If you’re looking for inspiration to achieve a big life goal, look no further than Dr Jon King. Jon’s made a habit of aiming high and getting results, achieving feats that would test even the healthiest person, let alone someone with all the problems that come with CF. If you want an overview of Jon’s backstory it’s definitely worth checking out the summary on his JustGiving page before reading on. In this interview we drill into the detail of how he reached three of his goals;
- Qualifying as a doctor from the prestigious UCL Medical School;
- Going from being on oxygen 24/7 and needing a lung transplant, to coming off the transplant list through sheer willpower and hard work;
- Cycling from London to Barcelona to raise money for the CF Trust.
Martin) Jon, thanks for giving your time to help us understand what makes you tick! Three of your biggest achievements (listed above) have all been massive targets. How do you approach goals such as these that some people think can’t be done?
Jon) That question couldn’t be better timed! I’ve actually just given a presentation this week about exactly that: focussing on how to gain and maintain motivation to do things that in all actuality are difficult enough for anyone let alone someone with the burdens that come with having a chronic illness.
With all of the three achievements you mentioned there was definitely a pattern in how I approached the aims and that was to set a goal, one that I genuinely wanted and one that I thought achievable regardless of the opinions of others. Those are the two rules of good goal setting, in my mind.
Setting a big goal on its own isn’t always enough to ensure you reach it though. So I also set small incremental goals for myself along the way. These incremental goals need to be goals you also want to achieve; this way the whole journey is something you want to endure and achieve and thus the journey becomes part of the goal and in itself motivational.
Each small goal would acts as a positive stimulus to encourage me to keep going – the final goal often not being focused on but instead the next small, achievable goal being the only thought in order to make these big tasks feel tangible.
For example, I didn’t go straight from school to medical school because a lot of advice was that it would be too physically demanding for me to complete a medical degree. The final aim and destination was to be a doctor. The journey entailed the smaller incremental goals of doing a science degree first, to gain the experience and confidence that university was not beyond my limits when it came to my CF. Once I’d gained that confidence and experience – for the sake of others as well as my own – I had planned to go on and complete a medical degree.
When it came to me exercising myself off the transplant list, however, the end goal wasn’t actually to come off the list. That seemed like a far too emotionally charged goal which could lead to a very negative spiralling if it was not achieved. Initially the primary aim was simply to improve my quality of life whilst I was on the list and improve my chances of surviving the operation. My secondary aim was that perhaps, as a consequence of this, I would become well enough to push needing a transplant back a few months but I did not focus on this as a goal.
What goals are being set is key to keeping the drive going in order to achieve them. I said that the only opinion that matters is your own when you set the goals, and it’s true. However, you still have to maintain sensible limits and give yourself as much of an opportunity as possible to achieve those goals by setting ones that you genuinely believe are achievable – not just wish to be.
Improving my quality of life through exercise required a lot of very small goals along the way to be mapped out. It also required them to be fluid and iterative. At the point of starting I was unable to brush my teeth due to my shortness of breath and needed a ventilator and oxygen all day. So the goals that were set along the journey had to be as small as walking to the end of the bed and back at the start. I also took the advice of some wise physiotherapists who pointed out that achieving goals is important to feed positivity back into the ongoing process and that sometimes I would be having good days and sometimes I would be having bad days. Therefore I should plan for these predictable stumbling blocks by having different aims for these different days. When dealing with something as fluctuating and limiting as cystic fibrosis it’s important to be kind to your body when you set yourself goals because the key to continuing on these journeys is a positive mental attitude, without which motivation is impossible.
It was this journey that allowed me to then prepare so well for my cycle to Barcelona. I drew on all these goal setting techniques to go from someone who hadn’t ridden a bike in 20 years to someone who cycled 600km in 12 days.
M) When facing such massive goals, how do you mentally deal with the naysayers? (You’ve mentioned that your consultants and family said you couldn’t become a doctor for example). How do you stop yourself from believing them? And if seeds of doubt enter your mind, how do you deal with those?
