Feeds:
Posts
Comments

Health in health care

January 14, 2014 by bobleckridge

Steven Charlap tells the story of the failure of his MDPrevent business which he had to close down last month. It’s an honest and thought provoking reflective piece. His idea was to have a medical practice which focused on health instead of disease, which advised patients and supported them in making lifestyle changes instead of prescribing for them. It didn’t work out. For a number of reasons……he didn’t get enough referrals from other health care providers, had many problems with health insurance companies, and, he says, the patients weren’t really up for it.

Based on our review of the credible research, our model mostly excluded dietary supplements and multivitamins because the science mostly did not support their use. When it came to pharmaceuticals, we didn’t rush to prescribe if there were a non-drug alternative. This approach was a turn-off to many patients who expected a prescription or emphatically clung to beliefs in supplements. And the no-cost, no-deductible, no co-payment provisions in Medicare’s preventive benefits may have had an adverse effect on people’s sense of its value. How much would you appreciate something that has no cost to you? For many patients, it seemed easier to take supplements than to be more attentive to food labels and exercise habits.

I have a lot of sympathy for this doctor. I think the present system of health care is not about health, and is not sustainable. I’m not so sure about the emphasis on prevention however…..let me explain – to prevent something has a negative tone for me, and I think health is a positive attribute. I prefer a focus on positively creating health, rather than negatively trying to prevent, or avoid disease.

His conclusion is particularly striking –

Patients loved my practice because I was willing to spend up to two full hours with them, most of it not reimbursed by insurance. The extra time often meant successfully making a diagnosis that had eluded other doctors for many years. It takes a very long time to get a thorough history and do a good exam and almost no time to prescribe a medication for a presumed illness. I chose the former. Insurance pays for the latter. Unfortunately, we still have a healthcare system that makes money by treating disease, rather than by preventing it.

and that last sentence is the real indictment in this story “we still have a healthcare system that makes money by treating disease, rather than by preventing it.”

What do you think? Do you think we need health care which helps people to create health? Would you like a service like that?

Posted in from the consulting room, health | 5 Comments »

Getting neutral

January 13, 2014 by bobleckridge

Mostly we react, but its better when we respond.

What’s the difference?

Reacting is automatic and rapid. Somebody presses one of our buttons and BUZZ out comes the response – anger, indignation, anxiety, hurt, sadness…..you name it. One of the problems with this reaction mode is that we get the feeling other people are constantly pulling all our strings.

It would be great if we felt more in the driving seat, wouldn’t it? To do that, we need to practice responding instead of reacting. What happens in response mode is that somebody presses one of our buttons, we notice it and think, ‘oh, there’s that button getting pressed again’, then in the short pause, we get to choose. What am I going to do about it?

It’s a bit like when the telephone rings. You don’t HAVE to answer it. You have a choice. The experience of exercising that choice, in fact, even the experience of having time to choose, is hugely empowering.

Here’s a simple little technique which lets you begin to change from reactive mode to responsive mode. It’s called “getting neutral” by the “Heartmath” people.

First deliberately move your attention to your heart area. Say, for example, you are speaking to someone on the phone, maybe someone who repeatedly winds you up. They hit one of your buttons but instead of automatically reacting, you say ‘hold on a moment’, put your hand over the receiver, turn your attention to your heart area, and now, take three deep, diaphragmatic breaths. One, two, three. Now return to the conversation.

This is called ‘getting neutral’ because its like when you are driving a car and the brakes fail. You can slip the gear into neutral, breaking the connection between the engine and the car’s wheels, stopping it from speeding out of control.

I’ve taught this method to people who experience panic attacks. Instead of spinning out of control, they turn their attention to their heart area, take three diaphragmatic breaths, and the panic stops.

It might not work every time, but one of the great things about it, apart from its simplicity and easiness, is that it gets more powerful and useful the more it is practised.

 

 

Posted in from the consulting room, health, life, personal growth | 2 Comments »

The A – Z of Becoming. B for Breathe

January 12, 2014 by bobleckridge

In the A to Z of Becoming, the second verb is “breathe”.

