, Sir, for a wonderful talk. However with respect, don’t you think we knew all of that?” The key-note speaker just smiled his deity-like smile and replied, “Now, be honest and show me the evidence that you actually DO what you KNOW you should do in your business.” The penny had dropped. This was no message from a higher-being; this was just someone saying how it is:

We know what to do – but more often than not, we don’t do it.

What a wonderfully powerful, yet simple message.

The reason I wanted to share this with you is because it translates as readily to your health as it does to the above business example. What you will read in this book you may already know a lot of – which is brilliant. All I am trying to do is highlight that fact. In doing so, I want to prompt you to actively think “I know this – but maybe I just don’t do this”. In essence I want to make you aware of your own “Knowing-Doing” gaps. This is the first step to realising that change can and is possible.


Tool Two: The Cycle of Change

This leads us nicely onto the Cycle of Change. Now I wanted to introduce this principle to you because we are all, whether we like it or not, in it. You may knowingly be trying to change or perhaps stuck stagnating on the Cycle of Change because you have not even considered changing a habit or lifestyle choice. That’s the beauty of it, it covers all bases.

To explain further, I want you to think of the Cycle of Change as a journey. It starts with a thought (or actually even before the thought) and proceeds along a journey over days, weeks, months or years to an action. It is this action that elicits a change in some part of your life. Even then your journey is not over, for we sometimes either needs to make efforts to maintain that change or sometimes we simply relapse and need to begin again at a point further back down the Cycle of Change. The points along your journey to change have specific sign-posts. What we’re going to do now is briefly touch on each of the sign-posted stages so that you can go away and consider where you are on the cycle for various things you may wish to change in your life.

First in the Cycle of Change comes pre-contemplation (Stage 1). Here you have not even considered changing something. For many of us there may be elements of our life which we should consider altering to improve our health but we simply haven’t reached a point in our lives where we need to or can even think about doing so. When we do however, we enter the second sign-post on the journey – contemplation (stage 2). Here you are considering a change but you have not yet planned or acted upon it. As this contemplation and resolve to enact upon your new desire grows, you are led nicely to the third stage – preparation (stage 3). This stage is all about preparing for your change to happen. It may be that you seek out who will support you on your decision to change or you are planning what elements of your life may need to change for it to be successful. You can only advance to the next stage successfully (unlike Monopoly, you don’t collect £200 when you pass GO) when all of the preparation stage is complete. If it is, then you can happily proceed to the fourth stage –action (stage 4). This is the stage where the change takes place. It is often the most high risk stage as it calls upon those two elements I asked you to have earlier – patience and hope. From this stage two eventualities usually happen – maintenance or relapse (stages 5). Both are equally important to the process of change and you can definitely learn from either. In a maintenance stage you reinforce your change and thereby further concrete it for life. In a relapse stage you will have experienced a hiccup and broken that change. That’s ok though – we are human after all! Besides, we learn the most when we are failing. If this does happen, all you need do is get up and dust yourself off, and move back to the preparation stage of the Cycle of Change again. From there its simple – you proceed forward again, this time with some added wisdom!



Tool Three: (Self) Motivational Interviewing

The final tool I want to share with you is what those in the medical profession sometimes refer to as motivational interviewing. Now if Lord Alan Sugar springs into your head with his sturdy finger pointing at you as he grumbles “You’re fired!” then you can relax. It actually has very little to do with interviewing. In fact, come to think of it, I have no idea why they even bother calling it that – though I’m sure somebody with a bigger brain will correct me after this is published. Instead I want you to think of Motivational Interviewing as a conversation. Now this may often be a conversation between you and somebody in the healthcare profession such your GP, a specialty doctor, or you and your personal trainer, for example. That is all great, don’t get me wrong. However what I want to say to you is that perhaps, for those of you who are maybe a little bit shy, don’t want to speak to a health professional right now, that Motivational Interviewing can be just as much about having a conversation with yourself. Hence, Self-Motivational Interviewing. I love it and do it all the time.

So what’s the conversation about? Well since it’s your conversation, it can be anything you want it to be about. As a guide for you, I like to think of mine incredibly simply and ask myself questions like:

  1. What is my health goal?
  2. Why is this health goal? (After all this is what is fuelling it, right!)
  3. What is stopping me from achieving my goal?
  4. How can I overcome these barriers to my goal?
  5. How can I break the actual goal (not the barriers) down into bite-size achievable chunks?

