Reduce Workplace Pain And Become More Productive | Dr Euan Lawson

Chris Williamson 0:00 (wind blowing) Hello, hello, hello. This week is an absolute belter. This genuinely could be the best podcast that I've done so far. Really, really happy with it. Dr. Ewen Lawson is my guest. He is the author of The Healthy Writer, also a general practitioner of medicine in the UK, and the host of the Blokeology podcast. Check that out on iTunes, Stitcher, all those good places. And today, we are talking about what it's like working at a desk. So very, very high proportion of people will spend at least a significant period of their week sat down working at a desk, looking at a screen. What we try to go through today is, with the help of Dr. Lawson's expertise, is to break down exactly what is good and bad practice when it comes to designing your workstation. So we're talking from seating posture, height of screen, cranial angle looking down, angle for your wrists, what you can do about reducing RSI, what you can do about reducing, um, stress on your eyes, improving your sleep, your work rhythms, how you can use some productivity tools and some productivity hacks to batch together your work into windows so that you're always accountable to yourself and so that you can improve your productivity. We go into journaling, we go into the health effects of sitting, of being sedentary. This really is absolutely jam packed, and I'm incredibly happy with it. Also, I have to say, the long awaited Love Island Podcast is now available and it will be a YouTube exclusive for the foreseeable future. So if you wanted to hear what it's really like living on Love Island with me, Johnny and Yusef, you have to go online. Head to YouTube and search Modern Wisdom Podcast. It'll come up. The response has been fantastic. We've broken through, I think, 3K views maybe already. Really, really happy with it. I've had loads of messages about it. So make sure that you head online. If you love the podcast on audio, every episode will be made available on YouTube as well now, and I'm going to be uploading video files for all of the old ones, including all subsequent episodes as well. Make sure that you head there, press subscribe, and please support the channel. But now it's time for Dr. Ewen Lawson. Enjoy, make some notes, and hopefully you will wake up tomorrow with a fresh set of eyes before you go to work. (upbeat music) Dr. Ewen

Chris Williamson 3:01 Lawson, welcome to Modern Wisdom.

Dr Euan Lawson 3:04 Hello, Chris.

Chris Williamson 3:05 How are you?

Dr Euan Lawson 3:06 Very well, thank you, and yourself?

Chris Williamson 3:07 Yeah, very good, thank you. So I put a post out on my Instagram earlier today, and I said, "Do you work at a desk? Do you suffer with any, uh, physical ailments or repetitive strain injury, neck pain, back pain, tight hips?" And my inbox absolutely exploded. I think I could have announced that I was getting married or having a child and would have probably got less of a response.

Dr Euan Lawson 3:32 (laughs)

Chris Williamson 3:33 Um, and yeah, the, the problem of working at a desk and sitting looking at a computer seems to be so widespread, and it was, it was a real, a real shock to me just how many people are, are, are, for want of a better term, kind of suffering in silence, dealing with it as a byproduct of, well, this is work and the same way as going down the coal mine, you know-

Dr Euan Lawson 3:59 Yeah.

Chris Williamson 3:59 ... however many years ago would have been, "Oh, well, you know, this is just, it's just a, um, an issue that comes along with the particular chosen industry that I'm in." Um, why do you think that the use of desk work is so widespread, but the optimization of it and the making of it to be a healthy environment doesn't seem to be?

Dr Euan Lawson 4:22 Um, I, I guess the whole kind of... I, I think you're right, it's a bit of a modern plague, isn't it? There are people that are absolutely just getting increasingly aware of their, the pain it's putting them through. Um, it... I guess the problems with ergonomics and things have been known for a long time, but I wonder if it's just a case of, us, you know, it's a bit, there's a bit of catching up to do. You're in that sort of phase where it's become the social norm to look at a computer all the time. And, and if you think about it, it's only, you know, it's only 10, 20 years ago we didn't have little screens to look at, the iPhone was only invent... iPad only appeared, you know, a decade ago, whatever it was, it's a really short period of time, isn't it?

Chris Williamson 4:57 Yeah.

Dr Euan Lawson 4:57 And so that, that... the health-related consequences of doing... looking at screens all the time, looking at computers, that screen time has just gone through the roof in the last few years, and I don't think the healthy kind of approaches to it have quite caught up yet, perhaps.

Chris Williamson 5:11 Yeah. No, I think that's, uh, I think that's definitely, definitely an issue, that you've got the industry being ahead of the-

Dr Euan Lawson 5:18 Yeah.

Chris Williamson 5:18 ... the research to a degree, or at least the, um, distribution of it and people's understanding. So hopefully today we can start to, uh, mitigate some of those problems, and people-

Dr Euan Lawson 5:28 Yeah, sure.

Chris Williamson 5:29 ... may, people may, uh, be waking up tomorrow with a fresh set of eyes as they go into work. So can you-

Dr Euan Lawson 5:34 (laughs)

Chris Williamson 5:34 ... um, can you give us a little bit of background to yourself please for the listeners who don't know who you are?

Dr Euan Lawson 5:37 Yeah. So, um, uh, I'm a, I'm a doctor. I'm, I'm a GP, so a general practitioner. And for those of them, those of you people not based in the kind of UK or Australia, New Zealand, other places, the GP is just a kind of like a, a specialist in family medicine, so it's cradle to the grave stuff. We see people before they get to hospital, from children to adults to kind of, uh, palliative care, end-of-life stuff as well. So-

Chris Williamson 6:00 Yeah.

Dr Euan Lawson 6:00 ... very much kind of the full spectrum of health problems.... and we also spend a lot of time looking after people and just prevent, there's a certain element of preventative health and managing people, helping people with, um, lifestyle things like obesity or other, smoking, other related factors like that. Um, I have, um, I was in the army a few years ago. I've always had an interest in being physically healthy, of course. But, uh, like everybody, I've had my own set of, you know, tr- wrestling with these kind of problems. That's spending too much time sitting at a desk or trying to lose a little bit of weight, trying to be active in a world that is determined to get us to eat more all the time.

Chris Williamson 6:35 Yeah.

Dr Euan Lawson 6:36 And that's one of my big moans about the modern world is how it's constantly, certainly in the Western world where you know, the society is pretty much trying to ram food down our throats-

Chris Williamson 6:44 Yes.

Dr Euan Lawson 6:44 ... 99% of the time. Wrestling with all that, trying to keep fit, trying to kind of maintain family life, not trying to get burned out, um, trying to stay fit and well. So that, that's my own personal interest, um, and my, it obviously aligns with my personal and my professional life as well as a, um, as a doctor.

Chris Williamson 7:01 Yeah.

Dr Euan Lawson 7:01 And I, I was involved in writing a book last year with, um, uh, Joanna Penn, a kind of well-known, uh, creative entrepreneur, non-fiction fiction writer, um, a book called The Healthy Writer, where we, and it was very much written for writers and for that group of people, but I think probably a lot of the stuff in there is applicable to anyone who finds themselves parked in front of a computer for their working life or-

Chris Williamson 7:22 Absolutely.

Dr Euan Lawson 7:23 ... they're not getting active enough and they just wanna do something about it.

Chris Williamson 7:26 Yeah. I agree. I think that's, I wouldn't like to guess the, um, the percentage of people, but a, a large majority of almost everyone will spend over 15, 20 hours a week, that's sort of towards the bottom end. And then you're talking, if you work in a call center or if you're a knowledge worker of pretty much any kind, it's that 37 and a half hours a week is probably 37 hours sat-

Dr Euan Lawson 7:53 Yeah. It's-

Chris Williamson 7:54 ... sat, sat at a screen.

Dr Euan Lawson 7:55 Yeah. It's insane. And I mean, the, I mean, there's the actual physical effects of just being sat there, but it's just the fact you're not moving as well that kind of... And it falls into, it's a, it's now become slightly a cliché that sitting is the new smoking, um, and the, and, uh, and it, it's kind of a lot of people have heard that in the last few years, but I think that kind of lack of movement, that's, and it's, you know, sedentary life, that's a, that's massively toxic, I think, and-

Chris Williamson 8:18 So just-

Dr Euan Lawson 8:18 ... try to combat that.

Chris Williamson 8:18 ... just how destructive is it?

Dr Euan Lawson 8:20 Um, I think it's certainly been, uh, the, some of the evidence around this is hard to pick out actually. That, I guess that's my other interest, that I'm really inter- I'm really keen on actually delving into the evidence and not just kind of putting out, uh, you, that, you know, uh, kind of vague opinion. And actually-

Chris Williamson 8:36 Anecdotal.

Dr Euan Lawson 8:36 Yeah.

Chris Williamson 8:36 Yeah.

Dr Euan Lawson 8:37 I, I, I, an- I recognize the importance of anecdotes as well that, you know, in certain extent, everybody that comes in to see you as a patient as an, and you know, they're then individual.

Chris Williamson 8:45 (laughs) That's a good point.

Dr Euan Lawson 8:45 And evidence, there's problems with applying evidence to individuals. That's a-

Chris Williamson 8:48 Yeah.

Dr Euan Lawson 8:48 That's the challenge of being a doctor. Um, it, it's hard to put a number on it because sometimes the relationship between sitting and poor health isn't completely demonstrable. It's not completely easy to show. Um, and it's a little bit contradictory in places. So I would s- you would struggle to quantify it.

Chris Williamson 9:04 Mm-hmm.

Dr Euan Lawson 9:04 I think what it's easier to show is that people who are physically active enjoy, uh, longer life, better quality of life, um, and a whole lot of other kind of measurements that go with that in terms of their risk of this cardiovascular disease, diabetes, they're all massively improved by being active. And it's harder to prove that just sitting as an activity is actually bad for you.

Chris Williamson 9:27 Yeah. I think-

Dr Euan Lawson 9:27 But I think it's the general e- ac- it's the general sort of the whole picture of y- how sedentary you are that's really important.

Chris Williamson 9:32 Yeah, for sure. I think certainly for myself, I, um, I could probably hold my hands up and say that I know I train very hard when I do and go, go and do physical activity, but I also know that I'm very sedentary at other points as well.

Dr Euan Lawson 9:50 Yeah.

Chris Williamson 9:50 And I think I've probably kidded myself into believing for quite a while that while it's fine, I'm, I'm looking after my activity levels across the day, therefore, if I spend three hours at a period in-between toilet breaks sitting at my desk and not moving and staring at screen, that's fine because the physical effects will be mitigated by me binning myself in a, a two-hour CrossFit session or whatever it might be.

Dr Euan Lawson 10:16 Yeah.

Chris Williamson 10:16 Is-

Dr Euan Lawson 10:16 Well, the, yeah.

Chris Williamson 10:17 ... is that the wrong way to look at it?

Dr Euan Lawson 10:19 No. No. Uh, actually, there is a, I looked into this a little bit for the book as well, and there's something that, you know, that you fall into that sort of slight category of weekend warrior, though I recognize it's not always just at the weekends.

Chris Williamson 10:28 Yeah.

Dr Euan Lawson 10:28 And there is, there is some evidence that if you do your exercise batched up, say at the weekend in that classic weekend warrior kind of approach, that does seem to, that does seem to be helpful. So you, you can mitigate some of the harms of your r- rest of your week being relatively inactive.

Chris Williamson 10:43 Okay.

Dr Euan Lawson 10:44 Um, I, I think there's... Some of the difficulty with this, you mentioned coal miners at the start.

Chris Williamson 10:47 (laughs)

Dr Euan Lawson 10:47 Actually, the difficulty with that is coal miners were incredibly physically active. They didn't do any-

Chris Williamson 10:52 (laughs)

Dr Euan Lawson 10:52 They didn't do any sitting down.

Chris Williamson 10:55 (laughs) Okay.

Dr Euan Lawson 10:55 But they do-

Chris Williamson 10:55 But I mean, at least that was, that was one, one bonus-

Dr Euan Lawson 10:57 Yeah.

