Transcript: Ben Williamson and Ryan Shuster

Recorded: May 21, 2025
Duration: 42 minutes
Video recording: Here

Ben Williamson:

Thanks for joining us. This week we’re talking about stress, specifically the impact it can have on you when you’re in a public or high-visibility role. I'm here with Ryan Shuster. Ryan’s actually my wife’s cousin, so I’ve known him for a number of years now at family Christmases, birthdays, and more. It’s been really interesting watching his journey. Ryan, thanks for joining us.

Ryan Shuster:

Thanks so much for inviting me.

Ben:

Let’s start with your background. In your own words, who are you, and why are we talking today?

Ryan:

As Ben said, I’m Ryan. I worked for years at the biggest trauma centre in the Southern Hemisphere as a trauma and ICU doctor. I’ve always been drawn to critical care. I thought of myself as someone who could manage high-pressure situations better than most. That belief helped me progress early in my career. But over time, I’ve realised that stress accumulates. You can’t treat it casually forever. For me, it came to a head about 18 months ago.

Ryan (continued):

I was in my second year out of med school, doing a run of seven night shifts. These were long 12-hour shifts looking after specialty medicine patients. Very complex cases, often 100 to 200 patients under one junior doctor overnight. The tasks aren’t all high-stress, but the volume and responsibility absolutely are.

One case I remember clearly was a teenage girl on the respiratory ward with significant bleeding. The team during the day had dismissed it, but I had concerns. I tried to escalate the issue several times. I followed the escalation process, including calling the MET team and speaking with ICU and gastro, but they all said the situation didn’t require ICU care.

That same scenario repeated over multiple nights. I ended up being the person going into the room repeatedly, telling the mother and daughter that everything was “under control,” even when I didn’t believe it myself.

Eventually, she suffered two catastrophic bleeds while I was holding her hand. She died in front of her mum. And then I had to go chart paracetamol for another patient and move on to the next ward. No time to debrief. No real follow-up involving me. Just move on.

Ben:

You were extremely junior at the time, yet you were carrying a huge amount of responsibility. Plus, the system removed a lot of your agency. How did you cope with that mental switch?

Ryan:

That was a key turning point for me. After that, I refused to let anyone take my agency away again. I became very assertive. If I thought a patient needed care, I would physically walk them to the ICU if I had to. I wouldn’t take no for an answer.

As for coping, in emergency medicine you have to compartmentalise. One minute it’s a cardiac arrest, the next it’s a stubbed toe. But I didn’t do it well. I started switching off emotionally, telling myself, “Just for this shift,” but it crept into the next day, and then my whole life.

Ben:

That mindset, focusing on the process rather than the emotional impact, is common in medicine. But most of our audience isn’t in trauma. How do you relate it back?

Ryan:

Here’s the thing. Your body doesn’t know the difference between battlefield trauma and a high-stakes board meeting. The same stress pathways fire. That’s why I learned a lot from the special forces community, US Tier 1 operators, SAS guys here. I started treating my body and nervous system like a soldier would.

I never felt like my life was in danger, but the stress response felt the same. So I prepared the same way. Physical health, mental modelling, breath work, meditation. You can’t control the moment unless you’ve trained for it beforehand.

Ben:

What kind of preparation did you put in place to actually lower that stress baseline?

Ryan:

It starts with understanding that stress isn't just mental. It’s neural, hormonal, systemic. I can't stop spikes, but I can lower my baseline. That’s the game.

On my way into work, I’d run five emergency scenarios in my head. Visualise what I’d do, step by step. Then if it actually happened, I wasn’t starting from zero.

I also built habits. Meditation, sleep routines, breath work. I learned to read the early signs in my body, tight chest or stomach tension, and act early. I treat my performance like an athlete would. You eat clean, sleep well, and train so that you can show up when it matters.

Ben:

Let’s talk about the mental cost. What did that accumulation actually look like for you?

Ryan:

It’s always in retrospect. I thought I was just tired. But I’d get home, sit down, and just stare at a blank TV. My two little girls would jump into my lap and I’d feel nothing.

It happened over six months. Slowly. Like how kids grow, you don’t notice until someone else points it out. Friends said I’d gone quiet, distant. Some thought I didn’t want to be around them anymore. But really, I was just shutting down.

Eventually, I hit a wall. I had a serious suicide attempt. I didn’t see it coming. It really was like I woke up one day and realised how close I’d come.

Ben:

That’s incredibly heavy and far too common among high performers. What’s changed for you since?

Ryan:

Awareness. From the people around me. My wife is more perceptive now. My friends are. But they only got there because I let them in.

If you’ve gone to someone and said, “You’ve seemed really distant this week, is everything okay?” that creates a loop. It sets a standard. Then they feel safe doing the same for you.

Modelling vulnerability is an absolute requirement. It’s something we owe to the people around us. I’ve had friends open up to me just because I shared my own story. It’s shocking how many people are close to the edge and hiding it well.

Ryan (continued):

One thing that’s changed is my internal metric. If I get home and have nothing left for my kids, that’s the line. That’s the signal that I’ve given too much to the job.

We’re the type of people who, when given freedom, will give everything to the role. But it doesn’t come for free. Something has to give. I’ve decided that can’t be my family.

Ben:

That’s a powerful frame. Making sure you keep something in the tank, not just for yourself, but for the people who matter most. Any final thoughts?

Ryan:

Put your pride away. Talk about the hard stuff. You’ll be surprised how many people will say, “I’ve felt that too.” And sometimes, that’s the one conversation that pulls someone else, or you, back from the edge.

Ben:

Thanks for joining us, Ryan. This was powerful. I really appreciate your openness.

Ryan:

My pleasure. Thanks for having me.