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Ahmad (00:00.847)
Does it help that I’m holding it? Like, see, I’m holding it like, you look great. You look really handsome. When I’m swapping the keys, right? One’s on you, three’s on me. And listen, what’d you think of the food? Was it all right? Lovely. Home cooked. Can’t get better. I’m honored. Fully enjoyed it and honored. And also lovely that the kids were there. Thank you. Right. I really wanted them to sit and chat with you. I wanted to chat with them. It’s nice. They’re cool. They’re super cool. Yeah. Yeah. I know.

So basically, I don’t know any guest who I have chased or harassed quite like you to get on the show. Honestly, I haven’t, no one. There’s one other person actually, Vanessa Gray. She’s still someone I want to get on. She’s a friend of mine. She’s brilliant. Every single time I speak to her on the phone, I’m like, my God, this would be a great podcast. But there was you, because I just think you’re hilarious. I think you’re funny. I think you’re ethical. You’re a real doctor, real proper surgeon.

So you kept, yeah, yeah, kept making excuses. What changed? Why’d you want to come on now? What happened Buster? I ran out of excuses. Well, I’m honored. I’m honored. Really? I’m honored. Idiot. That’s my sincere face. I’m honored. Dude, I love you, man. Seriously. We’ve always gone. And like you’re like a unicorn, you know, there’s hardly any real true.

ethical surgeons out there that I know of. Not many are there? So we’re going to talk about hypocrisy. You can talk about anything you like. your podcast. Well, you’re a knee surgeon. I mean, we could talk about knees. We could talk about how to look after knees. That would be a bit boring. I think all the people are desperate to hear how to avoid a knee replacement. No, just avoid a knee surgeon. Right.

But you’ve come with notes, so what did you come prepared to talk about? I know you, you’re organized. Show everybody the typed out. Look how neat you, I mean look at you. Neat, it’s printed. I know this is what I mean, like organized. but formatting’s important. I’ve done bold and underlined and headings and bullet points. This is what I mean, it’s just, God, you’re… But you gotta have a bit of OCD to be assertive. Can I have a look at it? No. Can I have a look at your notes? It looks like a CV.

Ahmad (02:28.656)
Medical ethics and facilitating fully informed consent to treatment. It’s really funny. Do you know on the drive back from kickboxing, I was teaching the kids about informed consent. I was saying, what does informed consent mean? I think it’s important that they know. All right, this is good. I like this. That’s why I printed it off. That’s why I brought it. I brought it because I didn’t want to do it to the injustice of getting it wrong. Because the wording, you know, words count, words matter. Words matter.

No, black lives matter. Don’t start. So, yeah, I should we have a look at this? So let’s talk about informed consent. Like we’re both, well, no, no, no. You’re a surgeon. I was a surgeon. That makes me sad. I still disagree. I’m still upset with you about that. I disagree with what you did. I know why you did it. It upsets me because you were, you’re a good surgeon.

in every sense of the word, not just a technically good surgeon, but a good doctor. You can’t be a good surgeon unless you’re technically good. And you can’t be a good surgeon unless you’ve got good decision making. And you can’t be a good surgeon unless you’re a good doctor, in terms of diagnostic skills and communication. And you can’t be a good doctor unless you’re a good person. So you’ve got to try constantly to be good in every sense of the word.

Good. So if you’re a good surgeon, there’s a lot to it. And you were, or are, see deep down, I still will cling to the word are in the distant hope that one day you might change your mind and come back. And that would be extremely difficult for you technically because you’ve burnt bridges big time. Yeah. And that makes me sad.

Do you know what’s happened is a whole load of people out there who’d have benefited enormously from seeing you now won’t. Okay. Put your devil’s advocate hat on and try and picture and imagine you’re me. Do you understand why I did what I did? A hundred percent. Of course I do. Why? It doesn’t make me happy. So explain to you. You’re being battered from every single direction. Mercilessly, brutally.

Ahmad (04:54.253)
And you were being battered for having the courage of your convictions and for speaking your truths and for being ethical. So you got a choice. You can either capitulate or you can stand your ground. Well, you stood your ground and you didn’t. Well, you did more than that, didn’t you? You know, you saw them and raised them. So you just put the ante up and you took, you know, you took the power in the situation, but there’s a price to pay for that. And you paid it big time. And that’s very upsetting because now, you know,

The positives and negatives. Negatives are, you know, all the good things you could have done down that path are gone. I find it painful to say that. I know, I know. It sounds so conclusive. Final. Yeah. But, you know, every fork in the path has got a different path, different route to go down. You carry on doing good in a different way. You’re reaching…

many, many, many more people now doing what you’re doing compared to what you were reaching where you’re seeing just one person at a time. So, I think of course I get what you’re doing. Does it make me sad? Yeah. Does it mean that’s wrong? Not necessarily. So you’re making me a little bit sad too, because the truth is, I don’t think many people understand the hurdles we’ve had to go through to get where we are. yeah. Like…

This was not an easy thing to do. I mean, it’s like the people who go in and start jujitsu, how many get a white belt, then how many get a purple, blue belt, a purple, a brown belt, and a black. The attrition rate is massive. And by the time you get to the black belt, I mean, a thousand people have dropped out. And it’s, surgery’s like that as well. There’s a lot of people who go into surgery, but don’t quite make it or want to be a surgeon and end up being a GP or, you know, whatever, end up doing A &E.

to get to the top and get the job you want and everything, it’s hard, it’s hard graft, do you know what I think? It’s not just that, it’s what it does to you or what it has propensity to do to you, what it can do to you as a person. Explain, explain. Hours and hours and hours, years and years and years of obsessive focus to the detriment of everything else around you, everything else in your life. You know,

Ahmad (07:15.469)
the things that normal people would take for granted in terms of hobbies, yes, time, sleep. Okay. And then decades of stress. Explain that. Why, why the stress? I know, but tell me about stress. Why?

Different elements. First of all, you’ve got the stress of being asked to do or expected to do so many things all at the same time and such a huge volume of things to deal with. So the jobs, the tasks, the responsibilities, the duties, they stack up. And you can’t, well, you could hide from them, but you can’t. And we’re not the kind of people who do hide away from me. We take on more work. The bigger the burden, it’s like, give me more to carry.

I love it. And do you remember like when you’re a junior doctor and you saw your bosses and you just wanted to be like your boss and you wanted to be like the professor? I did. I did. What? Yeah. Yeah. What? You thought they looked nice? You liked them? You’re being serious? my God. I was a complete opposite. Where are you coming from? Well, the guy that inspired me was Professor Hamlin up in Scotland. You know, he gave me a job. Well, then you were lucky. Yeah, he was brilliant. I think they say that with the people that you work for,

You’ve got as much opportunity to learn what not to do as what to do. And I spent, I think I spent most of my career as a junior doctor, looking at the senior doctors and saying, my God, I’m never going to be like them. I’m never going to be so cold and callous and heartless. Yes. You know, I’m not going to be like that. So you start off as a junior doctor and you want to be best mates and best buddies and lifelong friends with every single patient. And you put everything into it. You invest everything that you’ve got time, energy.

emotional energy. Yeah. And then you can only keep that up for so long. You know, you talk about the attrition. Well, what about the attrition on the individual? You know, people die. We’re lucky. We went into orthopedics and not many people die in orthopedics. Thank goodness. Okay. But when you’re doing general surgery, like we did as part of our training, you know, it’s nasty stuff. People going moldy, people’s legs dropping off, people bleeding to death. I didn’t like my general surgeons. They bullied me.

Ahmad (09:33.901)
bums, poo, lots of nasty stuff. You know, it’s tough. Do you know what my first general surgical job was in air hospital. And I went, I went there as part of my basic surgical training. So I’ve just done orthopedics as a house officer and then gastroenterology. And my first job is in general surgery as an SHO. And I have no idea about anything. General surgical. And I was a bit nervous and I went to see the first boss and he was in a clinic room. I said, who are you?

I went, I think I’m your SHO. He went, no you’re not. I’m busy, off you go. I went, okay. So then I went to the head of the department and I said, this guy said I’m not working for him. And he went, no you definitely are, go back. I went, okay. So I went back to him. I said, I’ve just spoken to the head of the department. He said, I’m definitely working for you. And this guy goes, Well, go next door and you ever done, you know, examined breasts?

I went, no. for fuck’s sake. I was like, sorry, I just come from orthopedics as a house officer. And he went, do you know how to dictate a letter? I went, nope, never used a dictaphone before. Well, son, you’re either gonna sink or float. We’ll know by the end of the day. Don’t bother me again. Speak to the matron if you need anything. And that was it. So the matron was the one showing me how to do a breast examination. And these poor women.

I didn’t have a clue what I was doing. I was just, I was really nervous, you know, brought up in a strict Muslim, like suddenly fondling these breasts and touching them, looking for a mass. I didn’t even know what a mass looked like. I’m like, my God, there’s a mass. No, that’s just like a fibroid. I’m like, I don’t have a clue what was going on. And then it took me ages to figure out the dictaphone. I mean, and the guy just did not like me. And at the end of the job, he complained to the other consultant and said, this guy is not fit to be a surgeon.

He was just a bully. He hated me. I don’t know why. So I’m not saying I loved all the bosses. I had fair share of really not nice bosses, but I did have quite a few. David Hamlin, who got me into orthopedics. David Haralumbis, Haralumbidis, Panis Thomas. I loved these guys. There were some good people. Andrew Ellis in Australia. But there were equally some people who I did not respect or like.

Ahmad (11:58.285)
I spent a lot of time thinking, I don’t want to be like these people. Yeah. Yeah. And one of the sad realizations is that you end up going through your career and you find yourself gradually metamorphosizing into something closer to what they were at each stage of your training. Do you remember our time? It was, there was a bit of abuse that went on. It’s changed now. The juniors don’t have a lot. How would you describe it? You know, what?

the abuse that we got. People might be like, what are you talking about? Like, explain like standing up at the – Never been abused. I’ve never been bullied. I’ve had so many people try to bully me. I may be a little bit weird, but if I come across a bully, my soul rejoices.

It’s my opportunity for the inner Hulk to express his anger with the world in terms of you have a legitimate justification for fighting back. I love bullies. You’re like bring it on buddy. Damn right. But like what I mean is, do you remember like when there was like the morning meetings and they would pull you up and ridicule your

you know, humiliate you. And it was like, what the hell, man? What’s the point of this? Like, I’m meant to learn like this. Yeah. I mean, there are a lot of egos, weren’t there? That’s an understatement. Yeah. So back to the point, there’s an attrition. You’re taking abuse constantly and you’ve got stress constantly. And the other thing as a surgeon or any doctor, I think it’s possibly worse for surgeons because it’s so, so black and white so much of what we do.

I think with the medics, they can start a tablet and if it’s not going well, they can reduce the dose or change the dose. They can go and start a different tablet, whatever. For us, well, you know, just to exaggerate, we’re going to chop it off. But you’ve got to be pretty damn sure that you’re going to chop off the right thing for the right reason. It’s a little bit more black and white. And so the decision making is that much more stressful because there’s consequences. And it’s not going back. No. So.

Ahmad (14:18.573)
You know, but for the grace of God there we tread lightly and we spend our entire careers tiptoeing along on ice. You’ve got some surgeons who thud along with hobnail boots with no regard for the bad outcomes, complications, whatever may happen because it, that’s just part of the job. But if you’ve got compassion, if you’ve got a conscience, then…

Every single little bad thing that ever happens or any major complication, it stays with you for life. You don’t shrug these things off. It’s not, these things happen. No, they hurt. It’s impossible not to take it personally. And you accumulate that baggage. You should be able to let it go. Can’t. And so as you go on through your career, you’re taking hit hit and it’s death by a thousand cuts or.

it’s dragging you down by a thousand bags of baggage. So it does, it takes its toll. I can understand why you look happy. You look like a weight has been taken off your shoulders. You’re looking healthy. You’re looking fit. You like my beard. I’ll call it bum fluff. Work in progress. It suits you. No, it does suit you. I just haven’t shaved today. That’s all it is. So basically I remember Mr. Foster, one of my surgeons.

Say to me, Ahmed, when things go well and your patients thank you and things are great, don’t get too happy. And when things go badly and you have complications and you have complaints, don’t get too down. Try and stay in the middle and moderate. Because it’ll be great a lot of the time, but if you go up too high, then the fall will be great as well. Just remember, there’ll be good days and bad days, and you’ve got good patients and bad patients, and just stay relaxed about it.

I always remember that, but I struggled with that because when you did do a great job and patients thanked you, you felt great. You felt like a superhero. You know, when I got a text message saying, Hey, I’m at, I’ve just run 10 K. Thank you so much. You feel great. You felt buzzing, but you know, when you had, but when you had a complication. Yeah. But you know what advice is the proper definition of advice is, don’t you? It’s something you should have listened to retrospectively. It’s something that you didn’t follow that you wish you had. That’s the definition. Do you remember how?

Ahmad (16:42.958)
Like, you know, it really eats you up when you have a complication. And the funny thing is a lot of patients don’t understand that oftentimes it was nothing because I did anything wrong or they did anything wrong, but shit happens sometimes. It does. Like infections, for example, or whatever. Shit happens and it’s outside of your control. And what I found really stressful, I’ll be honest with you, as a surgeon was not the operating. I loved that. That was just, I was in my zen moment. Operating was just beautiful.

What was stressful was the moment the patient left the operating table and the operating theater. Because then it’s in the hands of the gods. What’s going to happen? Is the wound going to heal on time? Is the bone going to heal on time? Are they going to have a complication? I used to find that quite stressful. Were they going to be compliant? That was another thing. I’d given my instructions and say, stay at home for the next two weeks and don’t walk on it. And three days later, I’m getting a phone call saying, I just fell out of a taxi and…

My foot really hurts and I think I heard something go and I’m like, what were you doing in the taxi? Three days post -op. I went into work for a meeting. I’m like, what? See, I’m a bit different. See, people say he’s operating fun. And I’ve had that from a, I’ve had that question from a few patients and relatively recently actually. And they say, is it fun? Yeah. No, really? No, it’s not stressful. Really? Yeah. It’s stressful. my God. For me, if you care about something loads and loads and loads.

I wouldn’t call it fun because you’re constantly trying to do your best. So you can’t. I think, I think that’s because you’re not very good and you need to concentrate to do a good job. Whereas I’m so good. I was just like relaxed about it. Challenge number one. No swear words. No gesture. You can swear. You can swear. Yeah. You get me there. So more important because we’re just wibbling.