You might think, ‘well that’s easy, I do that all the time!’ But I don’t mean automatic, unaware breathing. I mean the kind of breathing we choose to do.

Think of these two different kinds of breathing – primarily using the muscles of your chest, or primarily using your diaphragm. It’s this latter form of breathing which I’m going to focus on this week. Diaphragmatic breaths tend to slower, deeper and fuller than the more automatic chest muscle form. These deeper, fuller breaths change the balance of oxygen, and carbon dioxide in our lungs, and so affects the balance of chemicals in the blood. This has far ranging effects on your body, and your mind.

Here are two simple suggestions.

First, awareness of the breath. At any moment, in any place, turn your attention to your breathing. Without trying to change anything, see if you can just notice how you are breathing. How fast is your breathing? How regular? How deep?

Secondly, take three diaphragmatic breaths. Fill your lungs by breathing in as much as you can breathe in. Now breathe out, slowly, evenly, and as completely as you can. Once you have completed this out breath, breathe in again, again completely filling your lungs. Breathe out, slowly, evenly and completely a second time. And now do the same again a third time, once more filling your lungs to the top, and slowly, evenly breathing out to empty them.

Notice how you feel. How does your body feel? How does your mind feel?

Posted in from the living room, health, life, personal growth | 2 Comments »

Introduction to Integrative Medicine

January 11, 2014 by bobleckridge

I’m often asked what I and my colleagues actually do at the NHS Centre for Integrative Care.

Here’s a 20 minute video where I explain what Integrative Medicine is. This is based on a talk I’m giving to GPs next week so the intended audience is health care professionals but I thought anybody might find it interesting or thought provoking…..I hope it is!

In essence I think Integrative Medicine is a holistic approach to health making, and my understanding of health and illness is framed by the lens of complexity science, or, specifically, through the lens of the Complex Adaptive System.

 

Posted in from the consulting room, from the living room, from the viewing room, life, science, video | Leave a Comment »

View from on high

January 10, 2014 by bobleckridge

jupiter over ben ledi

 

When I looked out of the window this morning I saw a bright star shining over Ben Ledi.

My Starwalk app tells me that what I was looking at was Jupiter, and it was sitting smack in the middle of the constellation Gemini. It was too light to see any of the constellation but you can see how easy it was to see Jupiter.

There’s a saying in French about taking a view from on high (vue d’en haut). The meaning is pretty clear. When you think what it is like to look out over a land or seascape from a cliff or hilltop, you get the idea. In other words, its about taking an overview, seeing the bigger picture, seeing things in their context.

Iain McGilchrist describes how the left and right hemispheres approach the world differently. The left tends to focus in on things. It’s like using a telescope or microscope. It’s great for seeing the details and analysing them. It’s a kind of digital approach. The right however gets first claim on all the information flowing into the brain. It takes the overview, the more holistic, analogue approach. In some ways, you could say our right hemisphere is well designed to allow the view from on high.

The French take a variation of the view from on high, and include the concept in the expanded one of a “view from Sirius”. Sirius is the brightest star in the sky (the planets might look brighter but they aren’t actually stars).In 1752, Voltaire wrote a story entitled “Micromegas” about a giant from Sirius traveling across the universe and coming to Earth to have a look around. Not only does the view from Sirius include the idea of an overview, but it also captures the idea of everything being seen or experienced for the first time. When you travel to a new land, the everyday reality can seem strange and new, and stimulates your curiosity.

So, when I look out and I see the bright shining Jupiter over Ben Ledi, it sets off my thoughts about taking the “view from Sirius” and takes me into the day with a sense of wonder, of open-ness, and of being able to see the bigger pictures.

Taking a look from higher than Ben Ledi, but not as high as Jupiter or Sirius shows us just how thin the biosphere is…..its a pretty thin layer in the scheme of things!

biosphere

 

Posted in from the dark room, from the living room, movies, perception, personal growth, philosophy, photography, psychology | 5 Comments »

Happiness

January 9, 2014 by bobleckridge

I’ve read a lot of books about happiness, but this little article on the Huffington Post really caught my attention with this simple and useful infographic. Click through on the link to the Huffington Post in that sentence to find the links to the studies backing the creation of this image.