Chris Williamson 10:57 ... to take away from it, I suppose.

Dr Euan Lawson 10:59 Yeah. But they were incredibly good at dying young for various reasons.

Chris Williamson 11:02 (laughs)

Dr Euan Lawson 11:03 And, but if you look at senior executives, like, you know, your average CEO, they spent their whole life sitting down-

Chris Williamson 11:07 Yeah.

Dr Euan Lawson 11:07 ... but their sort of societal level that they operate at, they're incredibly likely to have good health outcomes as well. So that's why this sort of research around sitting and longevity gets a little bit tricky in places because you've got to take into account all the other stuff like smoking and drinking and exercise generally.

Chris Williamson 11:25 Yeah.

Dr Euan Lawson 11:25 I think if you look at a bit of, uh, one, I certainly saw one academic paper which looked at all the evidence and it certainly suggested that sitting down and being inactive actually caused deaths. And so I think it's reasonable to say sitting is killing people.

Chris Williamson 11:37 Wow.

Dr Euan Lawson 11:37 But that kind of, it's always, as Ben Goldacre would say, "It's, it's always a, it's a little sol-" yeah, I think you'll find it's a little bit more complicated.

Chris Williamson 11:44 Yeah.

Dr Euan Lawson 11:44 There's always complications around the edges. But, um, being active and, uh, tackling the sitting is clearly a massive priority for most people.

Chris Williamson 11:51 Yeah, definitely. So like I say, with this, uh, with this Instagram post that I fired out earlier on-

Dr Euan Lawson 11:57 Yes.

Chris Williamson 11:57 ... I got a whole host of, uh, of common ailments and there was an awful lot of cross-

Dr Euan Lawson 12:02 (laughs)

Chris Williamson 12:02 ... an awful lot of crossover. It was probably fairly representative sample as well. There's about 120 messages, so I've got a (laughs) I've got a good-

Dr Euan Lawson 12:08 Yeah.

Chris Williamson 12:08 ... a good sample size to work from. Um-

Dr Euan Lawson 12:10 Yeah.

Chris Williamson 12:10 ... I wanted to-... uh, speak to yourself first off and try and get any common mistakes which people make when designing a workstation. And on the backside of that, what are the op- most optimal fixes for them?

Dr Euan Lawson 12:30 Okay, so I've- I've not s- ever seen any rev- evidence of what th- the mistakes people make, but what I would say is that the big- the initial mistake is most people don't make any effort to design their workstation at all.

Chris Williamson 12:40 (laughs)

Dr Euan Lawson 12:41 The- the- is- so-

Chris Williamson 12:41 Is there a seat? Is there a table? Is there a laptop?

Dr Euan Lawson 12:44 (laughs)

Chris Williamson 12:44 Yeah, fine.

Dr Euan Lawson 12:45 Yeah. Is there anybody else sat there? No, this will do.

Chris Williamson 12:47 Okay.

Dr Euan Lawson 12:47 That is probably their approach. And s- hot desking, that's certainly gonna be the approach that a lot of people have.

Chris Williamson 12:52 Yeah. Well, that's all you can do, yeah.

Dr Euan Lawson 12:54 Um... Yeah, exactly. You just gotta turn up and plonk your butt down and, you know, and if you g- get a spare seat in the library, if you're a student, then you're happy-

Chris Williamson 13:00 (laughs)

Dr Euan Lawson 13:01 ... um, and is often the way it goes. So, uh, I'm not sure about the sp- specific mistakes people make. Um, the kind of things that... The first thing I would- we could perhaps talk about is laptops and notebooks.

Chris Williamson 13:11 Yeah.

Dr Euan Lawson 13:11 And I- I would say they're- they are kind of like the- they're- they are- they are to- they are toxic equivalent ergonomically. They are pretty horrific.

Chris Williamson 13:19 (laughs)

Dr Euan Lawson 13:20 And, um, they- they- they- they put you in all the wrong position completely, and using a laptop and just typing on it without any kind of effort to change it, the position that you're in, could- will, for a lot of people, be a source of a great deal of problems.

Chris Williamson 13:33 Okay.

Dr Euan Lawson 13:33 So, the first thing they do is they- they put your wrists at all the wrong angles and, um, the ideal position for your wrists is they're not resting on anything, and probably at about sort of parallel to the floor and 90 degrees to your body. So, the only way you can fix that normally is by adjusting the height of your keyboard. Now, if you're designing a workstation, then you can arrange for your desk to be at exactly the right height-

Chris Williamson 13:55 Yeah.

Dr Euan Lawson 13:55 ... um, so that you can make that work for your relative reasonably easy. The best way to fix it with a laptop is not to use the keyboard on the laptop, is to get an external keyboard.

Chris Williamson 14:04 Okay.

Dr Euan Lawson 14:05 Uh, and then because they're just not, you know, you've got the mouse sat in front of you, it's awkward, it tends to- your wrists end up contorted in the wrong position. So, an external keyboard's usually a really good investment. Um, the next thing after that is that you're probably always looking down at it if it's a laptop, unless you're- unless you're very small in stature-

Chris Williamson 14:25 (laughs)

Dr Euan Lawson 14:25 ... you're gonna- you're always gonna be craning down at your laptop. And so, raising your laptop up, so your eye- so your neck's in a neutral position is the best way. And that does mean it needs to come up quite a bit.

Chris Williamson 14:35 Yeah.

Dr Euan Lawson 14:36 Um...

Chris Williamson 14:36 Yeah. The- the screen of a laptop is naturally very low.

Dr Euan Lawson 14:39 Yeah.

Chris Williamson 14:40 A- am I right in thinking that having that cranial angle being more towards the floor will apply more stress to-

Dr Euan Lawson 14:46 I- I mean, I think that's the general thought and I kind of- I'm not an expert in ergonomics in that regard, but I certainly know that good ergonomic practice is to have your neck in a reasonably neutral position 'cause that- which is generally just sort of looking straight ahead, eyes slightly down possibly, um-

Chris Williamson 14:59 So, eyes- eyes level with the top of the screen, right?

Dr Euan Lawson 15:02 Yeah, that works well. If your eyes are level with the top edge, then actually you're- you're just looking very slightly down at the screen itself. Um, that's a- that's usually a good way to do it. Um, and that just stops your neck muscles having to work e- as hard when they're- when you're in a n- normal position, so that's highly likely to relieve a lot of, um, problems and discomfort. And you got to remember, even things like, you know, tension headaches, if your neck's in the wrong position and you're under a bit of stress, then a lot of headaches that we- certainly we see as a- as a GP, a lot of headaches are tension headaches, and that's all related to muscular tension in the back of the neck and all the muscles-

Chris Williamson 15:35 Where do, um- where do- where do tension headaches manifest?

Dr Euan Lawson 15:38 Uh, well, they're usually- the classic description is that they're a band, uh, sometimes around the front of the head, sometimes around the back of the head.

Chris Williamson 15:45 Okay.

Dr Euan Lawson 15:46 And they- they tend to be very- they tend to be much more constant, not easily relieved by medication, uh, as a general rule.

Chris Williamson 15:52 I'm looking at two points that I've got in my notes from messages I received earlier on. Headaches across brow and lower/back of skull.

Dr Euan Lawson 16:00 Okay, so that- you know-

Chris Williamson 16:01 (laughs)

Dr Euan Lawson 16:01 ... that is almost, yeah. So, that- there- there you go. And n- we didn't rehearse that at all.

Chris Williamson 16:05 No, we didn't (laughs) .

Dr Euan Lawson 16:06 But yeah, kind of, and that has come- that's exactly a classic description of a tension headache.

Chris Williamson 16:10 Okay.

Dr Euan Lawson 16:10 And you have to remember that there are mu- most, if you- you kind of, you only got to have a briefest glance at the anatomy of the head and neck to see that there are muscles that, you know, they interlock all the way up around your forehead, the side of your head. All those muscles interlock and if you have, y- the- the muscles in your neck are under tension, there's often a knock on effect that those muscles across the front of your head and your forehead are under tension and you end up getting headaches.

Chris Williamson 16:32 Okay.

Dr Euan Lawson 16:33 So, actually getting your screen position right can often deal with chronic headaches and- and kind of tension headaches, which is incredibly useful.

Chris Williamson 16:40 So, I suppose if you've gone Bluetooth keyboard-

Dr Euan Lawson 16:45 Mm-hmm.

Chris Williamson 16:45 ... and let's say that you are working at a notebook, that allows you-

Dr Euan Lawson 16:48 Yeah.

Chris Williamson 16:48 ... that allows you then to y- you could get anything. You could get a stack of books, you could get some-

Dr Euan Lawson 16:52 Yeah.

Chris Williamson 16:53 ... you could get a- a proper stand, I suppose, that you can put-

Dr Euan Lawson 16:56 Yeah.

Chris Williamson 16:56 ... your- put your laptop on, but freeing yourself up with keyboard and mouse from being attached to the notebook also enables you to get the screen up in the air as well, so you kill two birds-

Dr Euan Lawson 17:07 Yeah.

Chris Williamson 17:07 ... with one stone.

Dr Euan Lawson 17:08 Yeah, exactly. They're the two big things. If you get an external keyboard and raise up your laptop, and you're right, you can buy notebook risers and all that and spend money on it. I don't have one of those. I use- I- I use, I've, it's when I'm in my office, I would just use three or four weighty medical textbooks-

Chris Williamson 17:22 Yeah.

Dr Euan Lawson 17:22 ... go underneath my laptop and that just does the job very nicely. I have an old keyboard from an- an ancient iMac that I have plugged in with a USB connection-

Chris Williamson 17:30 Yep.

Dr Euan Lawson 17:30 ... and a- a dead cheap mouse, and there- there you go. I use my MacBook with those, and that's- I've- you know, and it's much more comfortable.

Chris Williamson 17:37 Yeah. Um, I think, well, I mean, for anyone who's listening, I know that you can get, if you- if you are, um, a workflow nerd, as some of us are-

Dr Euan Lawson 17:48 Yeah.

Chris Williamson 17:48 ... and you like- you like your gestures and stuff your multi-touch-

Dr Euan Lawson 17:50 Yeah.

Chris Williamson 17:50 ... tools, Apple do a partner trackpad which is-

Dr Euan Lawson 17:55 Yeah.

Chris Williamson 17:55 ... exactly the same as you would get on your laptop, on a MacBook Pro-

Dr Euan Lawson 17:59 Yeah.

Chris Williamson 17:59 ... or something similar, and it gives you the opportunity to do all the same. You can get a- you can actually get an expanded version of the Apple keyboard as well, which has got the, uh, one to nine num pad on the right-hand side of it-

Dr Euan Lawson 18:10 Yeah.

Chris Williamson 18:10 ... as well. So, you can-

Dr Euan Lawson 18:11 Yeah.

Chris Williamson 18:11 ... actually end up with a- a better functionality keyboard by taking it off and down, but, you know, to hear that you use, um-... something-

Dr Euan Lawson 18:19 Yeah.

Chris Williamson 18:19 ... that's, may- may- maybe not from, quite from this century-

Dr Euan Lawson 18:22 (laughs)

Chris Williamson 18:22 ... and you're still, you're still, you're still saying that it's, it's a, a viable alternative.

Dr Euan Lawson 18:27 Yeah.

Chris Williamson 18:27 A preferable alternative. That's, uh, that's-

Dr Euan Lawson 18:30 Yeah, I think-

Chris Williamson 18:30 ... re- reassuring. Someone's got some-

Dr Euan Lawson 18:31 I think-

Chris Williamson 18:32 ... line around somewhere.

Dr Euan Lawson 18:33 Yeah, I think, to be fair, I think it was about 2003, that iMac, so yeah, it wasn't, it wasn't quite last century, but it's, it's pretty damn close.