It’s got depth to it, but we’re wibbling a bit. So can I put it back? No, no. Yeah. But I’m just saying I had fun operating a lot of fun. I’m not saying it’s not fun, but it is stressful. In fact, you know, take that back. It’s not fun. Wow. It’s just not fun. I think that it’s it’s I’m concentrating. It’s hard work. It’s physical. And the knees are knees are much, much harder than for an ankle.

Ahmad (19:07.791)
You know that hardest joint, most complicated joint in the body. How many different operations do you do? Okay. So we’re going to talk about that. No, I think it’s important that people know because like it just goes to show how different a surgeon can be. It depends on their psyche and their personality. And even within surgery, there’s so many different disciplines and like what you do with needs. You know, I’ll be honest with you. I did not choose to do needs just because of what you actually, what, one of the reasons of what you said to me in the, in that cold room next door.

When we were leaving, you’re like, see, you’re so small. And you know, you’re quite tall. How tall is six foot two? Six, three, six, four. Then I lost my hair. No, what I’m saying is like, I’m a small guy and five foot seven. And these patients, you know, the big, big legs, it was hard work. It’s physically hard work. Cause you’re closer to the foot. I know the knees bend down lower. Knees was difficult. And what I’m trying to say is I quite liked.

the feet, it was light work, intricate, detailed complex. Cheesy stinky. Not really. And there was a variability because there was, there was literally something like 25 to 35 different operations I’d be doing. No one list was the same as the next one. And I loved that. Whereas because you guys go on and each toes a different thing. A toes a toe. Come on. Yeah, sure. But you know, tendons joints, you know,

bones, ligaments, it was just the variation. But I know people like knee surgeons who actually hate the variation, hate the unpredictability. What they want to do is come to a list and do the same operation three times in a day and that’s it. And that’s what makes them happy. And actually if you throw in a bit of variability or unpredictability, that stresses the map. Yeah, there’s a lot of boring people out there and there’s a lot of autists. I don’t mean that in a nasty way, but.

surgery does lend itself somewhat to people with OCD. And there’s a lot of our colleagues are, I believe, on the spectrum. Definitely on the spectrum. Anyway, back to what, before we go to ethics, look, I couldn’t practice the way I was because I knew they were looking for any excuse to get me. And the problem was, say for example, I had patients waiting to be operated on, right?

Ahmad (21:33.134)
And you know, and I know, you can get complications, wound healing problems, infections, whatever, or a complaint. And the funny thing is that most of the complaints that I would get were people who I didn’t operate on. They wanted me to operate on. And I said, no, I don’t think, because I really did not want to operate on them. And say, for example, a complaint is then made to a hospital. I knew they would just jump on that and find another reason to suspend me, investigate me. It was like they were blowing everything way out of proportion.

the most minor technicality, they were just latching onto it. So then I was thinking, I’m one, financially not viable, working out of this one tiny hospital. Two, I’m actually gonna be practicing in such a defensive manner, it won’t be in the patient’s best interest. And it’s gonna be so stressful, tiptoeing around, constantly looking over my shoulder, and who’s checking on, it just wasn’t a way to live. So you don’t blame me.

Never blamed you. Okay, good. Always understood. Like I said, still sad. Yeah. Anyway, informed consent. We know a little bit about that. Don’t matter anymore. Well, it matters to me. I’ve got to, you know, we’ve got to do informed consent. If we do the consent process is starts when you first see the patient, you’re chatting to them, you give them a diagnosis, given the options, option of doing nothing.

Pros and cons of doing nothing, pros and cons of each surgical option there might be. What it means in terms of outcomes, probability of success, rehab, longer term consequences, potential complications. That’s a conversation you have in clinic. You back it all up with your clinic letter. So everything’s documented. I send my patients emails with links to articles. I send them copies of papers. I send them advice sheets that are written.

Say to the patient, all right, read through everything. Once you’ve received my clinical letter, once you’ve read through everything, once you’ve read through all the attachments, then whatever questions you’ve got, email me back. So remember, I work in the private sector. You couldn’t, you literally couldn’t provide that level of care, that one -on -one level of care if you’re in the NHS where you’re seeing 30, 40 people, you know, plus a day. And that’s the…

Ahmad (23:55.95)
The prime reason I left the NHS is because I wanted to treat my patients properly and you can’t treat people properly if you’re rushing. And the one thing that makes you rush is a lack of time. Amen. Okay. So I wanted to do it properly, proper attention. So those patients get that information and then I say, go away, have a read. If there’s any questions, get back to me. If you want to go ahead with surgery, speak to my secretary, she’ll give you a slot. Okay. And.

On top of that, because of the litiginous nature of modern medicine, I’m now using a consent system, a digital pre -admission consent system called Concentric, which is brilliant. So I email a link to my patients prior to admission. I normally do it, I operate on a Tuesday, so I normally do it either on the weekend or sometimes on the Monday. And they get a link and they click on and they get

a digital consent form that’s full of loads of information with all the percentage risks, et cetera. And they have to sign it electronically. And then I get a PDF copy of that. And then when the patient comes into hospital, they get the physical paper consent form that belongs to the hospital. And we write the operation, we write the risks and the patient signs that as well. So that’s a huge, huge series of steps. Each one of them designed to kind of

bolster the overall consent process. So what you’ve described is exactly what I used to do, except for that electronic thing. I would bring them back two, three weeks before the surgery. And I know a lot of people say, well, will insurance company pay for that? I was like, I don’t care. They’re coming back. I would never consent on the day because I think that’s a form of coercion. You’re frazzled, you’re nervous, you’re stressed out. And like you’re literally asking them to sign on this piece of paper. They need, they need a cooling off period. But the consent form.

The hospital consent form that most patients sign on the day of admission, it’s got no legal standing. It’s not a legal document. It’s not a contract. It’s just a tick box exercise just to confirm, for me, it’s just to confirm they’re having the right operation on the correct leg. Exactly. Yeah. It’s the final piece of the jigsaw. It’s not the jigsaw. It’s not the consent process. No.

Ahmad (26:19.213)
It’s just an element. It’s the final. Exactly. The final countdown. What did you call me? I said the final countdown. sorry. So listen, so basically I used to do the exact same. I would actually film our last consent consultation and record the whole thing and explain everything. I would explain why they’re having the surgery, what their options are, what non -optive options look like, what the risks are, pros and cons, everything.

what to expect post -surgery, what to do post -surgery, elevation, icing, range of motion, exercise, you name all that kind of stuff, keeping the foot dry, limbo bags, whatever, and then how to mitigate any complications, what to look out for, et cetera, et cetera, et cetera, and give them my mobile number and send them the video and then sign it. And they’d be like, thank you, and days later, I watched it again, my God, I didn’t remember that, and I’m so glad you recorded it, and I remembered everything, and blah, blah, blah, blah, blah, blah, blah. And like you said,

You can’t do that in the NHS. I left the NHS because I was so stressed. I had a mental breakdown. I was treating patients like cattle, five minutes in, out, in. I was treating them worse than you would an animal. And it was like, how can I diagnose you? How can I plan a treatment, explain the treatment, consent you for it, all in like 10 minutes? It’s 15 minutes. It’s not possible. I mean, this is a process.

And I was like, no, the manager were like, no, this patient’s been for the NHS, physiotherapy, the MSK service, the musculoskeletal. Your job is to put them on the waiting list and consent them for it and see them in a year time. I’m like, this is boo. And so when, you know, funny thing is when I left the NHS, my colleagues were like, here we go, money grabbing surgeon. That’s the way you want it. And I was like, no, I just want to treat patients like my family. I want to regain control on my practice and treat them the way I…

proper doctor should. And what I was really surprised was that there was no pushback from my colleagues. They just accepted this gradual deterioration. Do you want to know about money grabbing? Tell me about money grabbing. What do you think the average NHS consultant annual salary is now? 120 ,000? Is it? Roughly. Yeah. So of my mates that I know who are still in the NHS. And then there’s merit awards. yeah. So it goes up. We should talk about that. What does that actually mean?

Ahmad (28:42.093)
People might not know. It means you’ve been compliant. Attending meetings. No, it just means you’ve been compliant. Yeah. Your mates are giving you the awards because you’re a good person and you’re not ruffling any feathers and you’re playing ball and you’ve got a funny handshake. So 120 grand ish plus, and many, many NHS surgeons now are operating once every week, once every two weeks.

Yeah, I’ve heard that. Do you know their lists have been taken away and after COVID or during COVID and never given back? Correct. And none of the consultants are pushing back and saying, give us our list back and the waiting list is high. But even more, their lists that they’re doing are only half full. The system is so inefficient and so many patients are being cancelled on the day, not the right operation, or they’ve waited two years. So by the time that they come up, either they don’t need the surgery or they need a different operation.

something bigger, something different. So the efficiency level is close to about 50 % in terms of theatre utilization. But they don’t even care. But they’re being paid 120 grand to do, not a lot. And so when not a lot’s going through the system and the waiting list of building up and up and up, the solution is employ more of them. Let’s get more of them in doing equally small amounts.

So there’s going to be a lot of our colleagues out there who can be very unhappy hearing this. Sorry. Hearing us saying this, hearing us talking about them, hearing us telling them. I don’t care. I don’t think they’ll be listening by the way. They don’t give a damn about my podcast. So I’ll give an example though. You know, I talked about this recently. when I first started my practice as a consultant, I had worked in Australia in fellowship and doing parallel lists. And I was like, I’m going to bring in parallel lists. You know, there’s so much downtime that needs to faffing around, taking hours to do a blog or whatever, putting them to sleep.

And you just want to get on the case. I mean, the operation would take me half an hour, 45 minutes, and they’re faffing around for an hour getting the patient to sleep. So I would literally go from one theater to another and do 10 cases in a day. And I would not even break a sweat. Remember, I’m not like you. I was having fun. And my list, my waiting list just dropped down. I kid you not, Ian. And then the senior consultant came up to me in my room, shut the door and was like very serious. I was like, is everything all right? Is everything all right, buddy? Like, what are you doing with the parallel lists? I was like,

Ahmad (31:07.054)
Yes, aren’t they great? Bringing down a waiting list. I’ve got it down to literally just a few months now. He goes, yeah, yeah. Don’t you understand, Ahmed? The waiting list is how we hold leverage over the managers. And you’ve just relinquished that power. And now you won’t get any work through to the private sector. And now you’re making them look bad. Exactly. Now, Ahmed, you won’t get any work in the private sector through choosing book.

You won’t get any patients going to the private sector through insurance to see you. So you’re just harming yourself and Ahmed, you know, the rest of us, we can’t, we can’t work like you. So, you know, the managers will start asking questions of us and it’s going to be difficult. You know, do you really want to do the parallel list? And I was like, fuck. Is this, is this. Was that the first nail in your coffin?

I think it was. I think they got me as a marked man. They were like, who the fuck is this idiot? Sorry, Frank. Who the fuck is this idiot? He’d have to bleep that one on you. I don’t care. Is this one to have an expletive on it? So as in like, people know, but basically dude, I was so stupid and so naive and so innocent. I just thought work hard, be the best and get rid of the waiting list and be innovative. And what I discovered was no, you have to play the game.

and I wasn’t playing the game. I wasn’t. Yeah. You have to play the game to a degree. To a degree. There’s an art, which is it’s the art of stretching that boundary. Yeah. How close can you tiptoe to that line without getting your foot chopped off? Yeah. But we digress. No, no, this is good. So basically I left. Ethics.

Yeah, I left the NHS because I didn’t think it was ethical to stay in the system. It’s too stressful. And I didn’t. And the only way you could stay in the system. And this is going to sound harsh to some of my colleagues if they’re listening and they are in the system. And Ian, you can tell me if I’m wrong or not. I’m nodding because I know what you’re going to say and I agree with you. I think the only way you could stay in the system is if you don’t give a frack about the patients and you don’t give a frack and you’re just there to pick up the paycheck, sign on, sign off.

Ahmad (33:31.535)
Goodbye, hasta la vista. Whereas to me, when I was watching my surgeons as a junior doctor, as a medical student, I wanted to be like them. I wanted to be ethical and they would tell me. I would have conversations with the medical student. I remember my professor telling me, Professor Brown, someone I did an elective with, even he was saying, look, I would never ever become reduced to a technician. Any monkey can do an operation. We are not monkeys. We are not technicians.

We are clinicians, we are artists, and you have to maintain that because, Ahmed, trust me, the managers are trying to rob us of this and reduce us to a technician. Hold on to what it means to be a consultant surgeon. I held on to that. But what I saw amongst my colleagues were they were happy to relinquish that pride and that title of consultant surgeon and become a fracking monkey technician and collect the paycheck and go home.

And I’m sorry. I wept. I wept as I saw that in front of me. Some people can tolerate that. Some people can live with it. Some people live with themselves in that situation. Others of us, we’re just not built that way. We’re just not.

So why did you leave the NHS? Every reason you just said. Not because you’re a money grabbing private surgeon who wanted to operate on everything that moved? If I was money grabbing, I’d be, I’d have 120 K plus salary for doing sweet FA turning up to the NHS two days a week. That’s my definition of money grabbing. Yeah. Yep. Yep. Yep. Yep. Yep. Yep.

But what you described in your consent process, I’m afraid to say is very unusual, and I would say the vast majority of people do not practice like that, even in the private sector. Yeah. No, I know this. I know this because what you’ve described is very similar to what I do, and I would have my patients tell me, wow, Mr. Malik, wow, now I understand why you wanted to see me again. I wasn’t sure why you wanted to see me.

Ahmad (35:43.118)
You know, I thought we’d gone through it and I told you I wanted the surgery. No one’s ever gone through this, you know, an operation as detailed as this before. You know, the previous operations, I just signed on the sheet. I’m afraid that was almost uniform, like what I would hear, the feedback. Like no one ever really explained everything properly. And that also made me sad. Yeah, but I get that in clinic all the time.

There you go. See, I’m not making it up. People go, thank you. Right. There’s a blessing and a curse. If you work really, really hard at something, you get better. If you start to get better, then people, some people will recognize that and they will start sending you the more complicated cases. Then if you get known for being the guy who sees all the second opinions, the complex cases, the revisions, all the really complicated kind of extreme reconstructions, well, then everybody.

send stuff to you and it’s a self -fulfilling prophecy, it’s snowballs. And the blessing is, well, great, you know, I’m getting sent all this really complicated stuff. The curse is when people turn up and literally like last week. So I said, I’ll come to see you because I’ve been told, you know, you can perform miracles. And they said, sorry, because you can, they use the word magic. And I just looked at them and I said, I’m so sorry. I said,

It’s, I’m so sorry to be the one to have to tell you, but there’s no such thing as magic. my God. You’re my twin magic. Malik. They used to say magic Malik to me. I kid you not. And so what it does, it just puts the pressure up and pressure up. And I spend, I spend probably as much time, if not more time saying no to people in clinic, explain to them what they’re not suitable. Cause they think that we can rebuild you. We can grow you and your knee.