J) Anybody who has ever been doubted in their life and tells you that they have never allowed other people’s opinions to affect them, even a bit, is a liar. I can’t believe that anybody has the ability to completely block out the opinions of others – especially if it’s coming from as caring a place as their family or knowledgeable a place as their consultants. In fact, it’s arguably dangerous and arrogant to do so.
In my mind the key to conviction comes from setting the right goal. I mentioned that a good goal is one you want and one you believe in. If both of these facts are the case then I don’t believe a lot can prohibit someone from pursuing it. In addition to setting the right goal though, I would also say that the ability to be resilient is also key to maintaining the conviction of what you want. When I use the word resilient, I don’t just mean perseverance but also flexibility. It’s important to be ready for unexpected events or setbacks and be prepared to work out how to circumvent them. This may mean delaying plans or going a different route but there’s always a way back on to the main road regardless of any diversion.
This is what resilience is in my eyes. Maintaining focus on the final goal, but also appreciating that flexibility along the journey may be required, really helps to achieve that initial goal that you always wanted and believed in.
M) On a more positive note, what things have your support network (family, friends, partner, colleagues, etc.) done that have helped you reach your goals?
J) Everything! I don’t think there are enough words or sayings in the English language which can even begin to express how helpful and supportive my family especially have been during my life! Despite regularly being anxious privately about the plans I set for myself, my family have never been anything other than encouraging and supportive in any way, whether that be financially, emotionally or practically.
The best example of this was when I decided to work abroad for a year in India as a doctor for a charity. Mumbai air is not the greatest and everybody had said it was a risk for my health. I had done what I could to put sensible provisions in place. And my parents, despite being worried, did nothing but help me plan for my trip, put me in contact with people to help me find the work I wanted and encourage me to go on an adventure. So I did. I left with lung functions of 67% and returned within two months when I was admitted for six months and referred to transplant surgeons. During that admission my lung functions dropped to 16%.
Despite that and despite the fact I had made such a huge misjudgement with my health, my parents have never stopped supporting my plans and dreams.
That kind of support makes life so much easier and I am lucky enough to be able to say that this deep level of support doesn’t stop at my family. I have friends and health care professionals who are also willing to be a great source of support and strength to me as well.
M) What advice would you give to the loved ones of other people with CF who are aiming high? (think in terms of how they can help)
J) I think the CF Trust is doing a great job at echoing exactly how I feel about this at the moment. The Life Unlimited campaign is such a brilliant concept and so accurate when it comes to how best approach life with CF, or any chronic illness for that matter. It’s important to live, not just exist.
I appreciate that it’s actually probably harder to watch someone suffer with CF at times than it is to have it. To watch your loved one struggle with different aspects of life and watch them gamble with their lives by being non-compliant and pushing themselves hard, when all you really want is to wrap them up in cotton wool and make it all ok for as long as possible, must be so difficult. I think people with CF sometimes forget how difficult that must be for those around them, but at the same time, it is important for people with any chronic disease to not allow themselves to be defined by their illness. It’s important that they set their own targets in life and strive for what they want regardless of what society deems their limits because of their condition.
Sometimes this might make the family and friends of those around them anxious, but I generally subscribe to the belief that people need to learn their own limits by reaching them and then pulling back rather than never quite finding out. I also believe that given the trust to do so, most people won’t push it beyond a safe limit, out of respect for those around them.
M) When you set a massive goal, do you manage to still achieve balance in your life (e.g. social life, etc.) or does everything else go out of the window? You mention in your blog the importance of rest periods, are these times you catch up with the rest of life?
J) I wish I could say that I strike good balances! My biggest weakness is probably that I’m very good at focussing on one big thing and doing it well but not so good at being able to focus on multiple big things at all, let alone doing them well at the same time! When these periods of time occur in my life, where I become focused on one thing, I tend not to become stressed at the thought of missing out on other aspects of life because I am focussing on what I want to do during that period. This keeps me content and anything else is actually a distraction from what I want to be doing. Maybe that’s how I see it or maybe that’s how I have taught myself to see it in order to make myself feel better for the fact that I’m rubbish at multi-tasking!