The final point is really important as some goals can just feel utterly insurmountable. And you know it is of course a very personal issue. For example, for one person, losing 5 pounds of body weight may seem like a terrifying and unachievable proposition. For someone else however this may be easy and yet they have instead blinded themselves with the enormity of setting a self-imposed 5 stone loss target. The trick with any goal is to agree bite-sized goals. They will after-all add up to that final goal; the one that you’ll finally turn to, your head at slight angle and a Wild-West Clint Eastwood squint in your eye, and growl  “Huh, you ain’t so scary after-all”.

So there you go, three tools to have in the back of your mind as you read this book: The Knowing-Doing Gap, The Cycle of Change and (Self) Motivational Interviewing. As we now amble onto the twenty one health conversations for twenty first modern living please don’t be afraid to flick back to these to refresh your memory. Alternatively you may find it useful as you go through the book to take a time out with a piece of paper and a pen when something really grabs your attention or sparks an idea.

Remember, like that friend we talked about earlier, this book is not on your Christmas card list!

Chapter 5 will be out next week! Follow me if you like at @drnickknight on Twitter!

The Health Conversation, Chapter 3: What is Health?

What is Health?

“Healthy citizens are the greatest asset any country can have” [Winston Churchill]

Health is individual. It’s also a chameleon, constantly changing its appearance as we move through our lives. And for these reasons, my health is most certainly different to your health; that’s not only in terms of our interpretation of what health personally means to us but also of its current state and its future state. So with so much variability you may begin to realise that it’s pretty bloody hard to define. Of course, by define, I don’t mean the textbook definition – I mean to define to you.

With all that in mid, what I want to attempt is to help build a really simple four pillar building in your mind. The four pillars represent physical health, psychological health, social health, and spiritual health. Try and picture this building. Each pillar is an equally important structural component to support that roof which is called ‘total health’. Without a weak pillar, the roof collapses.

Pillar One: Physical Health

I thought we should start with the most obvious, yes? Now I tend to think of physical health as referring to the health of our physical make-up. That’s from your skin, to your internal organs, to the millions of cells that exist within our body. These all work in an awe-inspiring dynamic, ever-changing, ever-adjusting synergy that allows us to manage the environment we exist in. Not only that but it helps to manage what, we ourselves, do to our body from the food we decide to consume to the illness we acquire or injuries we sustain. It is often the component of health we all most readily associate being ‘healthy’ with. It is also the one that we positively associate with being able to function in society with. What I’ll show you next is that you can achieve an even more brilliant feeling of total health when you refocus on the three other pillars of your building.

Pillar Two: Psychological Health

Now because I felt that psychological health, or mental health if you prefer, is often the elephant in the room when in comes to health, I wanted to introduce you to a formal definition by the World Health Organisation (WHO). The WHO state mental health as a subjective well-being, perceived self-efficacy, autonomy, competence, intergenerational dependence, and self-actualisation of one’s intellectual and emotional potential, among others. Bit wordy isn’t it. Basically it is a sensation of feeling good about life and positively engaging without yourself and those around you. And you know our psychological health is such an unbelievably important pillar to our total health roof. I say this in the context of a society where subclinical and clinical depression is on the rise, and life dissatisfaction, stress and apathy permeates at all levels. We all deserve a state of psychological wellbeing where we are not only free of mental disorder and disability but also free of unacceptable levels of stress in our life. It is crucial to allowing ourselves to have good, balanced total health.

Pillar Three: Social Health

We are social creatures. Now yes while, it is true that some are (much) more social than others, craving the limelight and social butterfly status, we all to a greater or lesser degree want to socialise. It is, as I am sure you will agree, an incredibly important and powerful component to our total health; to live in isolation without social contact has been shown to be detrimental to your overall health. After all, no man is an island. We are happier when we socialise, when we engage with people, when we laugh, and off-load stories and stresses. In the process treat and alleviate many burdening psychological health problems we may have and stop them from pathologically growing from seed into some horrible venus flytrap, eating away at our health. Friends are the best medicine. This pillar is being powerfully affected by modern life. While many of us may argue we have fantastic social access (although concerning this is increasingly ‘online’), we are also seeing an elderly generation facing years of increasing isolation and loneliness. This is an unresolved and emerging tragedy that we must tackle.