And I spend as much time explaining to them that sorry, that’s not reality. It’s not real. You know, this is the harsh reality. Okay. It’s not what you want to hear. You know, my knee hurts when I run marathons, don’t run marathons, you know, and, but people want a quick fix. Man. People want people, people want the impossible because things like the daily mail, God bless the daily mail, publish articles. and they give people unrealistic expectations.

Ahmad (38:04.974)
So our job is primarily to educate people about what they’ve got, what’s available, what’s real, what’s not real, protect them from the charlatans of which there are many out there. Dude, there’s so many. So many. Dude, there’s so many. You know there’s so many. And the problem, what I find difficult is that I think the public can be quite dumb sometimes. I’m sorry that sounds harsh, but it’s true because…

They get bedazzled by the lights and the big name and, that person’s a professor. Like, they’re a professor for a reason. Because if they were a really good surgeon, they wouldn’t have time for all that research and getting people to, you know, if they’re busy on a circuit talking at all these conferences, when are they actually operating? You know, they don’t think like, you know, and, and, and, the guy was very eloquent and he had the person, the doctor was so charming.

So charming, I’m like, what does that mean? What I’m trying to say is the public gets impressed by the things that don’t matter. So for example, I know someone very close to me who’s just had foot surgery and I don’t think it went very well. Simple bunion operation and ended up taking three, four hours. I mean, that’s unheard of. Ended up having a double fusion because apparently it was a really severe bunion and that’s bollocks. And it’s because technically they got it wrong in the first one, they had to do a second one.

because they shortened the first ray, they had to operate on the second toe. And what they’ve told the patient is, this person that I know quite well, it was a very difficult operation, but we’ve done a good job now. Instead of saying, I really struggled with this and it didn’t go as planned, but I’ve done this and that and blah, blah, blah, which is the truth. And at their latest follow -up, this person, I said, how’s it going? And they’re like, the doctor was really happy. What does that mean? Of course the doctor’s gone. The doctor.

Like, who cares if the doctor’s happy? You know, are you happy? Did they tell you what they’ve done and why they’ve done it and how it’s progressing? And now this person’s still not able to walk, even though they should be walking like four weeks ago and they’re in a… One of your problems? And they’re in a bit… Sorry to interrupt you. One of your problems, you’re acutely sensitive as am I. It’s a bullshit. Yes!

Ahmad (40:27.182)
You can smell it a mile away, you can see it a mile away and you’re allergic to it. so much so. And there’s so much of it out there. Right. And the problem is the public patients fall for it. And I’m like, I feel like we’re tiptoeing around the edge of a bigger issue here. We’re just skimming around the rim. Yeah. Of a big black hole of a subject. What’s that subject buster?

I don’t don’t what’s happened over the last three or four years, not much. How’s about every single fundamental principle of good medical practice and medical ethics having been ignored, breached, discarded? There’s not much to talk about really, is there? No. No big deal. We don’t need to talk about the big bad C No, move on. I I forget. on. Move on. Everybody’s Everybody’s moved Yeah, move on. Do you know know what? I’m good person. I’ve had my 10th booster.

I stand by Ukraine. You haven’t had your 10th booster. You’re still here. No, I’ve had a safe and effective one. Okay. And it’s really effective. I’ve actually even just signed up for my 11th one because it’s working so well. Yeah. And I’m standing by Ukraine. I’m draped, draping myself in the flag. I’m sleeping the Ukraine flag, the blue and yellow one, the blue and the more flags, more flags. You want to look like one of those nautical things with all the

A to Z. Yeah. So many flags. You want them all on you at the same time. Well, yeah, I’ve got a dovey now. Ukraine dovey pillowcase, the whole shebang. Ukraine. I thought Ukraine had gone. no, we’re standing by Israel now. No, we’re standing by Israel. So that’s that. God, you can’t believe you mentioned Ukraine. You’re so passe. That was that was last month’s crisis, wasn’t it? I’m reducing my carbon footprint. You know, you know, you know,

I’m really happy about reducing my quality of life, standard of living. You are the carbon they want to get rid of. I know, but I’m quite small. You’ve got a bigger carbon footprint than me. I think you should go first. I’ll be ahead of you. I’ll do my duty. And I love diversity, except a thought. That was clever. See how you got that one in there. Medical ethics. yeah, we should start.

Ahmad (42:50.222)
You know, we’re only 42 minutes in. It feels like an hour and a half. Sorry. I told you I was tired. So look, there’s an incredible article. yeah. Incredible article. And it’s only a preprint at the moment, but it’s been published by Alan Mordew and the guys from the heart group. So Liz Evans, the wonderful Claire Craig, James Royal. We should mention James Royal. I hope he’s listening. And if James Royal is listening,

I just want to say, James, you’re not like all of the doctors that I diss. You’re a real good guy. So this guy is a general surgeon, and you know this, and he’s been very vocal, especially in his department. He’s done an audit meeting, he’s presented, he’s come down, I think, to London, he presented there. He’s talked about all the weird and wonderful things he’s been seeing, which he attributes to the vaccines potentially. And it’s not been easy for him.

where he’s been speaking up and it’s difficult. It’s difficult being in the NHS, in the cult, in the belly of the beast because dude, I’m sorry I’m digressing, but you know, we left the NHS because honestly what we realized was it wasn’t a fluffy teddy bear. It was actually quite a dark, horrible beast that was there to grind you down, was not there to help the patient. And I – It’s like a communist totalitarian regime. 100%. Absolutely.

And the thing is, for me, I think it was simply a way of extracting wealth from the taxpayer and giving it to big pharma and management consultancy firms and whatever and giving this lip service of care. But James Royall, Buster, you are doing good work. I know you’re in the trenches and it can’t be easy, so well done you. Anyway, Karen. Yeah, I agree. I think he’s awesome. I think Liz Evans is awesome. I don’t know Alan Mordew, I’ve not met him. Liz Evans? Talking about Liz Evans, she’s set up that medical freedom…

Doctor’s Alliance, something, something. You know what I really like about her? She’s to me, an example of a proper Christian who is a Christian devout, but doesn’t go on about it and actually practices it like the action. So I’ve met too many people who talk about being very religious and devout, but they don’t walk the walk. And she’s one of the good ones. As is Claire Craig. As is Clish. The wonderful Claire Craig. She’s been here by the way.

Ahmad (45:12.654)
She’s amazing. She’s a very good one. Such a big brain. So articulate. She writes brilliantly. Analytical skills. Fantastic. She’s awesome. She’s absolutely awesome. We collectively, all of us, even those who don’t realize it yet, we all are lucky that we’ve got people like Claire Craig. So they wrote this article and it’s about medical ethics and to facilitating fully informed consent to treatment. See how we’re coming around.

Yeah. And.

At the beginning, they’ve listed a load of really, really important things. And this is why I printed it off, because I wanted to get it correct. So, Hippocratic oath, approximately 400 BC. The doctor is required to act with benefience which means first, do no harm. The precautionary principle. Then, 1947, the Nuremberg Code. Shall I read it? Yeah, yeah. Okay.

Voluntary consent of the human subject is absolutely essential without the intervention of any element of force, fraud, deceit, duress, overreaching, or other ulterior form of constraint or coercion. And the subject should have sufficient knowledge and comprehension of the elements of the subject matter involved as to enable him to make an understanding and enlightened decision. I didn’t read that very well, sorry.

That’s all about medical experimentation. So then the World Medical Association’s Declaration of Helsinki from 1964. Experimental treatment must only be carried out with the fully informed consent of the study participant. Article 3, the EU Charter of Human Rights and Article 6 of UNESCO Universal Declaration on Bioethics and Human Rights.

Ahmad (47:11.502)
Any preventative diagnostic and therapeutic medical intervention is only to be carried out with the prior free and informed consent of the person concerned based on adequate information. It goes on. The General Medical Council’s decision making and consent guidelines. For consent to be valid, a doctor must disclose to the patient all material risks as well as the benefits of the intervention and alternatives to treatment, including doing nothing. Consent must be completely voluntary.

with no coercion or pressure applied either by the medical practitioner, the family or the wider public. Okay, that’s the GMC’s own guidelines. The Montgomery case, Montgomery versus Lanarkshire 2015. So this is an embedded now enshrined in the UK Supreme Court in law.

An adult person of sound mind is entitled to decide which, if any, of the available forms of treatment to undergo and her, in this case, consent must be obtained before treatment interfering with her bodily integrity is undertaken. The doctor is therefore under a duty to take responsible care to ensure that the patient is aware of any material risks involved in any recommended treatment and of any reasonable alternative or variant treatments.

Parliamentary Assembly of the Council of Europe from January 2021 states, you must ensure that citizens are informed that the COVID -19 vaccination is not mandatory and that no one is politically, socially or otherwise pressured to get themselves vaccinated if they do not wish to do so themselves. This is the Council of Europe 2021. And ensure that no one is discriminated against for not having been vaccinated due to possible health risks or not wanting.

you be vaccinated. Wow. So that’s why I wanted to read this. Every single paragraph, every sentence of this has been breached. Everyone in the last four years.

Ahmad (49:18.606)
If five years ago, if I’d have come to you and said, Hey buddy, Nuremberg code, take it or leave it. It doesn’t really matter. We’ve all moved on. It doesn’t matter. We can just ignore the Nuremberg code. You’d have thought I was an absolutely insane nutter. You’d have thought I was a fool or a crazy, wouldn’t you? Yeah. You wouldn’t have. If I’d have said, you know, declaration of Helsinki, whatever, get rid of it. You know, the EU charter of human rights. If I said,

GMC is good medical practice, but whatever. It’s just advice. Take it or leave it. If I’d have told you that the Council of Europe could be utterly, completely ignored, you’d have thought I was a nutter. Do you know why I’m really upset right now? I could think about a million reasons. Narrate down. I’m upset because I’ve actually almost got tears in my eyes because I’d really hoped I was wrong.

And that, you know, in some respects, you’ve known one minute thought you were wrong. You’ve known deep, deep, deep down inside your core. This is what keeps us fighting, keeps us going. You know that you’re right. You know that your basic principles, your basic foundations of ethics and morals are sound. You can see my tears. You can see the tears in my eyes. I’m really sad because you’ve confirmed like so eloquently what.

they’ve all said because I’d love it actually if I was wrong. I would love it if all my doctor colleagues had done the right thing and my profession had not let us down and that you know what, I’m just a nut job. I’m just a nut job who got it all wrong. None of this disproves that you might still be a nutcase. It’s just that on this, we were right. We are right. It’s obvious.

So how can you, busting your stuff, how can you follow all of this? And this is the fraction. This is, this is such a few paragraphs. How can you follow all of that when you’ve got people in a car, driving into a car park, rolling their window down, getting a jab in the arm with no discussion, no advice sheets, no.

Ahmad (51:45.006)
No fact sheets. You’ve heard how I had no medical history. You’ve heard how I had mine. Yeah, given by a volunteer, a volunteer jab next jab next. This is absolutely infeasible. And there’s plenty written now. Plenty written that says quite clearly even even written in the Lancet published in the Lancet saying that these jabs, these sorry, vaccines are actually gene therapies.

you could classify them as a gene therapy. That’s missed therapy. That’s that’s been written up in the Lancet. Let’s go back five years. We’re going to say Neuron Per Code PA Council of Europe PA GMC PA. I’m going to have a gene therapy in a car park from a non medically qualified person with I don’t know what’s in it. They don’t know what’s in it. They’re not going to take my medical history.

There’s no even pretense towards informed consent. And then I’ll have one, I’ll have another, I’ll have another, and I’ll keep going. Just keep going. Because I trust the government.

What happened to all our doctor colleagues? How we’re meant to be the guardians of medical ethics. The GMC is meant to be this pillar of society that defends medical ethics, that issues the guidance, the good medical practice. And what I find personally, I just don’t understand it. How can the GMC not… There’s been a lot written on this. Yeah, but how can they not understand…

medical ethics as well as go back to our actual colleagues. What about our actual colleagues, our doctors? Lucy from the doctors of patients UK group always forget her surname. Wilkins? I don’t know. Sorry, apologies to Lucy. Lucy published a brilliant article in the conservative women in 2021 might have been about why do doctors why have doctors stayed silent? yeah. What’s that? I’ve got ideas.

Ahmad (53:54.606)
That’s a long, long list because, you know, if you try and oversimplify things, these things, you do them in injustice and you, and you’ll paint a false picture. So these things are because a lot of people, a lot of public members are really upset and angry at doctors. So, and I think it’s justified. Do you want me to give you some reasons being very clear that they are not excuses? Okay. Nothing going to say is justification. They’re just explanation. Okay. Right.

I’ll take myself as an example. From the age of five, I was programmed by my parents. You’re going to be a doctor. My granddad was a doctor. My dad wasn’t. My parents wanted me to be a doctor. I have always wanted to be a doctor. I don’t know the difference between whether they wanted it or I wanted it. It’s just been ingrained. I was always destined to be a doctor. Is that quarter Indian gene in you? That’s it. At least it wasn’t a lawyer. And things could always be worse.

So, from the age of five, I’ve been a good little boy. I studied hard. And what does studying mean? Study studying means that you, you take in information, retain it and you attain it and regard to take it. Yeah. No room for variation or opinion or dissent. You learn it, you regurgitate it. You get it dead right. You get your points, you get your marks, you get your A grade.