Chris Williamson 18:39 Not far off.

Dr Euan Lawson 18:39 The, um, the on- I, there is, that's a good point because I do actually find that, that, I, what I struggle with slightly when I use that is that I'm a lot... I'm used to using the gestures on the touch pad.

Chris Williamson 18:48 Yeah.

Dr Euan Lawson 18:48 So I do find that a bit awkward. But what I've tried very hard to do, and I've been doing this for the last few months, is, um, I'm trying to learn the keyboard shortcuts, so I don't use the mouse at all. 'Cause I actually think that's a much better way to go anyway. So, so you don't go to the mouse and have to start... And it just, you know, in terms of workflow, it's more efficient just to use the keyboard shortcuts anyway, so I'm working hard to learn them.

Chris Williamson 19:08 100%. So it does... uh, one of the co-hosts, when we do our normal shows, Yousef, who'll be listening, will be creaming in his pants right now as he hears you talk about-

Dr Euan Lawson 19:17 (laughs)

Chris Williamson 19:17 ... as he hears you talk about keyboard shortcuts. Have you used Alfred before?

Dr Euan Lawson 19:22 Uh, well, no. I know of Alfred but I, I never have used Alfred, actually, no.

Chris Williamson 19:25 Okay.

Dr Euan Lawson 19:25 You could sell it to me.

Chris Williamson 19:26 Oh, I mean, it is just an absolute game-changer. LifeHacks 104-

Dr Euan Lawson 19:31 Yeah.

Chris Williamson 19:31 ... uh, fully, fully explains how far down the Alfred rabbit hole myself and Yousef have tumbled.

Dr Euan Lawson 19:37 (laughs)

Chris Williamson 19:37 But, um, yeah, you are right. One of the, one of the main... Juju Mufu, who is a, a bodybuilder and tricker, but also big into periodization for work and training-

Dr Euan Lawson 19:47 Yeah.

Chris Williamson 19:47 He, he talks an awful lot about never using the mouse.

Dr Euan Lawson 19:51 Yeah.

Chris Williamson 19:51 He's got everything is set up to swipe, to move between apps, um-

Dr Euan Lawson 19:55 Yeah.

Chris Williamson 19:56 ... and you, you're totally correct, that the less that you can use the mouse... If you're looking at really dialing in to be as efficient as possible with your workflow, getting off the mouse is, is great.

Dr Euan Lawson 20:06 And a lot of people do get a bit, kind of... y- you talk about discomfort, and I'm sure a couple of people have probably mentioned repetitive strain injury. I think you mentioned it at the start there.

Chris Williamson 20:13 They have, yeah.

Dr Euan Lawson 20:13 Use- using the mouse is often a source of enormous discomfort for some people who get RSI.

Chris Williamson 20:18 Why is that?

Dr Euan Lawson 20:19 And, um, I, I, I guess it mushes... um, I don't know why exactly. I guess it's any repetitive movement, particularly when you hold some- y- you hold your arm... I mean you can get RSI anywhere in the body, technically.

Chris Williamson 20:28 Yeah.

Dr Euan Lawson 20:28 But I guess most people get it in their, um, they get it in their hands, wrists, forearms.

Chris Williamson 20:34 So fine, fine motor movement with little bits of control and sort of small stabilizations and stuff like that, I guess, if you're doing that seven or eight hours a day?

Dr Euan Lawson 20:42 Yeah. I think that's exactly it, and that's the kind of... So a lot of people then suddenly, you know, g- g- it becomes really uncomfortable and distressing to keep on doing that, and that's exactly the kind of thing that can trigger off a bit of RSI in some people.

Chris Williamson 20:53 Uh, you, you seem to have a, a pretty good understanding of RSI and am, am I right in thinking RSI actually has two, two distinct types to it?

Dr Euan Lawson 21:01 Yeah. Um-

Chris Williamson 21:02 Can you, can you e- e- elaborate on that for me?

Dr Euan Lawson 21:04 Yeah, sure. I could... I run... The... Basically, I'm not sure I have a good understanding of it, in that I'm not sure anybody has a good understanding of it-

Chris Williamson 21:09 (laughs)

Dr Euan Lawson 21:09 ... is the only thing I would say first of all.

Chris Williamson 21:11 But if anyone, if anyone does-

Dr Euan Lawson 21:12 (laughs)

Chris Williamson 21:13 ... we're relying on you here.

Dr Euan Lawson 21:14 Yeah, so, um, uh, the first thing I'll say is there's two types. RSI type one is easy, in that they, they are the ones where people do have a good understanding of it, and it's usually got a very distinct diagnosis. And the classic example is carpal tunnel syndrome, um, and lots of people have heard of that. It's where the, kind of, the, the, the, the nerve that goes through your wrist, the median nerve, there's a little sort of tunnel or space in the wrist there. And for various reasons, it can happen. Things like pregnancy, it can happen for all sorts of reasons. Uh, that gets a little bit, um, pressurized, that nerve, and you get symptoms that then go into your hand. And so there's a very... with things like carpal tunnel syndrome or certain tenosynovitises, where it's where you get an inflammation in the tendons going to your thumb or other things, there's a very u- there's usually a very clear treatment. Um, and, uh, uh, you know, there may be injections. There may be... carpal tunnel syndrome, you can even go on to have operations and releases. Um, they're the kind of the ones that are relatively easy to manage and as a GP, we don't feel too stressed by them because... and the patient doesn't feel too s- feels better because we can give them a diagnosis-

Chris Williamson 22:15 Yes.

Dr Euan Lawson 22:16 ... and o- and offer a management plan. That's in comparison to RSI type two, which is a whole world of pain-

Chris Williamson 22:23 Oh, no.

Dr Euan Lawson 22:23 ... you know, in, in several respects, because it's really nebulous and it's difficult to... there's not a single cause. It just usually is when people get numbness and discomfort and aches, maybe pins and needles, and it isn't really obviously reproducible. It kind of maybe varies a little, um, but it doesn't fit into any of the nice distinct patterns of these other kinda disorders like carpal tunnel syndrome.

Chris Williamson 22:49 But can it be, um, due to a, a, an repetitive action which could be causing RSI one? Does that make sense? So it's-

Dr Euan Lawson 23:00 Yeah, yeah, yeah.

Chris Williamson 23:01 ... is it ... you, you could be-

Dr Euan Lawson 23:02 Yep.

Chris Williamson 23:02 ... you could be suffering with both essentially?

Dr Euan Lawson 23:04 Yeah, I, I think, uh, in many cases, it probably is due to some kind of repetitive, you know, or various ongoing stress or tension-

Chris Williamson 23:11 Yeah.

Dr Euan Lawson 23:11 ... that is the case. So you definitely could, um, you, y- yeah, you, you could definitely have them coexisting in some shape or form.

Chris Williamson 23:18 Okay.

Dr Euan Lawson 23:18 The problem... Because it's not a sort of a definite way of managing it, it makes it harder to offer a definitive solution, like a steroid injection or a surgical operation, that you can do in carpal tunnel.

Chris Williamson 23:30 I understand.

Dr Euan Lawson 23:31 So it's a bit frustrating for patients, um, and it's certainly a bit frustrating, um, and for doctors as well, 'cause, you know, you, we, w- we're in the business of trying to help people. (laughs) and actually-

Chris Williamson 23:41 You can't, you can't work out what's, what's wrong or how to fix it.

Dr Euan Lawson 23:44 No, and it's ex- and you... the, the difficulty is... and this, this is where I s- I think there's been some tension between patients and doctors in this, is that you usually have to stop what you're doing. Uh, but, I mean-

Chris Williamson 23:54 Everything. (laughs)

Dr Euan Lawson 23:54 And that's really... that you s- th- that's the thing, but it depends how the doctor phrases it, of course-

Chris Williamson 23:58 Yeah.

Dr Euan Lawson 23:59 ... because that generally goes down incredibly badly.

Chris Williamson 24:01 Yeah.

Dr Euan Lawson 24:01 If you're... 'cause you're generally, you're either working, or if it was writers... no, no writer wants to stop writing-

Chris Williamson 24:06 Yeah.

Dr Euan Lawson 24:06 ... or it m- it might be something, like, work-related and people can't stop doing it. But I think the... my general advice is, it's not really so much about stopping what you're doing but you really have got to change up the way you do things-

Chris Williamson 24:17 Cool.

Dr Euan Lawson 24:17 ... in order to, to get it to resolve itself.

Chris Williamson 24:20 I understand.

Dr Euan Lawson 24:21 And if, if you're working at a keyboard, you're, you know, you're, you're, um, flying a desk in the day-

Chris Williamson 24:25 Yeah.

Dr Euan Lawson 24:25 ... you've probably got to alter how you do-... um, wh- I, you certainly got to watch your workplace, but I think some of the answers are a little bit more holistic and a bit more widespread as well.

Chris Williamson 24:35 Yeah.

Dr Euan Lawson 24:35 Um, uh, and certainly, Joanna in the book, The Healthy Writer, goes through this that actually I think she tried a whole lot of ... well, she got RSI very badly and she's a really good kind of case report in this regard. Uh, that actually she tried all the different mouses, the keyboards, all of that and it didn't make any difference, and what in the end fixed her was a whole body approach. And she act-

Chris Williamson 24:56 It was yoga, right? Oh. (laughs)

Dr Euan Lawson 24:57 Yeah, yoga, and that totally fixed her and I think that's the thing, if you get your core strength improved, you start, get your, improve your posture generally, you're, you know, it might address tension issues as well from stress and anxiety, actually then that might be the solution.

Chris Williamson 25:11 I think, uh, it, it feels like you're reading my notes off my screen at the moment, but I swear (laughs) to the listeners that you're not. I'd split up, um, optimizing your workstation into two categories, one of which was solutions when you're there and another was solutions when you're not.

Dr Euan Lawson 25:27 Yeah.

Chris Williamson 25:27 And I think as you say there, it- it- it needs to be married with the two. If, even if you optimize your workstation but when you go home that, you- you're sedentary at home and you're not-

Dr Euan Lawson 25:38 Yeah.

Chris Williamson 25:38 ... like you say, you're not building up any core stabilization, you're not getting your heart rate up, you're not getting any fresh air, th-

Dr Euan Lawson 25:45 Yeah.

Chris Williamson 25:46 ... all- all of these sort of things are- are gonna lead to, um, a problem on either side and they both need to be looked after, right?

Dr Euan Lawson 25:52 Yeah, absolutely. And I, I couldn't agree more and I, and I- I suspect it's far, far more important than actually the workplace stuff, all that st- B- and you get so many other benefits as well. But you can sort of imagine why a consultation with a doctor might go badly, 'cause you turn up complaining of pain in your wrist and your doctor tells you to get out and do a bit more walking or exercise or take up yoga.

Chris Williamson 26:10 Yeah, how does that, how does that help? Yeah, exactly.

Dr Euan Lawson 26:11 Yeah, you, they really could ... but actually I really do think it is ... so you gotta have those (laughs) conversations very carefully-

Chris Williamson 26:16 Absolutely.

Dr Euan Lawson 26:16 ... not to upset, to make people understand, but I- I think actually it's a massive part of it and, and going right back to what you said at the start, I suspect this is the kind of thing that, you know, 10 years, 20 years in the future, that workplaces will do automatically, that actually there'll be regular breaks, there'll be opportunities to stretch, to walk, get away from the screen, and rather than sitting in a call center eight hours straight, whatever it is, actually there will be requirements to-

Chris Williamson 26:40 Yeah.

Dr Euan Lawson 26:41 ... kind of, to build in proper breaks.

Chris Williamson 26:42 So we've, we've touched on it there, I'm gonna, I'm gonna, um, unload (laughs) the, the matter analysis that my very, um, very well-conducted Instagram research, uh-

Dr Euan Lawson 26:54 Yeah, yeah. (laughs)

Chris Williamson 26:54 ... came out, and then we're gonna try and design how someone could have a good working practice when they're sat at a desk. So-

Dr Euan Lawson 27:01 Yeah.