Pillar Four: Spiritual Health

This for me is the one pillar of my building that I am still in desperate need to use and learn about more. I tell you that because I think it’s pretty ignorant and unfair of me to jump on my literary soap box (I don’t think that the literary scholars will be hailing The Health Conversation as the read of the decade somehow!) and state how important spiritual health is when I am still learning to appreciate it more myself! Spiritual health will mean different things to different people. To be honest with you, I’m not even that sure how to define it. Then again, it’s like Louis Armstrong said, “Man, if you have to ask what jazz is, you’ll never know”, and so perhaps it’s not possible to properly define spiritual health. You just know it when you have it. So with that in mind, you may knowingly have it in your life already, or after reading this realise that you unknowingly had it in your life. Perhaps however, this is entirely new. So what could spiritual health mean? Religion? Possibly. Mindfulness? Could be. Or meditation and spiritualism? Maybe. In fact I guess that it could be any connection you have with an outside force or being that is in some way linked to religion or a spiritual way of life. People often associate its importance with when at the end of their lives but I am increasingly seeing its value through every stage of our lives as a key element to attain total health.

So what influences all of these different components of health? Well, to be honest, you know the answer already. Go on, think. I bet if you had a piece of paper and pen, you could right down a list of things in your life that influence the four components of your health. Broadly speaking we can divide them into internal and external factors. The internal factors pertain to what happens to your body naturally without your active engagement. The external factors pertain to what we do to our body and how it then reacts. These, as you might guess, are the more problematic issues like smoking, calorie rich diets, no exercise, sedentary living (yes that is a different problem from no exercise) and excess alcohol consumption. But we won’t dwell on these here as we’ll talk about these later. All I want you take away is the concept that there are four pillars to your health: physical, psychological, social and spiritual. To achieve the best possible roof that holds your total health, you need to pay attention to all four pillars. Equally.

Chapter 4 of the Health Conversation will be posted next week!

Dr Nick Knight @DrNickKnight

THE HEALTH CONVERSATION: Chapter 2 – Modern Living and Health De-Railers

Modern Living

“Unlimited choice is paralysing” [Susan Orlean]

There’s no doubt that modern living is pretty damn good. We are overloaded with a glorious abundance of choice and opportunity that excites and motivates many of us. What I want to highlight here in this chapter is that perhaps, just perhaps, the living has gotten a smidgen too good. We now have too much choice and too much opportunity. As a result, a number of problems (often related to our lifestyle) have crept-up upon us in the cold light of day with outrageous brazenness and are now systematically de-railing our health. After much self-debate, scribbling and whisky, I have narrowed down my top 5 health de-railers.

Health De-Railer One: We Hurry but Go Nowhere

Life has gotten significantly more fast-paced. We want financial security and cash faster, satisfying calorie-rich food faster, success in work faster and attention faster. It seems to have crept up insidiously over the past 50 years and transformed the way we perceive life and its now infinite possibilities. The ongoing technological revolutions have of course happily fuelled this desire for the ‘instant’. As a result, life, for many, is now an online process. We shop online, date online, work online, communicate online and socialise online. While some of you may think this is great news, please, please do think again. This online life and desire for the instant now means that for many of us, our lives are spent sitting on our fat-laden bums providing a suitable cushion tapping away at our keyboard or smart phone. As the quote above suggests, unlimited choice has paralysed us. Sadly it is a voluntary paralysis. Are we now held hostage to technology? More on that later.

Health De-Railer Two: We Stuff First and Question Later

Ourselves that is. But look, don’t worry because you are not alone slowly sinking in your own world of gluttony. For as a stern society we have slowly and collectively slipped into this way of life. We now all find ourselves treading water in a sea of sugars, fats and salts trying not to give in to them. It is truly a battle of will. Even those of us who try to eat healthily slip-up since many of these so-called healthy-option ridiculously expensive ready meals often contain more salts, sugars and fats than the cheaper unhealthy options! We are all facing this steep and uphill battle since he supermarkets don’t seem to be helping us; Instead of healthy meals and foods, we are seduced, teased and tantalised with deals for all of the foods that we probably shouldn’t be gorging on; the crisps, the microwave meals, the pizzas. Ask yourself, when was the last time you saw a bloody green-leafed salad on promotion by the check-out desk? Perhaps it is time to bring back some collective responsibility.

