Joanna Nell · 54 min
A doctor who spent 35 years listening to other people's stories finally found the courage to tell her own, and in doing so, gave a voice to the elders society had forgotten.
Hear this story
At eight years old, Joanna Nell decided to become a doctor after watching male doctors on television. When a teacher told her that job was for boys, something in her pushed back hard. She spent 35 years as a GP, first in the UK and then in Australia, drawn not to the science of medicine but to the stories of people's lives. She was the doctor who listened, who observed, who tried to get inside a patient's head. And for 35 years, she felt like a complete fraud, despite knowing she was doing good work.
Writing started as a way to de-stress after work, a private pleasure. But it became something else entirely. When her novels began finding readers, Joanna was suddenly asked to do radio, television, public speaking. For an introvert with social anxiety, it felt like standing naked on a speeding train. It took working with a psychologist to understand the childhood wounds underneath that fear. By then, just as she'd finally shed her imposter syndrome as a doctor, it arrived again as a writer.
Working in aged care, Joanna saw something most people miss. She saw people falling in love in their 90s, fashion shows, an old soldier getting dressed in his medals to walk through the city. She saw the difference between those who aged with humor and agency, and those who'd accepted society's story that they were done. Research shows that people with positive attitudes toward aging actually live longer. So Joanna writes lighter, more hopeful stories about getting older, not to sugarcoat it, but to take away the fear. Her books shine a light on elders our culture has made invisible, reminding us they still have so much to give.
“If somebody tells me it can't be done, then I'm going to try damn hard to make sure it is.”
“The cause of my demise was that my sliver of ice melted over the years and I took on too much. I didn't protect myself. I didn't set up boundaries very well.”
“For 35 years I felt a complete imposter as a doctor. Even though I knew I was doing everything, I always felt like any minute now the alarm bells would go off.”
The hero, today
Joanna spent 35 years feeling like a complete imposter as a doctor even though she knew she was doing a good job and people told her so, and the moment she overcame that, imposter syndrome as a writer arrived. She argues that the art of medicine, observation, intuition, and getting inside someone's head, is being lost under evidence-based protocols, and she loved putting those unquantifiable skills into everyday consultations. Research shows that the quality of someone's relationships at 50 is more predictive of their health at 80 than cholesterol levels, and connection, community, and purpose matter more than most physical interventions. People who hold positive stereotypes about aging and think optimistically about their future are likely to live longer and be healthier, which is why Joanna writes lighter, more humorous stories to take away fear around aging. She writes what she doesn't know rather than what she knows, exploring through fiction what her own future might look like and how she wants to show up in the world as she ages.
Yes. Joanna Nell is a real person who shared their own story in their own words. Kintsugi Heroes is a not-for-profit that shares first-person stories of overcoming adversity, told with the person's consent.
Kintsugi Heroes, a registered Australian not-for-profit. Every story is shared with the hero's own consent and reviewed under Kintsugi Heroes' trauma-informed content standard before it goes public.
Joanna spent 35 years feeling like a complete imposter as a doctor even though she knew she was doing a good job and people told her so, and the moment she overcame that, imposter syndrome as a writer arrived.
She argues that the art of medicine, observation, intuition, and getting inside someone's head, is being lost under evidence-based protocols, and she loved putting those unquantifiable skills into everyday consultations.
Research shows that the quality of someone's relationships at 50 is more predictive of their health at 80 than cholesterol levels, and connection, community, and purpose matter more than most physical interventions.
John Milham (Host) · 00:05
Welcome back to Kintsugi Heroes, helping people tell the stories they need to share so you can find the stories that you need to hear. I'm so excited to share my conversation with Joanna Nell today. Jo, who is a doctor and an author, started her journey studying medicine in the UK and came to Australia as a doctor caring deeply for her patients, especially in aged care. Jo loves understanding people, and it was that curiosity that led her to explore a hobby which became a phenomenon as a best-selling author. Her 5 award-winning novels, including The Single Ladies of Jacaranda Retirement Village, shine a positive and often funny light on aging, encouraging us to think differently about getting older and the value of connection. Jo's story is about embracing change, overcoming self-doubt, and showing us that it's never too late to embrace something new and do it with a touch of hope and optimism. Please join me diving in and being inspired by Jo Nell's incredible journey. So ladies and gentlemen, friends of Kintsugi Hero Podcast, this is actually my excitement to talk to someone I haven't spoken to in ages, and there's so much to talk to. But initially, I want to tell the listeners that my guest today is an incredibly accomplished person, someone I look up to, not just because of her original profession, but because of the profession she's shifted to now, which I could not imagine doing, even though I probably desperately want to. So Dr. Joanna Nell, who is now Joanna Nell, author, writer, and expert on aging. Welcome to Kintsugi Heroes.
Joanna Nell (Guest) · 02:07
Oh, thank you, John. It's wonderful to be here and wonderful to catch up with you as well.
John Milham (Host) · 02:12
Oh, thank you. I have to say, you were instrumental in shaping my understanding of some serious thinking and chatting that we did once in a book club, which was like, um, almost like a preview of the Ladies of the Jacaranda Retirement Village. But let me ask you first, you were a medical doctor working in various medical bits, but you spent some time in aged care and supporting the medical needs of people in that environment. But how did you become a doctor, Jo?
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People who hold positive stereotypes about aging and think optimistically about their future are likely to live longer and be healthier, which is why Joanna writes lighter, more humorous stories to take away fear around aging.
This conversation includes a teacher tells her no, the outsider who watched people, the human doctor versus the clinical one, what medicine is losing, from the nhs to medicare and when a hobby became a vocation.
