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PaRx People: A Conversation with Dr. Amir Khan
Dr. Amir Khan is an NHS doctor who works in inner-city Bradford in Yorkshire, UK, best-selling author of The Doctor Will See You Now, and resident doctor on ITV’s Good Morning Britain and Lorraine, who has appeared on other TV programs such as GPs: Behind Closed Doors. He has been a Senior Lecturer at both the University of Leeds School of Medicine and the University of Bradford, and in 2018 was named GP Trainer of the Year by the Royal College of General Practitioners.
Dr. Amir is a keen nature enthusiast who inspires hundreds of thousands of his followers on social media with daily videos and photos from his astonishing wildlife garden and local green spaces. He frequently shares TV tips and posts about the importance of caring for nature, and the importance of nature for our mental and physical health.
President of the Royal Society for the Protection of Birds and Vice President of The Wildlife Trusts, two of the UK’s largest nature charities, Dr. Amir also supports a number of other wildlife and environmental organizations. He is passionate about taking action to tackle the nature and climate emergency, while encouraging more and more people, of diverse backgrounds, to stand and speak up for nature before it’s too late. As a devoted uncle and godfather, Dr. Amir wants to ensure that the wildlife he treasures is still here for future generations to enjoy.
PaRx Director Dr. Melissa Lem sat down with Dr. Amir to learn about how his early experiences in nature inspired his unique career path, being an effective storyteller, how gardening boosts his health during stressful times, the importance of nature equity, and more.
Tell me about your early experiences in nature, and how they have may have contributed to your career and interests today.
I’ve had an interest in nature since I was a small child, but we grew up very inner-city and working-class—I grew up in Bradford, in Yorkshire—and didn't have a garden in the same way that lots of other people did. We had a backyard where my Dad parked the car, and that was about it.
But my Dad and I would watch nature documentaries on television. And I remember one picture book from school so vividly: there was a double-page spread in the centre of this book which was about British animals. It showed the British woodland at night, and in it were pictures of foxes, and deer, and owls, and badgers, and hedgehogs. I remember so vividly thinking, I have never seen any of these animals, and they live in the same country as us. This book was talking to you like they're everywhere.
So I decided at that moment—I must have been about 7 or 8—you know what, I am going to find these animals. Obviously I couldn't go into the woodland at night, but I could go in the daytime. I would call my friend Marvin, who lived down the street, and we would get our bikes and go riding to the woodlands. And we would try and spot animals from this book—which I might have stolen from school—and tried very much to work with what we saw. That kind of grew. We'd go out spotting nature, and matching it up with things we'd seen in books. My Dad was very unwell at the time, and so I'd come back and tell him what we'd seen, and he would get excited by what we'd seen.
And then things kind of evolved from there, really, into early adulthood. When I went to university, even though I knew about and felt the health benefits of nature, I think I lost them altogether—I think probably because of where I grew up, and my cultural background. Here in the UK, growing up South Asian, we didn't have that connection. But when I go back home to India, it's a huge part of our society over there. There are massive cultural beliefs in the connection with nature and protecting the environment and animals for a lot of religious reasons. When you're at university you've got a whole different outlook on life. You’re very young, you go out and party and you come back home, and that's about it.
It wasn't until after university, and getting into being a doctor, that I reconnected with nature and used that to help alleviate some of the stress of work.
My surgery is right in the centre of Bradford now. It’s a very socially deprived city and very multicultural. We’ve got a large Caucasian population, a large South Asian population, and a very large Eastern European population, so it’s kind of a melting pot of beautiful cultures. It's in a beautiful part of England in the north, and we've got really beautiful national parks close by, but you have to be able to drive, or take public transport to get there. This is part of the problem with nature access, which is I know is something you’re trying to address with what you're doing in Canada, and something we're working towards here.
Part of the reason I talk a lot about the health benefits of nature is because I grew up kind of not having it, and my patients at the moment also don't have access to it. They're not getting the benefits from it in the same way other people are. You can see the effects of the lack of connection with nature in your patients, and it’s just—it's just so sad.
What effects have you seen nature deprivation have on your patients’ health?
