Why this photo of Meghan fills me with such sadness and I think she should go it alone, by DR MAX PEMBERTON

Looking at pictures of Prince Harry on his recent solo trip to Lesotho, I couldn’t help but feel wistful. The old Harry – the one the public fell in love with – seemed to be back.

He laughed, joked and charmed everyone with that cheeky smile and mischievous twinkle in his eye.

What a loss that version of him is to us and the Royal Family. As his wife Meghan undertook an engagement thousands of miles away in California, I had feelings of sadness towards her too but for different reasons.

While her husband shone she looked lost, uncomfortable and – despite the crowds and cameras – rather alone when she attended a children’s hospital fundraiser.

As a former jobbing actress Meghan would have known only too well how brutally harsh and fickle the world of celebrity can be. She may have experienced that crushing feeling of queuing at a premiere or party, waiting to be interviewed, only to be cut short when someone more interesting appeared behind her. Last week, on the red carpet, it almost felt like she was back there.

It was a huge shift from her time as a working member of the Royal Family when she was always the guest of honour, always the one everyone was there to see.

Lots of people have commented on how stepping away from the glitz and pomp of the Royal Family has seen the Sussexes’ celebrity status taking a nosedive. But, for me, the far greater tragedy is how the social isolation must have diminished their lives.

Although distancing yourself from your family may seem like a good idea at the time, especially following a tiff, the reality is that family bonds are powerful.

They are both nurturing and anchoring and severing them can leave us adrift. Of course there are times when families are so toxic and damaging that they need to be permanently cut from lives. But most of the time, family is a ready-made, if at times infuriating, social circle that will always be there and guarantees you’ll never be alone.

It felt rather strange to see the duke and duchess carrying out separate engagements. We’re so used to them coming as a package deal, their hands seemingly superglued together in a tight grip, something that sometimes seemed less of a public display of affection and more like a clinging on for dear life as they navigated the road ahead.

Working so close with your partner does mean that you always have someone close by who has your back, who is on your side, which is very comforting. But there’s a down side too. You lose your sense of self and your own identity.

When you live and work together there’s little down time or respite from one another. Even the most loved-up couple needs a break from time to time.

I’ve had a few patients over the years who have worked with their husband or wife and it’s rarely plain sailing as it takes a very particularly type of person to be seen as a unit, rather than an individual.

One patient’s relationship didn’t survive and I have no doubt that working with their partner was largely to blame. They were highly successful fashion designers who had their own successful clothing label.

They lived together, ran the business, appeared at countless functions and were together every minute of every day. The strain was immense.

Neither of them were particularly hungry for fame but, as one of them told me after they’d split, they simply started to forget who they were and relied on each other for absolutely everything. It was too much.

That pressure has got to be even more intense when you live your life in the world’s spotlight.

Meghan is a smart and educated woman and she must know that her cachet comes courtesy of marrying a prince. There’s no sugar-coating it, although a successful actress, Meghan’s star would never have shone as bright, if she hadn’t married one of the most famous men on the planet.

Knowing that your status is even partly dependent on someone else is a tough place to be in psychologically as it magnifies your own fragility.

For most people – royalty or otherwise – it’s important to get emotional succour from several different sources, such as colleagues, family, old friends.

Variety is essential as it’s psychologically stifling to each look to one person for everything. I can’t help but wonder if Harry and Meghan are starting to realise that?

Gen Z might be in the full bloom of youth but it seems they are in a panic about looking older than their years. Social media is awash with them complaining that people mistake them for years – sometimes decades – older than they really are. 

One explanation for them ageing quicker than other generations is that, ironically, they have embraced ‘anti-ageing’ treatments such as antiwrinkle injections and filler.

In older people they might shave a few years off, in younger people who don’t need them they can change the structure and shape of the face, causing sagging and wrinkles – the very thing they are designed to prevent. In the pursuit of the very youth they already had, the young have made themselves old!

Finally, sense on GP visits 

The Royal College of General Practitioners (RCGP) said last week that all patients should be assessed by a GP before being seen by a Physician Associate (PA) to reduce their risk of harm. This would be a very big and welcome step in putting clear limitations and checks around what PAs can and can’t do.

The startling recommendations follow a vote by the RCGP council to oppose the role of PAs in general practice over fears for patients’ safety. Official bodies representing doctors have been very slow to listen to their members’ concerns, so it’s good that they are finally taking a stand. However, I don’t think their recommendations go far enough.

Regular readers will know I have serious concerns about the mass deployment of PAs, particularly the huge number of patients who are being treated by them without realising they are not seeing a doctor.

Alongside clear rules around what their role should entail, I think PAs should be renamed ‘Physician Assistants’ rather than ‘Associates,’ which is too vague and confusing a term.

There should be no shame in assisting a doctor and this title means that there can be no confusion for patients, which surely should be the most important thing?

Latest figures show that more than 50,000 ‘baby loss certificates’ have been issued since their launch in February this year. Until now, only those who had experienced a loss since September 2018 were eligible to apply but now that limit has been removed. Certificates can be requested by any parent who has experienced a loss before 24 weeks, or 28 weeks if it occurred before October 1992.

The scheme aims to recognise the devastating impact of pregnancy loss and to help grieving families move forward and I think this is such a good idea. Miscarriage affects people in very different ways. Some understand it as part of nature and move on, others have an horrendous time and feel tormented by their experience for many years.

The difficulty is that, unlike the death of a baby who has gone full term, miscarriage is not really recognised in terms of loss. If a woman says their baby died, everyone would appreciate the emotional impact that would have. But when it’s termed as miscarriage, it’s seen as something far less significant.

Dr Max Prescribes: A good night’s sleep

A poor night’s sleep can affect the brain for up to two weeks, according to latest research. The results found that a restless night still impacted attention, cognition and memory well into the following week. So get an early night, you’ll thank yourself for doing so in a week’s time.