Joanna Nell (Guest) · 02:44
Oh, that's a good question. And it was so long ago. I, I think I was about 8 when I decided that I wanted to be a doctor, and I now can't decide whether it was because I had been in hospital having my appendix out and had developed a crush on the lovely young doctor who, the house doctor who'd looked after me and was just sort of desperate to get back into hospital somehow, or whether it might've been a conversation with a teacher I'd had at school in far less enlightened age where we went around the class and everybody said what they wanted to be when they grew up. And I said, I think I'd watched something on television the night before, which looked quite exciting about doctors. And I'd noticed that all the doctors were male and all the nurses were female in that. And I just being a little bit of a contrary child said, I want to be a doctor. And the teacher said, no darling, you can't do that. That's a job for boys, for men. You need to be a nurse. And so I think there was just more belligerence in me than anything. If somebody tells me it can't be done, then I'm gonna try damn hard to make sure it is. So that was it. And I think that just set me off on a course then, you know, it was a seed that was planted in my mind. It, you know, whenever I mentioned it to adults, I got a good reaction. Yeah. Yeah. So, you know, it just became my path into that career.
John Milham (Host) · 04:04
That's so interesting, right? At an early age. And I love that there were multiple reinforcements, right? Both negative and positive for you choosing a calling rather than a career. But we so often see like the bright kids expected to become a doctor. And I've bumped into many of them that probably shouldn't have been, right? So perhaps their intellectual talents could have been pointed to some other place where they might have been a little happier and the patients a little better served. Do you think that was the right choice for you?
Joanna Nell (Guest) · 04:36
That is such a good question. Going back to your point, it's true, I think, that if you were a bright kid in the '70s or '80s, then, you know, you were set— would you want to be a lawyer or a doctor? I mean, there were basically two choices. I think that it was the right decision for me. I was really interested in people, and that was a sort of a curiosity that was born of being a little bit of an outsider. I was— I suppose you'd call it social anxiety— and I was very shy and bullied at school. And so I was the kid that was always on the periphery looking in, looking for the clues. I suppose I might have a diagnosis nowadays, but I'm trying to work out you know, how to interact with the other kids. And this just led me to, you know, a lifetime of observing people and becoming really interested in what makes them tick. So I was always more of a doctor that was interested in people rather than the pathology or the diseases. And yes, it was the right career for me for a very long time, but I think that I gave it 150% perhaps. And so time came, I think, when my batteries were just run low and there was an overlap of my writing and my medical career, but I don't regret it at all. I've, it's been the most wonderful privilege. It has been a, you know, a fantastic career for me, but I'm now no longer practicing for various reasons.
John Milham (Host) · 06:06
It always strikes me almost like two paths, right, the human and the clinical, right? And perhaps, you know, very few doctors sit comfortably in both pathways. From your actual experience, do you feel that, you know, that observation, you know, has some validity?
Joanna Nell (Guest) · 06:29
I think that is a valid observation, John, and I certainly can identify colleagues and people that I was at medical school with who were very interested in the physiology, and they had sort of very scientific and methodical and mathematical approach. I wasn't so good at maths. I was very good at English at school and language. And I think that we naturally gravitate towards where our strengths are. So I think a lot of them went into careers, perhaps surgical careers. You know, it's really good to have somebody in orthopedics who's good at angles, you know, very precise. And perhaps it's very good to have somebody in general practice who is interested in that sort of cradle to grave and the story of somebody's life and, you know, who uses their different skills. And I think that that's the beauty of a career like medicine is that there is a specialty for, for everyone. But I do think general practice and psychiatry do tend to attract those who are more driven by the sort of the narrative rather than the, the pathological.
John Milham (Host) · 07:35
You talk about GPs and, you know, being connected with people and you watching people out from outside, the acuity of that, right? Your ability to see people. People, both the humanness and also their context. Is that medicine? Like, you know, we often think about drugs and, you know, surgery, cutting open or attaching or detaching things, but isn't it— isn't everything context about, you know, the person? Isn't medicine that?
Joanna Nell (Guest) · 08:03
Yeah, look, I feel quite strongly about this, that we are losing the art of medicine, which is using all of those skills, that sort of observation, and not just the ability to see people, to actually get inside their heads. Yeah, well, You will notice there are also skills that you need as a writer, but get inside their head and to use a degree of intuition as well. And I think in our very evidence-based, protocol-driven medical world now, which certainly has its advantages, but I think we're losing a little bit of that art of medicine, which is sort of indefinable really. And I think that, that, that's what I really loved. I think I love putting those skills that weren't necessarily quantifiable into those everyday consultations.
John Milham (Host) · 08:49
The acuity that you display to diagnose people, you know, being brought to the framing of people in your books, right? So, you know, almost their aspects, their ability to be sort of appealing is their humanness in your world.
Joanna Nell (Guest) · 09:08
Yeah. And I think that being a doctor, we're naturally attuned to stories. We're hearing stories every day. And I want to say at this stage, you know, I have to reassure any anyone who has been one of my patients that you're not in a book, because no, oh yeah, there is such a thing as the Hippocratic Oath, and everything that I have heard in, in confidence stays there. But I felt that I take away the emotion and the essence of each of those consultations and seeing the whole person as well. And as a writer, it's very important to understand the backstory, and this is so true of a doctor understanding a patient. It's sort of why this complaint, why this illness, why now, you know, what has led, what has happened in their childhood, what wounds do they have, you know, what has affected their physical health, their mental health, you know, how they're seeking help. And this is where I found my— I did a stint in psychiatry in one of those wonderful old Victorian establishments, which was really quite revealing. And I really enjoyed that time as a young psychiatrist because we would formulate, you know, formulation around a patient. And it was, you know, the P's, what are the What are the predisposing factors? What are the precipitating factors? And, you know, what are the perpetuating— what things are just continuing for this person to behave in this way or continue? So, yeah, and I think it's taking all of that into account and naturally that extends to creating those characters because it's, you know, using all of the senses and examining somebody, observing and listening and putting those into characters as well.
John Milham (Host) · 10:44
You know, what is psychiatry but the marriage between sort of assumption and intuition, isn't it?