It's very difficult to pin effects on people’s health down to the absence of nature, but you know it contributes to things. We look after very young families, and there are a lot of teenage pregnancies. There are a lot of people unemployed. All of that factors into people's mental health, and physical health as well. You see the effects it has on things like cardiovascular disease and respiratory illnesses.
For the children, in particular, there's very little green space for them to go out and play. The local park is this tarmacked square with a swing and a slide in it—and that is the entire park. Any small patch of grass that might be there usually gets fly tipped on by something. So there's very little nature access, and you also see the effects of social deprivation on their health.
What is difficult for a lot of people to understand is that if they actually did have access to green spaces, some of the numbers of those conditions would come down. People’s quality of life would increase, and their mood would improve. It's not the answer to everything but it helps.
I did my training as a GP in a place called The Wirral, which is a very affluent area, and it was a whole different situation. It's all very multifactorial, but it was on the beach, and there was a woodland nearby. And there was a park—a real park, not just a piece of tarmac. You see the effects that these things have. Lack of access to nature and social deprivation tend to go hand in hand.
You live in the beautiful English countryside. How have nature and the outdoors influenced your health and wellbeing throughout your life?
Where I live now is the exact opposite of where I grew up. Semi-rural is how I like to describe it. It’s a very quintessential British village in the Yorkshire countryside, and we've got a lovely garden we've made as nature friendly as possible. We just have to step outside of our door, and within five minutes we're at a gorgeous location called the Yorkshire Dales, which is a national park. It’s just beautiful rolling hills. We've got quite a few kinds of birds of prey around as well; we go out spotting Peregrine Falcons and Red Kites.
It's such a difference from where I work. My neighbours are wonderful, but they are very different from the community I grew up in and the patients that I look after. The stark difference really makes you think about how lucky you are living in this area, actually feeling the tangible benefits of access to green space, and that calmness that comes along with it. But there is an element of guilt, there really is, because I talk about the effects of social deprivation on health a lot, and I live and breathe it at work. And then I feel like I can step away from it and come back to my own sanctuary.
I think those of us who do have access to nature should recognize how privileged we are. But we should also be doing what we can to ensure other people have that same privilege.
You know, I had all that interest in nature when I was a child, and then I took a break from it until I was in medical training. After medical school in the UK we do 2 years of pre-reg training. Before you get your full registration, you have to do two years of hospital medicine, and then you choose what career path you want to go down. I chose general practice, so I did a further three years of general practice training before I was a GP, and my work was really busy and stressful.
It was in that three-year period that I noticed when I went for a run or walk along the beach, I did feel better. At first I thought, oh, it must be the exercise, but I came to a slow realization that it was actually the outdoors and nature, because I could run on a treadmill but certainly didn’t feel the same as I did outside. Then I started looking into the science behind it, and it was all there. I really took an interest in it at that point.
And I realized that the more time I spent in nature, the less stressed and more productive I was at work, and the nicer I was to my patients.
The pandemic was a really tough time. In the UK, we set up these things called Red Hubs, or assessment centres where patients who had symptoms of COVID, but weren't necessarily unwell enough to need hospitalization would come. And we as GPs would assess them, and treat them if needed. At the start it was the same as everywhere else; there weren’t enough COVID tests, there wasn't enough PPE for the people who were doing the job. It was a very tricky time in terms of the anxiety that comes with those situations. We were hearing about clinicians catching and dying from COVID, and on top of that we were hearing about people from minority backgrounds being disproportionately affected by COVID, and dying from it. I felt like I was like a target for this virus.
So I would go to those Red Hubs, do those assessments, and come home and shower in the garden—well, hose myself down, because we don’t have a shower there. I would go straight into the garden to wash myself down, because that's what everybody was doing at that point. And the garden would immediately, immediately take a lot of that stress away. Because our garden is so geared up towards nature I just had to sit quietly in a spot, and we'd see some beautiful birds come in. It was early summertime, and the hedgehogs would appear in the evenings, and I would think, okay, it's not so bad. Life is not so bad.