Chris Williamson 27:01 ... um, tight hips, back pain, both upper and lower, neck pain, the headache across, uh, their brow and the lower back of the skull, uh, difficulty in opening up the chest from being in that anterior folded forward shoulder tilt.

Dr Euan Lawson 27:16 Yeah.

Chris Williamson 27:17 And a pain or weakness in between the shoulder blades which presumably is from the same, from not sitting with that open chest position.

Dr Euan Lawson 27:24 Yeah.

Chris Williamson 27:24 Um, if you were to try and design someone's working day, so we've got their keyboards down, off the computer, potentially an external mouse as well, we've managed to lift the cranial angle up b- by, uh, raising the height of the display.

Dr Euan Lawson 27:41 Mm.

Chris Williamson 27:42 What are we going to do next with regards to a seating posture? What about working rhythms, work rest and stuff like that during work? What can be done to assist in mitigating these problems?

Dr Euan Lawson 27:55 I mean, I think there's some basic stuff around seating posture you can do which is just, I mean, a- we're obviously talking seating at the moment rather than standing or anything else-

Chris Williamson 28:02 Yeah.

Dr Euan Lawson 28:02 ... more exotic, because that's simply not an option for most people.

Chris Williamson 28:05 Yeah.

Dr Euan Lawson 28:05 And it's, it's just simple stuff that actually, I- I mean, I guess, uh, your getting your feet on the ground is a massive thing. When you're sitting down and you're getting your, getting yourself in a nice neutral position, rather than your legs being stretched out and then that kind of changes the position of your lower back and, um, flattens out that kind of normal curve that you have in your spine, is actually sitting on your sit- s- actual sit bones, getting your feet flat on the ground.

Chris Williamson 28:28 Okay.

Dr Euan Lawson 28:29 And then trying to ... and obviously some of that then is about being aware of your posture, um, as you mentioned there about the kind of, the not opening up the chest, just dropping your shoulders, making sure they're nice and relaxed. I think just spending a few minutes every ... look, and we could talk about the rhythm of this but-

Chris Williamson 28:44 Yes.

Dr Euan Lawson 28:44 ... actually trying to build awareness, whether it's every 20, 25 minutes running through a little self-check-

Chris Williamson 28:50 Mm-hmm.

Dr Euan Lawson 28:50 ... about what is my posture like at the moment and trying to, um, uh, and trying to adjust it as you go is the kind of thing that if you do regularly can start to become automatic and you actually, um, improve, uh, i- improve your general posture.

Chris Williamson 29:05 Yes.

Dr Euan Lawson 29:06 Um, and I think in terms of rhythm, that, that sort of, breaks is critical. I- I- more than anything. H- taking a break is absolutely essential. And m- my m- my personal approach to this is when I'm in a big block of writing or sitting at the computer is I- I tend to use the sort of Pomodoro method anyway 'cause I find that quite effective, but it works really well with taking breaks. So 25 minutes, um, of work, set a timer on my watch, it buzzes, uh, and then I get up and I take five minutes off. And during that five minutes I'll almost, I will make sure I get up and I walk around, uh, have a bit of a, you know, and just, uh, get myself away from the screen as well-

Chris Williamson 29:44 Yeah.

Dr Euan Lawson 29:44 ... t- to help with my eyes, which we can also mention-

Chris Williamson 29:47 Yes.

Dr Euan Lawson 29:47 ... um, uh, to, to help with that. And I find that that really makes a huge difference. I, the key for me th- about taking breaks is, and the thing I would mention to people and this fits, uh, is that you've got to get away from the screen if you can. (laughs)

Chris Williamson 29:59 Yeah.

Dr Euan Lawson 30:00 Uh, th- you know, taking a break does not mean pushing the chair back-

Chris Williamson 30:04 (laughs)

Dr Euan Lawson 30:04 ... you know, slop-

Chris Williamson 30:05 Moving further away from the screen or closer to the screen.

Dr Euan Lawson 30:08 Yeah. (laughs)

Chris Williamson 30:08 Or looking at your, looking at your phone, looking at a different screen instead. (laughs)

Dr Euan Lawson 30:11 Yeah, looking at your phone and checking, you know, checking Instagram-

Chris Williamson 30:14 Yeah.

Dr Euan Lawson 30:14 ... and Facebook-

Chris Williamson 30:15 That's not a break.

Dr Euan Lawson 30:15 ... while staring at another screen while you're kind of slumping j- and in your, slump in your chair. That's really-

Chris Williamson 30:21 I'll, I'll take a break.

Dr Euan Lawson 30:21 That's not an effective break.

Chris Williamson 30:22 I'll take the br- I'll take a break from my newly refined posture to slouch in my seat, put my, my head at a 90-degree angle to the floor, and sneak a quick look at my phone instead.

Dr Euan Lawson 30:32 Yeah, exactly. So-

Chris Williamson 30:33 That's not, that's not what we're prescribing here.

Dr Euan Lawson 30:35 Yeah, and I think, you know, eh, most people listening will think, "Well, of course, I wouldn't do that," but, I mean, I've done it myself.

Chris Williamson 30:40 No, I think you might do. Yeah.

Dr Euan Lawson 30:42 (laughs)

Chris Williamson 30:42 I think you probably will.

Dr Euan Lawson 30:43 So actually taking- taking- taking a break is something most people know, but actually, it's putting it into action as well, isn't it, like all these things, and actually doing it properly so you give yourself a gen- a- um, um, an actual genuine chance of improving. I- I find if I do it, I can sustain much longer working periods, that 25 minutes, five minutes. I can do three or four hours of solid work in the morning and actually don't feel completely ruined by it.

Chris Williamson 31:07 I agree. I think there's, um... It's a- a short-term sacrifice of work obviously by taking a five-minute break, but f- the total volume that you get, the total ti- effective time under the curve of work done by the end of the day will always be higher. Um...

Dr Euan Lawson 31:23 Yeah.

Chris Williamson 31:23 It's interesting that you mentioned the Pomodoro Technique, which I am currently reading the illustrated guide to the Pomodoro Technique in a desperate attempt to try and make my work-

Dr Euan Lawson 31:31 (laughs)

Chris Williamson 31:32 ... my work life a little bit more optimal. But Be Focused Pro, for anyone who's listening, is um, uh, an app for Mac which is very, very light and it does exactly that. It allows you to work on one task at a time. You set a timer for 25 minutes and then once it's up, it goes to a five-minute, uh, break and tells you, "Right, now go away for five minutes and then come back."

Dr Euan Lawson 31:53 Yeah.

Chris Williamson 31:53 And I think, I think that... So during those five minutes, what are people doing? Walk to the water cooler, check the toilet, sort of, you know-

Dr Euan Lawson 31:59 Yeah.

Chris Williamson 31:59 ... look- look out the window?

Dr Euan Lawson 32:01 Yeah, there's a, there's... Yeah, I mean, there's a, there's a certain thing in terms of eye strain about looking out the window. There's a, a kind of a bit of advice which is the 20-20-20 technique for eye strain, which is every 20 minutes, um, take a break and look out the window, sort of focus on something 20 feet away for 20 seconds. I think if you're taking a natural break every five minutes and just, you know, changing the focal length th- where your eye is, eyes are concentrated, that's really helpful and that can be helpful in relieving eye strain.

Chris Williamson 32:28 Yeah.

Dr Euan Lawson 32:28 Um, so you can get some benefit from that as well, but I think that just the moving around is the key thing. If you, you know... I, yeah, absolutely I do that. I g- I get up, have a stretch, say I'm working in the library or the office, go out, have a look out the window, walk up and down the steps for, you know, few minutes, but try not to get engaged in any conversations-

Chris Williamson 32:46 Yeah.

Dr Euan Lawson 32:46 ... at the water cooler.

Chris Williamson 32:46 Let's get that five minutes 'cause that five minutes is gonna turn into 25 minutes.

Dr Euan Lawson 32:50 Yeah, exactly. And the key is just kind of a few minutes, try to think about something else completely-

Chris Williamson 32:54 Mm-hmm.

Dr Euan Lawson 32:54 ... and then actually back to it, and it's a... I- I just say the- the time under the curve, you end up far more productive. Um, and I find it really helps you focus as well because that 25 minutes is a relatively short period and so... And I d- I will give my all to that one task for 25 minutes and, you know, you then achieve much greater, deeper work. The Cal Newport kind of thing-

Chris Williamson 33:15 Yeah.

Dr Euan Lawson 33:15 ... which I know you've mentioned before I think.

Chris Williamson 33:17 Yeah.

Dr Euan Lawson 33:17 Yeah, and the Cal Newport book is one that I kind of... I recommend to almost every... You know, the peop- my colleagues, particularly younger academics, again, Cal Newport, this is the way to go, this is what you have to do-

Chris Williamson 33:29 Yeah.

Dr Euan Lawson 33:29 ... and you can be enormously productive with minor, relatively minor changes.

Chris Williamson 33:33 It's intense work, intense break, right? It's all or nothing-

Dr Euan Lawson 33:38 Yeah.

Chris Williamson 33:38 ... on or off, um-

Dr Euan Lawson 33:40 Yeah.

Chris Williamson 33:40 ... and I think an- an awful lot of the time especially because a lot of people maybe, e- especially knowledge workers, y- how many tabs have you got open at once? You're switching between 20-

Dr Euan Lawson 33:50 Oh, yeah.

Chris Williamson 33:50 ... 25 different tasks at once. "Oh, well, I'm also content sourcing for Instagram," so social media's up and I've... anyone-

Dr Euan Lawson 33:58 Oh, yeah.

Chris Williamson 33:58 Anyone who's listening knows just how much I hate the rabbit hole of cognitive manipulation that, uh, that occurs (laughs) as soon as you get onto a, onto a social media website. But yeah, it's um-

Dr Euan Lawson 34:08 Yeah.

Chris Williamson 34:09 ... it's-

Dr Euan Lawson 34:09 Yeah, m- m- multitasking is for Muppets. That's my-

Chris Williamson 34:12 (laughs)

Dr Euan Lawson 34:12 ... kind of my- my approach. It really is. There's n-

Chris Williamson 34:15 One thing at one time.

Dr Euan Lawson 34:17 There's... Yeah, there's not a shred of evidence that you can multitask as effectively as you can, you know, eh, the kind of the intense burst of productive work you get from focusing on one thing.

Chris Williamson 34:28 I agree.

Dr Euan Lawson 34:28 That's what we're designed to do. We're- we are, um, serial fo- we should be serial focusers rather than doing- rather than trying to mult- do multiple things. And it's incredibly satisfying. I fi-

Chris Williamson 34:38 Yeah, just ticking it, ticking it off the to-do list and getting it out of the way is such a lovely sense of achievement.

Dr Euan Lawson 34:44 Yeah, and I think, uh, even just that kind of... Even if it's a bigger part of... a bigger, um, a bigger piece of work, just knowing that you've really buried yourself 25, 30 minutes-

Chris Williamson 34:53 Yeah.

Dr Euan Lawson 34:53 ... done a really intense burst, um, it is... I- it is incredibly satisfying. The whole of The Healthy Writer I actually did with the Pomodoro method and I ticked off, I had little circles-

Chris Williamson 35:03 Yeah.

Dr Euan Lawson 35:03 ... and every, every circle represented two Pomodoros and it was the one thing that, looking back and when I could see 100 of them ticked off with the edit-

Chris Williamson 35:10 I was gonna say, how many, how many did it take?

Dr Euan Lawson 35:13 I think it was about... For my bit it was over 100 hours of editing-

Chris Williamson 35:17 Oh, wow.