Joanna Nell (Guest) · 10:50
Yeah, it is. It was fascinating and sort of slightly terrifying as well. But I, I think that that really did help me grow as both a doctor and a, and a writer. And this is no coincidence really that so many writers, famous writers actually started off as doctors as well. You know, like Anton— and I'm not putting myself in the same bracket.
John Milham (Host) · 11:10
Wow. Yeah. You, yeah. You and Chekhov. No worries.
Joanna Nell (Guest) · 11:13
I'm big, big noting myself here. No, not. Anton Chekhov, Somerset Maugham. Wow. Arthur Conan Doyle. You know, all of these people have started off as doctors and transferred those skills into their writing.
John Milham (Host) · 11:26
Into narrative, right? Yeah. First of all, you were practicing in the UK and then came to Australia. Is there a difference culturally, you know, that manifests in like being a patient?
Joanna Nell (Guest) · 11:38
Well, I think anyone who has been a patient in the NHS and particularly the NHS of recently, the UK will understand that, you know, accessing healthcare is difficult. I trained in the '90s to become a village GP, and that's what I was. I had a practice, a partnership down in the New Forest before we moved to Australia in 2003. And that was the job that I trained myself really to do, and I loved it. And we moved to Australia supposedly for a year. My husband was seconded down here with his job, and it was absolutely wonderful. But the culture shock of moving to a health service that wasn't free at the point of delivery.
John Milham (Host) · 12:22
Yeah.
Joanna Nell (Guest) · 12:23
But that was run by Medicare was a very different model. The idea of charging people for healthcare was an anathema to me. I did take a long time to adjust to that, but I felt that the standard of healthcare here was very impressive and I don't know what's happening with the NHS, but I just wish that we could apply some of the aspects of Australian healthcare. We're extremely fortunate here. We do pay for it, but it is world class.
John Milham (Host) · 12:52
Like every system, there's no perfect one, or at least no, no system operates perfectly. But, you know, we sometimes forget to be grateful for amazing things. I personally was just involved in a period and I sat back, had a chance to watch it over a few days from my hospital bed, being incredibly happy about the people involved in the system. Do you think people are called into health? Like, is it a— is it something that some people like— the nurses put up with an amazing amount of, of, you know, kind of challenge and trauma. You know, are you called to do that regardless of the cost?
Joanna Nell (Guest) · 13:34
Oh, you have to be. You have to be. Certainly, you know, nurses and, you know, the vast majority of doctors are not in it for the money. You know, they could take their skills and make a lot more money somewhere else. And I think that the reason that healthcare works as well as it does, really on the scent of an oily rag, is thrives on the goodwill of the people who work in it, who see it as their vocation, who give above and beyond in terms of their hours and their emotional involvement. So I think, you know, if goodwill were to be withdrawn, the whole thing would collapse instantly. But yes, you, I think you have to be called and, you know, by the same token, there are some people for whom it, it's not, it's not the right environment.
John Milham (Host) · 14:24
Yeah. There's always people who get caught up in the momentum. I always think when I'm going there that I should be like bringing fruit, right? Because it's like that sense of you are doing this and not getting paid enough. Maybe I should sort of be offering the, you know, like a basket or something.
Joanna Nell (Guest) · 14:40
I think they prefer chocolates really. But I think all that anybody asks is an environment where they are allowed to do their job, that they're supported to do their job, that they're treated with respect, and that occasionally somebody says thank you for what you do. And that's all it needs.
John Milham (Host) · 14:57
Beautiful.
Joanna Nell (Guest) · 14:58
Just gratitude.
John Milham (Host) · 14:59
And a good reminder too of how we can support people. Just, you know, occasionally the affirmation and admiration being passed on is enough.
Joanna Nell (Guest) · 15:09
I think in general we don't tell people enough, you're doing a great job. You did a really great thing there. I mean, it is extraordinary what that can do for one person's, you know, who may be having a bad day, who may be struggling and may be thinking of quitting. And one person said, you know, you, you've changed my life, or, you know, thank you for what you do. You can't put a price on that.
John Milham (Host) · 15:30
Yeah, that's great. Going from that purpose-driven sort of, you know, reminder, you know, obviously it can be a bit of a, you know, a stressful environment, but it's also, you know, there's that level of gravitas that's attached to your activity in the health world. Did you find a purpose-driven motivation in writing, or was, was that a different experience?
Joanna Nell (Guest) · 15:53
Look, I think that's an ongoing process, and I think I've been confused about that for for a while. And I was listening to a video by Elizabeth Gilbert recently, of Big Magic fame, and she was talking about the difference between a hobby, which is something you do just for fun. There's no stakes with that. Nobody recognizes it. You know, you just do it. A job, which is something you just need to do for money. We all need to pay bills. It's not necessarily enjoyable. A career, which is something, a job you do, which you love and, you know, you're willing to make sacrifices for. And a vocation, which is a you know, some sort of profound calling and you cannot not do it. It is your life's passion. And I think that my relationship with my medical job and my writing has changed. It's gone through a transformation. It started off as merely a hobby, which I did, you know, purely for my own pleasure. It's actually quite therapeutic, really, for me. It's something I did to de-stress after work and sort of pour my feelings into my writing. And especially as someone who was kind of talked over as a kid and, you know, I wasn't really— I didn't really use my voice as a child. It's sort of having a, you know, something that nobody can take away, the words that you write down on the page. It was great. And yes, medicine was my career and, and it was my vocation. But then, you know, writing took on a little bit more, became a bit more of a job and then a career when I was published. And so the, the sort of relationship between all of those has— is ongoing because now I've been lucky, I think, to have had two vocations. But at the moment, writing is my vocation, and I think it always has been, but it's just been pushed into the background and just kept as a hobby for a long time. It is now my career as well. It's, you know, it's my job too, which sometimes makes a difference when you're doing something purely for your own enjoyment on your own terms to dealing with deadlines and reviews and publishers and publicity and all that sort of thing. It can change the relationship with it. So I think I'm still working my way through that. And the one thing that hasn't changed is that I have suffered from lifelong imposter syndrome. You know, for 35 years I felt a complete imposter as a doctor, even though I knew I was doing everything, you know, I was doing a good job and people told me I was doing a good job. I always felt like, you know, any minute now the alarm bells would go off and they'd sort of pull me out in handcuffs and say, what are you doing here? You don't know what you're doing. And it took me sort of 35 years to get over that. And I had just about by the time imposter syndrome as a writer came along and thinking, what am I doing here? What do I know about writing? So it's—
John Milham (Host) · 18:46
You went and recreated the challenge just to make second half of life interesting.