One real way nature helped me during the pandemic—and again, it's one of those moments that stays with you—we had a lot of deaths in nursing homes here; it was very sad. We would go into homes where large volumes of people had COVID, very unwell old people. PPE is a huge barrier toward that connection you have with someone who is dying. You get on with it, but I found it very difficult.
When you look after patients in care homes you get to know them really well. They're the patients you see the most because they need you the most. If the husband was in, I knew the wife who was at home, or the kids. I would have a list of family members I had to ring to give progress updates on what I had done, or if something awful had happened I'd give the bad news.
I remember leaving the nursing home one day, sitting in my car, and speaking with one particular wife I knew really well. It was a really tough conversation. I had to explain to her that her husband was imminently dying that day, and she was really worried he was going to be alone. I remember thinking, God this is just awful, after I put my phone down. I just sat in my car, slightly overwhelmed by it all. And then a robin caught my eye that was coming in and out of a hedgerow. It was flying in and out with little bits of nesting material, and I was just—I watched it for about 20 minutes, and for that whole 20-minute period I didn't think about what had just happened. I was just watching that that robin build its nest.
I'll always be grateful to that little robin because it allowed me to move on from that very overwhelming feeling of, Oh God, I don't think I can go back to work. I've got a whole clinic this afternoon, and I just don't think I can do it.
Well you know what, if a robin can build a house in the bush, I can go back to work. It was just a wonderful moment to watch.
You mentioned your garden. Tell me more about how gardening, and spending time in your garden, contribute to your health and wellbeing.
Hugely, hugely. It's been a massive factor. When I bought this house, I just thought, we've got to get a garden. We've got to make sure it's a lovely garden. It doesn't matter what the state of it is, as long as it's big enough we can do things with it. And so the minute we bought the house the garden became my priority, and I wanted to make it as nature-friendly as possible.
But I had no idea how, because I’d never gardened before in my life (laughs). So, I bought a lot of books, and I read—well, I pretended to read, I read the bits that looked interesting—because it was a lot. And I got to planting nature-friendly plants and insect-friendly plants, and I'd spend ages at the garden centre talking to them, and getting the right types of flowers and shrubs that might attract insects. That's the basis, isn’t it? You've got to have good soil, and then once you get the invertebrates, other things will come.
We built a pond as well—it took us a week, but we dug out a pond—and we got in some pond plants, and within about three months we had frogs. Which was amazing, because we were told it would take a couple of years before frogs arrived. They didn't spawn for a couple of years, but they would come and hang out in the summer.
And so we had these insects passing around, we had the frogs, and then I thought we needed birds. So I built a big space to handle our bird feeders, because the book I read said birds like coming to like a restaurant with a menu of different types of food. One bird feeder with one type of food is just not going to cut it. I think we've got 19 bird feeders in our garden, and they've all got different things in them.
And it’s amazing. You just can't believe that the birds you see in Birds of Britain books are coming into your garden. I just record them all on my phone, and I post them online, and I go, “I can't believe this is happening in our garden!”
Then we started to find lots of different types of poo in our in our grass. I didn't mind it at all, but I wanted to know what it belonged to, so I took some photos of the poo and posted it online, and said, “Does anybody know what this poo belongs to?” And some of it was hedgehog poo, and others were badger poo.
It was so amazing. It was like that picture in the book from when I was a kid of the woodland, except it was our garden.
So then I researched what those animals liked to eat, and I started putting that out, and again, captured them on video, because it's just fantastic to have records of these visitations. Now we've got the birds, we've got the hedgehogs, we've got badgers, we've got all these beautiful pollinating insects in the summer, and the frogs. And we've got birds nesting in our nest boxes every spring now, which is phenomenal, to see them coming in and out feeding their chicks. It’s a massive garden, but every inch of it is geared up towards the wildlife that lives around us.
My sisters and their kids come over, and we sit outside in the evenings and watch. As long as we sit far enough away hedgehogs will come out and eat their food. They absolutely love it, and I love it. It’s just wonderful. And that connection with nature, I think, is really important. That excitement you get when you see an animal is really, really important. Because I'm not sure children have it as much anymore.
