Heroes Not Zombies

I finished reading William Fiennes, The Snow Geese, this morning, then as I looked out of my window I saw this sight

I followed them round to the other side of my house….

I don’t really know what to make of these “coincidences” in life, but they certainly heighten the sense of emerveillement in le quotidien……

I really enjoyed ‘The Snow Geese’. It’s one of those books I’ve had lying around for a long time, but only recently decided to read. It has that wonderful combination of beautiful writing and fascinating, thought provoking facts, which I love. The main themes of the book, based around the writer following snow geese as they head north to their breeding grounds, are about freedom, our connection with nature, and the strong instincts to head home (migratory birds have two homes really…..one for the summer and one for the winter).

What I didn’t expect to find were some references to homesickness from a medical perspective, and, given that I’m a doctor, it should be no surprise that those passages leaped out at me.

Baron Dominique Jean Larrey, Inspector of Health of the French armies under Napoleon [described nostalgia in the following terms] First, an exaggeration of the imaginative faculty: patients thought of their homes as enchanting and delightful, and expected to see relatives and friends advancing towards them. Second, the appearance of physical symptoms: fever, gastric disturbance, ‘wandering pains’. Finally, depression, listlessness, weeping, and sometimes suicide.

How fascinating to see this holistic description and understanding, beginning with an individual’s inner, subjective, mental processes, leading onto whole body dysfunction with specific disorders in certain organs and systems, then progressing to a life-threatening state of mind. What cures did such doctors suggest? Larrey recommended distraction – through “music, recreation and regular exercise”.

In 1858, James Copland, in his ‘Dictionary of Practical Medicine’, described nostalgia as a cause of disease, rather than as a disease itself (where does a disease begin? Can you really say where health gives way to disease?) However, he still considered it to be a serious problem.

The patient nurses his misery, augments it until it destroys his nightly repose and his daily peace, and ultimately devours, with more or less rapidity, his vital organs.

Fiennes quotes from a 1996 edition of Psychological Medicine ….

What strikes one most in the sparse literature on help for the homesick is that often only returning to the old home environment brings real relief.

Well, well, well…..how often is it the case that the solution to a problem is to deal with the problem?! I know that seems obvious, but if it’s so obvious why do we persist in using drugs which merely mask symptoms as first line treatments for so many problems?

I’m particularly struck by the holistic, contextually bound understanding of the nature of homesickness in these works. How have we allowed the practice of medicine to decline to its currently dehumanised, mechanistic form? A doctor must understand the narrative context of a patient’s illness to arrive at a correct “diagnosis”, not just hunt a lesion and divide illness into real or imaginary, organic or functional. A person can only be fully understood as a whole person, body, mind and spirit, inextricably embedded in their unique physical and semantic environments……and, so, “cures” should be based on this perspective rather than the diminished, reductionist one, shouldn’t they?

We are connected. Intimately, complexly connected. ‘The Snow Geese’ reminds us how connected all creatures are to their environments and to the rhythmic change of the seasons. Good to be reminded of that in this snow and ice bound December in Scotland.

How are you going to spend your wintering?

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