Joanna Nell (Guest) · 18:51
Well, maybe it just, it's part of sort of perfectionism, I think, isn't it? Perhaps is to constantly look at yourself and think, am I doing a good job or not?
John Milham (Host) · 19:00
Well, you mentioned right there perhaps that psychologist popped up just briefly because you mentioned diagnosable, right? Which, you know, took me to the thoughts of neurodivergence. It's interesting, you describe those kind of symptoms like as an earl, as a child looking in, you were kind of an outsider trying to find your space, intellectually knowing what you're looking at, but socially or emotionally unable to sort of find the slot. And then And, you know, imposter syndrome is one of those things that constantly pops up for the neurodiverse and rejection sensitivity and so on. So, you know, interesting choice then to go into a public career vocation job that says, please look at this that I've done and assess it and then tell me loudly exactly what you think of it. That's, uh, must be very challenging.
Joanna Nell (Guest) · 19:54
It is really challenging, John, and I think, yes, look, probably I would have been given a diagnosis as a child, and I think that the reason I— my interest in other people was that I think there's something called hyper-empathy.
John Milham (Host) · 20:08
Yeah, yeah, yeah, yeah.
Joanna Nell (Guest) · 20:09
Neurodivergent people can have. Anyway, look, the biggest challenge for me, you know, I came out and proud as an introvert after reading Susan Cain's book. I don't know if you've read it.
John Milham (Host) · 20:18
Yeah, yeah, I have.
Joanna Nell (Guest) · 20:19
The Introvert in a World That Won't Stop Talking. And I thought, yay, this is my superpower, you know, is be an introvert. But standing up— part of the writing process and publishing process, publishing a book, that nobody tells you is that suddenly you go from being on your own with your thoughts, you know, putting them on paper, to having to stand up in front of crowds of people and bare your soul. And, you know, in my case, I've been very fortunate that my books have attracted media attention, so I found myself on national radio and television and It honestly felt like I was standing there kind of on the top of a speeding train, you know, naked. And, you know, like, this is— I was hurtling towards this, and I almost gave back my advance and thought, I can't do this, I cannot do this. And it was only working with a psychologist who specialized in helping people overcome their fear of public speaking that helped me to go through with it. And it wasn't necessarily a nuts and bolts public speaking, this is how 'You speak into a microphone, this is where you look,' or whatever. She was looking at everybody's individual psychology of why are you not this person who can stand up? What is in your past? What is that childhood wound, that belief, that false belief that you've carried with you all your life that means that you don't think anybody wants to hear what you have to say, or that you're not worthy of standing up here and speaking to other people? So that was really a very valuable part of that process that allowed me. And of course, you know, once you get started and you get practiced in something, it becomes so much easier. And now, of course, you know, several books on, several years on, I'm, you know, I am much more comfortable with that. It's one of the things about publishing a book that people don't tell you, that there are ups and there are downs. There are huge highs and there are actually really low lows that, you know, you can't voice because it sounds like ingratitude.
John Milham (Host) · 22:22
But one of those, getting over that Well, that's something I've always wondered, because people own you once you hand them the product of your mind and creativity, the art. They feel like they've taken possession of it themselves, and then that gives them a pro— the right to comment, and they can comment positively or negatively. I've always been interested. It's kind of like the author is not meant to be upset about being called all sorts of, you know, you know, negative things, right? So do you feel like you can't respond, like saying, get stuffed, that's not, not, you know, like, that's not fair, or that's not nice, or—
Joanna Nell (Guest) · 23:07
Oh, look, I often say I think you need a thin skin to write a book and a thick skin to publish it.
John Milham (Host) · 23:12
Publish it. Yeah.
Joanna Nell (Guest) · 23:13
Wow. Yeah, that's good. Yes, you do. I mean, essentially you're handing over a product. I am very happy for the editing process. I find that very collaborative, very constructive. So I don't mind on an editorial level suggestions and comments. Sometimes if there is a sort of a slightly negative editorial feedback, it usually arrives at 5 o'clock on a Friday evening by email when, you know, you have the whole weekend to sort of simmer down.
John Milham (Host) · 23:42
Yeah, yeah, yeah, yeah.
Joanna Nell (Guest) · 23:42
And deal with those feelings. But they're usually right. And I think that you just have to get over the sensitivity and yeah, realize that it is a business after all. It's a— publishing is a business. And I stay away from reviews if I'm going to believe the bad reviews. I can't pay any attention to the good reviews, which is a shame. Sometimes, you know, my husband does filter out on Goodreads the good ones, but it's amazing, you know, it's human nature. You can look at 10 reviews and 9 of them are 5-star, absolutely glowing, and then one, you know, is less than flattering. And I know writers that have sort of given up their careers over something like that. And oh, absolutely, you know, it— we're so sensitive to that, but that's what makes you creative people are, I think.
John Milham (Host) · 24:33
In some ways, you know, like say with people who have been diagnosed with ADHD and rejection sensitivity, you know, dysphoria, that idea of that one review, right, can actually dominate someone's life, right? You know, that they can ruminate and can have an incredible impact on your ability to do something that you're good at again. In, right? So yeah, the power of words, I guess, you know, like that's what, that's your craft now.
Joanna Nell (Guest) · 25:01
And you know, not every book is for every reader, you know, you can't, and there's never been a book that's had, you know, glowing reviews from everybody, as many books as there are people. So I try not to think too much or dwell on that too much.