I know I sound like a big kid—I always sound like a big kid—but I just think it's fascinating. I can't quite believe that they've chosen our garden.
You travelled all the way to British Columbia to explore our beautiful nature last summer, which is when I met you for lunch on the beach in Vancouver! What were some of the highlights of your trip?
Oh my God, your nature is like our nature, but on steroids. It’s, like, huge.
When people ask me how British Columbia was, I always tell this story. We have some deer in England, and when we drive around there are always road signs saying there might be deer around. But never in my 40 years have I ever, ever seen a deer crossing the road. But in BC you have bear signs, and you’re not lying to us like ours in England—they’re real signs that mean something.
We went bear watching, and saw some incredible bears. I was like a kid in a candy shop when I saw the sea otters, and they were just as cute as they are on the telly. We saw elk, we saw lots of deer—creatures that we just do not have here. We were incredibly close to a bald eagle where we went kayaking. We saw osprey as well, which are really rare over here. We went whale watching, and saw a couple of spouts rather than any whales, but it was just nice to know that they were there. And all that on the backdrop of the beautiful mountains, and forests, and beaches.
You guys are far more geared up to outdoor activities than we are. And I think that's where we're missing a trick, really. We have lots of beautiful places and lots of gorgeous villages in the countryside, but I often feel our amenities and our nature are very separate. Whereas I feel like BC has done a really good job in in in making nature a little bit more accessible.
You use such an accessible blend of humour and science to communicate, whether it’s as a best-selling author, on TV, or in one of your viral social media videos. Can you give us some tips on how to communicate the benefits of nature to patients and the public effectively?
The way I try to do it is to share my excitement and wonder, and use pictures and words expressing that. Rather than kind of shove it in their faces and say, you've got to go out and do this, it's talking about my experiences in it, and how amazing it makes me feel and how excited I get.
It's all about accessibility, isn't it? We've got to remember that everyday patients are not that interested in the science and evidence. They don't want to know statistics; they don't want to know what will make them 23% more happy, even though that's important to us as people who work on evidence. What they want to know is if it will be fun, and if they’ll feel better afterwards.
And if they can see you doing that, and actually succeeding in it, but failing in it sometimes as well—when I talk about my gardening adventures, I'd say about 30% of my plants have died—you know, it's trial and error. Access to nature can be trial and error as well.
I try to encourage my own family to go out there and get the benefits. My nephews and nieces come out with me, and when they come back they're so much more productive after spending some time in nature.
They just have to visualize it themselves. When I'm talking about nature on a more formal basis, on television, then I might refer to a little bit more of the science. But you've got to be really mindful that people lead really busy lives, and some of them have really chaotic lives as well. Saying, “You should be doing this,” can add to the pressure of the many, many things that we should all be doing but don't do.
And so we’ve got to make it sound like they are going to enjoy spending time outdoors. It’s a break from the chaos; it's a way for you to spend time with your family or with yourself, however you want. And it's actually enjoyable, and I do it and it makes me feel better, and I'm hoping you can just squeeze a little bit in wherever that may be.
I know there's that study that says you've got to spend 120 minutes in green spaces each week because you feel so much better. And that's great if you can, but any access to nature is better than not. I think if we start being too prescriptive, it takes the fun out of it.
That's such an interesting perspective, because as you know, here in Canada we have a national nature prescription program. We hear feedback all the time that patients respond well to nature prescriptions.
I think if you're talking to a patient about it, and it's very specifically about their well-being, and what plan you're coming up with together for their well-being, it's absolutely fine to be prescriptive about it then. But when you're talking about it en masse, on social media, or on television, I don't think being prescriptive about it is as useful. So you're absolutely right. You have to pick when it's the right time and when it's not.
It’s the same with anything you offer to patients, the menu of treatment options we have. Some will work better on some patients, and some will work better on other patients. It’s working with the patient in front of you and coming up with a—I hate this word, but I’m gonna’ say it—a shared management plan that’s important.
You mentioned how the population you practise with in the UK is primarily urban and lower-income, which can present barriers to nature access. How do you think we can we redesign our urban and mental landscapes to reduce those barriers?