So you go through school from the age of five all the way up to 18, constantly being a good little boy, studying, learning by rote, being programmed, regurgitating. The more accurately you can regurgitate, the higher your mark. So you learn to regurgitate. So you comply, you comply, you comply. You get sucked into the system and then you get to the age of 18 and then you’ve done your O levels showing our age. Then you do your A levels.

then you get to medical school. And you think, wow, I’m going to really start learning some important stuff. And you suddenly find out that actually you’re just a little plankton in medical school. You’re a nobody, you’re nothing. And there’s vast amounts of information that you need to assimilate and regurgitate. And so now from the age of 18 up to the age of 23, you spend another five years of…

Ahmad (56:21.967)
assimilating, regurgitating, assimilating, regurgitating. And you suddenly realize how big the hierarchy is as well. The hierarchy goes all the way back to school. If you argued with the teachers, you probably wouldn’t get a good grade, but also you wouldn’t be a good little boy. So you wouldn’t be on that path to go to a good university or go to medical school. I was head boy of my school. I was a super good little boy. Things changed along the way. And…

And so you’re compliant and you comply with the system. And then you go to medical school and you find out that my God, the hierarchy seems even stronger because at medical school you’re exposed to doctors. And even with it, doctors, there’s a huge hierarchy. Okay. So you do what you’re told. You think, well, okay, I’ll qualify. When I become a doctor, I’ll, I’ll become a little bit more free thinking, a little bit more independent, a little bit more autonomous. You become a junior doctor. You’re a grunt.

absolute grunt and you have to do exactly what you’re told. You’re not there to argue or disagree with your seniors. You’re there to do what you’re told. Then you have to pass more professional exams. So you and I, we were doing exams right the way up until the age of about 35. Yeah. Yeah. And what were we doing with those exams? Assimilating and regurgitating. Not much, not much.

analytical process. No one asked for my opinion. No one asked me to critically appraise. No, nothing. No, no, no, no, no. Remember, we go to take. Yep. Then you get to the age of 35 ish. You become a consultant. By then you’ve invested half your life, decades, after life decades into this path. And what you’ve also done is you’ve accumulated debt. yeah. Significant debt. yeah. And you’ve got you’ve got.

peers, you know, contemporaries who’ve gone down different paths, law, private equity, whatever. Owning their own homes, comfortable, settled. Some of the city lot even beginning to think about retiring. Yeah, exactly. And you haven’t even got your first proper job yet as a consultant. Exactly. And you’ve got debts and you’ve got financial responsibilities. And by that age, you’ve got kids and people and you send your kids to a private school. And you expect you to have a certain standard of living. People expect you. You’re a surgeon. The costs are massive. Costs are massive. Especially if you live somewhere like London. Yeah. You know,

Ahmad (58:43.15)
A small modest house in London with two kids at private school. Vast, I mean the costs are just eye watering. So you’ve got all these pressures. And then you get into the system, you think, right, when I’m a consultant, I’m not gonna be like those other consultants where the old guys who I couldn’t stand detested them. You know, I’m gonna be different, I’m gonna be better. And all of a sudden it’s like, bang, no, a consultant doesn’t have autonomy. A consultant is a porn.

on a board, just another piece, just another cog on that wheel. You’re not the boss at all. You’re not the boss at all. The managers are the boss. Do you know what? I became a clinical director, head of the department thinking, okay, getting to the consultant wasn’t the boss. I’ll get to the head of the department and I’ll be the boss. Guess what I found out? No. An employee. Yeah. Yep. And I would get told, these aren’t your patients, Ahmed. These are the hospital’s patients. Yep. You will do what we tell you to do. Yep. And you’ll tell your colleagues to do.

And suddenly I found that being a clinical director was, I was just now the agent, the camp guard, now telling the camp, imprisonment prisoners what to do. It was awful. Yeah. So you’ve got decades of learning how to and practicing the art of compliance. And then you get to the end and you find out that if you don’t comply, everything you’ve worked for,

and everything you’re aspiring or hoping to achieve will be taken away from you. And it’s done very easily. Very easily. Very easily. Because that GMC registration isn’t actually, I’ve discovered, a way of making sure that there are safe doctors around. It’s to make sure there are compliant doctors around. And if you don’t comply, well, we’re going to weaponize the whole process, punish you accordingly, and make an example of you.

to warn all the other doctors, this is what’s in store if you step out of line. by the way, let’s wrap up part one now. I need to catch that babysitter. Okay.

Ahmad (00:00.302)
One, right. So sorry about that. I saw the babysitter leaving. No you didn’t. You went off for a poo. You had an urgent poo. It happens. It’s not something to be ashamed of. Do you know what? I actually sharted. No. So when Jackie was leaving, I was like, hold on one sec. I haven’t seen Kat come home. How can she be leaving? And I haven’t paid her. And I was like, so yeah, somehow Kat managed to sneak in without me noticing. That’s fine.

Ninja. It’s good because we were getting heavy. It was getting quite, it was a bit, it was a bit intense. Look, you were going on about how they’re following the orders, the consultants, they’ve now become the boss, but they’re not. And then what you’re saying, the reasons why no one’s, but there’s more to it. Tell me, tell me, tell me. Okay. So we’ve got, we talked about compliance. We talk about programming in terms of information and regurgitation. The registration being a second.

the registration being a noose around your neck. Yeah, yeah. The GMC. Yeah, yeah. And also… And all licensing boards, America, Canada, Australia, they’ve weaponized it everywhere, by the way. Yeah. So people, and doctors in particular, are taught…

taught for many, many years, not how to think or taught specifically to not think. Okay, not to think critically. That’s what I’m trying to say. They’re not taught the art of critical thinking and they’re taught not to think critically. Okay, they’re taught to comply. Then you’ve got the pressure, the societal pressure, the financial pressure, the hierarchical pressure to be a compliant, good little member of the team. Yeah.

It goes deeper because from the educational perspective as well, and we could have some great conversations about the Rockefellers and their influence and their long -term influence on education. I’ve done a podcast. That’s not okay. I haven’t watched that one yet. Let’s not go down. That was an epic one. Yeah. Okay. So, education, the way that people are taught, the way that people interact, the worst thing ever is this, is this the way that people now,

Ahmad (02:16.206)
They’re used to only dealing with like a 250 character tweet Yeah, it’s longer than that if you send somebody a tweet because they got a blue tick and it’s a few pages of tweet Eyes glaze over they don’t read it. They just want a punchy tweet Same applies to doctors so At the at the good extreme you’ve got the people who read the papers they read a paper and

And within that paper, there’ll be references to other papers and they’ll go and look at those references and read the other papers and they’ll keep reading until they really know and understand the subject. Okay. At the opposite extreme, you’ve got doctors who just are perfectly happy to follow guidelines and protocols. They’re happy to be told what to do, told what to think by someone else. They’ve, they won’t even read the abstract. No, no. So huge danger where people just read the headline.

They just read the headline like a newspaper headline and they believe it. Never read the headline, read the article. Even the article can be flawed. These papers are being written by Big Pharma. All the time. Ghosts written by them. The data itself is not available for peer review. It’s the summary of the data which they hold. So I review articles all the time. So I’m on the editor or board of two journals. I review for a number of other journals. I’m constantly reading articles and constantly.

critically appraising them, okay, reviewing them, even editing them. So this is this is kind of a hobby of mine. And the reason I’m happy to do that, and it’s time consuming, you know, and you don’t get paid for it. No, don’t get paid a penny. But the reason I am more than happy to do it, I feel compelled to do it as part of my job, because it’s part of my learning process. And the more you read, the more you learn. But I’m critically appraising what I’m reading. Classic example of paper I reviewed, literally just a few days ago.

In the abstract, it says most people have x, y, z or x. You’re reading through the paper, 50 .3 % of people had x. In the abstract, most people. Well, they’re not wrong. They’re not wrong. Technically speaking, they’re correct. However, in my review, I’ve said that’s not appropriate language. More appropriate language would be roughly half of people have x, roughly half.

Ahmad (04:46.638)
Not most. So there was a brilliant paper published about myocarditis in the Journal of Cardiology. And it’s a classic paper, classically bad. And in that paper, they said most people got better. You go, that’s fine. So it’s not a big deal, myocarditis. Their definition of better was that a health care practitioner, which could be a doctor or a nurse,

just a healthcare practitioner had deemed that the patient was better. That was their definition. And their definition of most was something like approximately, I’d have to get the paper out and reread it, but I think it was about 55%. So if I told you that 45 % of people don’t get better, you’d say, my God, that’s bad. Or I could say most people, 55 % with more than 50%, most people get better. And what’s the definition of better? you look better. I know.

Absolutely utterly appalling paper and it was published in a high in an allegedly high quality journal. I worked in a very prestigious unit with a professor collecting outcomes for this study where they would use a kind of cartilage scaffolding for knee defects and I had to score it out of a hundred, this knee score and the higher the better. But you know, a hundred is like you can run and exercise and do everything.

But like 80, 90, it’s like you can’t do that kind of stuff. You’re just walking comfortably or after a certain distance it’s painful, blah, blah, blah. And good or excellent results were scoring 90 or above. And very few were getting that. And then the professor said, no, no, let’s change the threshold to 75 and above, which is excellent now. And good will be 50 and above. And I was like, yeah, but that’s not right. That’s not right.

And I didn’t play ball. I went off on fellowship and while I was away on fellowship, the paper got published according to the way this person wanted it to be published and my name wasn’t on it. And this paper was used to justify this treatment as an excellent operation when I knew actually it wasn’t. I had spoken to countless patients over the phone and scored them and they were telling me how much pain they were in and they weren’t doing well and they were stiff and they can’t do this and can’t walk up the stairs.

Ahmad (07:11.438)
Here was the paper saying, excellent results, majority of people, fantastic. And I thought, right, this is bullshit. So anyway, moving back to when you were saying the doctors, the reasons why, I think you’re right. I think that you’re breaking it all down. But I’ve said something on my podcast and one of my listeners printed it off and sent it back to me. I want you to tell me what you think of this critically. Give me feedback. Tell me if I’m wrong. When they say first, do no.

What doctors actually mean is first do no harm to my license, do no harm to my income, do no harm to my reputation, do no harm to my standing in the community, do no harm to my career, do no harm to my mistress, do no harm to my holidays, do no harm to my kids’ private schooling, and maybe then, if it really comes down to it, do no harm to my patients, but only if I’m sticking to the guidelines. Is that a bit harsh?

bit black and white. See, I would, I can understand where you’re coming from. I can understand some of the emotion behind that sentiment from your perspective. And it’s completely understandable.

I’d like to temper it. I’m playing devil’s advocate a little bit, but I’d like to do it. I love feedback and tell me when I’m wrong and just do it. I still, you may call me naive or just wishful thinking, but I still choose to believe that a majority of doctors believe that they’re good people and believe that they’re doing the right thing. No, I actually do think that. I do think that. I think the majority of people in medicine,

are good people and are trying to do what’s best, but are mistaken. I see. I would disagree with you. Really? Define good people. They think they’re good people. Yeah, yeah, yeah. 100%. No, no, no. But I judge people on their actions. No, no, you’re right. No, I agree. They think they’re good people. And this is what I mean by I think the majority of evil that’s actually done in the world isn’t done by true evil people, but people who

Ahmad (09:31.854)
think they’re good and they do the evil. So here’s a good fact. Which profession? 1930s Germany. Doctors. Largest member, professional membership of the Nazi party. Because look at us, we’re good people. Work that one out. Work that one out.

I don’t think anything’s changed. Mic drop. I don’t think anything’s changed though. If the Nazi party was here tomorrow, it would be the exact same thing happening all over again. Doctors would line up, look at me, I got my little pin badge, nice little sports sticker. I’m a good person. I mean, you know, this is a great party. Is that a bit harsh?

We learn nothing, do we? We learn nothing. History repeats and repeats and repeats. All the time. So I think, you know, I think if I was able to reinvent the whole medical profession, I would, and as a dean of the medical school, teach them, first of all, all the shit that we’ve done wrong over the centuries. Tripanning, you know, lobotomies.

Arsenic, mercury, leaching, bloodletting, you name it, poisoning, purging, the whole. And I would say, look at this dumb shit we’ve done. And you know what? The lesson of this is we could be doing the same dumb shit right now, and we should really critically appraise everything we’re doing. And there’s a danger we could be doing the same dumb shit tomorrow. So have some humility and park your arrogance and ego because we don’t deserve any. So I would do that.

I would teach them properly, holistically about nutrition and health and sleep and diet and fasting. And I would get rid of registration licensing boards. But that is an irony, isn’t it? Healthcare. Yeah, healthcare. How much, how much are we as doctors taught about health care? We’re, we’re talking about zero sickness management. I think there’s another element here. Did you read the Hippocratic orphan med school? Cause I didn’t know you didn’t either. Did you? No.

Ahmad (11:42.158)
I don’t need somebody else to tell me. I’m being a real hypocrite here. I’m just quoting all this stuff. But what I’m saying is I didn’t quite I never at one point, but they did say, right, we didn’t know we never signed a declaration. No, we never signed an oath. We never saw it stood there and swore allegiance to the okay. Did you have a lecture on nutrition? You remember? I can’t remember. Diet, how to eat proper. I can’t remember. You remember any diet and sleep? Do you remember? Do you remember how?

vaccines were made and what was in them? Not really. Isn’t that mental? Not really. You were taught anatomy, physiology, pathology, tablets and drugs. Yeah. Yeah. Yeah.

Ahmad (12:27.886)
And they put us on a pedestal for what reason? So that we’re on a pedestal. So that we can look down on them and they can look up at us. So then they’re more likely to comply. Yeah, right. That’s what it’s all about, isn’t it? You want to be that position of authority. If you want to look at it from a purely cynical perspective, yeah. But you don’t have to. So I would get rid of licensing boards. You don’t need to be registered or licensed to practice. No, I’m sorry. No.

I don’t understand why you might say that. I think they need to be completely overhauled. No, no, the whole centralization is the problem. It didn’t exist 100, 120 years ago. Good doctors, bad doctors. You’ve got them. You don’t need a national licensing system. That’s how you get captured. It has to be decentralized.

I’m trying to think of arguments to argue with you. You’re still in the matrix. It’s hard to think out. I can see the matrix. I’ve had the red pill buddy. All right. Okay. But I’m dipping in and out the matrix. I’m right. Just like Neo. I would also, I would also not. Like a fat bald old cynical, bitter, twisted Neo. It’s not like Neo am I? No, you’re not. I’m afraid. But you have done jujitsu. So you are relative. Yeah, proper jujitsu.

Unlike man cuddling that I do. You just cuddle on the floor. I don’t get it. I think you would enjoy it. I don’t know what you’re suggesting. I would love to cuddle and roll with you on the floor. That’s a different podcast. And then choke you out. yeah. You could try. Once you’re on the floor, you’re all mine.

So listen, so basically what I would also do is I would also make sure there was no socialized, centralized, public doctor system. Everyone is self -employed. I think when you work for a company or a hospital, you’re captured. You need to be a self -employed individual. You have to be self -employed. Check some measures though, because the assumption there is that everybody is good.

Ahmad (14:40.942)
and sadly you and I know that there are a lot of bad eggs out there. Therefore you need safeguards, you need checks and measures to actually protect people. But the problem is – It’s a free market. It’s a free market. Look, if you’re rubbish – Yeah, but then that means you’re gonna have to let people get hurt. And that doesn’t happen right now? Yes, he’s – Dude, no seriously. This is why I’m struggling with what I’m trying to say because – Ian, tell me, you’re telling me – The system didn’t stop shipment, did it? Right, shipment. And how many doctors, what has a GMC registration actually done?