2013_HappinessMatrix

Nice, huh?

Good to see how you can easily boost happiness simply by smiling (warning: the smiles have to be authentic – artificial smiles don’t work!) And I am really struck by the power of gratitude, and by performing acts of kindness.

So, how about just taking those three, and trying them out for the next few days. Start a gratitude journal and write in once a day, maybe preferably at night before bedtime……just list, and write a sentence or two about, whatever you experienced today that you feel grateful for, or write about who you are grateful to, and why. Set out each day to perform at least one act of kindness, or, even better, see if you can speak kindly and act kindly all day long. Finally, play some music which makes you smile, or look at some photos which make you smile, or delve into your memory banks for moments in your life which made you smile.

Posted in from the consulting room, from the living room, health, life, personal growth, psychology | 2 Comments »

Active care in dementia

January 8, 2014 by bobleckridge

Here’s an interesting article about patients with dementia.

It focuses on interaction. This particular piece gives examples from America where Catholic and other Christian care homes introduced regular services of prayers and hymns, and showed how these old traditions connected with the patients when other forms of care didn’t. I don’t think this means that Catholic or other religious people have, or can have, a better experience of dementia than others, but I do think it highlights yet again the need for carers to be non-judgemental. Where a person has strong religious beliefs, engaging with them through their lens of understanding can really bring about surprising changes.

But what I especially like about this article is how it highlights three things – the need for compassion, the need to remember that all human beings are individuals, and the need to enter into active engaged relationships.

Like anything else in medicine, helping someone suffering from dementia requires understanding, compassion, and dedication. Care needs to be tailored to each patient’s personality, life history, and stage in the development of the disease. When this is done well, new possibilities open up. What might have been an atmosphere of regret and hopelessness centered on the disease’s relentless progress can be transformed into an upbeat outlook that celebrates abilities, rejoices in moments of recognition, and looks to the future with hope.

and

We simply do not know what is transpiring in the mind of another person. It is all too easy to place all the blame on the dementia patient, lamenting and even despising their disability. But were we to do so, we would be letting ourselves off the hook a bit too soon. Awareness, understanding, and affection are not merely the outputs of some inner dynamo. They also emerge in response to what others do, say, and feel. In some cases, unresponsiveness may say less about a patient’s disability than a failure on our part to offer something worth responding to.

 

Posted in from the consulting room, health, psychology | Leave a Comment »

Family horizons

January 7, 2014 by bobleckridge

IMG_0656

 

Most days, most of us are focused on present needs and desires. We are good at knowing when we are hungry, thirsty or tired, and knowing what we’d like to do about that.

If we have children, our horizons are pushed out a bit – when we think about where to live, once we have children (or are considering having children), we think ahead to the next few years of their lives. What are the local schools like? What is there for them to do as they grow older? What kind of environment is this for children to grow up in?

That got me wondering about how many generations ahead we ever think.

Think about life from the perspective of a 25 year old this year, 2014. Let’s assume a reasonable life expectancy of 75 years. So when your horizon is yourself, at 25, you have about 50 years of living to consider, or till about 2064. Many of the decisions you take about how you are going to live now will affect how you will be living over the next 50 years. Now, what if you have children this year, when you are 25? If they have the same life expectancy as you, then they’ll live for the next 75 years, until 2089. You might well consider how the choices you make now may influence the kind of world which they will live in until 2089.

Take another step and think  about them also having children when they are 25 years old, (that would be in 2039) and life expectancy remaining at 75, then those grandchildren will live till 2114….a hundred years from now.

This is starting to get a little shocking, but let’s push it, a not unimaginable distance further and consider your grandchildren’s children. Sticking with the same pattern, your grandchildren’s children will be living in the world of 2139, and their children to the year 2164.

Yikes! Your grandchildren’s grandchildren will live in the world of 2164 (if you are 25 this year and having your first child).

That’s a hundred and fifty years from now.