I think it's about bringing green spaces and nature to the people, rather than the people to the green spaces. And that is beneficial to both parties. But it has to go above people like myself. It has to go to policymakers and planners who have the power to take over areas of land that aren't being used in any constructive way, and regenerate them where that is going to be the most beneficial. All the science points to people who have the least access to nature gaining the most from spending time in it.
Our target area is full of socially deprived schools and child and family centers. But if we—it seems so simple as an idea—made the walk to school easier for parents, and more scenic and greener so children could get excited about the nature they saw, then they’d be more productive at school with better concentration levels.
The air quality would also improve. I think Bradford is in the top five worst air quality places in the UK, because of the volume of vehicles there. And it’s situated in a valley where air doesn't really flow as well, so the air quality is appalling. All of those factors eventually lead to people in those areas having shorter lives, having poorer prospects at work. And a lot of it can be remedied by changing these roads, in places that don't need to be roads, into green spaces.
But of course it’s costly, and money is in short supply, so that's the barrier. A lot of it is cost, and willingness as well. But communities can get together and try and improve their own areas. And we try and do that with some of our communities that we work with, and we've got social prescribers, which you've also got. At Wildlife Trust we work alongside them and try to change small areas of what is essentially tarmac to beautiful squares of wildflowers.
It’s such a complicated question, and the answer is just not easy, but the answer is the same. It’s bringing the nature to the people who don't have access to it, who can't get on two buses to get to the Yorkshire Dales, or pay for the train fare to get anywhere. Those are the people that need it.
People have also got to feel that they belong in these green spaces. Whether there are cultural barriers, or they’re from minority backgrounds, or they haven't been given opportunities to go to these places, or they have experienced something that makes them not want to go back there, we've got to make nature welcoming to everyone.
I’ll be honest with you. When I go for a walk in the Yorkshire Dales I am often the only Brown person there. It's a very friendly place where people say hello, but you'll also get stares. And you don't know whether they’re stereotyping you because you're Brown, or because they're being friendly—you just don't know. We've got to make everybody feel welcome. The barrier is for both sides: the person who doesn't necessarily feel welcome for whatever reason, and the people who are not welcoming—we need to stop that as well.
I had a similar conversation with someone from The Wildlife Trusts charity. It’s easy to say, culturally speaking, that people from minority backgrounds don't get out in nature, but actually there is quite a lot of appetite in people from minority backgrounds to get out in nature. Knowing where to start or being given the opportunity is often the most difficult part. But to some people, saying, “I'd like to go for a two-hour walk in in the mountains,” sounds horrendous. So we've got to start small and make the activities they're doing there applicable to them, and what they enjoy too.
We were both kids of colour who grew up into physicians and nature advocates. What do you think about the power of representation in encouraging racialized youth, and our colleagues, to engage in this intersectoral work?
It's a double-edged sword. You don't want to be the sole person other people come to for advice around this area. I can’t represent an entire population group and their thoughts. It’s slightly racist in thinking that we can, that we're all a homogeneous group that thinks the same and wants all the same things.
But I can tell you what might work for some people from minority backgrounds. We talk about how there are lots of different age groups, different religious beliefs, and different ways people prioritize nature depending on their cultural background. As someone from the Indian subcontinent, nature plays a big part in our religion. My mum, she's an older Asian lady, and she talks about times when she was in India growing up, going for beautiful walks along rivers, and having a great time. Over here it's very different when I take her out for walks. She does enjoy it, but she'll be in a full sari, like a full Indian get-up, and she'll be in flip flops. And after about half an hour, that'll be enough.
However, I think it's important that people like you and I exist in this space. In the past, certainly, when I was growing up, I would not have seen someone like me on TV talking about nature. If there was someone like me on TV, you'd be talking about, you know, probably some cliché to do with the Indian subcontinent. I think it's important that, visually, we're out there promoting it and talking about it, and making it welcoming for everyone.
You hold leadership positions in a number of nature charities. How did this come about, and why is it important to you to be a health professional leader in this field?