Dr Euan Lawson 35:18 ... but after the first draft, once-

Chris Williamson 35:20 (laughs)

Dr Euan Lawson 35:20 ... once that had been done. But i- it was kind of, it was incredibly satisfying to see, to color in the boxes and, but to know that each of those was a really valuable, a really good piece of the puzzle. It was great.

Chris Williamson 35:31 So what, what you're saying is that we are, for all that Chris Ryan from Sex at Dawn may disagree, we are monogamous when it comes to most optimal workflow approach-

Dr Euan Lawson 35:41 (laughs)

Chris Williamson 35:41 ... we should be-

Dr Euan Lawson 35:41 Yeah.

Chris Williamson 35:41 ... we should be monogamous, not polyamorous.

Dr Euan Lawson 35:44 Yeah, absolutely. (laughs)

Chris Williamson 35:45 Okay. Okay.

Dr Euan Lawson 35:46 Totally. Yeah.

Chris Williamson 35:47 A- a task is for one at a time, not for two, not for two or more at a time.

Dr Euan Lawson 35:51 Yeah. (laughs)

Chris Williamson 35:52 Fine. Fine. Absolutely fine.

Dr Euan Lawson 35:54 Yeah.

Chris Williamson 35:54 So, um, you- you touched on it there and one of the, um, next main issues which people came up with was an inability to switch off at night. Eyes flickering-

Dr Euan Lawson 36:06 Mm-hmm.

Chris Williamson 36:06 ... as if you're still staring at the screen. Also, eye strain. I know that my business partner, Darren, who will be listening, has just had to start wearing glasses. Although he actually manages to pull them off, as much as I wish that he didn't, um...

Dr Euan Lawson 36:18 (laughs)

Chris Williamson 36:18 ... he's had to start wearing glasses, and I think to myself, would he have needed to had we spent the volume of time that we do in front of a screen? So what's, what is looking at a screen doing to our eyesight?

Dr Euan Lawson 36:31 I think the main thing is... I don't, I don't know if there's any evidence that it increases your risk of, um, refractory problems where you need glasses, but... So it may just be he has a little bit of a, something like an astigmatism which is just give him extra problems-

Chris Williamson 36:44 Darren, you're just, you're just blind, mate. Darren, you were never, you were never ever destined to be able to see properly I'm afraid.

Dr Euan Lawson 36:48 (laughs) No, just born, born...... damage.

Chris Williamson 36:51 Cursed with that, yeah. (laughs)

Dr Euan Lawson 36:53 (laughs) Um, I think the main thing about staring at a screen is it dries your eyeballs out. They end up like shriveled up. The, uh, we normally blink about once every five seconds or something, uh, 12 to 15 times a minute, uh, something like that, off the top of my head, I think is the right amount. But when you start staring (laughs) at a screen, you stop blinking, and, um, to the extent that you only blink about sort of five or six times a minute, so once every 10 seconds.

Chris Williamson 37:14 Wow, so you're, you're talking about like a, a f- 60% reduction.

Dr Euan Lawson 37:20 Yeah, yeah, I mean, it's huge. And I, I, I kind of, the whole thing about tears is obviously they're required to keep your eyes moist (laughs) and stop them drying out, and they help clear, um, bugs and ... they said not, so it's an important protective mechanism for your eyes as well.

Chris Williamson 37:33 So is m- is it moisturizing the cornea on the front of the eye then, to a degree?

Dr Euan Lawson 37:36 Yeah, certainly. There's always that film of tears across the front of your eye, or across in front of your cornea, and if you, you, you, as anybody, your cornea, if for some reason you can't blink, you say you get like a, a facial nerve palsy, a Bell's palsy, where you can't, you can no longer close your eyelids properly.

Chris Williamson 37:50 Okay.

Dr Euan Lawson 37:50 One, one of the priorities for us when we see something like that is to, people have to tape their eyes shut at night and they have to use artificial tears. Otherwise, the front of their eye dries out and the cornea can become quite damaged, ulcerated.

Chris Williamson 38:02 Oh, wow.

Dr Euan Lawson 38:03 Now, I'm not saying staring at a screen will do that to you, but you're at that kind of point where blinking s-

Chris Williamson 38:07 Well, the bottom end, the bottom end will be getting towards it, right?

Dr Euan Lawson 38:10 Yeah, yeah. Blinking's important, you know. That's, you know, and if you stop blinking as much-

Chris Williamson 38:14 (laughs)

Dr Euan Lawson 38:14 ... then you're not going to ... y- your eyes are gonna feel uncomfortable and they're gonna get gritty and irritable and maybe slightly itchy and just feel just, you know, like you've got sand, we've all had that feeling, you know, your eyes have been sprinkled with sand.

Chris Williamson 38:26 Yeah.

Dr Euan Lawson 38:27 And they just feel dreadful. Um, and so there's a couple of things you can do that perhaps can reduce eye strain. One of them is to sit a little bit further back from your screen. So usual advice is more than... I certainly read a, there was a good study which showed more than fif- people who, who were sat more than half a meter away, 50 centimeters from their screen, had less eye strain. And that's probably about an arm length or so. So, and the ridiculous thing about that is, and laptops are bad for this, that we, as well, it's another way that laptops damage us-

Chris Williamson 38:54 (laughs)

Dr Euan Lawson 38:55 ... is that we crane over them and our nose are pract- is practically touching the screen.

Chris Williamson 38:59 Yeah. Well, the whole point is because the, the screen is, I'm just looking at mine now, it's two inches-

Dr Euan Lawson 39:03 Yeah.

Chris Williamson 39:04 ... away from the top of the ... uh-

Dr Euan Lawson 39:05 Yeah.

Chris Williamson 39:05 ... the top of the keyboard. So again, if you're not on bluetooth key-

Dr Euan Lawson 39:09 Yeah.

Chris Williamson 39:09 ... bluetooth keyboard, bluetooth mouth, your mouse, you're, uh, tethered. You're tethered, your face is tethered to the front of the screen. (laughs)

Dr Euan Lawson 39:15 (laughs) Very few people type with their arms straight out in front of them. The, uh-

Chris Williamson 39:18 (laughs)

Dr Euan Lawson 39:18 And I wouldn't recommend that either. So your-

Chris Williamson 39:20 (laughs)

Dr Euan Lawson 39:20 ... laptops are designed to be bad for your eye, in terms of your eye-

Chris Williamson 39:24 Yeah.

Dr Euan Lawson 39:24 ... uh, uh, in that regard. Um, so, uh, so that's really important. I kind of, I've, I've lost my thread now in terms of the eyes (laughs) .

Chris Williamson 39:32 Um, moisturizing the eyes, you were talking-

Dr Euan Lawson 39:34 Yeah. Oh, yeah, 50 centimeters.

Chris Williamson 39:34 ... about a, a number of, a number of solutions. Yeah, 50 centimeters.

Dr Euan Lawson 39:37 Yeah, yeah. So you have to be more than 50 centimeters away. So that's really what... So, yeah, that's what I was gonna say, is that (laughs) , um, use the zoom function. You know, who, who, how many people are, are sitting there with their Word document on 100% or whatever writing software you're using? Just crank it up to 200%, 250% and sit back a bit.

Chris Williamson 39:54 Yeah.

Dr Euan Lawson 39:54 Um, there's no requirement to be close enough to see the screen. All computers have accessibility features ami-

Chris Williamson 40:00 Yeah.

Dr Euan Lawson 40:00 ... within them. So from that regard, there's, you've just got to learn to delve into the settings a little.

Chris Williamson 40:04 Okay.

Dr Euan Lawson 40:05 Push the, push the screen away from you and, um, increase that font size.

Chris Williamson 40:09 I'm gonna guess a potential solution for someone who is maybe looking to go maximally optimal of this, would be to go for an external display as well? A larger external display that could potentially be mounted up on a wall or could be just raised up with a stand, and then you'd have the, the keyboard at where you need it. You could have the, the larger display which allows you, if some people feel like they need to be able to multitask but also want to have the large size font, you can't, you can't have your cake and eat it with this, can you? You can't have lots of-

Dr Euan Lawson 40:38 Mm-hmm.

Chris Williamson 40:38 ... things on a small screen, plus all of them be really big.

Dr Euan Lawson 40:41 Yeah.

Chris Williamson 40:41 Or else you're gonna be, you're gonna be whizzing a- whizzing around the screen like a, like a f- a blue bottle. Um ...

Dr Euan Lawson 40:45 Yeah, and I think about multi-screen options are easy, and certainly I do that in my office. I've got a PC that sits in my office and I use, uh, whatever it is, cable that connects it up-

Chris Williamson 40:54 Yep.

Dr Euan Lawson 40:54 ... DVI adapter, and I have my laptop screen on one side and-

Chris Williamson 40:58 (coughs)

Dr Euan Lawson 40:58 ... the, um, external monitor on the left from the PC on the other side. So I've got a couple of monitors, um, and, you know, I can flick betw- either just different workspaces on the MacBook. And so I've got a two-screen option, dead easy, just using my laptop that I normally use and can take home with me.

Chris Williamson 41:12 Yeah.

Dr Euan Lawson 41:13 Um, dead easy. Works really well.

Chris Williamson 41:15 Yeah, that sounds great. So can you just tell us the 20-20-20 rule again, and why, what that's doing in terms of the, the focal length for your eyes and stuff like that?

Dr Euan Lawson 41:24 Well, yeah, I think the, the whole thing about the 20-20 rule is so every 20 minutes or so, take a break from your screen and stare at something 20 feet away for 20 seconds. And I think it probably just helps reduce eye strain rather than your eyes being fixed in a certain s- y- all the muscles around the eye, the ocular muscles, being fixed in one position. It just forces you to contract and move them a little bit as well. So they have to do the work of pulling open your, um, of changing the focal length so you focus at a different distance. So it gets them moving, but it probably also just when you look somewhere else and you move around, it forces you to blink.

Chris Williamson 41:58 (laughs)

Dr Euan Lawson 41:58 And it makes you blink. Now, you can co ... I've read some places where it says make sure you blink every 30 seconds or what have you, or you know, blink every 10 seconds and it will become natural. I've, I find that hard to believe that it wouldn't be a constant distraction trying to remember to blink. So-

Chris Williamson 42:13 Yes. Yeah.

Dr Euan Lawson 42:14 So the tr- the trick is just to change, to change where you're looking a little. So you look at something a little bit different, and then that'll, you'll naturally blink when you do that.

Chris Williamson 42:22 Yeah.

Dr Euan Lawson 42:22 Um, and, you know, you'll achieve the goal of actually blinking a bit more often, moisturizing your eyes, giving your foc- giving your muscles a little bit of a change of perspec- a change of focal length, which will just work those ocular muscles a little, and that's, uh, likely to reduce the- u- your eye strain generally.

Chris Williamson 42:37 So I suppose that ties in again, as we've said, with the Pomodoro technique of going for the 25 minutes, you can do that-

Dr Euan Lawson 42:44 Yeah.

Chris Williamson 42:44 ... as part of your little loop that you do to get up to go to the bathroom-

Dr Euan Lawson 42:47 Yeah.

Chris Williamson 42:47 ... to do whatever it might be.

Dr Euan Lawson 42:48 Y- yeah, absolutely. If you don't, you don't have to even think about the 20-20-20 thing if you're doing the Pomodoro because you're gonna do it naturally anyway. So it, it becomes, it, it ceases to be a problem. But if you, for some reason, you can't get up or you're stuck at a desk-

Chris Williamson 43:00 Yeah.

Dr Euan Lawson 43:00 ... you can't move, even just 20 minutes just doing this thing for sort of 20 seconds-

Chris Williamson 43:04 Yeah.

Dr Euan Lawson 43:04 ... will actually help reduce your eye strain. And the other thing to reduce your eye strain is get a little, get a little, um-... get some artificial tears. Get some eye drops.