John Milham (Host) · 25:16
Extraordinary number of books and I wish I'd read a lot more of them. One thing going to your books, right? I always felt Peggy Smart was the, was the beginning, like the character that must have driven you to create.
Joanna Nell (Guest) · 25:32
Yes, dear Peggy. So she was the protagonist in my first novel, The Single Ladies of Jacaranda Retirement Village, and she's, she's my everywoman in a way. I think I was writing that while I was working in aged care and doing a lot of my work in retirement villages, and she, in a way, she's not not based on anyone, any one patient or person I knew, obviously. She's 79 turning 80, moving into retirement village where she bumps into an old school friend, Angie Valentine, who has lived a very different life. And Peggy's forced to sort of review her choices in life, to be a mother and a daughter and a wife, and to have lived a very quiet life where Angie has been this jet-setting fashionista with a very different attitude. Yeah, yeah, aging. So I put everything into her. I mean, she has all the, the ailments that have a bit of imposter syndrome, limitations that every 79-year-old woman has. But I wanted to see her blossom, as like I wanted to see so many of my patients sort of overcome their internalized ageism and sort of get out there and do what they were still able to do, rather than being, you know, told by society or their grown-up children that they shouldn't be doing this or they should be doing that. So yeah, she, she was the one who started it.
John Milham (Host) · 26:56
Yeah, I say that because I had a sense that I'd met Peggy, right, in conversation or in characters that you commented on in book club, right? And I've— that fascinated me because you spoke about the medical role you had in the aged care, and you were so caring for them. It was just a way of like solving— like you mentioned it, you're solving some of the problems when you couldn't do physically, right? And you needed to emotionally.
Joanna Nell (Guest) · 27:26
Well, yes, look, that is a really insightful comment, John, because I think that's really one of the motivations for writing is that I can rewrite the narrative. I can affect what happens to my patients. Sometimes it doesn't always feel like it. It feels like they just run off and do their own thing and I think, oh, okay, you're doing that, are you?
John Milham (Host) · 27:46
Okay. They have their own sort of—
Joanna Nell (Guest) · 27:49
Yeah. Yeah, so much as I try and control them. But I think in a way, yes, subconsciously it is. It's a way of rewriting the narrative, controlling, you know, what, what happens to people where, you know, we can't cure aging, you know. And I think that it was my way of just injecting a little bit of life and hope and optimism into that process through my characters. I noticed a definite divide in how people were aging, and I saw or some who did it with gusto, you know, very positively. They were sometimes a bit of a nightmare to their families and to everyone else because they were very driven to manage their own independence, to keep their own agency, you know, even when it caused some problems, you know, with mobility and, and that kind of thing. And others who seemed very resigned to it, very depressed with it. And of course, you know, when Old people moan and complain to their families. Families don't want to visit them, you know, they just complain about ailments. And we can't reverse the clock, but what we can do is look at what we can still do. Yeah, do the best we can with that. And I'll just go into a bit of a science as well. One of the interesting things about attitudes to aging is those that who think more positively about aging, hold those more positive stereotypes about old age, are likely to live longer. And this has been known in studies from Harvard, the Mayo Clinic. Yeah, yeah, it's been repeated. So thinking positively and optimistically can actually help you to live longer. And even people who have the gene for dementia, which is a very small number of people with dementia, those who are optimistic and think positively about their future with dementia are half as likely to develop dementia as those who worry about it. So how we think about aging really does affect how we age. And I think that's another reason for wanting to sort of tell positive stories, you know, lighter, more humorous stories, is to take away some of that fear and dispel some of those myths around aging.
John Milham (Host) · 30:03
That's so important what you just said, because it's accessible. We can, like, people say, what can I do about aging? Well, you can smile more, right? Or you can, absolutely, you can accept more. More, right? And that actually gives you a tangible benefit.
Joanna Nell (Guest) · 30:18
There's, um, another study— well, you know, of course I do have that science background— but there's a study that showed the quality of somebody's relationships at the age of 50 were more predictive of their health at 80 than their cholesterol levels were. Wow. Wow. So it's all to do with relationships, community, And socialization, that is a huge thing. You know, yes, there's no smoking, you know, exercise, alcohol, all those other things, but it is relationships and connection, community.
John Milham (Host) · 30:56
Yeah.
Joanna Nell (Guest) · 30:57
And, and purpose.
John Milham (Host) · 30:58
Yeah. Well, the study just out, I think the WHO, you know, published it, that I've heard quote a lot because it's so pithy, right? That loneliness is equal to smoking 8 or 15 cigarettes a day, right? So, you know, that, like, you— we talk about sort of that physical healthiness, right? But if you're, you know, sit at home alone, you know, sort of being depressed, you undo all that behavior anyway.
Joanna Nell (Guest) · 31:26
Oh, it is. It's— and when we talk about an epidemic of loneliness, in fact, I think there's a Minister for Loneliness in the UK. And yeah, it does set up a stress response in the body, and that can lead to heart disease, diabetes, all those sort of metabolic things. And of course, loneliness is, you know, could be an inevitable part of old age. We lose friends and, you know, our partners and things, but that doesn't necessarily mean we have to be lonely. And the new book I've just written— sorry, I'm gonna—
John Milham (Host) · 31:57
no, no, no, the Funeral Crashers.
Joanna Nell (Guest) · 32:00
Well, it's called that, and it's not really about, you know, death and funerals.
John Milham (Host) · 32:05
I love how you borrowed from Four Weddings and a Funeral for the tagline. That's beautiful.
Joanna Nell (Guest) · 32:10
But it was really based on my my father-in-law's experience. He spent the last 15 years of his life as a widower, and he was a very gregarious man. He loved people, he loved intelligent conversation, and, you know, and he found that the number of people who, you know, he had to talk to were dwindling.
John Milham (Host) · 32:27
Yeah.
