Eric Tian

In 1958, a 20-year-old Hunter S. Thompson was asked by a friend about advice on life. His response, captured in a letter, is worth reading in its entirety, but here is one memorable section:

“Let’s assume that you think you have a choice of eight paths to follow (all pre-defined paths, of course). And let’s assume that you can’t see any real purpose in any of the eight. THEN— and here is the essence of all I’ve said— you MUST FIND A NINTH PATH.

Naturally, it isn’t as easy as it sounds. You’ve lived a relatively narrow life, a vertical rather than a horizontal existence. So it isn’t any too difficult to understand why you seem to feel the way you do. But a man who procrastinates in his CHOOSING will inevitably have his choice made for him by circumstance…

I’m not trying to send you out “on the road” in search of Valhalla, but merely pointing out that it is not necessary to accept the choices handed down to you by life as you know it. There is more to it than that— no one HAS to do something he doesn’t want to do for the rest of his life. But then again, if that’s what you wind up doing, by all means convince yourself that you HAD to do it. You’ll have lots of company.”

George Mack recently suggested that there is no such thing as being working too hard; there is just being under rested. Here is a short excerpt from the post:

“1. Winston Churchill used to work 16 hours per day in his old age during the war — but he also worked in bed every day until 11am. He had a nap after lunch, and a 2 hour nap before dinner at 8pm before working late into the night.

2. John. D Rockefeller took a 30 minute nap everyday at 12pm. No meeting was important enough to move this out of his calendar.

3. Advice I’d give my younger self: Don’t focus on energy output (working too hard). Focus on energy production (recharging activities). If you produce more energy than you burn, it’s impossible to burn out.

4. The person that is well rested might be able to work 16 hour days 6 days per week. The person who never works but scrolls TikTok all day can struggle to do 30 minutes without burning out.

5. Josh Waitzkin has this concept called the “Simmering Six”:

“Most people in high-stress, decision-making industries are always operating at this kind of simmering six, as opposed to the undulation between just deep relaxation and being at a 10. Being at a 10 is millions of times better than being at a 6. It’s just in a different universe.””

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I do not completely agree with this idea – I think a job devoid of meaning, recognition, or support can be debilitating regardless of rest – but it illustrates an important point: that we should include rest in any discussion of being overworked or burnout.

I have developed multiple running injuries over my life, and all of them were due to inadequate recovery. I was not running significantly more or harder than others, but I failed to prioritise areas such as nutrition, sleep, and mobility alongside the ‘work’. Yet when I presented to my physiotherapist, his immediate response was, “You were running too much.” I think we missed the broader picture.

The Chinese described this cycle of rest and work as Yin and Yang centuries ago and it still remains relevant today. If we feel overworked, we may simply be under rested. Perhaps better recovery, not less work, is the key.

A few years ago, a psychiatrist I was following said something along the lines of:

“Loneliness is the biggest risk factor for physical and mental health that we do not talk about. In medicine, we focus too much on the disease, like blood sugar levels, renal function, or CT scans, and ignore the person’s connection to others.

It is the greatest silent epidemic that medicine is doing nothing for.”

At the time, I found this statement hyperbolic. There are clear clinical benefits for investigating blood markers and imaging – these help prevent and treat a staggering amount of illnesses. In medical school, our exams revolve around being able to interpret and correlate these findings, which are often backed by strong clinical evidence. To say that loneliness was on par with this was, well… surely an exaggeration.

But over the years, my view on this has shifted. Search “loneliness” into pubmed and you will find hundreds of papers in the last year investigating the link between loneliness and health – and that’s physical health, not just mental health. Consider some of these statistics from the CDC:

Social isolation significantly increased a person’s risk of premature death from all causes, a risk that may rival those of smoking, obesity, and physical inactivity.

Social isolation was associated with about a 50% increased risk of dementia.

Poor social relationships (characterised by social isolation or loneliness) was associated with a 29% increased risk of heart disease and a 32% increased risk of stroke.

This is in a context of 1 in 6 Australians experiencing loneliness (a statistic likely underreported), and increasing rates of loneliness in Australian youth aged 15-24 since 2012.

Anecdotally, I have found that patients admitted with few or no social supports tend to have poorer outcomes compared to those with strong, supportive networks. This has manifested in sudden deteriorations or passings that were unexpected. Too often for coincidence.

So a few years on, I think this psychiatrist was onto something. Loneliness is most definitely a crisis. And it is the role of modern medicine to recognise this and intervene, similar to how we would treat a broken femur, or an infected lung: compassionately, alongside patient wishes, and urgently.

Last night, I returned home to find five adolescent males loitering outside my apartment. One of them was smoking a cigarette and the other four were on their phones. As I scanned into the building, the five of them followed me inside without a word.

When the elevator opened, I scanned my floor and they entered with me. No one pressed another floor. They stood silently between me and the exit, the room filling with cigarette smoke. One of the jackets smelt of alcohol.

The door opened and I excused myself. They shuffled to let me pass. As I turned the corner, I realised that the five of them were walking with me to my room.

It only struck me then that something potentially insidious was unfolding. The boys didn’t look threatening, but there was the potential for intoxication and with that, violence, and anything could happen then. I began to panic inside, until my neighbour opened the door.

“You can’t smoke in here,” he said. The person rubbed the cigarette out on his jacket and muttered a soft apology.

“You boys alright?” He asked. A silence emerged as the five glanced at each other, before walking away without a word. As they turned, I noticed one of them was carrying an empty beer bottle in his jacket.

All I could manage was a short “thank you”. He waved it off, as if this was a commonplace occurrence and didn’t just potentially save my life.

With the boys gone, we exchanged a few words, and for the first time, had a real conversation. I learnt his name, that he used to work in the ADF, and was renting as part of a year-long travel itinerary with his wife. After a while, we bid each other farewell, and I locked my door with a smile.

“Tonight, I could have been hurt, mugged, or died, but made a friend instead,” I wrote in my journal. Blessings can arise from the most unexpected of situations.