Between 1850 and 2000 the world population increased from about 1 billion, to 7 billion people. The growth rate is not even – it’s exponential. In that same period we have consumed probably about 80% of the world’s non-renewable resources, and that consumption is increasing exponentially too.

WorldPop-7billion-102811

What kind of world will your grandchildren’s grandchildren be living in?

Does thinking about these increasingly distant family horizons influence any of the choices you might make this year?

Posted in from the living room, life | Leave a Comment »

Stoner’s view of love

January 6, 2014 by bobleckridge

Did you read “Stoner”, by John Williams last year? It’s been quite a phenomenon in the UK, having sold precious few copies in the author’s lifetime, then suddenly becoming a bestseller with rave reviews here this year.

I liked it. A lot. But let me just share with you a couple of wee passages which describe how the main character, Stoner, comes to think of love as he gets older. Firstly,

…he began to know it was neither a state of grace nor an illusion; he saw it as a human act of becoming, a condition that was invented and modified moment by moment and day by day, by the will and the intelligence and the heart

and, also

….that the person one loves at first is not the person one loves at last, and that love is not an end but a process through which one person attempts to know another.

Well, I’m sure if you’re a regular reader here, you’ll know why that first passage grabbed me – “a human act of becoming….” and I especially like the thought that love changes all the time, and that the will, the intelligence and the heart are all involved in creating that change.

Then, well, how wonderful….to describe love as a “process through which one person attempts to know another”. I do think that is so often forgotten….that love isn’t just a feeling or a state, but it is an ongoing act of trying to know another. Funnily enough, that makes me think of my verb of the week – attend, particularly, with regard to the latin origin of ‘attend’ being about a reaching or stretching out towards….

Posted in books, from the living room, from the reading room, life, personal growth | 3 Comments »

The A – Z of Becoming. A for Attend

January 5, 2014 by bobleckridge

Over the course of the next six months, I’m going to share with you some thoughts on 26 verbs….one per week. Each verb is an action. Each of these actions will support your process of becoming as fully YOU as you can be. I believe that’s why we are here – to develop and manifest the uniqueness of who we are. Every single one of us is an utterly unique expression of the universe. There is no other, has been no other, will be no other, expression of the universe with the same uniqueness as YOU.

This is a life process, and its a process of becoming. It’s not a process with a fixed end point, and we never quite know how it’s all going to go but I’m working from the core belief that every day I can contribute to this process of becoming by choosing how to live, by choosing which actions to take.

So, let’s start with A.

My A verb is ATTEND.

Let’s think about some of the meanings of the verb, attend.

  1. to be present at
  2. to go with, or accompany
  3. to take care of
  4. to wait upon
  5. to watch over, or look after
  6. to listen to, or give heed to
  7. to wait for or expect.

The English word, attend, comes from the 14th century French, “attendre”, meaning “to direct one’s mind or energies”, “to wait for, pay attention”, and from the Latin, “attendere” which literally means “to stretch toward” (or “give heed to”)

So, what are you choosing to be present with today? What, or who, are you choosing to be with, to accompany?

What, or who, are you taking care of, looking after, listening to, or giving heed to?

What are you waiting for, or what do you expect of today? What are you “stretching toward”, reaching out to?

Attending to something involves paying it attention, and it seems to be that whatever we pay attention to gets bigger. The more we think about a particular issue, the more that issue looms large in our minds. Attending to, in that sense, is a bit like a magnifying glass.
Attend

Lotus root and yen

So, when we attend to something, or someone, today, whether that be our thoughts or feelings, or objects, people, activities……whatever it is will grow.

What do we want to grow? Which thoughts, which feelings? Who, or what, do we want to nurture?

I’m only going to share one verb a week, and I’m going to explore that verb every day for a week (that doesn’t mean I’ll write about it here every day, mind you!) I invite you to share this with me. I’m inviting you to explore these verbs with me and share as much of your exploration as you want, in whatever way you want…..comments, your own blog, Facebook, tweets, instagrams…..whatever works for you.

This is an invitation to participate in becoming more truly, more fully YOU.

 

Posted in from the living room, life, personal growth, photography | 10 Comments »

« Newer Posts - Older Posts »