I do believe in rest periods though. For me these are days where I allow myself to recuperate from the physical stresses of life and focus on rest, relaxation and treatments. I don’t always manage to fit daily physio in to my day for example so I make sure I have days I dedicate to extra physio. During episodes of intense exercise, I view these days of rest and treatments as the CF equivalent to an athletes need for a day of massage and ice baths.
M) Any general tips you’d give to parents of young children with CF?
J) As I alluded to before, I think watching your child grow up with CF must be one of the hardest things in the world. I fully appreciate the fact that parents must be scared about a lot of things when it comes to well-being, especially during the period when their child transitions from needing their parents for all health-related matters to being independent self-caring adolescents.
It is a very difficult situation. Personally, I think its important that people feel free and able to make decisions for themselves; to make their own mistakes and really learn what does and doesn’t work. I see it every day at work with patients who may or may not be able to cope at home with extra social care. Whenever it’s unclear what the outcome will be my stance is always that the individual should be given the freedom to fail, not have that freedom taken away and have it assumed they will.
The idea of someone else making decisions for an individual or limiting that individual in any way has always, throughout time, led to resistance and revolution. Obviously if parents or families try and limit what their child with CF does or is exposed to it comes from a caring and loving place. Despite the fact that the person with CF may react like a stroppy teenager – I have done so many times in the past and well into my twenties! – they will know why the limitations are being placed upon them.
It remains frustrating though, to not know what ones potential could have otherwise been. Therefore wherever possible the person with CF will appreciate being supported rather than limited. In turn, this will hopefully lead to the person with CF being willing to place plenty of safety measures in place in exchange for this support. It becomes a partnership at this point and, in my experience at least, comes down to a sensation of trust. Whenever I was told not to attempt something, I always felt that what the person was really saying was that they didn’t trust I’d only attempt it to an appropriate and safe level. All I wanted was to experience everything I could; learn my limitations and reach my full potential. But as soon as I was asked what could be done to help, I felt as though I was respected and those around me had faith in me. I then wanted to work with them as a team to reach my goals whilst keeping them happy as well.
In my eyes it is therefore important that people with CF are allowed to want and aim for the same things as anyone around them and these desires should be facilitated. I don’t really subscribe to the idea that people can be told what to do and what not to do unless they themselves agree on some level with what is being said or why it’s being said. It’s something I put into my practice as a doctor; if someone clearly doesn’t want to quit smoking then there’s nothing I can say that will make that happen. Instead I have to allow them to make that realisation for themselves and then be there to support them as soon as they do.
M) Specifically with regards to becoming a Dr, I was always told it’s something I shouldn’t go for as being in hospitals/surgeries puts me into too much contact with illness (and obviously for susceptible CF people, that puts us at risk). Did you find this to be a problem for you and how did you deal with the added risks of being in these places?
J) It has been a problem for me. A high percentage of healthcare professionals would have MRSA positive swabs if tested and I have had three episodes of MRSA chest infections since becoming a doctor. However, it isn’t something I think about or worry about.
I live my life by quite simple rules. I weigh up decisions by comparing the risks and the benefits that each one carries. I then use these to make a decision about whether one outcome is more favourable than another. Most of the time I choose to avoid the worse negative outcome rather than fixating on the best positive one. In the example of being a doctor, I could either have been a doctor and have hospital acquired infections intermittently, or, I could have chosen a career I didn’t want to do but never have those infections. The first option has a negative outcome related to my health, the second option has a negative outcome related to my quality of life. In this instance, quality of life trumps health every time and so it’s an easy decision to become a doctor but put myself at risk.
I then never have to worry about that decision again. I’ve made the decision to be a doctor knowing it’s potentially risky, but it’s a decision I have weighed up and would make every time given those outcome options. So then I just focus on being a doctor and accept any issues that come along with that if and when they come.
