Heroes Not Zombies

Have you come across the slow movement yet? It started with “slow food”. Slow food, of course, is the opposite of fast food. It’s pretty easy to figure out what a “slow food” movement would be about. Fresh, locally sourced ingredients, individually prepared, and savoured as its eaten. Taking the time to really appreciate each and every mouthful. A bit like “mindful eating” really. 

Next came the “slow city”. The mayor of San Miniato in Italy, with local support declared his town a “slow city”, banning the opening of fast food restaurants and chain stores, encouraging walking, cycling and the nurturing of green public spaces. Several other towns have signed up to these principles creating the “slow city movement”.
There’s a lovely blog named “slow love life“. Read this phrase from its front page….SLOW LOVE means engaging with the world in a considered, compassionate way, appreciating the miraculous beauty of everyday moments, and celebrating the interconnected nature of life”
Then, recently some scientists have called for the formation of a “slow science” movement, posting this manifesto online  and asking for scientists to freed from the perpetual pressures to produce publishable results, to be less outcomes driven, and more exploration driven.
So, how about a “slow medicine” movement? Where doctors, nurses and other health carers take the time to fully understand a person’s illness, and are able to establish therapeutic, compassionate relationships. Where there isn’t a reflex to jump into a “quick fix” by prescribing a drug which will only mask the disease or temporarily modify it. Where it’s a fundamental value to discover what is unique about every individual and to help to stimulate and support every patient’s ability to self heal and self repair. In other words where the focus shifts from short term, outcomes driven goals, to improving quality of life and enabling people to actually develop and grow through the process of being ill.

Acute, fast Medicine
Acute, fast medicine has its place, and that place is at the edge of life. When your illness is sudden and severe I think the advances made in medical technology make a HUGE difference. Quick decisions, and rapid, precise actions bring the ultimate results – the difference between living and dying today.
Acute, fast medicine involves a sharp focus on only what is important to achieve a well defined outcome (not dying for example) in a short period of time (minutes or hours usually).
This model is just not appropriate either for trying to help someone to have a healthy life, or to live a good life in the presence of a chronic disease.
If someone has a condition like diabetes, multiple sclerosis, asthma etc, then using the fast, acute methods to rapidly change a very small part of the whole person is not enough. The timescale of a chronic complaint is weeks, months or even a lifetime. The outcomes which make a difference over that timescale can’t be so easily defined and measured. They are about qualitative rather than quantitative change.
The crucial shift from acute problems to chronic ones involves a broadening of the focus, a deepening of understanding to encompass the whole person inextricably embedded in the multiple contexts of their life.
This takes time, and it takes the establishment and maintenance of a relationship.

Manifesto for Slow Medicine

• Every person is unique. It takes time to get to know a person. Appointment times should be long enough to discover a person’s uniqueness.
• Good health care is developed from an understanding of the person who is ill or who wants to stay healthy. Understanding should take place before acting.
• More than a knowledge of disease is required to deliver good health care. There also needs to be a knowledge of the person. Diagnosis should not be limited to knowledge of disease. It should encompass a knowledge of the person.
• Doctors, nurses and other healthcare professionals  are people too. Every health care worker is unique. Recognising and nurturing this uniqueness is as important as defining knowledge, skills and attitudes required to carry out tasks.
• Delivering good health care requires self awareness and understanding on the part of the person who is caring. Reflective practice should include working on personal growth.
• The core of health care is the relationship between individual people – patients and carers. Priority should be given to the relationship.
• Good health care is relationship based, not event based.
• Continuity of care should therefore be given priority in order to support and develop healing relationships.
• Health care is for life. Defined, time-limited outcomes are arbitrary and are not a substitute for life long care.
• Health carers should work in supportive, understanding environments which enhance the delivery of healing relationships. These environments are co-created by the leaders, managers and health care professionals working in accord with compassionate, person centred values.