Chris Williamson 43:13 Okay.

Dr Euan Lawson 43:13 You know, if you've got really, if you get really bad eye strain, eye drops are an absolutely ... You know, they work. They will, they will, they will do the, um ... That's what we give to people who can't blink properly or, like, you know, have got facial paralysis-

Chris Williamson 43:24 Yeah.

Dr Euan Lawson 43:24 ... and can't close their eyelids. They, they will, they will do the job.

Chris Williamson 43:27 Okay. So is there a reason why you would get this, uh, the manifestation of eyes flickering at night-

Dr Euan Lawson 43:35 Yeah.

Chris Williamson 43:35 ... as if you're still staring at a screen? Do you understand what that's due to?

Dr Euan Lawson 43:38 No (laughs) .

Chris Williamson 43:40 (laughs)

Dr Euan Lawson 43:40 I'm not sure, but I suspect it's somebody, you know ... It's somebody who's just got too much screen time and is not making a- and is not reducing ... I mean, uh, my th- my sy- my sense is ... I, I don't think, I'm not aware of any sort of specific neurological problem that that is due to.

Chris Williamson 43:55 Yep.

Dr Euan Lawson 43:55 But it sounds like somebody who desperately needs to unwind a little and have an hour-

Chris Williamson 43:58 (laughs)

Dr Euan Lawson 43:59 Somebo- somebo- someone who needs to have an hour before they go to bed of not looking at a screen.

Chris Williamson 44:03 Yeah.

Dr Euan Lawson 44:03 I mean, and s- and we're, and we haven't talked about sleeping, but we've, we've got a chapter in sleeping, The Healthy Writer. And, uh, I mean, for me, it's a superpower and I prioritize it now more, in my life, more than I have ever done in my whole life, because if I don't sleep right, my life is rotten, and if I get my sleep right, I feel great. And part of that good sleep hygiene is turning, not looking at my screen. I go to bed at 10:00. My screens go off at 9:00.

Chris Williamson 44:29 Digital suns- sunset, right?

Dr Euan Lawson 44:32 Absolutely. And you can do that whole using flocks or those, the things that change the kind of the, um-

Chris Williamson 44:37 The hue.

Dr Euan Lawson 44:37 ... the background. Yeah, the hue of your screen, and I do a little bit of that as well, but actually you can beat just th- the off switch-

Chris Williamson 44:42 Mm-hmm.

Dr Euan Lawson 44:43 ... (laughs) is the way to do it.

Chris Williamson 44:44 Yeah.

Dr Euan Lawson 44:44 And I think if you really value your sleep, then you've just gotta get off your devices and, you know, read a book.

Chris Williamson 44:49 Yeah. No, I, there was a, some really interesting studies. Have you read Why We Sleep by Mathew- Matthew Walker?

Dr Euan Lawson 44:56 I have, yes.

Chris Williamson 44:56 Oh, I mean-

Dr Euan Lawson 44:56 Very good.

Chris Williamson 44:57 ... anyone, anyone who's listening who's having trouble sleeping, before you try and get ahold of melatonin or think that burning incense or getting a diffuser in your room is where you need to go, buy Matthew Walker's book, Why We Sleep. Or if you can't deal with the reading of that, if you want to listen to Joe Rogan podcast 1109 ... I know it off by heart because of how many times I've listened to him on it.

Dr Euan Lawson 45:19 (laughs)

Chris Williamson 45:19 It's one of my favorites, and he is, he's absolutely fantastic. And the, the, um, (sighs) the summaries that he makes and the, um, conclusions that he draws about just how important sleep is to short-term and long-term health, longevity and all the rest of it, is, uh, they're terrifying. They're nothing short of terrifying.

Dr Euan Lawson 45:41 I, I'm, I, I think, I, I've, you know, if ... Moving is really incredibly important, getting more exercise, but, you know, there three pillars of going, being healthy are moving more, eating a bit better, however that is, but sleep is number, it's absolutely up there as that kind of holy triumvirate-

Chris Williamson 45:58 Yeah.

Dr Euan Lawson 45:58 ... of being healthy. And if you're not getting your sleep right, everything else falls apart. And I've got three kids. They were like, they're now a little bit, they're now like 11, 12, and 13, but when they were one, two and three, I wasn't getting a whole lot of sleep.

Chris Williamson 46:10 Mm.

Dr Euan Lawson 46:11 And I just, you know, my, kind of the difficulties of motivating yourself to do exercise, to cope with your normal work, the kind of, the, um, extra kind of anxiety it provokes and they're kind of-

Chris Williamson 46:23 The difficulty level on everything's-

Dr Euan Lawson 46:25 ... meant-

Chris Williamson 46:25 ... been turned up right.

Dr Euan Lawson 46:25 Meant- They're meant h- Oh, it just cranks ... And, you know, obviously, as a doctor, I've had some experience of sleep deprivation and in the army they were-

Chris Williamson 46:31 (laughs)

Dr Euan Lawson 46:31 The army were quite keen on it as well at times.

Chris Williamson 46:33 Yeah.

Dr Euan Lawson 46:33 So I've been through the pain of not sleeping, and life is just so shabby- (laughs)

Chris Williamson 46:38 Yeah.

Dr Euan Lawson 46:38 ... that, actually, that's why I prioritize it. Um, and there's so many things you can do which don't require taking medication. The evidence for melatonin is really weak. There's a little bit of evidence in older people over the age of 55 that it can help you get to sleep a bit quicker and your quality of sleep's a wee bit better, but there's not good evidence it makes any difference in younger folk.

Chris Williamson 46:58 There's potential for resetting circadian rhythms when traveling as well, right? I think it's a good way to hack jet lag, or at least Matthew Walker alludes to that in the book. Um-

Dr Euan Lawson 47:07 Is, yeah, they've certainly looked at it hard. I've, I, I'm not sure how good the evidence is for that either. There may be a wee bit. Yeah, I know that it's certainly been tried by a lot of people. Um, they-

Chris Williamson 47:13 So rely on, rely on what we know works, which is digital sunset, reduce-

Dr Euan Lawson 47:18 Yeah.

Chris Williamson 47:18 ... reduce the, or increase the melatonin response naturally-

Dr Euan Lawson 47:23 Yeah. I mean, there's, there's, there's-

Chris Williamson 47:23 ... by not having blue light pouring into your eyes an h- 20 seconds-

Dr Euan Lawson 47:26 (laughs)

Chris Williamson 47:26 ... before you go to bed.

Dr Euan Lawson 47:28 Yeah, well, I think that's it. I think my eyes would be jumping around a bit, um, if that were the case, if I were, if I did that, and I don't. My, my phone goes on airplane mode at night and happy days.

Chris Williamson 47:37 Well, I think one of the ... Anyone who's listening will know what I'm about to say. One of my number one solutions for anybody is to charge their phone over the other side of the room-

Dr Euan Lawson 47:45 Yeah.

Chris Williamson 47:45 ... and when you, when you get into your bedroom, uh, as I explained in a Hacker in your Pocket podcast and in number 10 with Kai Wei from the Light Phone, your, um, when you are in a inertial frame of reference, the likelihood of you staying there when you're on your phone is greater. So use your phone when you're standing in your bedroom, fine, but as soon as you lie down, you're not allowed to have your phone in your hand, because if you're laid down-

Dr Euan Lawson 48:09 (laughs)

Chris Williamson 48:09 ... with your phone in your hand, you're probably gonna l- you're probably gonna stay there, and it's more likely you're gonna stay there than if you were sitting, more likely that if you were sitting than if you were standing. So, charge the phone over the other side of the room, get an alarm clock that doesn't require you to put an alarm on your phone-

Dr Euan Lawson 48:22 Yeah.

Chris Williamson 48:23 ... or do both, and then your alarm will go off over the other side of the room and you've gotta get up.

Dr Euan Lawson 48:27 Mm-hmm.

Chris Williamson 48:28 It blows my mind, it blows my mind that there's an entire industry-

Dr Euan Lawson 48:30 (laughs)

Chris Williamson 48:30 ... of these rug alarm clocks. I don't know whether you've seen them where you have to-

Dr Euan Lawson 48:34 No.

Chris Williamson 48:34 ... you have to stand on a little mat to turn an alarm clock off. I'm like, "Well, you could just put an alarm-"

Dr Euan Lawson 48:39 (laughs)

Chris Williamson 48:39 "... anywhere else that wasn't next to the bed and it achieves the same objective." But that's, you know. I'm not gonna get sent one of those for free anymore, definitely. I'll pass you on to-

Dr Euan Lawson 48:46 No, I think you've blown it there, certainly.

Chris Williamson 48:47 Yeah. Rekt, yeah.

Dr Euan Lawson 48:47 You're, you're (laughs) you're right off their list.

Chris Williamson 48:49 Ruined it.

Dr Euan Lawson 48:49 The, um, I, my, I mean, the thing is, if you're a student and y- your room is your bedroom sort of thing, then absolutely you've gotta deploy some of these strategies. But if you've got a separate bedroom, then don't let the phone in your room.

Chris Williamson 48:59 Yeah.

Dr Euan Lawson 48:59 You know, bedroom is a phone-free zone.

Chris Williamson 49:02 Yeah. That's, I mean, that's the, that's the absolute goal, right? Um-

Dr Euan Lawson 49:05 Yeah, yeah, definitely.

Chris Williamson 49:06 So moving on, hot desking-

Dr Euan Lawson 49:09 Mm.

Chris Williamson 49:10 ... and university libraries. So you actually, you actually touched on this earlier on.If someone doesn't have the capacity to, um, let's say, perfectly customize or build, build their ideal work station, I know that ... Am I right in saying that almost all doctors will be using shared desks at work?

Dr Euan Lawson 49:29 Um, well, yeah-

Chris Williamson 49:31 Un-

Dr Euan Lawson 49:32 ... um, yeah, certainly there, a lot will be.

Chris Williamson 49:34 Yeah.

Dr Euan Lawson 49:34 And certainly GPs. When, there's, a lot of GPs work part-time and you're, yeah, you're gonna be sh- a lot of premises struggle, so you will, you are, to a certain extent, you're, you won't have your own room, you'll be going in and out, yeah.

Chris Williamson 49:43 Mm-hmm. So what are the, um, carry-in-your-bag, or the, I guess, the SOS, um-

Dr Euan Lawson 49:51 (laughs)

Chris Williamson 49:51 ... pack of trying to fix ergonomics for work there?

Dr Euan Lawson 49:55 Um, yeah. So I think, I mean, an external keyboard and a mouse, relatively light, should be able to, I think, if you've got a notebook. Uh, I, I guess it depends on whether you're using your own laptop-

Chris Williamson 50:03 Mm-hmm.

Dr Euan Lawson 50:03 ... and notebook, or whether you're using a, you know, like say a university student uni, using one of the PCs in the library-

Chris Williamson 50:09 Yeah.

Dr Euan Lawson 50:10 ... or whatever's available. I guess the first thing I'd say is you don't have to carry anything with you, just to take a moment to, you can adjust the height screen of all of those, you can move things into the correct position, you can adjust the height of the chair.

Chris Williamson 50:20 Mm-hmm.

Dr Euan Lawson 50:21 There's actually, rather than just plonking yourself down in, you know, whichever, you know, weirdly proportioned person was there before you-

Chris Williamson 50:28 (laughs) She's almost definitely not gonna be exactly the same as yourself, yeah.

Dr Euan Lawson 50:31 Yeah, quite. The, and, and actually, take the time to make the adjustments. And as I said, get the, get the height of that screen so it's just, you know, the top of the screen's level with your eyes. Get the, um, uh, get the seat at the right height so that you're kind of, your, your thighs are likely to be parallel to the ground and your feet are flat on the floor. Do those things first so that you're absolutely sorted out. I think then if you're doing your own, then in terms of working continuously, I would make sure I had some way of, not my phone, of, um, preferably, uh, of, uh, a little alarm for 20, 25 minutes-

Chris Williamson 51:04 Mm-hmm.

