10K Subscribers!! - Behind the Clinical Skills Q&A with Dr James Gill

right um hi Wow 10,000 subscribers thank you I genuinely blown away I really didn't expect this at all certainly not in the speed of time which it's happened so I can only say thank you you guys have done tremendous thing in terms of empowering me believe it or not I kind of consider myself to be a very extroverted introvert so whilst I can do you know a lecture and frankly do enjoy them I do pay the toll afterwards so it's exceptionally gratifying to see that when I've been doing the clinical skills videos and things like that that you guys at home getting a an outcome from that you're getting a benefit so thank you that's really inspiring so that I can try and focus do more of them similarly with that thank you for all of the comments that you put you know the the humorous ones the dodgy ones you know all the very note it takes time out of your viewing to stop and actually put a comment you know you a comment does require you to engage and thank you for that whether it's positive or negative you know we've you've managed to you know reach out to me and I am so very grateful for that I hope that some of the suggestions and changes that you've seen you'll acknowledge have come from comments that yourselves have made and yes perhaps because this is supposed to be a video of you guys getting to know me a bit we acknowledge Bob the silent partner here I'm the doctor I have a skillet in my front room what's wrong with that no um bob was a present when i first heard that has going to go to medical school and he's kind of being with me through every house ever since but there are some bits of him which is still drawn all over where you can see where I was learning the various bits of anatomy particularly for the suturing of the skull I just want to reiterate you know I didn't think that we were going to get to 10,000 subscribers anywhere near this and I'm absolutely astonished with the response that everybody's come forward for and you know I said hey let's do a little video if people are interested and you know you can ask me a few questions and they're like and to be honest I actually didn't think it was going to be a great idea and I really didn't think anything was going to come of it 2,200 people voted to give 92 percent response for yes I have questions and on the back of that 67 people sent questions there is some duplication there and some questions you know but we'll definitely look over a lot of these questions in a moment well perhaps I mean 2% of people I'm more inclined to agree with that the whole dude get over yourself I really don't care who you are which if I'm honest it kind of covers me most of the time one of the things I kind of want to establish before I go any further people will have asked or you know suggested that I'm putting on a voice or something like that when we do the clinical examinations okay if you could look up please and if you look down I slightly pushed back against that the reason being is that it's part of kind of my Asperger's brain all the rest of it I view things that I wear multiple hats you know if I'm out with my friends you know then I'm wearing a certain hat if I'm doing an examination of a patient or in a clinical setting then I've got sort of a a dr. Gill hat on if I'm you know in Tigger mode then that's a different hat that lets me do different things and that's always helped me manage who I am and who people are expecting me to be it also helps me compartmentalize so you know work is one thing and when I'm in doctor mode that's one way of doing things and then that changes depending on where I am so I do want to you know just reassure I'm not in any way putting anything on and I think to do so I'm particular than film it would be quite disingenuous and that's something that I would never want anybody to describe me as I have you know we all have our lines as it were and I think that you know people have a lot of latitude to their behavior but personally I think one thing that is inexcusable is you know buying being disingenuous not being who you are people can't know you if you're hiding from them and sometimes will withhold parts of ourselves as I say you know that's in a dr. Gill clinical hat but it is still a valid part of me and I hope that you can see that distinction when people say oh you know you're a little bit different when you're doing this or you know what I've seen you're doing this video down it's a cycle show or heard me on the radio even you know that's a different person yeah but they're all parts of the same me there's one question here which is saying you know would it be possible to do examinations on real patients I'd love to be able to do that because I think there is a huge learning benefit for that but I'm not sure whether or not it's going to be easy to do and because patients involved it'll probably have to go through the ethics approval which means paperwork but we'll certainly give it a go because there's an example of I don't know a patient who has a hernia then we may be able to do a history with that patient which help students see what particular questions are needed to be asked to get all the information on the GI system about this hernia but similarly people will also be able to see how I'm phrasing the questions during that history and how to improve their clinical skills with that that might also dovetail well to do the history and then a whole examination for the patient so it's something I can definitely look at so nearly two thousand votes and 67 questions so I have a chat I tell I'm I thought this was a really good place to do the video I'm actually sat on a shipping container it's not the most confident world so let's go over to the regular seat okay so we've got the the iPad here and let's see if we can go through some of the questions and things that people have put pretty big so celestial when did you become aware they were extremely popular with the SMR community and what were your first