Joanna Nell (Guest) · 32:27
The exception being at funerals, where he loved going to funerals. He said you'd always get a good feed. He was a Yorkshireman. Yeah, good, good feed and a good cup of tea and a good chat. And so in fact, I think once I'd sort of started thinking about that, there's a whole scene of people who look for any sort of social event. And of course the one that is popping into their, uh, you know, in their mailbox or their feed, you know, with increasing frequency is—
John Milham (Host) · 32:53
That's right. It's not like you're invited to weddings very often, are you?
Joanna Nell (Guest) · 32:57
Yeah. And so it's about, you know, two lonely people who meet at a funeral.
John Milham (Host) · 33:01
And it's interesting because I, I was thinking when connection becomes even more significant from a a holistic medical point of view, when being around people and maintaining relationships has that immediate physical response in ageing Australians, we tend to lock everyone up in a sort of, as Dame Edna said, the maximum security retirement village and move them away from that multigenerational capacity. So where did that come from? Why did we suddenly see them as kind of as inmates rather than elders?
Joanna Nell (Guest) · 33:44
Yeah, look, that's been happening for a couple of centuries now. That hasn't happened overnight, that sort of outsourcing of ageing. I think there used to be institutions for— they were all living in the— ending up in the poorhouse. And so the model of aged care has changed. We tend to see it as this siloing, this sort of warehousing of old age. On the other hand, I will say that I've seen people who have been very lonely and struggling on their own in the community who have moved into aged care, into nursing homes or retirement village and have literally flourished.
John Milham (Host) · 34:18
Yeah, yeah.
Joanna Nell (Guest) · 34:18
Through company, you know, maybe eating well. So, you know, it can work. But I think you made that important point where, you know, we are looking at a loss of that connection with other generations. And, you know, we all saw that wonderful TV show, the— was it the, um, Toddlers' People's Home for 4-year-olds? Yeah, yeah, yeah, yeah.
John Milham (Host) · 34:40
Beautiful.
Joanna Nell (Guest) · 34:41
And, you know, that was a social experiment, but gosh, what a powerful one. We saw the transformation in there. So I think the model that we'd all like to see eventually would be some kind of multi-generational living. You know, there are people who live with families when they're, they're older. But I think, you know, with both parents working and children being so busy now, it's very difficult. There's a lot— increasing number of people waiting for home care packages because ideally people want to age in their own homes. But it's something that I think we need to address now. And the, the Royal Commission has been out for, you know, a couple of years now. I think we're not moving fast enough to make those changes. And it's up to us, John. It's up to our generation to say if we don't like the look of what's ahead of us, then we need to change it now. We need to vote with our feet and to think of more innovative ways of dealing with old age.
John Milham (Host) · 35:35
Yeah, we can't solve this problem using the same model that, you know, got us into trouble. When you were caring for older Australians in that context, why would they enjoy life, right? What, you know, because we tend to think as looking in from outside or family members locking our troubled elders away, we tend to have negative connotations. What's the positive about, you know, that you encountered, that you saw as you cared and helped them?
Joanna Nell (Guest) · 36:04
Well, that's partly why I began writing stories about with older characters, because I was, you know, I was seeing these great stories. I was seeing one retirement village I worked at, you know, I would see them doing fashion shows and they would made love in their 90s and hundreds, and it was just glorious. And there was a lovely old chap who was an old veteran, Second World War veteran, and his way of, you know, maintaining his independence, if you like, or doing what he loved, was to get dressed up in his suit with his blazer, put his medals on.
John Milham (Host) · 36:42
Oh wow.
Joanna Nell (Guest) · 36:42
Get on the bus, and he'd walk into the middle of the city in Sydney. He'd walk around Hyde park and visit the sites, and people came up to him to talk to him. Wow. And that was his way of, you know, you know, seeing— he loved being out there. He didn't like being locked up, but it gave him a sense of freedom. So look, there are challenges, and I'm not— I never try and sugarcoat it, but those who aged with a little bit of, yeah, wry humor, you know, were able to see the humorous side of things, find the sort of accidental— life's accidental comedy, they were the ones who seemed to get the most out of it. So I think it comes back to that attitude. I'm not saying that everybody can physically do things, but I think a lot was to do with, this is what I can still do, I'm not going to dwell on what I can no longer do.
John Milham (Host) · 37:36
Yeah, it's such an interesting point you make there because it's a sense of is that there's a point in our lives where we learn, you know, either through reflection or through the evidence of our experience in life, you know, aging is what you decide to make of it, right? That you— like that comparison point between when you were young and then when you measure the loss of your capacity from like 25 or 28 when, you know, we were, you know, bulletproof and conquering the world. And then there's a point where you say, well, that's not the right person to compare myself against. It's, you know, I need to compare myself against who I am now or who I want to be for the next, you know, period of ageing. Is that part of something doctors or, you know, people, you know, support people or nurses in aged care can offer, right? That kind of support, like, let's review ageing.
Joanna Nell (Guest) · 38:30
Oh, I'd love to think so. And I try to do that one patient at a time. And I must admit I ran up against brick walls. I, I had endless frustration, not with the individuals but with the, the system and the facilities and just society's general ageism. I found very, very difficult. But I think that we have to take individual responsibility for aging too, and aging is not something we suddenly think of when we get to the 65 It should be something with— and this is where this multi-generational thing is. We, you know, because we don't see aging, we fear it, and we think, you know, old age, that makes us think about our own mortality, doesn't it? We don't want to think about that. So we don't—
John Milham (Host) · 39:16
that last 25 years always creeps up on us, doesn't it?
Joanna Nell (Guest) · 39:19
But I think, you know, that I can look at somebody at 40 and tell how they're going to be at 80. Not all the time, but, you know, it's to do with you know, how much that person will prioritize their, their health and, and well-being, their stress levels, you know, and, and setting themselves up with all the right lifestyle habits. I mean, everybody's very much into resistance training and weight training and everything at the moment.
John Milham (Host) · 39:46
And ice baths.