Are you telling me there are not shit doctors right now? You’re telling me there’s doctors who are not operating and injecting unnecessarily because they get money from it? And there’s not these perverse incentives out there? And that they can’t talk a patient into a procedure even though they don’t really need it? And that stuff isn’t happening right now? You’re trying to tell me unethical practice is not happening right now? And right now, these people are being protected and guarded because they’re in that NHS system. If they get sued, the government pays.

They can experiment. I’ve had doctors tell me, yeah, I practiced minimally invasive surgery on my NHS patients. You know, and then once I got competent, I took it to the private sector. They treat the NHS patients like guinea pigs. You’re telling me that’s ethical? No. You know, if you’re fully self -employed, right, like you and I, I would argue we are more ethical and we have more integrity than someone who’s in the NHS because… But we’re not average. That’s the problem. No, no. We’re not…

typical. No, no, because we also know our peers, most of them, vast majority have one foot very firmly planted in the NHS and a little toe in the private sector. When you go full time private, you’re only as good as your last patient. Every patient you treat, you treat like your family because you’re, you’re only as good as your reputation. And most of what you get is word of mouth. So if you treat your patients badly, guess what? You’re not going to have any business. You’re not going to have any. You’re not 100 % right because.

Even within the private sector, I’m aware of some real shitbags who are terrible surgeons and even worse human beings who practice unethically. And I’m aware of that within the private sector, not just the NHS. So you need some kind of checks and measures to protect the public. And don’t they get found out though? Well, they don’t seem to, no. No, these are probably the people that…

Ahmad (17:00.718)
like the guy that you were talking about who just changes the definition of good. And maybe they’re just good at blagging their way through. yeah, your foot dropped off because it was so difficult and I did such a good job. So the problem isn’t the system, right? I would argue the problem isn’t the system and that they need checks and balances. The problem is that society has been dumbed down and that we worship doctors and we don’t question them. And what I would do is tell all the kids that I’m going through school and you know,

One, question everything, question your teachers, question authority. Don’t put anyone on a pedestal. And you know when you see your doctor, quiz the hell out of them. And you know, don’t let them blag you out of anything. So what you do is you raise society, bring down the doctors from their pedestal. The system isn’t checks and balances because when you start getting in registrations and licensing, all you’re doing is getting a captured market, a cabal, a mafia, and that’s it. And you’d – Like most of these things, there’s a reasonable, sensible, appropriate middle ground.

Okay. It’s like extremism to the left. Wrong extremism to the right. A completely unregulated system like the wild west is chaos. So overregulated. No, no, no. So I’ve captured. I’ve is unethical. I’ve had someone on talking about the wild west and the wild west like everything is a construct that we’ve been sold from Hollywood that actually wasn’t very true.

The Wild West wasn’t as wild. It was unregulated. These were territories that didn’t come under the federal government. But you know what? There was law. There was jurisdiction. Because guess what? You know what? If you stole from someone or you did some nasty shit, you got a bullet in your head. There was a simple justice. You didn’t mess around because when you did, there were repercussions. And when you start bringing in governments and rules and lawyers and that, you know, it just all gets messy in that respect. Keep it simple.

So when you, what I’m trying to say is if you’re a doctor and you know, and you do a lot of bad stuff and you get found out and people are going to come to you and get you in trouble, you’re going to be incentivized to not do that. The problem is the current system that we’re in allows these people to act practice unethically and they get protected and they can carry on doing what they’re doing. You know, I’m right. You’re always right to some degree.

Ahmad (19:23.982)
Whatever. All right, back to… I’m not disagreeing with you, but what’s the answer? Back to your private surgeon. But what’s your answer to that? I mean, it’s all very well saying, right, this is wrong, this is wrong, this is wrong. What’s the solution? Do you honestly think that we could dismantle the GMC? 100%. Really? We didn’t have it 120 years ago. No, no, that’s true, but that’s not the answer. Yeah, I think we could. How? You literally dismantle it. How? What do you mean how? Tell me how you’re going to dismantle the GMC. You just say you…

have no power over anyone. No doctor needs your licence, no doctor needs your registration, no doctor needs to pay you anymore. Goodbye.

that’s it. Wouldn’t that be lovely? Yeah. It’s not going to happen. So the biggest misconception was that this GMC is run by doctors. Remember, did you not think GMC was run by doctors for doctors? I might have done when I was younger and more stupid. Now do you know what it is? Yeah, I know exactly what it is. What is it? It’s a control mechanism. No, but run by who? How many doctors are actually at the top level?

like one or two. They’re all managers, business people, civil servants, executives of the government. It’s an executive arm of the government. I must say, I got called an expert witness to a GMC hearing in Manchester several years ago. I was flabbergasted about how thick the people who were making the decisions on the actual fitness to practice panel were.

I’ll take that back. It’s not fair. It’s not fair to call them thick. I used that was a wrong word. How ill -informed and uneducated they were about the issues on which they had the power to pass judgment. I had to go back to absolute basics. I couldn’t believe how slow they made me go. It was like I was talking to school kids. I got to the stage where I actually asked for a flip chart and a felt tip pen.

Ahmad (21:23.374)
I was drawing them pictures, trying to explain the basics to them. And it was only by drawing pictures that I managed to get through to them. Right, let me read out to you. This is the chief executive and senior management team of the GMC, right? You’ve got Charlie Massey, he’s the chief executive and registrar. He leads it, right? And what’s his experience? Director general role at Department of Health England. Worked in the pensions regulator.

Child Care and Drugs Review in the Prime Minister’s Strategic Unit, worked on Royal Mail and Post Office and HM Treasury. He’s not a doctor. You got Sean Gallacher. If you could take it all the way to the top, a health secretary. They’re not medical. They’re not medical, but Sean Gallacher, right? 25 years experience in central government. Lots of government positions there. Una Lane, Director of Registration.

Before that, Assistant Director of Revalidation, Head of Policy and Planning, Fitness, blah, blah, before joining Legal Services Commission for eight years. Colin Melville, duties for all stages of medical, blah, blah, blah, blah. Colin is a registered doctor, there you go, so you’ve got your first doctor now. Anthony Olmo, General Counsel and Director of Fitness to Practice, he’s a lawyer. And then Director of Strategic Communication, Paul Reynolds.

Again, UK Pensions, Protection Fund, Actuary, Institute of Actuary, Ofgem, Civil Servant, Neil Roberts, Director of Resources, worked in aerospace and defense, Chartered Management Accountancy. Of all these people, one is a doctor, civil servants, government officials. This isn’t an independent body. They’re designed to control us. And

act at the will of the government. The nominal reason for that is to protect the public from dodgy doctors. But that’s BS. But that’s BS. Because if that’s the case, right, when it really came to the crunch, and I would say it goes back decades, if you really want to show the most obvious example, COVID, lockdowns, social masking mandates, experimental gene

Ahmad (23:41.614)
Where the fuck were they? I’m not even going to say Frank. Where the fuck were they defending the public? Where were they defending the public? Where were the lawyers? I know, but when it really mattered, where was the GMC when it really mattered? Where was anyone?

It’s not just the GMC. It’s not just the medical profession. Where were the lawyers? Where were the human rights lawyers? Where were the professors and ethics? Where were the judges? Where was the police? Where was the army? Where was anyone? The whole world went mad. The whole world. Not all of the whole world. Not the whole world. I’m going to go back on what you said. The whole world went mad. I don’t like that. I don’t like that. That sounds like Matthias Desmet talking.

Exactly. I was going to push back. So I’m really glad because that makes it look like, we’re at fault and we lost the plot. The whole world was fooled. Hooked lying in sinker. How about from a very small percentage. The good news. How about brainwashed? How about coerced? How about coerced? I like the word fooled. Psychological warfare? Fooled. Fooled.

It’s a little bit condemning because it kind of implies that at least to some degree, the people who were fooled might be fools. No, so I don’t like that. I’m gonna push back, I think yes to a lot of those people, but there were a lot of people who were really coerced and pressured. Listen, look, if your job – The care workers, the care home workers are the best example we’ve got of that. Look, if you’re being told you don’t take this job – What happened to them?

I know, I know, but why does nobody care about, why does nobody talk about the care home workers? And here’s about 40 ,000 of them lost their job for no reason whatsoever. We’ve just moved on. Move on. So what I’m saying is imagine like you’re the, you’re a single parent or you’re married and, but you’re the main breadwinner and you’re told if you don’t take this job, you’re going to lose your job. And you’re like, I don’t know what else I can do. I don’t know what other job there is. There are no jobs. If I don’t earn, we’re going to lose our house.

Ahmad (25:46.638)
we’re going to have to, you know, to go into debt. I mean, these, we can’t feed our family. These are major stresses. I just went through it just a few months ago when I lost my job and I was like, my God, financial stress is a killer. These people weren’t fools that said, okay, you know what? I’ll take the job. I think.

If you said, I’ll take the jab because I want to go on holiday and all the kids are going to get their job because we’re going to go on holiday. Well, you’re a bit full. If you took a job for that convenience. Well, yeah, you don’t deserve liberty and freedom. Because you traded it for a temporary convenience, you know, like everything, as soon as we start generalizing. Yeah, so they realize that the generalization is wrong because there’s always exceptions. Yeah, there was a lot of people who.

who are really angry. I get people emailing me, I said, you know, I took a shot, I took two shots and I’m so pissed off. I’m so angry. I hate them for what they did. I took one shot. I’m a fool. I was coerced. I went in there with my little t -shirt on and I was like, okay, you know what? I was going to find out more about it. Bang, in my arm. Mother. You know, like, you know, never ever get treated like that as a surgeon, you know. So there, it wasn’t, they weren’t all fools. We were.

manipulated, coerced, biological, psychological warfare, bio warfare on us. It was evil, man. It was not mistakes were made. It was evil. And yeah, I’m still angry.

Ahmad (27:26.03)
I’m sad. Yep. I’m sad as well. But angry. I’ll be sad for a bit. Sadness means like food, it’s like air, it’s like breath. It’s like as you take another breath, so you can get angry again, which gives you the motivation and the strength to carry on and carry on fighting because you know that what you’re doing is right. Yep, yep, yep. So that’s why I don’t believe in the GMC and anything like

any kind of licensing board, all captured. And the reality is, if they can be captured once, they can be captured again. And they’re so rotten now, none of these things can be fixed. I mean, what really upsets me as well is I’ve realized that this whole shit show’s been going on for a very long time. I went to Jackie DeVoy’s movie, Playing God, and what was desperately sad was hearing parents and loved ones talk about the harm.

medics have done in the medical profession over literally 34 years. And you know what, they’ve been fighting for justice and they’ve not got any. There’s been no justice. No one’s been held accountable. No one’s paid for the sins and the wrongs. And people have literally died in the process of getting justice for their loved ones. And I worry that even with COVID, no one’s actually gonna pay. There’s gonna be no Nuremberg. I mean, what I see,

All around me is people getting gongs and awards, people at Wimbledon getting clapped and getting damehoods and knighthoods. And they’re getting away with it.

Ahmad (29:05.55)
far yet.

Ahmad (29:10.318)
Look at what’s her name? Michelle moan. Is it moan? How do you pronounce it? The blonde Tory peer, house of Lords. She got something like a hundred million pound P P contract. And forgive me if I get the facts wrong, but apparently it was all substandard. None of it got used, but that hundred million is not being given back. She’s got a super yacht in the med, I believe. Wow. Not given a single penny back. You look at Matt Hancock’s.

Was it his pub landlord was given a multi -million pound deal. Again, for masks or something like that. And he’d never had any involvement in that kind of business before. The corruption is incredible. This is what I mean. So the bigger, the bigger, the bigger, the bigger the corruption, the bigger the crime. The more, the more, the more likely would you get away with it.

Ursula von Leiden, president of the EU Her husband Her husband, involved with Pfizer Text messages suddenly disappeared? Yeah, yeah

And like someone like me, who just literally points out the emperor’s got no clothes. Think about a bush, right? A bush is growing in your garden. You don’t prune it. So it’s growing too big, too big, too fast. The outside is still alive. The sun can’t get to the inside. The inside dies. The inside rots. The whole bush dies. Do you think?

And I remember when I was a kid, we were doing Latin and classics. Okay. And you looked at the Roman empire. You think, wow, they were awesome. Look, look at the, look at the tech they did, how organized they were. How did they fall? How cool with the Legionnaires? Yeah. Yeah. But what did the Romans ever do for us? Yeah. Yep. And so how did their society just crumble to nothing? We had the dark ages. Right. And the Roman legions were beaten by a bunch of.

Ahmad (31:16.942)
hun savages or whoever they were. It didn’t seem to make sense. Yeah, exactly. It kind of beginning to make sense. Now, are we seeing the beginning of the fall of Rome? Yeah, a hundred percent. Is our society becoming so deeply institutionalized in its corruption that it’s beyond salvage? Rhetorical questions. Don’t answer it. Don’t dwell on it. But you know, if you can’t do the big stuff,

and you just do baby steps. Look at the things that are wrong around you. Think about the things you can do and take little positive baby steps and keep moving forwards. To be honest, I did think about Rome because we studied at school and you talk about this, the largest contiguous land empire or whatever. And then I don’t know if Genghis Khan’s army was empire was bigger, but Rome was huge, stretching across Europe and Asia and Africa.

And how did it fall? But you know, it was all there. They were diluting the currency. They were the value of the money. They were the metal wasn’t pure. It was, you know, it was fake money that they had. Nobody would print money, surely. Yeah. To artificially boost the economy. Surely not. Surely not. For the benefit of the people at the top. Right? No. They were doing that. They were giving the bread and circus, you know, because hey, hey, distraction.

Look there, it was their equivalent of TV sports and cherry vapes, right? Have your bread and circus and just be distracted and amused and don’t worry about the bigger problems that are actually going on and how you have no money and there’s no security and no jobs and you’re just fam and forget all that. And the reality is it was very decadent and very decayed and very corrupt. And the people at the top,

only cared about themselves and their families. And the people at the border weren’t actually quite barbarian, they’re just not Roman. And they were like, well, you’re a bunch of great. And they were organized and they were ruthless. And that’s how they took over and that’s why Rome collapsed. If you want a picture that’s been painted of how our world and our society might drift further and further.