thoughts when you found out well believe it or not I was having a dinner party and I got my friends over because I was I was going to go off and do something I must confess I forget what it was it may have been the island but either way I you know I'll go off and do an adventure and I'll have my friends round for lunch just in case I you know expire onset adventure and in passing one of the chaps said that he'd been listening to videos online to help him sleep and he got a terrible shock earlier on in that week when my voice had come out of his speaker whilst he's trying to sleep which gave him a real shock and that was where we discovered that people were you know listening to the clinical skills videos for more than necessarily just learning the medicine and it's been entertaining to say the least there's been an awful lot of ribbing at work about it but looking over the comments that people have made people get a real benefit here you know people saying that they helped some sleep and they were relaxed from it and ultimately as far as I'm concerned they're two of the most important factors for life I mean with that there are many many reasons that people get anxious and when I was at medical school my best friend and he had generalized anxiety disorder say he'd stand there and getting a flaming panic if the bus was late you know it was a generalized anxiety disorder lots of little things nothing in particular who getting really worked up and stressed and it's one of the things that I now have an awful lot of time for when it comes to helping my patients it's not unusual to see patients who are well in themselves but have an inner what's the phrase I'm looking for on ease and I will do anything I can to help these patients overcome that sense of dread that they have inside that compared lies their entire lives so if somebody is listening to these videos whether art it's three men and a boat whatever and they are getting some release they're getting some way of grounding themselves they're getting some way of calming that in a storm them brilliant I mean you know anxiety and sleep go hand-in-hand and I just want to try and expand upon that forever I regularly see people who come into the clinic saying that having problems with sleeping the cat just water girls on cat we'll deal with that in a moment and sleep is vital if you're not getting you know your seven hours at least a night it's gonna have a huge impact on your mental health and that's going to go with depression it's going to go for anxiety it's going to go with eating disorders it's a huge number of problems and previously as human beings we used to sleep very well you know we were controlled largely by the clam the Sun not the clock and when I was on the island we didn't even have watches let alone our phones and the Sun would go down and you'd realize you were getting tired and if you weren't on fire due to that night then you slept and I slept for hours and hours whilst I was there much better than it do back here and it was a wonderful time in that regard so you know that brings back if people are finding a benefit of sleep you know maybe listening to three men in the boat then magnificent I can only say thank you for telling me this because it shows that I'm helping somebody and even if that's just one person out of everybody here who's subscribing that's still one person that has had a benefit from hear it one person who is slightly better than they were and hopefully that person will be able to take something they've learned and share it with somebody else maybe that's going online and buying audiobooks maybe it's you know listening to you know their laptop with all the lights down low in the corner of their bedroom whatever it is if somebody has managed to benefit then every minute of this has been worthwhile so with that in mind let's have a look at a few of these things shall we so 92% of people said that they had questions and 67 people actually put those questions down below so let's see what some of those are M will you ever do a collaboration with dr. Halle Berry I don't think she'd be interested [Music] Lucey Mary is it possible to do longer demonstration videos even if a friend acts as a patient as mentioned maybe we'll be able to try and include some histories with the examination videos for education of the students but you can't really extend an examination longer than it is you know if it takes five minutes to examine the chest then that's how long it takes to examine the chest you've also got to think about the patient discomfort you know if you're stretching out an examination for no clear purpose then a patient is going to feel unnerved by that and it's important to remain professional and get whatever assessment information you need from the patient as quickly and professional as you can do house was some rat hoon my apologies if I've mispronounced that have you considered audiobooks because what you do is quality stuff thank you for the comment and I to be honest in terms of selling audiobooks the eleven thousand subscribers that have got now I am astounded by all the way through my childhood a lot of my training I hated my voice I you know I hate myself recorded and would just cringe I mean everybody does that to some degree but my voice has always been some so different compared to my friends and things like that and oddly nobody in my family speaks as I do you know I'm from Derbyshire you know it's all garbage you're born and born you know darbus of bread strong an arm but we can add but for some reason I don't know where there's too much TV here what it was but I've ended up speaking like this and I can't help it but I'm not sure about audiobooks I I as I say I'm doing three men and a boat for my sister and her my sister and her nephew but the concept that people are enjoying listening to my voice I find a thoroughly bizarre okay Chris M I play your videos for my 94 year old grandfather he was knocked Amaterasu decades from the Vietnam to the 1990s and he