Health De-Railer Three: We Seek Gratification without the Graft

Let’s be honest, we all like an easy life. If we can get our personally sought after life-rewards without doing much work, then many of us will happily collect them in this manner. This, rather than get it through hard-work. Now don’t get me wrong, there are perhaps a time and a place for this (after all, it is efficient). The problem however is that the mentality of seeking the path of least resistance has leaked into our daily mind-sets. Our previously impermeable brain defences that protected our desire to work hard, to study at school, to climb the career, and to work for that healthy body have well and truly been breached. As a result the inverse has now happened and many of us object to matters of effort like being physical active, cooking healthy low-fat meals or building careers. As for that final one, building careers, it terrifies me the amount of teenagers in school who seem to be seeking out instant fame over an actual career

Health De-Railer Four: We Brush Stress Management under the Carpet

Stress is a killer on our health. Directly, it saps our body of energy, makes us a bag of nerves and has the potential to make us feel utterly physically and mentally drained. Indirectly, it sends us down that less promising path that is plagued with losing focus on the fundamental elements of life that keep us healthy (like sleep, balanced diet, being active and avoiding excessive vices like smoking, drinking and drugs). Instead we look past these now blurry fundamentals and instead focus on the elements in our life that provide instant gratification and thereby unburden us of our, even if just for a little while. So forms do these instant gratifications come in? Well although it has many disguises I am sure at least some of the following will trigger a small, subtle nod of acknowledgement: excessive smoking, drinking alcohol, binging on fast food and late nights. The sad reality is, as much as that period of stress relief is nice, it is still temporary and once over, you will still need to deal with it.

Health De-Railer Five: We’re Blind to the Boozing

So I am sure I’ll get a few angry reactions to this next comment but I will crack on all the same – the world would be a better place without alcohol. Now as you know I enjoy a whisky but that said I still stand by my statement. While yes you can argue the few benefits of alcohol (which we talk about later) the damages of alcohol excess overwhelmingly outweigh them. We as a society have become complacent to the excess of alcohol and it has now insidiously and successfully permeated into our daily evenings and weekends without us even realising it. Nowadays, if we are honest with ourselves, not many of us actually keep track of how much we drink in the week, or the typically more heavy weekends. I know I don’t. What I can assure you of though is that it will in all likelihood exceed the national recommendations on consumption. That short-term gain of social lubrication is brutally countered with accidents, violence, hangovers, relationship breakdowns, empty wallets, addiction and damage to the body and the mind. It’s sad but it’s true. I’ve seen it first hand.

So for all of modern living’s spoils and glory it has, it seems, led-us by the hand cunningly into an unhealthy trap. All of these de-railing issues (sedentary lifestyles, poor diets, stress, vices and laziness) are responsible for the bulk of lifestyle-diseases like obesity, type two diabetes, high blood pressure and heart disease that now dominate our GPs and NHS services. These more pressingly cripple our health. In this trap we are not caught up in some fictional spider’s web, nor are we to be rescued by some handsome prince or Zena Warrior princess (whichever you prefer). In fact we have trapped ourselves and our only saviour therefore will be ourselves. Now, being ever the optimist, I will tell you that there is hope and if you are patient (remember – hope and patience!) then you can and will be your own saviour.

After all isn’t that partly why you picked up this book?

Next Week’s Chapter 3 is on TOTAL HEALTH @DrNickKnight

THE HEALTH CONVERSATION: Prologue and how to use my book

The Health Conversation: My online book for everyone

By Dr Nick Knight



This is a book for everyone.

I have written it with a mere personal hope to remind, refresh and recharge the actions that we may take in life and which influence our health.

Be rest assured that closing your eyes and listening to whale music does not feature.


About the Author

Nick is a 34 year old doctor training to become a General Practitioner with a special interest in fitness, exercise and lifestyle health. He currently lives in London with his new wife, Jess. They both dream of escaping to the countryside one day and getting a dog called whisky. Nick, incidentally, also likes whisky.



Please consult your General Practitioner before enacting upon any of the advice or descriptions in The Health Conversation. This book is written for everyone but health prescription needs to happen on an individual basis.




Prologue: My Passion

How to Use This Book

Modern Living

What is Health?