Oh, I'm just as surprised as anyone, really, about that. When they contact you and ask you, I'm like, are you sure you’ve got the right person? (laughs)
So I'm currently the President for the Royal Society for the Protection of Birds. I think the name may be slightly misleading, because it's not just birds they protect; it’s entire habitats and ecosystems. It’s one of the biggest wildlife charities in Europe, and the oldest in the UK. It started off back in the early 1900s, when a lot of birds were being shot for their feathers and put in hats, and since then it’s grown into this big space. Prior to that I was, and I still am, the Vice President of The Wildlife Trusts, which is another big charitable wildlife organization, with nature reserves.
So I guess I got these positions—well, I know I got these—because I am in the media. I'm on TV, I write books and I write articles. I think having that reach is important for these charities. I’m very vocal about the importance of access to nature for certain groups of people like the socially deprived and minority groups. And when I do put things out on social media, the nature I see on my runs, on my walks, in my garden, it's all accessible. I try and make a point of saying, “Look, this is everyday stuff that, if you do get the time to go outside, you too can see them.” It has to be really everyday, accessible nature.
Nature doesn't have to be big tigers for it to be fun and exciting and interesting. The tiny things are just as much fun.
I keep having to say this, because I think it's really important: I have absolutely no kind of educational training in nature and zoology, and I feel really bad because I don't want to take positions away from people who are actually qualified to do them. But I think what those positions in those charities allow for is accessibility. That’s the key when I go to the meetings, and think about accepting these roles—the big thing for me is accessibility and acceptability, accepting everyone.
I am the first person, a bit like yourself in your new position (Editor note: the first person of colour to be President of the Canadian Association of Physicians for the Environment), the first person from a historically marginalized background to be the President of the RSPB, to be the Vice President of The Wildlife Trusts. And, you know, I am really proud, but it's very overwhelming. I would never have heard of The Wildlife Trusts when I was growing up—that’s not an organization that would have featured anywhere in my life. But if I'm out there, talking about it on channels where people like me growing up are also present, they will know about it. And they can see what’s there for them as well.
You’re an incredibly busy person, yet still manage to find time to head outdoors regularly. Do you have any tips for people trying to fit nature into their lives?
I am really busy, so I have to fit it in. I enjoy it, and I think that's important—the enjoyment makes you fit in. I tend to run outdoors every morning, and in the summer and springtime it’s beautiful because the sun's coming up, and it's gorgeous. Right now it's not so gorgeous because it's pitch black, and it's usually pouring down with rain, but it's still outside.
Even at this time of year, if it's not raining, I will very likely see owls, which are my absolute favourite birds. If I see one just kind of silently fly by it sets me up for the entire day. I generally get back from work quite late, so I don't have time to do any outdoor activity in the wintertime, but after work in the summertime I'll be outside until the sun goes down. I have my dinner out there, and we might invite the neighbours around, and you're immediately surrounded by nature.
On the weekends we love to go walking, whether it's in the Yorkshire Dales, or driving somewhere else to go for hikes, and that is super important. I like to combine it with a café and eating cake. If we could have a walk and some cake that's the perfect afternoon. It’s the best, right? (laughs) Coffee and cake and walks, can't beat it. Or bike rides in nature and cake—oh my God, the best combo.
You’re busy. Everybody's really busy. And, you know, things will only get busier. And that whole thing of, it'll be better after next week, or after next month things will calm down—it never happens. You've got to make time now for it. Trust me. I've learned myself the hard way, spending time working on lots of different projects, and then thinking, why have I got these headaches? Why am I always tired? Because I haven't done the stuff I enjoy doing.
You’ve got to protect that time that's yours so you can be better at the rest of life, essentially, or try your best, anyway.
What role do you think health professionals have to play in inspiring people to protect nature and the planet?
So many roles. But I think understanding the health benefits of nature is an important one—because if we know something helps us, we will protect it. We've got to promote nature to our patients, in our communities, and in our everyday lives. It’s also got to be do as I do, not just do as I say.
All of those things: promoting the health benefits, protecting these areas for our patients’ and for our own sakes, and talking about it to our patients, so they then can go forward and protect it too.