truly enjoys your professional demeanor and calming voice you help him sleep I can't thank you enough dr. Gill I can only say thank you to Chris for you know saying that I've already said it sleep is so important and if he is getting any benefit here magnificent I I cannot thank you enough Chris for you know just giving that feedback it's wonderful it really is what's your favorite meme or joke that made you left hardest in the comments of one of your videos that's from Casablanca J either the double-vision because I realized that it seems a bit strange when you're doing this pointed star looking for any changes in a person's vision to keep on any double vision any double vision but perhaps the most that I laughed or now feel self-conscious about is the placing a bit of paper again I have odd terms of phrase at times or odd alliterations and I'm surprised how people have you know locked onto that one of my friends did suggest however that if things really take off we record more videos by and just have them created by put a bit of paper productions I'll leave you to decide if you think that's a wise idea or if that's riding the meme just a little bit too hard I would love as persons for talking through the 4th wall this is probably an appropriate time to formally introduce this on so this walking furball this is data and I got him when I was at medical school he was a rescue and he's been with me ever since yeah when it comes for anxieties and things I'm pretty sure that Dekker has separation anxiety if I leave the room he normally comes with me if I go to the toilet and shut the door he'll sit out on the other side yelling whenever I've gone on my adventures and been away so when we were in the Himalayas were there for four weeks I come back and my housemate will explain at length how he's been a very noisy individual bitter on subject to sleep this chap helps me sleep so he frequently pops up when I say frequently what I mean is without fail after I've sort of laying down in bed sits on my chest and then promptly goes to sleep he's like a a furry version of a weighted blanket okay I'm saying if the cat will permit well have a look at few more of these holders calm do you experience ASMR yourself what are your thoughts on the phenomenon from a doctor's perspective thanks I don't think I do and if I'm honest I've never heard about it until people started making comments on the videos about it I'll be honest it's not something I've really actually looked at but I think perhaps from a you know a medical perspective it might be worthwhile seeing if I can find anything in the literature to point one way or the other I mean Kaley underneath have you had anyone approach you in real life about your videos no or about S&R no but if I can find any good evidence then it might be worthwhile directing you know some of the patients to these particular resources if it is helping them to relax so it's something to think about Gabriel a simulator Thank You Gabriel I've seen your name pop up quite regularly in the comments and you're always quite useful in terms of giving feedback on the videos so I really appreciate your contributions here did you make the intro tune yourself with your piano no unfortunately I'm not blessed with the gift of music I have two left feet and two club hands as far as music is concerned I've never been able to get I can play one hand or can play the other but it was never able to connect both together so now this is a stock things I got however I have a plenty of comments saying that people absolutely loathe that intro and it's something as I am actually considering abandoning so what what do you guys think I'd be quite interested now on that so Chris Lowry asks you naturally evoke through your channel a love of helping people whether medically all through sleep did that love have a specific origin any fond memories you can trace to being developmental and fostering that desire to help / teach people Thank You great keep up the great videos doctor honestly I was very lucky I was raised by my hero my granddad was a giant of a man in the quietest possible way and everybody knew him and the thing that he was known for was his exceptional kindness oh it's never big and it was never showing but everybody knew that if you had a problem you spoke to her if hidden and he wouldn't necessarily be able to fix it but he wouldn't make it better or help in some way and the best of his ability at that and I like to try and keep his memory going with that same approach as a doctor there's an awful lot of things I can do nothing about but even those things I can do nothing about I might be able to help them and I might be able to reduce their troubles about whatever the problem is I frequently have patients coming and with money worries and stresses at home I can't do anything about the husband and their wife or you know the issues that haven't when they're children but I can talk to them I can be there I can listen and I can give them support and maybe you know help them with medication over a short period or direct them towards counseling services or look at other things that they can do to help themselves out and I think having somebody who you know won't necessarily try to fix things but will do everything in their power to try and help it's a very very valuable thing for a patient not all patients go to the doctor for a fix a lot of the time they go there to say I have a problem and just have somebody listen to them and I'd like to think that my par is proud of the the work that he did with me the care that he gave me when I was growing up and I'd like to think that he can be proud of his parenting that perhaps going where we didn't expect to go on that one [Music] Arvind Venkat have you considered doing a podcast and all seriously what did you feel when the ASMR community started loving you a video describing that would be awesome I can do a lecture quite easily because I know what I'm talking about and I will do prep beforehand and I'll make sure