Key Tools

Twenty One Conversations for Twenty First Century Health:

Conversation 1:                Age as a Barrier

Conversation 2:                Alcohol

Conversation 3:                Bodyweight

Conversation 4:               Celebrity

Conversation 5:                Death as Part of Life

Conversation 6:                Diet

Conversation 7:                Exercise

Conversation 8:                Existing Health Conditions

Conversation 9:                Family Empowerment

Conversation 10:              Internet

Conversation 11:               Mental stimulation

Conversation 12:              Mood

Conversation 13:              Sedentariness

Conversation 14:              Sexual Relationships

Conversation 15:              Sleep

Conversation 16:              Smoking

Conversation 17:              Social Respect

Conversation 18:              Stimulant Drinks

Conversation 19:              Stress

Conversation 20:              Teamwork

Conversation 21:             Technology Drain

A Quick Reality check

What to Do Now?

Summary of The Health Conversation

Appendix 1:                       How Doctors Diagnose

Appendix 2:                       Snapshot Health Card


Prologue: My Passion

I often wondered what a prologue was. Yes, I am most certainly not going to pretend to be clever enough to know already. Thanks to the Internet (which we will discuss in all its shades of grey later), I now know it to be an act or event that leads to another. Here is my prologue – from garden hole to GP trainee.


It all began when I was a kid. To me, playing was largely defined as throwing my battle-scarred action-figures on their latest mission into some cavernous muddy hole (that I had joyfully torn out of the wonderfully manicured garden-bed that my parents had slaved over), and then dunking them in some ice-cubed filled water pit. Little did I realise that this was the start of my fascination with the human body. You see, deep down, apart from the subliminal messages I was sending my parents (clearly I wanted a pond) I was asking my action figures to ‘survive’ in extreme and challenging environments. I was asking them to push their, albeit plastic, physical abilities and mental strengths to their very limits. I was, I guess, concomitantly testing 1990s Chinese manufacturing durability.


Now that passion, to explore the human body and mind, it seems has never left me. In fact, 25 years on, that child’s play which saw me constantly muddy and sacrificing toys to huge garden holes, has grown into my career. And I bloody love it. You see after three long degrees including a degree in Sports and Exercise Science, a PhD in Performance Human Physiology and finally a degree in Medicine, I now work as a doctor in specialty training to become a GP by 2018. I should add that this was never the plan. I chased a girl to Oxford to do my PhD (she then dumped me a month into being there). I then only went into medicine initially after a stint in the City, where I fast realised I a little too rough around the edges to cut it or enjoy it. I wanted to roll my sleeves up and have an adventure.


Ok, so it is true that all my patients might not have just escaped from some muddy garden hole (though I’m sure it happened in a movie once) or bucket of ice-water but what’s happening to them is not a million miles away – their bodies are being stressed, attacked and challenged – this time however by disease, illness, trauma and the degenerating chronicity of their health. And you know what, this isn’t anything that new; Thousands of years ago Neanderthals had similar problems, and then some, in the form of hunting huge carnivorous animals with a bit of sharpened wood. No thanks.


Nowadays and exponentially more so since the supercharged and flamboyant arrival of the 21st Century, a new problem is thrown up: choice. Choices are all around us. It is these choices that are leading many of us blindly and unwittingly into health troubles. We have our modern day health enemies, hidden as wolves in sheep’s clothing, like as our dear and old loyal friend the television remote, fast-food on every paved street, and a pathogenic and inherited fear to break a sweat with some exercise. Trust me when I say that if our bodies had a voice these would not be the choices they would make. That is the thing though isn’t it. They, our bodies, do have a voice. They are making their statement of intent and distain at what we are doing to ourselves very well known: heart attacks, type two diabetes mellitus, obesity, depression (yes, depression) and chronic lung disease.


Of course luckily for us we also live in an era that celebrates unbelievable advances in scientific research that filters from the laboratory into our everyday lives, and developments in medicine that allow us to identify, treat and prevent disease better and earlier than ever before. And you know what, for me, it’s that fine balance, that personal artistic interpretation between the wise, the not so wise, and the dam-right stupid choices we make in life, combined with our pre-determined genetics and those life events that just happen, that make you and I just so fascinating to explore.


I feel incredibly fortunate to be a doctor. We have a privilege to go beyond the looking glass and step into and affect (hopefully for the better) our patients’ and their families’ lives. With that comes a responsibility, one which I take very seriously. This book, I hope will reflect that, and too reflect my passion for health. It is just one way in which I wanted to share what I have had the privilege to learn, see and experience as a doctor in his early years.