Dr Euan Lawson 51:04 ... so that you kind of stick to it. I've got a little watch, my watch buzzes, so that's handy in the library. When I'm at the, when I'm at the university library. Um-

Chris Williamson 51:11 It would be cool if there was a, a web-based Pomodoro timer, wouldn't there? Like a cloud-based one.

Dr Euan Lawson 51:15 Yeah.

Chris Williamson 51:15 I wonder if, I wonder if someone's come up with that. That would be a really good ... If someone needs a business idea, come up with-

Dr Euan Lawson 51:21 Yeah.

Chris Williamson 51:21 ... Be Focused Pro for web browser that would allow notifications to pop up. That would be lovely.

Dr Euan Lawson 51:27 Yeah.

Chris Williamson 51:28 (laughs)

Dr Euan Lawson 51:28 Yeah, that's the kind of thing, yeah, absolutely. So you need to, you need to have that handy. I would, um, you know, if you can, a, a notebook riser's a little bit of a big ask, I think, 'cause they're probably quite bulky to fit in a bag.

Chris Williamson 51:37 Yeah.

Dr Euan Lawson 51:37 But if you've got some books with you, you may be able to use them. The only thing I'd say is there are always books in the library. (laughs)

Chris Williamson 51:43 Yeah, there, that's a very good point. You're not gonna be short of them.

Dr Euan Lawson 51:44 You just got to go to the near, you've just got to go to the nearest shelf and pull off two or three books, doesn't matter what they are.

Chris Williamson 51:49 Yeah.

Dr Euan Lawson 51:49 Stick them under your laptop.

Chris Williamson 51:49 You're not taking them out. No one's gonna, no one's gonna crush you.

Dr Euan Lawson 51:51 No, the librarians will put them away again, they're very nice like that.

Chris Williamson 51:54 (laughs)

Dr Euan Lawson 51:54 In fact, they prefer it if y- they don't like it when you put them away, they prefer it to do it themselves, because we do it wrong.

Chris Williamson 51:59 Yeah, they like to, like to, they like to work, don't they?

Dr Euan Lawson 52:01 (laughs) Yeah.

Chris Williamson 52:01 I've always found that-

Dr Euan Lawson 52:02 They, they don't trust, they don't trust students, and p- they definitely don't trust staff to put them back where they got them.

Chris Williamson 52:07 Agreed.

Dr Euan Lawson 52:07 So they're then lost forever.

Chris Williamson 52:08 Agreed.

Dr Euan Lawson 52:09 Um, so you could grab a book. So you don't, you just use what's there, that's easy. Um, and then a little external keyboard and a mouse, and you're good to go. I think a little bottle of eye, um, if you're gonna, if you're, if you're really settling in for the long haul-

Chris Williamson 52:21 Yeah.

Dr Euan Lawson 52:22 ... then, um, uh, some eye drops is a good plan. And that probably-

Chris Williamson 52:25 Is there a, is there an optimal frequency for using the eye drops? Every couple of hours, or during every break? Is that, is that, are you gonna end up swimming, swimming in tears if you do it every break?

Dr Euan Lawson 52:32 Yeah, dripping, yeah, like crying.

Chris Williamson 52:34 Yeah.

Dr Euan Lawson 52:34 Yeah, uh, no, not especially. The general advice with these is we put them in every couple of hours if somebody's got absolutely nothing going. I think it depends how you feel.

Chris Williamson 52:43 Yeah.

Dr Euan Lawson 52:44 Uh, one, one or two hours, I don't think you need, every 20 minutes would be a bit-

Chris Williamson 52:47 (laughs) A bit much.

Dr Euan Lawson 52:48 ... yeah. I personally, I despise putting in eye drops, it's like-

Chris Williamson 52:51 It's, um, um, it's never gonna be an easy task to accomplish, is it?

Dr Euan Lawson 52:54 Yeah, you're prob- not old enough to remember the Friends episode where they tried to put eye drops in Monica for the whole episode.

Chris Williamson 53:01 Okay. (laughs)

Dr Euan Lawson 53:01 (laughs) So, it, is, it turns into one of those for a lot of people. (laughs)

Chris Williamson 53:04 Okay.

Dr Euan Lawson 53:05 So I, I would say a couple of hours is good.

Chris Williamson 53:06 Got you. Okay. So I wanted to talk about some more, some of the slightly more funky solutions that I've seen-

Dr Euan Lawson 53:13 (laughs)

Chris Williamson 53:13 ... which exist for, uh, people who want to really optimize their work station. I know that Johnny, another one of the co-hosts of the show, um, he has a really fancy desk that g- does both seated and standing.

Dr Euan Lawson 53:27 Mm-hmm, nice.

Chris Williamson 53:27 And I know that the, um, receptionist at, uh, BFIT, which is the, uh, physiotherapy place that I go to round the corner, uh, sits on a BOSU ball. When I go in, she's on a, sat on a big, big Swiss Ball, um-

Dr Euan Lawson 53:40 Yeah.

Chris Williamson 53:40 ... ba- bouncing around. And I just, I wanted to know what the, um, efficacy of those particular approaches are, and if there's any others, any other sort of, uh, weird and wonderful approaches you've seen for ... I know, I know Ben Greenfield has a treadmill office.

Dr Euan Lawson 53:56 Yeah.

Chris Williamson 53:57 A tread- a treadmill station where he can, uh, walk on a TrueForm Runner at the same time as dictating-

Dr Euan Lawson 54:03 Yeah.

Chris Williamson 54:03 ... and writing and stuff like that.

Dr Euan Lawson 54:06 Yeah, Ben's a bit, he's quite out there though, he's pretty full on with his-

Chris Williamson 54:08 Oh, yeah.

Dr Euan Lawson 54:09 ... self, um, efficacy stuff.

Chris Williamson 54:11 Oh, yeah.

Dr Euan Lawson 54:11 Uh, (laughs) um, I would, the problem with all this is, uh, this is probably worth, uh, a, a, um, fairly minor digression, is that the evidence is rubbish, um, for a lot of this stuff.

Chris Williamson 54:21 (laughs)

Dr Euan Lawson 54:21 It's really har- and it's not rubbish as in, it's just hard to do good research, medical research into this kind of thing. Because, you know, you can't do it, there's no sort of placebo effect, or you can never quite know what you're, whether you're measuring it in motivated people who then feel a bit better, or, uh, so the evidence is really hard to pick out. Um-

Chris Williamson 54:39 Tenuous, right?

Dr Euan Lawson 54:41 Yeah, it's just not good quality. And so it re- makes it really hard to offer definit- you, you lurch into anecdote, uh, quite quickly.

Chris Williamson 54:48 Mm-hmm.

Dr Euan Lawson 54:48 Uh, and personal opinion. Um, I would say there's not an awful lot of evidence for Swiss Balls. So that kind of, what's, they, they can fall under the category of dynamic sitting.

Chris Williamson 54:56 Yeah.

Dr Euan Lawson 54:56 That kind of, where you've, you've got to continually adjust and micro-adjustments, but, you know, kind of using core strength and, to keep yourself in an upright position. Um-I have a Swiss ball in my room and (laughs) I don't use it very often.

Chris Williamson 55:11 Yeah.

Dr Euan Lawson 55:11 Sometimes, if I'm a bit bored, I'll sit on it.

Chris Williamson 55:12 Yeah.

Dr Euan Lawson 55:13 Um, there, there isn't great evidence they make a huge amount of difference, but it's one of those which I think if you get relief, it does force you to sit in a probably much better... It improves your posture. You, you got to, you can't slouch on a Swiss ball, or you end up on the floor. You know, you're o- you're obliged to put your feet flat down, you got to, you know, you've got to engage your core and you got to sit up straight.

Chris Williamson 55:32 So potentially, rather than the, the Swiss ball actually being something magical in and of itself, it's just forcing you into a position that you could replicate on a normal seat?

Dr Euan Lawson 55:41 Y- I, I would s- I would think that's almost entirely it. Though I think there is a, there is a kind of evidence, there is research that's gone on around dynamic sitting-

Chris Williamson 55:49 Mm-hmm.

Dr Euan Lawson 55:49 ... to try to work out if it's all the micro-adjustments that makes a difference. I haven't read anything that really convinced me that there's great, definitive, um, evidence that makes a great- it makes enormous difference. Um, the other thing then is you're kind of into standing desks, uh, as you mentioned. Um, I've also got a standing desk at work. I haven't got a posh one, um, I think (laughs) I think there were pictures posted at the time when the book came out last year that mine was just an old school desk, like a primary school desk, which I cut the legs off and then I whacked a bit of one-inch MDF on the top. Um, and I didn't even nail it together, I just rested it on there, and, um, that, I find that really g- I find that really good. I w- I kind of enjoy working there. But I like the variety. Sometimes I sit, sometimes I stand, sometimes I wobble around on my Swiss ball and sometimes I think that is the kind of... The thing about these slightly wacky things is that it's just the variety that is really helpful, um, and makes a difference to me. Um, there isn't, and there is some, a little bit of evidence for stand-up desks in the literature that they can, um, help in some respects but f- for back pain particularly, but nothing, nothing really monstrously good.

Chris Williamson 56:55 Okay.

Dr Euan Lawson 56:56 Actually, there's a lot more evidence for Ben, uh, Greenfield's treadmill desk-

Chris Williamson 57:01 Okay.

Dr Euan Lawson 57:01 ... which, um, quite a few people use, and that certainly seems to be, uh, I've certainly r- read a couple of papers. One of them showed, you know, things like they measured people's cholesterol and, you know, kind of blood glucose to check for diabetes, and those, all those sort of markers were quite significantly improved when someone used a treadmill desk. Um-

Chris Williamson 57:19 Wow.

Dr Euan Lawson 57:20 ... but the weirdness of that, I mean, and I suppose that makes sense because you're walking (laughs) .

Chris Williamson 57:24 Well, yeah.

Dr Euan Lawson 57:24 So, so it's better than sitting there doing nothing.

Chris Williamson 57:26 By a distance.

Dr Euan Lawson 57:28 Yeah. And they did also comment that they noticed that the, you were s- and as I always thought would be the problem with a treadmill desk is it's just blooming hard to concentrate when you're walking-

Chris Williamson 57:39 Yeah.

Dr Euan Lawson 57:39 ... on doing something else. And there is a, there was a reduction in your sort of cognitive capacity when you're on a treadmill desk.

Chris Williamson 57:44 Yeah. Well, you've g- you've got to spend a little bit of, um, expend some mental force just walking, right? Not falling over.

Dr Euan Lawson 57:51 (laughs) Yeah, yeah, exactly. When you think you're doing it automatically, but it does require a little bit of effort.

Chris Williamson 57:55 Yeah.

Dr Euan Lawson 57:55 But it's really good for sort of relatively low-level tasks and a- and, you know, Ben, when we chatted on his podcast about it, he said exactly that. "It's done for answering emails, you know, doing other bits and bobs, admin tasks, not for the really deep work, the Cal Newport sort of really high-focused..."

Chris Williamson 58:09 Cal, Cal would not be happy with a w- a walking desk at all.

Dr Euan Lawson 58:12 No. If Cal was here, he would probably, absolutely, he would be slapping us.

Chris Williamson 58:16 Yeah, the tre-

Dr Euan Lawson 58:17 No uncertain terms.

Chris Williamson 58:17 ... the treadmill would be out of the window. Um, I'm just looking at... So I got hold of the Biohackers Handbook, which is-

Dr Euan Lawson 58:24 Uh-huh.

Chris Williamson 58:24 ... uh, something Ben Greenfield's actually affiliated with. Partway through that, I've got the work, um, edition of this open. There's one on work, one on sleep, one on nutrition, one on exercise. And it is showing me the effect of body position on introvert vertebral disc pressure.