Ahmad (33:42.094)
down this dangerous, dangerous path towards this technocracy, right? This autocratic, nightmarish technocracy. have a read of James Erath’s book, Timestamp. Do you know James? Nope. I’m a good glimpse. He’s a great guy. And, how’d you spell his surname? E R I T H. All right. Just have her have it. Get hold of the book. What’s it about? It’s.

time traveling love story that’s what I’m gonna say and it starts off in the future with where our society could end up if we carry on down this path. Is it a sci -fi book? Sort of yeah. I kind of like sci -fi I’m reading sci -fi right now. 2058 Earth is ruled by the elite. I hate that word elite. They’re not the elite class. I hate that word. They are the parasite class. Thank you. They are the parasite predator class.

Have you heard about my tick analogy? So the, you know, a pass tick is a parasite. Yeah. Just sucks your blood. And so, you know, for the longest time, I think this predator parasite class has been like a, like a little mouse on the, on our, on our backs. Although, you know, the promise is now the size of my middle child is huge and it’s on our back and it’s weighing us down. She’s good because we’ve now noticed it.

We’ve noticed, but it’s draining our energy, but you notice it and I notice it, but dude, there’s a lot of people who don’t notice it. And all they do is their shoulders are humped, their backs are bent over. They’re walking slow. They’re just looking down at the ground. Yeah. What’s that? Once you’ve taken the red pill, you ain’t going back. The blue pill doesn’t work. I know, I know. So freed. All right. The boundaries between reality and artificial intelligence have disappeared.

Freedom is an illusion to all but the minority who manage to spoil it. right. Okay. Sorry. I mean, this sounds good. When did it come out? When was it? Right. He wrote it in 2021. I think. How’d you find out about it? Met him. You met him. Yeah. Dude, a time traveled romantic thrill at this. Romantic. What the hell? Right. Come on. We must have some stuff to do.

Ahmad (36:08.846)
Ask a question. All right. We’re going to waffy again. Come on. OK, no, no, no. Let’s let’s give me a question. OK, so now this is a sincere question. You know, for people out there who want to go and see a doctor, right? I find that too many people aren’t prepared. Don’t know the right questions to ask. Don’t know how to prepare for a consultation. They just pitch up.

expect the doctor to tell everything. As a doctor, as a consultant surgeon, how do you think people should come to you? What’s the best way they can prepare for the consultation and get the most out of you and your knowledge and everything? We were just kind of slacking off the concept of generalizations, but that’s the massively generalized question because people vary. You’ve got some little old ladies, little old men who…

want to be treated in a doctor knows best paternalistic fashion. They don’t want to ask lots of questions. They don’t want details. They want to be told what’s best for them. You’ve got other people who seem to have a PhD in nitpicking who want to know the ins and outs of a fly’s ass. So what I meant by that is I think it’s always a good idea to go to see a doctor knowing what you want out of that consultation. Do you want, and I think it’s good to know,

Do you want a diagnosis? Do you want a treatment plan? Do you want options? So it’s good knowing what you want. And then when you get there, understand what a consultation looks like. So think about the history. Think about what’s actually happened to you. Think about the chronology. So when the doctor like you questions them, you’ve got your answers. You’re going like, yeah, this is what happened to me. But dude, I can’t generalize because everyone’s different. This is why, you know, this is why I was going to say our job.

Your job, mate. This is why my job, you know, one of the joys of my job is you’re dealing with people and every person’s different and you’ve got to tailor what you do to that individual. But look, there’s no one single formula. But the thing is, no, I would not, you’re an exceptional doctor and a very rare doctor. Do you mean that in a good way or a bad way? In a good way. That’s nice. You know that. And what I’m trying to say is most doctors now, you’re in and out. The insurance companies are paying peanuts. So instead of saying, right, here you have half an hour, 45 minutes.

Ahmad (38:37.134)
And because insurance companies are giving them less money, they go, okay, fine. It’s a 10, 15 minute consultation. So they will not be giving the care that you give. Right. So I spend an hour with some of my patients. They are pre warned that they’re complicated. They get a one hour slot. There you go. You just proven my point. No one does that who is insurance model based practice. So if you’re a self funding type consultant, so most of my practice was self funding. I actually stopped working with the big insurance companies because it was, it was,

It was just the exact same as NHS. They were dictating to me how to practice. What I’m trying to say is, you and I are different. Most, the vast majority, 90 % plus doctors follow the insurance model, the managed healthcare model at the detriment of the patient. And the patient knows not how it should be. So what I’m trying to say is, how do we educate our patients?

to say to them, look, this is what you should expect when you go and see a doctor and this is what you should get out of. You don’t know. I don’t know. I have one bit of advice. What’s that? Take someone with you. See, that’s a great piece of advice. Four ears are better than two ears. And when you’re listening to a doctor, you know, people have done studies and they’ve shown that you retain somewhere between 25 to 50 percent if you’re very lucky, most people 25 percent in information if that. Right.

And also they remember 25 % incorrectly. Did you know that? No. Yeah, so it’s not only that they don’t remember the majority of information given to you, they remember another chunk incorrectly. Yeah, do you know, even it goes back to the concept of videoing consultations, there’s an argument that perhaps every single consultation should be videoed and every patient should be given the video.

My patients would even say this to me. do you mind if I record it? And they would take out their little voice memo. I’d be like, no, no, just film the video. Yeah, I get that. And they’d be like, really? Put their phone on the desk. I was like, I’ve got nothing to hide. And actually, it’s better for me because you’ve got the record and there’s no confusion. And I would say whenever possible, bring a friend or family member.

Ahmad (40:48.622)
because it will help you with the memory recall. And I’m not saying this because you’re old or young or female. I tell this to everybody and it applies to everybody. So that’s an example of, I think something very important. You should take something. See, it’s all coming out now. There it is, bit by bit. Pearls of wisdom. This is what I want. So if you’ve seen a doctor.

If you’ve got questions, if you can’t get through to that doctor, back to them to ask your questions after the consultation. If you can’t even get through, walk away, don’t go back. That’s a golden piece of advice. If you can get through, but they won’t answer properly, or, you know, they’re just unreliable, then walk away. Find somebody better. Find someone better. Yeah. Yeah.

Because if you can’t get in touch with them to query an operation or whatever. That’s the tip of the nice bow. It’s a little red flag saying there’s probably a lot more wrong with this individual. Because for example, what happens if you’ve had the operation and you’ve got a concern and you can’t get in front? I mean, I don’t know about you, but I give my number to every patient. And I would say to them that I operate on any problem, any concern, you message me. Because I would rather…

If you’re worried or concerned about something, you just literally message me and I give two second replies and say, I don’t worry about that. And then you’ve relaxed. I use my email address or whatever, but there was a way for them to contact you. The reason I let the email address is it gives you more of an opportunity to sit down when you’re answering and make sure that you’ve got the correct details in front of you. There’s a terrible temptation. If you get a WhatsApp message or a text to answer and it might be the wrong Mr. Smith. So I didn’t have that problem. And because one, I think I was running quite a boutique service.

So it was very, I wasn’t operating on a lot of people, you know, maybe 10 a month. I knew everyone intimately. I knew what was going on. And so it’s not like I was churning high volume. I knew all my patients. And actually one of the things I found was that no one, and I mean this, no one abused that system. Like no one was sending me memes.

Ahmad (43:02.606)
or just randomly messaging. Even after giving my number, actually, I still found the problem was that people wouldn’t contact me. And I’d be like, hey, why don’t you tell me your bandage got wet? Like, this is wet. You know, it was stuff like that. Like, I didn’t want to disturb you, Mr. Malik. So I thought people were actually really good. But I think that was also because I selected who I operated on, and they tended to be really good people. Good eggs.

Does that mean that you excluded people because you didn’t like them? No. Or you didn’t feel quite comfortable with them or because they were a bit difficult or they were overbearing? Because we all meet a wide range of people. Yeah. So. And it’d be, it’d be very morally questionable to turn people away because you just got a feeling that you don’t like them or they’re going to be troubled. It wasn’t, it wasn’t about me not liking them. It’s about.

So I remember once I treated an accountant and he said, you know what, you remind me of me. I was like, how? And he goes, you’re just so happy. And you know, all your patients are lovely. And the reason he knows this is because quite often the service I would offer is like, I’d say, look, if you’re not sure about this operation, you’ve heard it from me. Maybe you might want to hear from previous patients who’ve had the surgery and they can actually give you advice about how to recover because they’ve actually gone through it. So it was something I did oftentimes and it was a passive forward thing. So.

You know, then when once the patient has actually been in touch with a former patient, they were like, by the way, if you ever have anyone who wants to talk about this, I’d love to offer my take on it. So it’s kind of like passed it on and on. And then, and then this guy was like, you know, those two people you put me in touch with, they were lovely. They were beautiful. They were such good people. I was like, yeah, I’m like, I love all my patients. You’re all wonderful. He went, you know what? That’s the secret. You pick who you work with. You know, I’ve got a wonderful client list and it’s because I choose who I work.

And it’s not because I said, I don’t want to work with people who I don’t like. That’s not that I would know that there’s some people that I wouldn’t click with. Like this patient would be like, do you know what? Asking me questions that didn’t make sense or asking me the same question 10 different ways. They just weren’t happy. And you know, I would not found the answer to that. So you know what I would do? I would say, Mrs. Jones, I’ve tried to explain to you the treatment option.

Ahmad (45:20.302)
and I’ve done it in the best of my ability. But in the last three consultations, it seems like you don’t understand what I’m trying to explain or you keep coming back with the questions. Can I suggest we get a second opinion? And perhaps that other person will be able to answer it in a way that satisfies you. It might be even that you feel more comfortable with that person because I know I’m not everyone’s cup of tea.

and I won’t be offended if that’s the case. And oftentimes they would say to me, no, no, I don’t want a second opinion. My neighbor told me to come see you, you’re the best one and blah, blah, blah. And I’d be like, that’s very nice of you, that’s very kind of you. I really appreciate that. I’m not saying I don’t want to treat you. I’m saying get a second opinion. And actually, if you’re satisfied and happy and want to come back to me, come back to me. But equally, if you want to stay with the other surgeon, you can stay with the other surgeon. I’m just telling you, second opinions are really useful tools. And they would always say, no, no, no, well, I’m going to come back. I’m going to come back.

And you know what, 80 % would come back and say, I had that second opinion. I’m very happy now. And if it’s okay, I’m going to be having the operation with them. Because I knew that they weren’t 100 % comfortable with me. And it was better that, and if you love your kids and you love your patients, you need to be able to let them go. You don’t want to cling onto them. So that’s what. I’m with you. It’s all very wise. There’s another thing, which is,

sixth sense. So another thing that I say to patients on a regular basis is if you see a doctor and if your sixth sense has got little alarm bells ringing, for God’s sake, listen to it. Right? Your sixth sense, that kind of subconscious brain, subconscious brain is millions. Also, you’ve got instinct. Same thing. Same thing. Same thing. Millions of years of evolutionary instinct.

purely for survival benefit, subconscious brain is probably bigger than the conscious brain. And a good example is if the best way to pass a multiple choice exam is fast, you sit down, you read the question, bang, answer, bang, answer. Go through as fast as you can, finish it, stand up and walk out. I’ve done that in exams and people are like.

Ahmad (47:41.774)
you’re 20 minutes into a one hour exam. I’ve done that too. Don’t second guess yourself. Because the minute you start, your logical brain starts arguing against your subconscious brain’s answer and trying to rationalize reasons as to why you might be wrong. Well, maybe it’s a double bluff. Maybe, you know, it looks like it should be A, but maybe, maybe D might be right. And you start getting it wrong. So your subconscious brain is really powerful. Yeah. Yeah.

If as a patient, you go to a consultation and you walk out and it doesn’t feel quite right, you weren’t given enough time, they looked a bit dodgy, anything, just whatever your sixth sense is telling you, listen to it. That is bloody, bloody golden advice. Another bit of advice. that’s… You were like, you can’t generalize, and now it’s all coming out. No, no, but you said, how do you make somebody prepare? No, no, no, no, no. But there’s one…

what somebody I know, I know, I know. So, his, I’ve got one. I’ll tell you, it was really good. It was really important. I’ll tell you, I think everyone should really write down the questions they have and the questions that I would ask, right. The questions that I think generally for everything pretty much is say, what’s my diagnosis? Give me a diagnosis. Come back. Okay. Go, go talk. If you’re not sure, don’t do it. Right. When it comes to surgery.

I mean, if you’ve got something nasty, if you’ve got something like cancer, where time is your enemy, the longer you leave it, the worse it gets, the poorer the prognosis, et cetera, the quicker you treat it, the better. And don’t let’s go down that rabbit hole. It was just a concept. Well, luckily for us, for me, we don’t work with that kind of emergency stuff.

Most of the stuff that I deal with is pain, function, lifestyle, keeping people mobile, keeping people active. It’s elective, it’s planned. Elective. So there’s no rush. No. So if you’re thinking, should I have something? Should I not have something? OK, well then the answer is don’t have it. 100%. Simple as that. I would say, and tell me what you think of this, I would say to my patients, look, the only question, you know when you’re ready for surgery,

Ahmad (50:06.478)
when the only question you have is, how soon can I get it done? Yeah, good analogy is like, if I said to you, I’m going to chop your arm off and you go, no, please don’t. And I go, no, I’m going to chop your arm off. And I go boom, and I chop your arm off. And you go, you bastard, you chopped my arm off. Why’d you do that? I hate you. Yeah. Or I come over to you and your arm is gangrenous and you’re going septic and you know that you’re going to die and that arm’s going to kill you. And you say to me, please, will you chop my arm off? And I go, all right. And I chop it off and you go, I love you. Thank you. Yeah.

Same operation, just chopped your arm off. Two very different situations. Exactly. And I would also say to people, look, I’ve given you so much information and you’re still asking lots of questions. And I think the reason why you’re asking all these questions is you’re trying to get control of the situation and it’s because you’re not sure and you feel helpless and you’re uncertain. And that means you’re not ready for the operation. You know when you’re ready, when honestly, just how soon can you get it done?

But going back to the list of things, so I would say is first of all, ask your doctor, you know, what is my diagnosis? Because if you don’t have a diagnosis, you don’t have a prognosis, you don’t have a treatment plan, you have nothing, you have nothing. So get a diagnosis. Don’t just get what, you know, faffed off like, it happens, you know, or it’s your genes, you know, get a diagnosis. Because the other thing as well is you could get treated. And if you don’t deal with the underlying diagnosis, it might come back or the operation will be suboptimal. I had a terrible problem. What’s that? It’s around a friend’s house. They had a lovely white.