M) You went through medical school – did you manage to fit in any of the social side of uni? The medics I knew at uni partied harder than anyone else – was this something you could enjoy too, or did lack of free time & energy levels mean you weren’t able to?
J) They do don’t they?! I’ve never understood how medics do that! No, I wasn’t a medical student at all in that sense!
I made the most of university life with regards to socialising and having fun but not to the extent of having endless nights out or an unlimited ability to party. I didn’t mind that at all though, to be honest. Maybe because it was my second degree or maybe just because I knew it would have far too negative an impact on the rest of my week. Either way, it wasn’t a part of the university life I particularly was involved in but by no means did it prevent me from making a huge number of friends, enjoying a major part of my life and collecting a whole range of memories.
M) Do you have any tips on how to maximise productivity when managing CF together with a massive workload (& possibly socialising)?
J) I wish I did! I’m still learning as I go on, even now as a 31 year old man!
I think the only piece of advice I could give that I have actually followed would be to plan well and prioritise well.
M) Junior doctors work notoriously long hours in their first few years. Was this something you were able to fit in (both in regards to having the energy and also the hours in the day alongside the treatment)?
J) During my first year as a junior doctor I somehow worked full time. I lived with three of my best friends and was having a long distance relationship. I somehow managed to fit all of those things in well enough to enjoy each facet of my life and avoid too many admissions. I am told by my consultant that I struggled for a lot of that year but when I look back on it I just remember great nights with my flat mates watching films and sharing stories and brilliant days at work enjoying the company of all the variety of people I have the privilege of working with every day.
After having been so ill during my sabbatical, however, I have since returned to work part time and am building back up to being full time year upon year. I’ve always struggled with mornings, all my life. The worse my CF gets during times of infection, the more I struggle. Despite this though, once I struggle through the morning and get to work I somehow manage. I still manage to see my friends regularly as well as endure the long trips to Old Trafford on a fortnightly basis!
If I’m honest, I find it difficult to fit in work, socialising and treatments. One of the three tends to be sacrificed at any one time and for a lot of my life that one was generally health.
I try my best not to allow that to be the case anymore which is why I put such an emphasis on rest days. These days are there for me to focus on my health and put work and socialising to one side. Being part time allows me to do that well. In an ideal world perhaps I would do all three everyday but it’s not an ideal world and I think it’s ok to admit that non-compliance is the norm. Therefore I have stopped being ashamed of that fact and stopped hiding it, and instead admitted it and worked out how to compensate for that fact. For me, that’s to have a day or two a week designated to my health.
M) Following on from this, how have your employer(s) reacted to negotiating work patterns that suit your situation?
J) As I mentioned, I now work part time which did require some negotiation at one of the hospitals I worked at. Eventually, as a compromise wasn’t able to be met, I had to move hospital. On the whole though, since going part time, the hospitals have been superbly supportive of my needs and accommodated wherever possible.
UCL medical school and UCL hospitals in particular were amazing and always made an effort to get to know me and my needs as much as possible. I always felt as though I could approach them for help if need be during times of illness and trusted that they trusted me – CF can be such an invisible illness and there’s nothing worse than people being suspicious about whether you do actually need provisions or not.
M) Re: beating the need for a transplant, it seems like everyone but you thought it couldn’t be done – was this the case? Was it your idea to beat the need for a transplant through hard work, or did someone else have to convince you it could be done?
J) I’d say that my aim initially was never to beat it. I had accepted it was my fate. What I didn’t want was to be stuck at home on a ventilator and oxygen for the next two years as I waited around for a new pair of lungs. I wanted to be able to function on some level as a human again, even if only a few hours a week before needing hours of bipap to recover and to also maximise the chances of me surviving the operation.
I also wanted to regain some control over my life as for the first time in my life CF was definitely winning and putting a limit on what I could do and aim for. So I decided I had to succeed beyond my expectations in some way in order to give myself that power over CF again. At the time I was struggling to brush my teeth so I decided I had to run a 10km charity race for the CF Trust before my transplant.
