Heroes Not Zombies

This beautiful multi faceted sphere always inspires me. It reminds me how wonderfully complex we humans are. When a patient would come to me with a problem I was always aware there would be many sides to the story. To focus solely on one aspect of their illness would always be a mistake. I had to take the time to help them tell their whole story and to unravel the many different influences and factors involved in bringing about their current illness.

I recently read about “The Invisible Kingdom. Reimagining chronic illness”, by Meghan O’Rourke. The haven’t read it yet but I’ve listened to a couple of interviews with her and she describes the real epidemic of chronic illness affecting society and how our current health model doesn’t enable us to address it effectively. Everything I’ve heard her say resonates with me.

I’ll pick up a couple of points here. She stresses the importance to patients of being heard and seen, of being believed and not dismissed as mentally ill if there are no abnormalities found in their physical tests. I would say every single week without fail, I and my colleagues were told by patients “You are the first doctor to have really listened to me”, or “I’ve never told anyone what I’ve just told you”. The patients we saw all had chronic illnesses and the vast majority had exhausted all the other services before coming to us to try the homeopathic or integrative approach. Our emphasis on non judgemental listening over the course of a one hour consultation was surely the key to facilitating this kind of experience. Meghan O’Rourke points out that clinics based on ten minutes appointments are never going to manage to achieve this kind of outcome, and, although some would say it’s not possible to change that I believe we should push for it, just as we should keep demonstrating the benefit of continuity of care. The problem is there are not nearly enough doctors. The solution is to train and retain far, far more doctors.

Another important point she makes is that we live in hyper individualised societies and consequently we pay far too little attention to the individual’s connections – their relationships and environments. If we know poverty predisposes to ill health we should tackle poverty. If we know poor housing contributes, precarious poorly paid jobs, discrimination and poor education contribute we need to address all of those. Surely Covid has made that even more obvious than ever. If inadequate ventilation of workplaces and public enclosed spaces promotes the spread of viruses, let’s invest in clean air technologies and practices. If a cocktail of endocrine inhibitors saturate our water and our air, let’s address that. If the agrochemical industries produce and market obesogenic, poor quality food, let’s tackle that.

We are seeing huge increases in chronic disease in our so called developed societies. Surely we need to consider a lot more facets/factors than we’ve been doing if we want to create better, healthier lives for more people.