Sofa. White. White sofa. Sat there for most of the evening. Stood up, covered in blue. They said to me, use your jeans.

Ahmad (51:46.638)
That’s not funny.

Dude. You asked for it. Right. Ask me some serious questions. No, I’m going to, I’m going to. So I think people are interested. I think definitely people are. Dude, are you kidding me, man? People are struggling to navigate the sick care system. So listen, I think get a diagnosis. What I would also say is ask the doctor, why did this happen to me? I think it’s important. God, I hate that question. No, no. And you’re thinking as a, but no, no, you’re thinking, you’re thinking as a knee surgeon. You’re thinking as a knee surgeon. Shit happens. Why not you? No.

Is it my diet? Is it my lifestyle? I’m talking about in medical terms as well. Yeah, yeah, I’m not talking about just knee surgery. I’m talking about like, like trying to understand why the thing happened in the first place. So it doesn’t happen again. that gets that’s getting very deep. That’s getting very anti modern medicine. Yeah. And I would be a problem. And I would say if I don’t have any treatment, what’s going to be the what will happen? And if I have treatment, what are the different types of treatment and what are the pros and cons of each one? See, there’s a very interesting point in the recent paper.

by Alan Mordew and the heart guys, they start off talking about surgical consent. But then the paper evolves into a wider discussion. And they say, well, if all the principles of medical ethics and consent apply to surgery, where it’s very obvious, why do those exact same principles not apply to medicine with drugs? Because they should apply. Especially vaccines. Why should they not apply? And that was the point of the paper. Yeah. So the

General principles are fundamental and they apply across the board and they have been, we’re talking about surgery here. This is what made me think of it. Why the hell are the physicians different from the surgeons? Exactly. Where have their basic principles gone? They don’t have any. No. This is what I mean that – People being prescribed drugs. That they don’t need. Without any proper discussion. I’ll give you an example. Go for it.

Ahmad (53:46.798)
How do I nominate, nominate this? How do I make this anonymous? So it’s not a family member and she’s not old and I’m not related. An elderly lady who I don’t know, who might be 92 or older was rung up by her GP. This is entirely hypothetical. It was rung up by her GP who said,

We’ll call her Joan, made up name. Joan, you’re 92, we want you to get to 100. I’m going to prescribe you a tablet. 92 year old happens to be switched on and says, what for, why? it’s a cholesterol tablet. She said, well, why do I need it? because we want you to get to 100. She’s like, okay. Doctor says, you don’t even have to come to the surgery. I’ll do an electronic prescription. You don’t even have to come and pick it up.

That prescription will go to the pharmacy. The pharmacy will post it. They will deliver it to you. Nice. Now part of that generation, she doesn’t want to argue with a doctor. So she doesn’t. So it all goes through, but then she phones me up and we have a chat about it. She’s not been to see the doctor. He probably doesn’t even know what she looks like. He’s probably got her medical records there, but she hasn’t had a blood test. He has no idea what her cholesterol levels are. And even if they are high, who cares?

She’s 92. No, no, but high cholesterol is nothing. Yeah. Cholesterol is life. Yes. I mean, again, this was just to make a point. Let’s not get. But I don’t want people to think that all it’s because. No, I just pick this as an excuse. Exactly. We could have a long chat about cholesterol. I know. I know. yeah. And and so these tablets arrive in the post and I all I can say to her is I think that’s disgusting. How can that doctor prescribe you a treatment?

without having met you, without having examined you, without having a proper discussion with you, without even knowing what your cholesterol is, and all of a sudden these tablets just arrive in the post, that doctor has almost certainly got a target to meet. Are they called QOFs or something like that? Yeah, so let me explain it. So I had a retired GP, I gave a presentation at a meeting and I was talking about this and this retired GP, Rachel stood up and went, everything that Doc Malik has said is actually true. She said just,

Ahmad (56:16.91)
I need to explain to you, even before the patient came into my room, as the system would tell me, right, the next patient, pop -ups would appear. This patient needs to be prescribed statins. This patient needs to be prescribed antihypertensives. This patient needs to be prescribed PPIs. Just because of their age and demographics, it was like, hit the target, prescribe this drug. It didn’t matter what they were coming to see the GP for, she said. I didn’t know what they were here for. It could have been, they couldn’t sleep, they were feeling down.

They needed a medical signature on something, a report, it doesn’t matter. I had to make sure that by the time they left that consultation, in five minutes, five, that I had prescribed them a statin and a PPI and whatever. And the problem was that if I didn’t, the system would recognize that and say I was not hitting my target. So the next thing that would happen is that I would get a conversation with one of the partners.

And then the next thing that would happen is it would be discussed at the next partner’s meeting. And the next thing that would then happen is you’d be called up for an investigation and questions asked. And if that carried on, then it might even go to the GMC because why is your prescribing different from your peers? Are you not practicing properly? That’s what’s going on. Where’s the pushback?

Where’s the ethics? Where’s the morality? Where’s the integrity? This is why, honestly, when I left, I was done with my profession. I’m actually, I was ashamed of being a doctor. I didn’t see many examples of people that I looked at and went, you know, what amazing role models. I saw a bunch of people who were cowards and spineless and lacking integrity and morals.

I saw lots of pathetic people and I was ashamed of being a doctor. Sorry, mate, that’s how I feel. You’re welling up. Why are you welling up? All six foot three of you? Yeah, I can’t argue with you.

Ahmad (58:34.03)
But because we’re more than just a title when we chose to be doctors, it wasn’t just a job in you and me weren’t all we’re doctors and surgeons. It was never for you and me for you and me. And it was never a fucking job, was it? Never has been. What was it?

what I am.

your essence, wasn’t it? It was never about, I’m just collecting a paycheck and look at me. I mean, you identified yourself as being a doctor, a surgeon. But when you now see that beautiful thing that it could be,

disgraced and belittled and made into this worthless crap.

You find ways to fight. This is what I’m doing. You lead by example. You practice good medicine. You don’t kowtow and just capitulate with the system. You do what’s right for each individual patient. Back to basics. Basics that nobody should ever have left.

Ahmad (59:45.006)
You educate people, which is exactly what you’re saying. In a bottom up approach, empower the people to ask the right questions, to demand proper quality healthcare. Demand proper doctors, proper doctors, hold them to account because what the park we’re going down at the moment, we’re heading towards. This is why James is James Errith’s book is. It’s got such insight. It’s horrible to read, but this potential.

nightmare technocratic future. But the path we’re going down, people can’t even get to see, we hear it all the time, constantly, constantly hear stories about, I can’t get to see a GP. I can’t even get through on the phone. Certainly can’t get a face to face appointment. If you can get an appointment, it’s for several weeks time. If you do get an appointment, it’s a 10 minutes lot. That’s ridiculous. 10 minutes.

You’ve waited weeks and weeks and weeks to discuss a really big, important problem. You’ve got 10 minutes slot. It’s ridiculous. And the doctors, they’re not thinking. They haven’t got time to think. They haven’t got time to be a diagnostician. They haven’t got time to show any empathy, to discuss, to have shared decision -making. It’s just tick box conveyor belt. And the doctors are complicit. They are making their own destiny. They are.

There will not be such a thing as a GP soon. Some people would argue there already isn’t such a thing as a GP because we’re already getting these physicians assistants or noctus as people are calling them, non -medically qualified people, filling the role of a doctor pretending to be pseudo medical with a couple of years training, ridiculous, dangerous, very dangerous.

And, and then we’re going to get to the point where all you’re going to have is triage systems, AI and God help us then, there’ll be, there’ll be no judgment, there’ll be no experience, there’ll be no compassion, there’ll be no humanity, we’re just going to have AI based systems doing triage that will, it’ll be the virtual world of pop -ups. And do you know what’s really scary is because…

Ahmad (01:01:58.67)
Say, for example, take aside the corruption and big pharma influencing nice guidelines. And you should look up who’s on the nice guidelines and the executive board. Fascinating. Again, not doctors. All business leaders, pharmacists, accountants, venture capitalists, God knows name, you name it. But you corrupt, say, a few bunch of individuals and then roll out guidelines across the board to thousands of doctors and say it prescribes statins to everybody. So you could say it’s, you know,

just unethical, you can capture people and it’s fundamentally corrupt that way. But the other problem, say even if AI is completely altruistic and not corrupt or captured in any way, the system doesn’t work because the model is we treat everyone the same. And the reality is every patient is an individual. And you can’t say because on a population -wide basis, this is what we do, that we will then apply it to you, the individual because,

It doesn’t work like that. And AI will never ever tailor it. The guidelines and protocols will always be right, pop up. You should be in a statin. I’ll agree with you and disagree because I think it’s all an issue of timing. I’ve read too many sci -fi books and today’s sci -fi is tomorrow’s science. Yeah, reality. So.

Algorithms, every thought process that we are programmed little brains go through. If you map it out in enough detail, it’s ridiculous levels and levels, levels of detail. You can map it out. You must be able to map it out. Otherwise it’s just random thoughts. There must be, there must be method in the madness. If you can map it out and you end up with an algorithm, it may be a huge algorithm, but it can be done. And as AI gets more powerful, then it becomes more feasible.

So eventually you will get AI doctors who are far better diagnosticians than some of the current doctors. I’m not saying all of them, but some of them. It will happen. The big, big fear is what happens on that journey where we’ve got crap tech, but people making money out of it. But AI will not be examining you. AI will not be reading your body language. AI won’t, it’s not the same. I think – Medicine is more than a science. It’s an art. Let’s hope that that –

Ahmad (01:04:22.062)
of technology is way, way, way, way beyond the lifetimes of not just us, but our children. Is it scary? It is very scary. But what’s happened is the role of a doctor, a doctor now is just an automaton, non -thinking, non -feeling. Honestly. You said it earlier, you just, you described medicine as an art. You use the word art. It’s a scientific art or an artistic science. And it’s that amalgamation of the two.

that’s critical. If you get automaton doctors with no compassion, no art, no thinking, yeah, following tick box medicine.

that’s the path towards hell. Yeah. It’s like companies, if you’ve got a company, a small startup company, and they’ve got an ethos, they’ve got basic principles, why they wanted to do a certain thing, whatever they’re, you know, make a certain widget, make an aeroplane, whatever, because they love flying. And that company grows because they’re passionate and they’ve got a clear vision of what they want to achieve in life. And their work is their passion. Therefore, they’re successful. Okay.

gets to a certain size and all of a sudden that company ends up run by the accountants. So big companies become soulless. As soon as things run by accountants and just by numbers and balance sheets, then it loses its soul. It loses its original purpose. It’s ethos. And then it becomes not just no longer human, no longer, but it can become inhumane where the system becomes cold.

Some people might even say that’s demonic, that lack of soul, that lack of humanity. We’re getting a little bit altruistic. How do we go down this one? It’s not, but I mean, it’s true though. I mean, this is the problem with the doctors or automatons, non -feeling, non -thinking, but there are some exceptions and they’re even more worrying. Your friend invited me to a birthday party, 50th birthday party, never met him before. And I went along just to find out why. He came rushing over.

Ahmad (01:06:27.662)
and he raged and ranted about all the injustices and told me what an amazing job I was doing and how amazing and fantastic and he agrees with everything. But he knew, he knew from ages ago, even before I woke up to what’s going on. And when I asked him, what are you doing about it? He said, you know, I’ve got kids and private education, I’m not in a position to really do anything about it. And this is the situation we’re in now, where even the doctors who know what’s going on,

aren’t actually speaking up and saying anything. I know you’re right. You know you’re right.

But I’m not counting this. How do we but no positive. OK, positivity. Just look at the newspapers over the last few days. Look how the tide is beginning to turn. Just think of the big dam, that huge volume of water building up behind that wall of the dam and the pressures building and building and building. And you just need one drop of water to go through one little crack. And that’s the beginning of the end. That dam will burst.

It is bursting. The truth is coming out. The facts are finally beginning to appear in mainstream media. Can I just say something? Credit to you. You know, some people might not know about you. You’re not like a big Peter McCullough and a Robert Malone. I’m definitely not Robert Malone, am I, buddy? Buster. Buster. Buster. But like you’re quite vocal on Twitter and you got into trouble with your own hospital when you weren’t wearing the mask and everything. It’s been quite difficult, like navigating, isn’t it?

No, tell me. Basic principles. Do you think my life’s been difficult? I’ve been blessed. And every single potential difficulty that comes along is a learning episode. It’s an exercise. Yeah, there’s no such thing as being beaten. This is what I wanted other doctors to hear. What I’m trying to say, this is, this is what I want people to hear. Like you didn’t say yes, you didn’t comply and you

Ahmad (01:08:34.51)
You’re still here. You’re still practicing. You pushed back. You wrote pages and pages. People should hear this. You wrote back to your head of the hospital and said, look at all the evidence. There’s no evidence that masking works and everything. Didn’t you do that? I might have done.

Ahmad (01:08:54.478)
but it was a balancing act. And we’ve got friends, colleagues in the freedom movement who have taken a more…

Ahmad (01:09:14.734)
have taken an approach where they’ve martyred themselves or become a martyr for the cause. You told me not to martyr myself. Am I in that category? Yeah, a bit. But you’re doing brilliantly. Okay. You look physically well, you look mentally well, your eyes are shiny, you’re happy, you’re radiating positivity, you’ve got a beautiful family. I’m in a good place. You’ve got successful podcasts.

You know, you’re keeping your head above water and you’re doing bloody well. And I’m hugely relieved for you. Thanks man. And I think there’s an element of luck because every single one of us, everything we do, we’re surrounded by potential luck or good luck, bad luck. But I’m getting a lot of love from a lot of people from around the world as well. Do you know that? Because A, you deserve it and B, you need it. I’m sure you need a lot more validation.

or have needed a lot more validation recently to know that you’ve done the right thing because the decisions that you’ve made have been so big. I just want to say a quick thanks, but carry on with this thought, but Gareth has bought me some coffees and said, love you, man. You’re some boy. I’m like, Gareth, I love you too, man. Patricia, I love your podcast and admire your fortitude and standing by your principles. The world needs more people like you to bring truth to light.

and stand up to the bullies who think they have power over the rest of us, they are mistaken. Anyway, let’s move on. So look, in terms of advising young doctors, right, let’s just look at some young doctors that are out there right now.

What would you advise them? Like, you know, you’re an experienced clinician, you know, you’ve got man of integrity and honor. What would you say to them at all of them out there? You know, who are looking at becoming a consultant and what would you say? What advice would you give them? Geez, your questions are so big. Yeah. And difficult. Sorry. You can do it. You and I know that, you know, to be brutally honest, if a young person came up to us now and

Ahmad (01:11:32.91)
I said, shall I be a doctor?