Joanna Nell (Guest) · 39:48
I'm not so sure about the ice bath. I've seen the evidence for that. I think the weights are a good idea, but the ice bath, I'm yet to be convinced. I certainly won't be adopting. No, no, it's not something that's, you know, we are aging from the time we're born, you know, from the, from the time our, you know, little bodies come out, they are turning over cells. Cells are reproducing, but each time they do, they don't do so accurately. And so it happens at a chromosome level, at a DNA level. But we can— our lifestyle and our health habits influence that from a very early age as to how quickly We age. And so I'm not suggesting radical diets or all the woo-woo sort of stuff that costs a lot of money. In fact, pretty much all the positive aging tips I can recommend cost nothing at all.
John Milham (Host) · 40:41
Oh, wow. There is a nonfiction book in you, I think, at that point.
Joanna Nell (Guest) · 40:47
But imposter syndrome, John. I'm not qualified to do that.
John Milham (Host) · 40:51
Well, I'll be the get a fire and say, you really have to, Jo. It's been such great advice and insight. Your books are of a theme, are also really funny. And this is apropos of nothing, but are you funny, Jo?
Joanna Nell (Guest) · 41:08
I think I'm a lot less funny in real life than I am on the page. It takes me about 4 drafts to be funny, John. So I love to laugh. I grew up with all those. My father loved comedy, you know, all the British sitcoms.
John Milham (Host) · 41:22
Yeah, yeah. All the The comedians of the '70s.
Joanna Nell (Guest) · 41:25
And my husband is probably the funniest person I know. I just love to laugh. And I think that when I became a doctor, I very much found that there was a culture of the sort of guillotine— sorry, gallows humor.
John Milham (Host) · 41:40
Yeah, yeah, yeah.
Joanna Nell (Guest) · 41:41
A dark humor, which is not necessarily cruel, but it's maybe feel inappropriate to those who are outside that. And I know that, you know, there are a lot of emergency services and other personnel who have their own portion of that. And it's a survival. You cannot go through life taking everything seriously because it, you know, it's a recipe for burnout. So I have always looked for the humor, the comedy, and I've used it in medicine as well. You know that sometimes in a very dark situation, a sort of humor sort of bubbles up and it's an instant relief. It releases endorphins and serotonin and all those really good feelings chemicals. So it's almost like a prescription. I can— I try not to, you know, go for the 1-2-3, you know, stand-up comedian joke thing, but I try and bring out the humor to give light and shade in the writing. So I don't, you know, I do tackle some pretty dark issues and I don't shy away from all those things. I've just written a book about funerals, but, you know, I could only do that Yeah. If it had humor and, you know, I think we all recognize that life is full of comedy.
John Milham (Host) · 42:57
On YouTube, there's a standup comedian. He must be 85 and he's super cool. And he, I just, a joke the other day, he just said, I, I, you know, he said, I've discovered Facebook and I was doing one of those surveys about, you know, finding out your spirit animal. And he said, mine, mine came back as extinct.
Joanna Nell (Guest) · 43:18
Can I steal that and put that in a book?
John Milham (Host) · 43:20
I'll tell you his name. He's very good. But it's interesting because you talk about that gallows humor, and I find some of the challenge watching it as I become older and actually become a better person, you know, gratitude drives me, and I find that replaces the need. So I see in, in the medical profession so often that professional detachment detachment as a way of managing the vicariousness of their, you know, interaction with people who are suffering or, you know, trauma. I get it. But is there a better way? You know, like, I feel like gratitude and connection and sort of leaning into the humanness of people will get you appreciation back rather than just trauma back. Is that naive me.
Joanna Nell (Guest) · 44:11
No, no, it isn't. They say— I can't remember who it was who said it— described the sliver of ice in the heart. And I think, you know, both doctors and writers to a degree need that as a sort of protective thing. And I think that that's what— something I wasn't very good at doing. And that was ultimately the, the burnout in your life, cause of my demise, was that I— my sliver of ice melted over the years, and I I, I took on too much. I didn't protect myself. I didn't set up boundaries very well. I got very involved in my patients' lives and problems, and that led to my ultimate burnout. So I think there must be a balance somewhere. I think there are a lot of healthcare professionals who are on the verge of burnout. Yeah, yeah. And in fact, this Dr. Hilton Koppi, whose book One Curious Doctor has just published— I heard him speaking on Conversations with Richard Feidler, and I've been in chat with him. He actually was diagnosed with PTSD through his work as a doctor. It was not necessarily one act, but an accumulation of trauma over his career. And he sort of written a book about that. And he now runs writing retreats for doctors. And I think that that's where writing actually is a really powerful— I call it decongestant. That's not the right word, is it?
John Milham (Host) · 45:39
But, you know, like, um, yeah, you know, like the medical term, but yeah, it's sort of a de-escalator, isn't it?
Joanna Nell (Guest) · 45:46
It absolutely is. So I think that we need to look after each other better, you know, and we all recognize when somebody is heading towards burnout, which is why it's important, I think, for— it's easy when someone appears brusque and short and to then be that in reverse. And so I think that's where we all need to be kinder, you know, on both sides of that. And both more understanding. Wow.
John Milham (Host) · 46:10
Yeah, absolutely. And of course, Kintsugi Heroes is built on exactly on that premise, right? That the stories that people share have the power to lift as well as release, right? So there's personal release and there's a community lift or inspiration or, you know, acknowledgement, normalization, right? Which are all good things, I think, for, for wellbeing. Incredible thoughts there. Just on your books, because they are kind of related by by the character, the stage of life, the sort of cuteness of their imperfections, right? Like, the main characters are often kind of, you know, having a thing, but they're not horrible things, you know? Like, they're life and they're true to life, but they're not— they don't turn them into sort of, you know, narcissists and all that stuff, right? So is that the place you like to be, and is that the world you're creating and where we're gonna join you and enjoy so much. Is that where we are?
Joanna Nell (Guest) · 47:10
I'd like to think so. I have a dark side like everyone. I remember the book that we met at book club. I think my choice was The Road. Was it The Road?