that everything is ready I'll know the jokes that I'm putting in I know where I'm getting the students to engage me and I'll know where I'm potentially going to you know beat the round the head with the information ask for podcasts though I don't know if I've got enough to say in that regard it's definitely something we can keep on the table and maybe look at in the future but at the minute I don't I don't think it'll work but we'll see we'll see so can I give you a defining point in my career I worked in ITU at one point and you see everything coming through that but the interesting thing about ITU is the patients who come to you they are the sickest in the entire hospital but those patients have gone into out into ITU because we feel that there is a fighting chance that if we give them every single opportunity that modern medicine has to offer they may stabilize and they may improve okay so with that in mind we had a lady came in she was similar eight as myself I think 30s at the time and she'd crashed her bike and hit her head and sustained what's called a diffuse axonal injury basically your brain gets shaken and all the connections break it's very very bad and I remember thinking with this lady she sort of got under my skin it's like everything is trying to kill me you know just uh you know how dangerous is life and then one of the seniors put it a different way to me said yeah life is very dangerous and in fact life so dangerous you may as well just stay in bed but if you then did stay in bed you're gonna die of pneumonia and pressure sores so get out there and live your life your life is the most important thing you will ever have and you don't know when it's a gift that's going to be taken away from you so use the time well okay use the time that you've got and get out there and live because you don't know when it's going to change perhaps in irrevocable ways and that that was a really profound thing for me and based upon that that's kind of how I've gone to do the island it's what's have met every space cow boots you know it's the thing that actually lets me get up and do crazy adventures are you alright cat you're not getting sufficient levels of attention the iPad is on the knee why is cats not on the knee this is not acceptable never work with what's the phrase children or animals better better okay well with cat firmly ensconced I'm gonna see if I can move the camera down actually without destroying everything oh no and cat has now run off so that's not going to happen okay so we'll wrap up the last few of these because I'm pretty sure that there's not many more people still watching because we're all bored rigid so what are your hobbies I quite like running and cycling it keeps me fit and also keeps my brain sane I find that sometimes everything just gets a bit much and for want of a better phrase my brain can get a scratchy and I find getting out into the woods and going through a run getting muddy and just generally being having my own time weaving really really useful how long have I been practicing medicine from sixty-four vampire girl I graduated in 2010 and so now when August this year all have been practicing for ten shockingly long is a home and oddly enough I trained at warrant medical school graduated and then somehow never escape the gravitational pull and ended up back there as a clinical lecturer now but I actually think that gives me a very good insight into helping the students because I remember those same lectures I remember being in the same theatres as they are and I also remember which lecturers inspired me and those that helped helped me get more sleep hopefully for the vast majority of the students certainly in lectures I'm not putting them to sleep but I certainly remember you know how engaged certain members of staff got me and I want to make sure that my students feel you know similar infused all my chosen subjects okay after doing Bear Grylls the island is there any other reality style program you'd consider taking on or any style of program really I do - does the same as I'd never consider Bear Grylls to be a reality TV show it was more we went away and had an amazing adventure with you know medical oversight and it happened to be shown on TV the results of that was an interpretation of the inventors that we had over there certainly there was some selective editing that a few of us and the groups weren't entirely pleased about but I'm lucky that I still keep in contact with a lot of those people I think if you've survived for four weeks on a desert island with no food and things then you know that there's some special bonds but in terms of doing something further I'm currently discussing about maybe trying to do a program or about mental health we'll see whether or not how that happened so watch this space for the time being okay you couldn't and finally I play videogames and I'm a big fan of Diablo because I'm quite like a well go around dungeons but more interestingly for me is horizon zero dawn I really really enjoy the post-apocalyptic fiction to it and more importantly it's got robot dinosaurs what more could you ask for so with that I think robot dinosaurs is probably a very good place to end this thank you to all of you who've subscribed if as I've mentioned if you found a benefit to watching in any videos from a clinical perspective why there aren't you know the three men on a boat has helped you relax or sleep thank you for sharing that information with me it certainly empowered me to do more videos if it has benefited you I'd be really grateful if you could share it maybe somebody else will get a similar benefit and at the end of the day you know hopefully we can all help each other with that I'm gonna set again thank you for the 10,000 subscribers I've got at the moment hopefully we will build together into this you know great little community thank you for the comment the questions and all the slightly odd statements and yeah I will hopefully see you guys soon yeah take care have a good evening