Dr Euan Lawson 58:41 Mm-hmm.

Chris Williamson 58:41 So 100% disc pressure, the effect of, uh, the effect on four postures on the intervertebral disc pressure as measured between the third and fourth lumbar vertebrae. So 100% when standing. If your back angle when sitting is at 110 degrees, so a little bit leaning back, it would be 105%. At 100 degrees, 115%. At 90 degrees, at 140%, and at 80 degrees, at 190%. And that's sourced to Hedman T. and Ferne G., 1997, Mechanical Response of the Lumbar Spine to Seated Postural Loads.

Dr Euan Lawson 59:23 Yeah.

Chris Williamson 59:24 So not being in, uh, being leaned forward, which I see an awful lot, especially if you look in university libraries, you'll see that people, a lot of the time, will naturally hook their feet under themselves-

Dr Euan Lawson 59:37 Yeah.

Chris Williamson 59:37 ... onto, onto the little wheels and they'll pull-

Dr Euan Lawson 59:40 (laughs)

Chris Williamson 59:40 ... themselves right forward. Do you know what I mean?

Dr Euan Lawson 59:42 Mm-hmm.

Chris Williamson 59:42 So their feet are on-

Dr Euan Lawson 59:42 Yeah, yeah.

Chris Williamson 59:43 They're not even on the floor, they're on top of the seat, o- on the, the base of the seat.

Dr Euan Lawson 59:46 Yeah, yeah.

Chris Williamson 59:47 And then they're leaned right forward. Apart from the little bit of assistance you'll get by having your elbows pushing up from the desk, you're gonna be looking at nearly double the, uh, disc pressure-

Dr Euan Lawson 59:59 Yeah.

Chris Williamson 1:00:00 ... which is, which is pretty catastrophic, I imagine.

Dr Euan Lawson 1:00:02 Well, the only thing... Uh, well, I've got a couple of thoughts. So, so the first thing I'd say is, the simple fix for that is plant your feet on the floor, as I said earlier.

Chris Williamson 1:00:08 Yeah.

Dr Euan Lawson 1:00:08 That kind of, that fi- that is the one hack that fixes that completely. Because you're right, it does put you into a really awkward position. The only thing I'd say is it's a slightly proxy marker, that. It doesn't actually tell you whether you'll get back pain or give you any problems.

Chris Williamson 1:00:20 (laughs) Yeah.

Dr Euan Lawson 1:00:21 It's-

Chris Williamson 1:00:21 Can you back deal with it? Yeah, fine.

Dr Euan Lawson 1:00:23 Y- Yeah, it's just measuring increase in pressure in one intervertebral space, actually doesn't necessarily mean it will turn into anything later on-

Chris Williamson 1:00:29 Pressure doesn't equal-

Dr Euan Lawson 1:00:31 ... because actually m-

Chris Williamson 1:00:31 ... uh, negative...

Dr Euan Lawson 1:00:32 Not necessarily. I, I, but I agree, it doesn't, I wouldn't wish to underestimate it. It's clearly a pretty rubbish posture-

Chris Williamson 1:00:38 Yeah. Yeah.

Dr Euan Lawson 1:00:38 ... (laughs) as well. And, uh, likely to c- quite likely to cause you problems in the longer term. But I'm always a bit wary about... The, the problem with it, the, the research is you can, you, you see evidence like that but it, it very r- it's very difficult to translate it into people who get back pain by, you know, later on down the line so the real-

Chris Williamson 1:00:54 Hm.

Dr Euan Lawson 1:00:54 ... sort of clinical endpoints that we're interested in.

Chris Williamson 1:00:57 Interesting. Yeah, that is cool. So I wanted to touch on more of the outside of the day, outside of work and outside of writing, uh-

Dr Euan Lawson 1:01:06 Yeah.

Chris Williamson 1:01:07 ... health. The more sort of general health, as we could call it. And I know that you are a fan of gratitude journaling, based on some of the bits that I've read about you.... I wanted to allow you to elaborate. We haven't touched on gratitude journaling almost at all yet so far, although I do do it. I wanted to hear your thoughts on it and, um, your experiences with it.

Dr Euan Lawson 1:01:29 Yeah. So my ... And one of the things we wanted to do with the book was just to point out that writing in particular wasn't all just catastrophically bad for your health. There was a slight danger that the book was just gonna be-

Chris Williamson 1:01:40 Give up being a writer, it's going to destroy you.

Dr Euan Lawson 1:01:41 Right. Yeah, exactly. Stop immediately, it's horrific.

Chris Williamson 1:01:44 Yeah.

Dr Euan Lawson 1:01:44 Um, and one of the clearest bits of evidence about writing was writing is... I mean, there's certainly some medical stuff about writing as therapy, um, and people with mental health problems and other things. But actually for, just thinking for people in general and, um, for the wider population, there's something everybody can do, gratitude journaling has a really pretty decent... has, has some decent evidence that underpins it. And it goes back to, um, some Californian psychologists, um, who looked into this, uh, Emmon and McCullough. Um, and they ... There was an experiment. It goes, I think it was back to 2003 or the early 2000s, sometimes like, sometime like that, and they, they ran one of these studies that psychologists love to do. Um, and they got the participants to write down just a few things they were grateful for every day, whether that was the, you know, the kindness of a friend or a, a beautiful sunset. And incredibly, they only had to write a sentence and they only had to do it once a week, so it was really not a big ask.

Chris Williamson 1:02:37 That's low investment, right?

Dr Euan Lawson 1:02:38 Yeah, that is really... You know, the biggest problem with that would be remembering to do it because it's so low.

Chris Williamson 1:02:42 Yeah.

Dr Euan Lawson 1:02:43 Uh, it's absolutely tiny. And, um, they found that it really seemed to... They, they stopped... They found some clear improvements in wellbeing for those people and that they felt better. But really inter- one of the things that really piqued my interest about that study is because I can be a little bit cynical about some of these psychologists, psychology studies. They're often got very low numbers and, you know, you've got to be careful about how far you draw your inferences with them.

Chris Williamson 1:03:08 Yes.

Dr Euan Lawson 1:03:08 But they also, they also found evidence that the, um, the families of the participants had noted that their loved ones were ... Seemed to be better in themselves-

Chris Williamson 1:03:19 Brilliant.

Dr Euan Lawson 1:03:19 ... and they had improved wellbeing. And I thought that was r- that was a really, um, interesting kind of nugget as part of that, that really kind of, for me, gave this a lot more credibility.

Chris Williamson 1:03:30 Mm-hmm.

Dr Euan Lawson 1:03:31 And, uh, the, the California psychologists have gone on to do more studies and there's some Manchester, um, psychologists who've also looked into this and a host of others. But what they also found ... So they also found that there was good evidence that doing a gratitude journal, um, could improve your sleep.

Chris Williamson 1:03:47 Okay. Okay. (laughs)

Dr Euan Lawson 1:03:48 Um, and they... It reduced your anxiety, improved your sleep. So it feeds exactly back into what we were saying before, that if you have better sleep and you sleep longer, well, crikey, I mean, that is ... You can, you know ... The, the effects that Matt Walker have talked about-

Chris Williamson 1:04:01 Yeah.

Dr Euan Lawson 1:04:01 ... has talked about in his book, that means that you're less likely to get cancer, you're less likely to have a heart attack-

Chris Williamson 1:04:06 Alzheimer's.

Dr Euan Lawson 1:04:07 ... you're less li- you're less likely to have a stroke or Alzheimer's.

Chris Williamson 1:04:09 Yeah.

Dr Euan Lawson 1:04:10 So actually, there is incredible power if a very simple intervention like a gratitude journal can reduce your anxiety, can help you to sleep a little bit better, there is... I mean, you've got to be a bit careful about pulling this chain out too far.

Chris Williamson 1:04:23 Yeah, downst- downstream, where do you, where do you stop?

Dr Euan Lawson 1:04:26 Yeah. But there is ... If it makes you feel better at the time, then that's a pretty good place to start.

Chris Williamson 1:04:31 Yeah.

Dr Euan Lawson 1:04:31 Because people are not very good at doing stuff that will keep them or get, make them live six months longer when they get to 70.

Chris Williamson 1:04:37 (laughs)

Dr Euan Lawson 1:04:37 They're good at doing stuff that makes them feel good at the time.

Chris Williamson 1:04:40 Yeah.

Dr Euan Lawson 1:04:40 And I think that's the lot of the experience of doing a gratitude journal that I've found and a lot of people have found is that it just helps you feel a little bit better about your life, helps you ... It gives you a more positive slant on life and it reduces that sort of stress and anxiety. Um-

Chris Williamson 1:04:55 There's a, an interesting, an interesting point that Yousef made on one of the last podcasts where the, the typical experiment, he says, "Look around your room for something red. Now close your eyes and tell me what in the room is blue," because the reticular activating system focuses for ... It, it narrows in, right?

Dr Euan Lawson 1:05:13 (laughs) Yeah.

Chris Williamson 1:05:13 And his, his argument was that something similar was going on, that it's very difficult to hold anxiety in the mind at the same time-

Dr Euan Lawson 1:05:21 Mm-hmm.

Chris Williamson 1:05:21 ... as searching. I ... On my gratitude journal, I'll, um, (laughs) hold my hands up and say that some mornings, finding something which isn't what I wrote about the, the day before or just the first thing that comes to mind, I, I am grateful for the taste of coffee, I am grateful for, you know-

Dr Euan Lawson 1:05:37 (laughs)

Chris Williamson 1:05:38 ... it, it can be, it can be moderately challenging some days to come up with something which is meaningful, but that search for what is, what does have meaning to me today? What am I genuinely grateful for today? It forces an awful lot of worries out. It's very difficult to hold both of those things in the same moment.

Dr Euan Lawson 1:05:58 Yeah, that, that may be exactly what's going on. I, I, I certainly haven't looked too hard into what the psychologists think. I, I mean, it's one of those things that people who get depressed and then anxious often have intrusive negative thoughts and kind of ongoing difficulties breaking out of that cycle of negativity.

Chris Williamson 1:06:15 Mm-hmm.

Dr Euan Lawson 1:06:15 And you know, that's the whole basis of something like CBT really, is to help link how you think, with how you behave, with how you feel and break some of those barriers down. And I wonder sometimes if gratitude journals just start to nudge that along a little bit. They, they, they're an almost like an initial step, perhaps with the, the, the bit you mentioned about actually holding, um, negative thoughts in your head at the same time for those who haven't got as far as, you know, having full-blown depression or anxiety kind of problems-

Chris Williamson 1:06:42 Mm-hmm.

Dr Euan Lawson 1:06:42 ... is that they're just a really simple little hack.

Chris Williamson 1:06:45 It's nice. It's nice.

Dr Euan Lawson 1:06:46 Did you ... You do, you do them e- every morning?

Chris Williamson 1:06:48 Uh, I do, yeah. Um, so I've got ... I'll put a link in the show notes to, uh, The Six Minute Diary, which is (laughs) scandalously a rip-off of the Five Minute Journal, but-

Dr Euan Lawson 1:06:59 (laughs)

Chris Williamson 1:06:59 ... is, is, um, better as far as I'm concerned. It's by a company called Your Best Self-

Dr Euan Lawson 1:07:04 (laughs)

Chris Williamson 1:07:04 ... and, um, it's available, it's available on Amazon.

Dr Euan Lawson 1:07:06 Okay.

Chris Williamson 1:07:06 The, the link, the link will be in the description. But it's three minutes on a morning and three minutes at night. Three, three things you're grateful for is the first thing you do in the morning.

Dr Euan Lawson 1:07:15 Mm-hmm.

Chris Williamson 1:07:16 And yeah, it's, it's interesting, um...It helps to