John Milham (Host) · 47:18
Yeah, The Road.
Joanna Nell (Guest) · 47:18
Cormac McCarthy. That's right. I mean, talk about dark, you know, post-apocalyptic.
John Milham (Host) · 47:22
I remember that discussion. It was quite, quite vigorous.
Joanna Nell (Guest) · 47:27
Yeah, it was. So I've moved on from that. And when I first started writing, I, I wrote the kind of stuff that I thought you're supposed to write, which is angsty and dark and a bit literary and, you know, lots of—
John Milham (Host) · 47:40
a tribute to our intelligence.
Joanna Nell (Guest) · 47:43
And I just found that that wasn't my authentic writing voice, which is a little bit more whimsical.
John Milham (Host) · 47:51
It's playful.
Joanna Nell (Guest) · 47:52
And that's how I like to travel through life. You know, it's not going to shield me from awful things that happen. But I think you can't change those things. What you can do is try and, you know, skip along with it rather than let it drag you down. And that has just gone into the stories I write. Apparently I write uplit. This is the genre I write in, which is taking somebody— and it's not necessarily a nice comfortable arc, you know, it's taking somebody with all the problems of the world and and taking them through and giving them a sense of community and bringing a more positive— it's not always a happy ever after, but it's a sort of a more hopeful ending. And I feel that that's where a nice place that I'd like to stay in life.
John Milham (Host) · 48:43
I really love the— it's demystified and kind of made it more accessible to me, right? The nature of like an old age home and, you know, like I'm kind of now planning the kind of the invasion I make on one now, right, at some point, right?
Joanna Nell (Guest) · 49:01
And you escape.
John Milham (Host) · 49:02
Yeah, I think that's just a wonderful aspect of it, though, because in that realness, like, in the identifiability that you've created, right, you've also invited us into that space of aging. And I think one thing that older people feel, from my own experience and conversations, is a sense that we've been uninvited from life, right? That we're not seen, we're not heard, we're not valued. And we have so much to give and so much to share and so much stuff that we're finally working out. And then we don't have an outlet to do it.
Joanna Nell (Guest) · 49:37
Yeah, that is sort of invisibility, isn't it? Yeah. It creeps up on you, doesn't it? You know, and there's some aspects of invisibility that are quite good. You can nip down to IGA in your Ugg boots and no one's going to notice. But no, I think to be overlooked and to be, you know, devalued and dismissed just because of your age, when in fact we should be holding up elders. You know, this is the thing about, you know, our Acknowledgement of Country, which I think is absolutely fantastic and the right thing, but I wish that we would also acknowledge all elders. Yeah, you know, you, you have something so valuable to contribute. So it's really me shining a light into that dark corner. And the wonderful thing about literature is it's been shown to increase empathy in reader. So, you know, gosh, if we could all read a little bit more. But it's giving somebody the opportunity to actually see the world of that person through their eyes, walk in their shoes. And which is why in my second book, The Last Voyage of Mrs. Henry Parker, that book— it's no spoiler, but that book is written from the point of view of a woman who's living with dementia. So she has memory loss, and she's trying to solve the puzzle of where her husband is. And we only see it through her eyes, which, you know, it can be frustrating at times, but she runs rings around people, and she still has that sort of agency. So, you know, I don't want to think that the stories are all completely light and fluffy, but I think it's a way of making the issues more palatable, making life more palatable, and entertaining myself, and hopefully entertaining the reader too.
John Milham (Host) · 51:16
No doubt about that. And I think that's so important because, you know, while they might be difficult, you know, premises, right? We're still human. We still have to live with that. So, you know, it's real life, right? So it's so good, even though if it's uplifting, it's still real life. So, and Jo, you are far too young to be considered, you know, to answer this question. So just try to—
Joanna Nell (Guest) · 51:37
I think we're the same age, John.
John Milham (Host) · 51:40
Just try to— which means for me you're way too young. So, you know, taking that hypothetical, right, how do you feel you will age?
Joanna Nell (Guest) · 51:49
Hmm. Isn't that an interesting question? How I'd like to think. Look, I have good genes to an extent. You know, my grandparents have all lived to their 90s. My father's about to turn 90, and although he's losing his sight, is doing quite well. So I suppose I'm exploring this through, through the writing. I, you know, there's an adage, uh, write write what you know. I don't. I write what I don't know. I'm exploring what my own future looks like. I can set myself up and try and do the right things. I'm lifting a few weights now and trying to look after myself and in fact prioritize my own health.
John Milham (Host) · 52:30
Yeah, yeah.
Joanna Nell (Guest) · 52:32
Which is a really interesting concept. But I hope that I can stay positive and connected and You know, none of us can, you know, there's a lot that we can't prevent in terms of health and ageing, but I just hope that I am that woman who tries to escape from her nursing home or, you know, creating mischief as long as I possibly can, John.
John Milham (Host) · 53:01
Yeah, I love that. And what a way to finish up, Jo. Fantastic. Thank you for sharing so much. And for giving us so much insight into the process that I'm so blown away by what you've created and how you support it and the industry of it. So well done. And like, not that you need my congratulations, but I really look forward to what comes out in the future and, you know, something that I can then use to grow old disgracefully.
Joanna Nell (Guest) · 53:28
So, well, thank you, John. It's been a really interesting discussion. So thank Thank you very much for inviting me.
John Milham (Host) · 53:35
So thank you on behalf of Kintsugi Heroes. Thank you very much, Jo Nell. Thank you for listening to this episode of Kintsugi Heroes. Thank you to Colin Lilly for permission to use Broken as our theme music for this series. If you enjoyed this conversation, share the podcast with a friend and let us know by leaving a rating and review on Apple Podcasts, Spotify, or wherever you get your podcasts. If you'd like to support Kintsugi Heroes and the stories we share, head to kintsugiheroes.com.au and follow the instructions to make a tax-deductible donation. Thank you for listening, and we'll see you next time.
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