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

When I looked at photos of Prince Harry during his recent solo trip to Lesotho, I couldn’t help but feel wistful. The old Harry – the one the audience 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 for us and the royal family. When his wife Meghan got engaged thousands of miles away in California, I also had feelings of sadness toward her, but for different reasons.

While her husband beamed, she looked lost, uncomfortable and – despite the crowds and cameras – quite alone as she attended a fundraiser for a children’s hospital.

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

It was a huge change 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 for.

Many people have noted that moving away from the glitz and pageantry of the royal family has caused the Sussexes’ celebrity status to take a nosedive. But for me the much bigger tragedy is how the social isolation must have diminished their lives.

While distancing yourself from your family may seem like a good idea at the time, especially after an argument, the reality is that family bonds are powerful.

They nourish and anchor us, and if we separate them, we can be set adrift. Of course, there are times when families are so toxic and harmful that they need to be permanently removed from their lives. But most of the time, the family is a ready-made, if sometimes annoying, social circle that will always be there and guarantees that you will never be alone.

It felt quite strange to see the Duke and Duchess carrying out separate tasks. We’re so used to them coming as a package deal, their hands seemingly glued together in a tight grip, something that sometimes seemed less a public display of affection and more a clinging to dear life as they traveled the road before them.

Working so closely with your partner means that you always have someone around who has your back, who is on your side, which is very reassuring. But there is also a downside. You lose your sense of self and your own identity.

When you live and work together, there is little rest or respite from each other. Even the most beloved couple needs a break every now and then.

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

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

They lived together, ran the business, appeared at countless events and were together every minute of every day. The tension was enormous.

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

That pressure must be even more intense when you live your life in the spotlight of the world.

Meghan is a smart and educated woman and she should know that her cachet comes from marrying a prince. There’s no sugar-coating it, although Meghan’s star, a successful actress, would never have shone so brightly if she hadn’t married one of the most famous men in the world.

Knowing that your status is even partially dependent on someone else is a difficult situation psychologically, because it increases your own vulnerability.

For most people – royalty or otherwise – it’s important to get emotional support from a variety of sources, such as colleagues, family and old friends.

Variety is essential because it is psychologically stifling to focus on one person for everything. I wonder if Harry and Meghan are starting to realize that?

Generation Z may be in the prime of youth, but it seems they’re panicking about looking older than their years. On social media they are inundated with complaints that people consider them years – sometimes decades – older than they actually are.

One explanation for why they are aging faster than other generations is that, ironically, they have embraced “anti-aging treatments” such as anti-wrinkle injections and fillers.

In older people they may shave off for a few years, in younger people who don’t need them they can change the structure and shape of the face, causing sagging and wrinkles – exactly what they are intended to prevent. In pursuing the youth they already had, the young have made themselves old!

Finally a feeling for doctor 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 the risk of harm. This would be a very big and welcome step in putting clear limits and controls on what PAs can and cannot do.

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

Regular readers will know that I have serious concerns about the mass use of PAs, particularly the large number of patients they treat without realizing they are not consulting a doctor.

In addition to clear rules about what their role should entail, I think PAs should be called ‘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 among patients, which should be the most important thing, right?

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

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

The difficulty is that, unlike the death of a full-term baby, miscarriage is not really recognized in terms of loss. If a woman says her baby has died, everyone would appreciate the emotional impact of that. But when it is called a miscarriage, it is seen as something much less important.

Dr. Max prescribes: A good night’s sleep

According to recent research, a bad night’s sleep can damage the brain for up to two weeks. The results showed that a restless night continued to impact attention, cognition and memory well into the following week. So make sure you go to bed early. In a week you will thank yourself for that.