Revolving Door Syndrome

Nothing is certain but death and taxes.Death is coming for all of us, but why are we so afraid of talking about it?As a doctor, most of my job has been about saving people. Saving people from harm to their body or mind and alleviating suffering.But what if some of our choices are causing more suffering? What if by sterilising and ignoring the process of death we now just see death as failure?Medical care has come so far in the last century where far fewer people die in childhood and many are living well into their 90s.But how we in Modern Western society approach death, dying and living has changed drastically with the growing trend of death denialism and a lack of opportunity for people to just talk about death. On this episode we bring on Treza Gallogly, a death doula. Doulas have been popularised as a support person and advocate for women in pregnancy helping to bring life into the world. Now there is a growing need for that support in dying.As a death doula Treza walks with her clients who are making their last journey into death, helping them and their families navigate the next chapter.But helping people through their dying months, weeks, or days is not just about death, it is about living. When we start becoming less uncomfortable with approaching death, this is the moment when we really start to live.

One of the biggest challenges facing us in the 21st century is significant demographic change.We have an ageing population with people living much longer and with fewer children being born. This is resulting in a growing use of immigration to provide the economic activity to fund core public services like health, education and justice.Meanwhile growing income inequality is contributing to worse rates of preventable illness as health funding is diverted away from public health interventions that actually keep people healthy.It's time we take a much longer term view to the social and economic challenges our country will face. Much longer than the 3 year election cycle.To talk about this further, I bring you the economist Shamubeel Eaqub For New Zealand and our people to find success, we need to be realistic, but hopeful to get through tough times. Whether we like it or not, New Zealand will undergo significant change. And with that, we must be truthful and open about the risks associated with this change.What is at stake here is social cohesion. If we continue to become more divided, we risk losing the prosperity, freedom and progress that has been hard fought for by generations that came before us.But, if we can find a sense of common ground, collective identity and a shared vision and set of values, maybe, just maybe, we will change that trajectory to a better future for all to thrive.While you listen to this episode I want you to really ask yourself, what does it mean to be a New Zealander? Send us an email, DM or a voice note on our social media to let me know what you think.

This is part two of a two part series with Dr. Mike Murphy. On episode one, we took a deep dive into the relationship between the healthcare system and the pharmaceutical industry.We examined the incentives for a for-profit system that does not necessarily value overall patient health outcomes in the wider social context. Check out episode one if you haven't already. In the second half of our conversation, we talk about psychedelics. There's a lot of chatter, excitement, and what you may call hype with the emerging studies on psychedelic therapies.On this episode, we continue to take a sceptical eye on this new field of medicine, cognisant of the risks of falling into the same trap as conventional pharmaceutical silver bullets. We discuss states of consciousness, potential benefits and harms of new therapies, and the need for safeguards during times of significant change.

As doctors, we rely on the pharmaceutical industry to produce medications, from everyday paracetamol to advanced targeted cancer therapies. The industry faces constant pressure to innovate and create profit for shareholders, while governments face pressure to approve and fund these medicines from patients and clinicians.What we are seeing is a rise in medicines spending. People are living longer, with more disease and requiring more medications. The newer medicines are costing exponentially more while sometimes providing only small incremental benefit when compared to older and cheaper medicines.When we only have a limited pot of resources to fund our healthcare system, we need to start asking the question of how effective is this spend and who seeks to benefit? And if we continue promoting a sickness system that is heavily reliant on pharmaceutical silver bullets, will we create a happier, healthier nation?Joining me on this episode is Dr Mike Murphy, an emergency doctor, and clinical director of medicinal cannabis clinic, Cannaplus. Having been involved in clinical trials, Mike understands the costs, process and drivers of developing new drugs. Together we unpack the complicated relationship doctors have with big Pharma as well as holding a hopeful but sceptical eye on emerging psychedelic therapies.