And that was the catalyst for it all. As things improved and I became more and more capable, the idea that I would potentially beat the transplant began to become a concept. Eventually it became apparent that, regardless of what the surgeons were to say, I wasn’t going to accept a transplant as I was making such great improvements.
I couldn’t have done that alone though. Everyone needs a team around them when they are striving for anything and, thankfully, I had two wonderful physiotherapists who took my desire to run a 10km race seriously despite being on bipap at the time. I was expecting to be patronised or humoured sympathetically, but they genuinely took my desire seriously and we devised a plan together to make it happen. Without them (Pam and Charlotte), I wouldn’t be where I am today.
And of course my parents and sister who rallied around me and did everything they could to remove all other stresses from my life and encouraged me to keep going whilst I was exercising despite being so unwell.
M) Did you tell anyone else about your plan? If so, what was the general reaction? Was everyone fully supportive?
J) I’m quite a private person. I told those who needed to know: my physiotherapists and my family. I also sought inspiration and advice from a colleague who went to the same medical school as me and had managed to run 11 marathons and an Ironman, despite having rheumatoid arthritis. I needed advice on how to go about exceeding beyond expectations and achieving something unthinkable and he really helped. I’ve always thought that a great way to learn is not to necessarily to find the absolute best in the field but someone who is just ahead of you – someone who still remembers what it’s like to be in your position as well as someone in a position you can just about imagine yourself being in. For me it’s always been a motivational and positive learning experience.
M) With the experience of hindsight and looking back on how people (friends, family, etc.) were when you began trying to beat the need for a transplant, what advice would you give to the loved ones of anyone else trying to overcome a seemingly impossible medical goal?
J) My advice here is exactly the same as a parent with a child who has CF. The key is to try and actively support the aim wherever possible in order to give the power back to the person with CF.
The feeling of losing control on your life is one of the worst feelings I’ve ever felt. I struggled to sleep more than half an hour at a time for weeks and would spend hours on the edge of tears just reflecting on the position I was in. But when it suddenly hit me that I could get myself out of it, to some extent at least, by using exercise, I needed those around me to support me and believe in me. When they did it gave me so much hope and strength. Had my family tried to dissuade me, or had my physiotherapists not genuinely planned for me to run a 10km, it wouldn’t have taken much for me to give up.
M) What specific exercise/diet/regime did you use to improve your health so dramatically?
J) I used interval training as my exercise to help build up my stamina, and had simple small incremental goals to improve my performance. Interval training is such a good way to keep each training session interesting and fresh as well as build up from a low level of performance to a high one in a noticeable and rapid way.
I initially started with small bursts of 10 seconds walking relatively fast and then rested for as many minutes up to 5 as I needed before doing the same again. Little by little I would either increase the period of time I was walking fast or increase the pace for those periods I was walking fast (and eventually running). Eventually I could run non-stop for 30 minutes.
Alongside that I would eat regular carbohydrate and protein rich meals. I made sure I was getting as many calories on board as possible and always weighed myself to ensure I wasn’t burning more calories than I was taking in. I also kept myself extremely well hydrated, generally only drinking water.
The last important thing was sleep: 7-8 hours every night.
M) What specific methods did you use to help tackle such a huge goal? For example, did you break it down into more digestible targets to reach weekly? Use visualisation?
J) As I mentioned, I would set myself small goals which I would build on incrementally session upon session, making sure that I achieved a gain somewhere between each session in the gym.
The gains were not specifically planned in the sense that I didn’t have an aim of being at a certain level by a certain time. However I would be in the gym five times a week and would make sure that I improved somewhere each time, even if it was just one interval being longer or faster than the day before. This way I knew that, week on week, I was making quite big improvements.
I would always document my performances and save them. I would then go home and look at them and identify where a possible gain could be made. That would be my aim for the next session. Given I had no specific target and no specific timeframe it was a very iterative process but one that worked exceedingly well.