Would you say yes?

Do you know what? Yes and no. I would want the right type of doctors. I still believe in the profession and what it could be. Could you do it again? Would you do it again? If I could go back in time? Two similar but separate questions. If I could go back in time, I would do exactly everything that I’ve done already. But I would definitely do things even better though, like knowing what I know now about how to be healthy.

100%. I would do everything the same. I’m talking about career, not, not personal lifestyle choices, but career choices. If I could go back and do it again. Yeah. Yeah. 100%. I loved it. It was a great ride. Do you think you loved it? Do you think that right now, if you had the same brain, you put in a younger body, do you think you could stomach going through the system? Now? Do you think the truth is? No.

Because even when I was a junior doctor, I came up against lots of obstacles because I was different. I was not the kind of junior doctor that just did what the bosses told me to. In some respects, the bosses sometimes would say to me, I’m a bit of a troublemaker because you don’t just blindly follow. And when I was, you know, finished my training in London, I found that I couldn’t get a job in London. I couldn’t.

Ahmad (01:13:04.622)
get no one was coming up to me and saying, Ahmed, we want you in the department. And one of the, not professor, one of the consultants came up to me and said, Ahmed, I really like you. The problem is a lot of the guys are threatened by you. They think that you threaten their private practice because you’re a really good surgeon. You’re very confident. And also you won’t just go along and you might cause trouble. And I was like,

am I like that? And he went, yeah, you are. shit. And I got to a point where I wasn’t even getting shortlisted. And the only reason I got the consultant job where I got it was because they didn’t know who I was. I was out of the area and the region and they even had someone else shooed in for the job. But once I got into the interview and I performed.

the external, you know, college representative who was to make sure that it was a fair process. He came up to me and said, that was the best interview I’ve ever seen. They had to give you the job. They couldn’t. And the first thing one of the consultants in the department said to me was, you weren’t our first pick. And that was all he said. And he walked away and I was like, great. Yeah. So I, I have got a history of what was his name? Jeff Taylor.

I’ve got a Mr. Jeff Taylor, Mr. Jeff Taylor, Mr. Jeff Taylor. Yeah. He said that to you. Yeah. Mr. Jeff Taylor. I’m not judging. Yeah. But what was his name again? Mr. Jeff. That they had a boy from Oxford lined up and he didn’t get it. I think that that guy’s now got a job in Oxford. But basically, yeah, I think. I didn’t play ball, I didn’t suck up.

I did not suck up to people, I didn’t like that. I’ve got a very simple way of looking at people and no one is above me and no one is beneath me. I was quite happy picking up a mop and mopping the surgeon’s theater floor and people would say to me, but you’re the surgeon, don’t, I’m like, so what? Like who cares? I’ve just wiped my baby’s bottom this morning and changed the nap, yeah I can mop this floor. So I’ve always thought like that and I don’t suck up to people.

Ahmad (01:15:26.35)
I think you can judge, you can judge a consultant. You can judge a doctor, especially a consultant. You can really, really judge them about how they treat the people beneath them, right? How they treat their juniors, how they treat the medical students, how they treat the nurses, how they treat the porters. So you know what my wife told me? Really judge them. Do you know what my wife said to me last night? she was like, she was like, I just got a message from one of the registrars that she’s working with saying,

I’m so glad I’m not operating with this other person. And I was like, why? And she went, well, those were reps, sorry, the rep, a rep, a surgical rep said to her, I’m really glad that you’re going to be at this list. I’m looking forward to coming to work. I’m really glad it’s not that other registrar. He’s some guy from Oz. This other registrar was from Australia. And I said, why? She went, well, he’s a nice guy. He’s just really rude to the theater staff. And then I said to him, what?

He doesn’t sound like a nice guy then. She went, yeah, you’re right. I went, why’d you say he’s nice? She went, well, he’s entertaining and he’s funny. He’s respectful to me and post -exam, but he’s really rude and aggressive and not polite to the theater staff and the reps. I went, I would never describe him as a nice guy. And she went, no, you’re right. Sorry. Yeah, he’s not a nice guy. He’s nice to me, but he’s not a nice guy.

And I went and this has come back to he’s he’s nice to his peer, who someone he thinks is equal, if not better than him. But the people that the staff below him that’s called conditional niceness. Yeah. For a reason. To me that guy’s I see you next Tuesday. there’s plenty of them. Plenty of them. So anyway, go back to you know, what would you tell these junior doctors coming up for the ranks?

You know, the next generation. Cause mate, one day we might need operations and I don’t know about you, but I’m terrified. I’m never going to be sick. I’m never going to be, I’m going to be alive. And then going to be dead. God. That’s my dream. What I’m not going to be is that horrible bit in the middle. That gray beige. I’ve been given a diagnosis and therefore I’m sick. Yeah. How am I never going to get a diagnosis? Never go to hospital. Never go to the doctor. My personal choice.

Ahmad (01:17:50.03)
Mine too. Dude, honestly, like considering I spent like half my life in the hospital, I now fear going anywhere near a hospital. Understandable. How bizarre is that? I mean, it was my second home. I mean, you know what it’s like as junior doctors. Sometimes we spent more time in the hospital than we did at home and with our wives. We regularly spent more time at work than we do at home. Right. That was the norm. Yeah. And that’s like a pillar, a temple of doom to me. Advice to young people. Yeah. Yeah. Yeah.

Read. We are all gifted with a superpower and that superpower is the ability to read. But read properly. Don’t just read the abstract. Don’t read the headline. Don’t read the abstract. Read the paper. If there’s one skill in life that’s invaluable to go with the ability to read, it’s the ability of, four, critical thinking. Analyze things.

And make your own opinion. Read the methodology, read the results, read the discussion, work out whether it’s right or wrong. Do you believe what they’ve said? Just because it’s published, just because it’s written, doesn’t mean it’s right. It’s somebody’s opinion. Yeah. Cannot rely on the peer review process because that’s other people’s opinion on that opinion.

We now know that so many medical journals are corrupt. That’s a good word. They’re captured. They’re biased. They’re influenced. Major conflicts of interest. Absolutely. So number one, read. Number two, think.

Ahmad (01:19:35.726)
There’s another key principle, I’m trying to think of words to use that are not gonna be too offensive, but it’s do the right thing. Just do the right thing. And you don’t need to be taught that. You need to unlearn actually all the bullshit and actually go back to your essence. Your body, you know what’s right and what’s wrong. Yeah, but this is where I’m a bit worried because we’ve all met colleagues, we’re surrounded by colleagues who…

who seem to be NPCs, non -player characters. There seems to be nothing there. Nothing there. And when you try and talk to them and you try and present facts, their eyes glaze over. And, you know, I’ve, I’ve shared papers and data and information with, tried to share it with colleagues and with some friends. And they’re like, I don’t want to read. I don’t want to read that. Yeah. Pardon. Yeah. So one approach is to say,

Instead of bombarding somebody with an opinion saying, right, did you know the Japs caused myocarditis? And they shut down and think, no, you’re an idiot. No, they’re safe. They’re completely safe. The government told me they’re safe. So you’re an idiot. I’m not going to engage. Another approach instead is to say, well, I’ve come across this paper and it really perturbs me. I’m really worried about it and I’m not really sure about it. And I’ve read it, but I’d really, really greatly value your opinion on it. If you could please read it.

and then let me know what you think, I’d be really grateful. Because then what you’re not doing is you’re not imposing your opinion on them. In which case instantly, you’re in a situation of conflict and they’re fighting back and the shutters come down. You’re so good at this. Yeah. Instantly they think, yeah, yeah, yeah. I’ll have a look at that for you. I’m more.

in your face kind of thing, which I appreciate is not the right thing. I’m learning. Thank God I’m married to a wonderful, wonderful woman who’s got the patience of a saint who’s spent literally.

Ahmad (01:21:37.486)
30 something, I mean, so much trouble now. 31 married years. Can I tell about how you were speaking to her in the car? Remember that time when we were driving back? No, private, personal. No, come on, this is hilarious. So you’re in the back of the car, we’re driving back from the restaurant, I’m dropping you off home, and you’re like, yeah, yeah, effing and blinding, yeah, yeah, yeah, I’m the big orthopedic surgeon here, I’m a proper knee surgeon, yeah, yeah, yeah, rah. And then suddenly your phone rings and like.

It’s your wife and you’re like, hello, hi. Yeah, I’m just coming home. Yeah, yeah, I’m just in the back of the car with them. It’s good. Drop me off. Okay. Right. Yeah. I love you too. Love you. Okay. Bye. And then, yeah, right. Okay. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right.

it’s it probably in the scottish accent. I can you do that? And there can only be one boss, right? And there is only one boss. Let’s just face it. Right? I mean, trust me. I know there can only be one saying before you’ll purposely get me into trouble.

that my wife’s got patience for saying because she is a far more intellectual, emotionally intelligent diplomat than I am. And she’s gradually painfully teaching me to take a more intelligent and diplomatic approach to the way that I argue, engage, see even my use of the word argue, a point, no, engage in a dialogue. Bring people along, bringing people along a path.

is so much more effective than trying to drag them along. I’m not very good at it, I’m learning. All right, okay. So you’ve done the advice to the junior doctors, great, great advice. Now it’s the signature question. You’re on your deathbed buster, right? Don’t worry, it’s painless, you’re gonna go very quickly. You’re surrounded by your loved ones. What words and perils of wisdom are you gonna pass on? What are you gonna tell them? I’d say.

Ahmad (01:23:57.262)
winning lottery ticket is hidden. Shut up. That’d be a funny last line, wouldn’t it? It’d be great. It’d be great. Yeah. I’m not your father. You look at my kids. I’m definitely their father. I’m not your father. I would say.

keep trying. Just keep trying. Keep moving forward. Do better. Do better. Mean thing to say. You could have been better. My kids are awesome. I’m absolutely in. All of my kids are brilliant. there’s a great thing, which is I can’t say it. Don’t be a sad. No, that’s a great. No, no, I’ll say it. Don’t be a

You know what, honestly, I think, but I don’t have to say that. I know. I think God came down and, seriously, God came down and spoke to the prophets and said these simple words, don’t be a dick. That was not the anatomical gender I was thinking of. And I bet people were like looking at each other going, we can’t sell this to the masses. No, no, we can’t do this.

We need to make it a little bit more complicated and then we need to make like tomes and volumes and then sell it to the public. And we need to be the masters of this knowledge and we’ll control them and guilt them and shame them. Don’t be a dick as, no, no, we can’t do it. We can’t tell them that. If I’m lucky enough to have my wife and kids by my deathbed, I’d have two words.

Ahmad (01:25:52.43)
You have to count. Five words. I love you.

Thank you, just thank you. That’s nice. Do you know what, just before we end, I just wanna say, you know. Not thank you, I bow. Off I go. But thank you for being brilliant. Yeah, right. One of the things I love about you is despite being the six foot three typical orthopedic surgeon, you’re just such a gentle soul. One of the things you shared with me, I don’t know if you remember it was, you talked about how when you first dropped off one of your kids at university.

And then you drove around the corner and had a little cry. No, I didn’t. You did? No, I didn’t. I was blubbing. I had snot coming down my face. It was, yeah. I didn’t have a little cry. I was sobbing. Yeah. I think that now, honestly, like I love my little gang. I love hanging out with my crew and I’m literally counting down the days when I think, shit, they’re going to leave.

And you remember you told me you told me this. I’ve got this constant urge every time I see a parent with a young kid, especially if the kids playing up and they’re getting a bit stressed. A constant urge to go out to them and say, it goes so fast. Enjoy every second. It goes so fast and you can’t get it back. And you know, you don’t want to go up to every single pair and say to every single time it goes so fast because old people say that all the time. But it’s true. And that’s why you got to work hard.

work hard, make the most of things, because it goes so fast. One of the beautiful things that’s come out of me not practicing anymore, don’t get sad, is I do get to spend a shit ton of time now with my kids. Yeah. And I have the bestest conversations. Invaluable. Mate. And they’re so funny. And so you saw my son, do you see how many times he came home and cuddled me and told me he loves me? And it’s just, it’s just magical, mate.

Ahmad (01:27:53.262)
Most important bit of advice to a parent, there’s a few. Dining table. Got to have food, you got to have dinners around a dining table. You talk where there’s conversations, good arguments, but you talk and you resolve differences of opinion. But you learn to argue in a friendly fashion.

That’s an art that seems to be lost by so many people in society now. Do you know what? Cause you, you know, we, I, we used to be guilty of that where even like breakfast or tea time, you just put the plate of food on a table. They watch TV. They don’t talk. I’m mind numbing. Do we’ve stopped all that. You know what you saw today? I was very honored. I was absolutely loved having dinner with you and your kids. It was brilliant. I’m honored to have had the opportunity. It was brilliant. It was lovely. It was lovely. The negotiating, who gets the food. And the other thing is gadgets.

Yeah. If there’s a tool of Satan on this planet, it’s this. The screen. It’s the screen, whether it’s a phone or a tablet. And you see kids sitting at a table, you go out for dinner, like you’re on holiday and you see like three generations of a family sitting around a big long table. And some of these families, the kids are all at one end. The kids are all just immersed in this horrible world. Not engaging with the parents or the grandparents.

I want a horrific lost opportunity that is for them to speak to their grandparents, to learn values, you know, so much. So it’s not to medical students and it’s not to whoever’s around my death bed. It’s to, it’s to parents. Cause this is important because it’s the kids. They’re coming after the kids. They’re coming after the kids. Get a dining table or a kitchen table.

eat at the table and number two, get those bloody gadgets out of their hands. Amen to that. Listen, I really appreciate you coming. You’ve probably had a long week. It’s the end of the week for you. I know you’ve got a long drive home. It’s late now. It’s dark. You finally made it. You came to to. I hope it was worthwhile. Yeah, man. I feel like we chatted a lot of kind of shit. Dude, you don’t know how I roll. This is how we do it, man.

Ahmad (01:30:15.726)
People love this, I’m telling you right now. You’ll see the reviews, everybody will be like, I love that guy. You need to bring him back, bring him back. You need to come back. We’ll be meeting up soon. I’m looking forward to that. yeah, we are. You’re gonna love it. It’s gonna be brilliant, brilliant. I’m dreaming about this. yeah. Don’t tell anybody what we’re doing. I’m not telling anybody. It’s gonna be brilliant. yeah. All right everybody, on that note, we’re gonna end. God bless, thanks Ian.

Ahmad (01:30:44.75)
I hope you had fun.