Right, so serious paragraph aside, how do I want to wrap up my first ever prologue? Whether it’s the science behind our health, or how medicine helps us battle and beat disease and disability, I admire the human body. It transports us into a hidden world full of life, death, adventure and struggle that rivals any Hollywood Blockbuster.


And for me, it all began with one plastic toy and a garden hole….



How to Use This Book


“Whether you think you can, or you think you can’t – you are right” [Henry Ford]


This is a book talking to you about every day issues which influence your health. It’s a mix of my opinion, observation, rant and information. That’s it really. There is I promise, no hidden agenda, no magical secrets revealed to lead you to everlasting good health and no hidden message. It is not a Sudoku puzzle of health but should instead be Ronseal™ for health i.e. it does what it says on the tin.


As such I have written The Health Conversation without any long scientific, medical or encyclopaedic rambles. It is instead written largely from my memory (which is not great, I must confess) using the last 15 years of experience I’ve been fortunate to have across science, health and medicine. This calls upon what I have learned in academia, anecdotally experienced myself, seen in society, and learned inside the NHS.


There is too very good reason I have chosen to write it this way. And no it is not because I couldn’t be bothered to drudge up the umpteen oversized (and overpriced) medical and scientific textbooks that now live in my basement cohabiting in unison with the mould that is slowly over taking it but it was rather a genuine conscious choice to leave them there. You see by doing this, the detail and depth of information I hope to provide will stay true to my goal of delivering digestible, simple conversations about health and the issues surrounding them that we all need to be aware of. In keeping with this same theme, I have deliberately renamed the chapters as conversations and kept them short and snappy at to three pages or less. Let’s be honest, if I can’t summarise in three pages what you really need to know about one of these topics I’m not doing my job of delivering digestible information! Besides, who really wants to read a 4th, 5th or even 6th page about smoking or exercise?! I know I bloody-well wouldn’t. If I wanted that, I’d go back to medical school again. At the end of each conversation I’ve included 5 key takeaway points.


So that’s my part of the deal. What do I ask from you in return? Well, first of all I want you to treat this book like that friend who’s not quite on your Christmas card list but you see them occasionally for coffee (when it’s convenient to you and you’re at a loose end). By that, I mean pick this book up, put it down, dip in, and dip out. I want you to enjoy it when you read it but not be burdened by it. Of course, it may also be that not all of the health conversations are relevant for you – in which case, please don’t read them and do something more fun instead. Perhaps on the other hand, it may be that a particular health conversation is relevant to a family member or a friend. If this is the case, pass them the book with the chapter ear-marked for them.


Now I only have two requests to seal this completely unofficial and in no way legally-binding partnership between you and me. The first is that you must have hope. Jokes aside, we all possess the ability to fine-tune our health. Just consider that quotation by Henry Ford at the top of this chapter for moment; it’s about self-belief isn’t it? That is the reason why it’s my favourite quote. For self-belief is fantastically potent and contagious and has the ability to transform our lives and those around us. Whatever your goal, perhaps triggered by your doctor’s orders, your parents’ comments or just something you see in the mirror that you are not happy with, you can achieve it. Don’t listen to any silly bugger who says otherwise. So please, that is my first request, that you have hope. It costs nothing. The second and final request is please be patient. Things do not happen overnight. If you can overcome this, the greatest adversary to any goal known to human-kind, you will in time, achieve your goal.


So that’s it. If you can have hope and be patient then this book may help provide insight, direction, and support to you as you go about achieving those health goals that you yourself decide to set.


Before we launch into the twenty-one conversations that form the body of The Health Conversation, I want to talk to you about a three matters. The first matter to discuss is the many challenges that modern living has unceremoniously thrown in our face (while supposedly enriching our lives) and how these have affected our overall health. The second matter involves asking you to consider what health actually means. Yes in the first instance this is a seemingly simple question but actually I think it’s more complex than we may first think. Finally I hope to provide you with three principles (the knowing-doing gap, self-motivational interviewing, and the contemplation cycle) that I’d like you to have in the back of your mind as you thumb through the various health conversations.


Remember – don’t think too hard as you read this book. It’s designed to inspire not give a headache.




Have a great week, all and please come and say hi on twitter and share this blog.