Not letting a hospital stay get in the way of training!
M) What specific exercise/diet/regime did you use to get fit for the London to Barcelona cycle?
J) With regards to my exercise regime, I used a very similar one to that which served me so well for coming off the transplant list. This time, however, I had a specific target and a specific time frame. This meant I had to plan the incremental targets ahead of time in order to make sure they would lead me to gaining what I needed in time for when I set off to Barcelona.
My diet on the other hand did need changing. It needed to be higher in slow-release carbohydrates each day and was complimented with supplements that were dense in quick release carbohydrates during any cycling session. I otherwise did my best to calorie replenish as much as possible, although as long as I could keep my strength to weight ratio up, I wasn’t too strict on losing some weight, as I knew it would help me on the bike.
M) One of your posts is about the psychological strain of facing such a tough challenge, as well as facing CF in general. I found it to be one of the best posts on the blog (even though you later expressed regret at writing it). You mention in it that you write to “declutter” your brain from all the stress, which is something probably everyone with CF can relate to. Do you still regularly write? And have you tried other methods, such as meditation, talking to people, etc? Any recommendations?
J) I first found solace in writing when I was on the transplant list. My mind would be full of so much noise that I sometimes struggled to focus on anything at all, so I began to write. Nothing public. In fact, to this day nobody has read any of those journeys through my mind. Each and every time I put pen to paper I thought I had a point and a focus to my entry but my mind would take me along a hundred different tangents until, every time, it would run out of steam. I would suddenly stop writing at a point I was never intending to make and often a point that didn’t quite make sense to end on, but a point at which my mind was empty again. Even if only for an hour.
So in the lead up to Barcelona I knew that writing would be a useful way of removing any stress the event may be having on me. This time I decided to make it public because the whole purpose of the cycle was to raise awareness of what CF really is. I didn’t post as often as I wish I had and I still have a few posts in mind that I want to sit down and write. It’s very exposing though and I think I sometimes held back – not always because I felt vulnerable to others though, more often because allowing myself to access my thoughts left me vulnerable to myself.
Another tool that I do use is mindfulness. During my hospital admission when I was on the transplant list, the only time I would have respite from horribly painful shortness of breath was when I had my bipap on during a session of mindfulness. I still use it today whenever I’m short of breath or too stressed to fall asleep. It’s a brilliant technique to help me relax and regain control of my thoughts and breath.
M) Are there any books, podcasts, articles, websites, films, etc. that have helped you on your journey?
J) Music helped me. It has always helped me.
I think I’m someone who responds well to genuine empathy because I don’t like opening up or exposing myself too much to people. Genuine empathy really helps minimise that sensation of being vulnerable to someone. My main fear of opening up is that the other person will not understand how I feel or what I am going through. This then means that I have made myself vulnerable (to the person or the emotions of my thoughts) for no constructive or worthwhile reason. Although I can speak honestly and objectively about what I have been through, I rarely genuinely open up to people.
I think music has a brilliant way of being empathetic as there is almost always a song to represent exactly how you feel at any one point in your life and so can either help you through difficult times or inspire you through others.
M) Is there anything we haven’t covered that you’d like to share in terms of how you achieved your goals?
J) I don’t think anybody has ever put together such a great list of questions! They were exceptionally probing and a useful tool for me to reflect with!
I don’t think there is much missing from what you have already asked me. I’d like to take this opportunity to thank you for approaching me and deeming me worth any space on your website and would like to commend you for coming up with and putting together such a great idea. I look forward to its development!
M) Thanks Jon! [*blushing*]
A huge thank you to Jon for sharing his wisdom with us. You can find out more about him at his JustGiving page, his blog or follow him on Twitter on @JonKingBYD
*ALWAYS ENSURE YOU SPEAK WITH YOUR MEDICAL TEAM BEFORE MAKING ANY HEALTH RELATED CHANGES TO YOUR LIFESTYLE*
CyFi Life - Advice on Leading Healthy and Fulfilling Lives from People with CF 