Hello and welcome to episode 3 of the Cambridge Progressive Medicine podcast series.
In episode 2 we discussed how our current concept of health is predominately based in western medicine. We explored the huge advantages that western medicine has afforded us, whilst recognizing that its usefulness is limited to set number of conditions and diseases which it understands.
We recognized that human beings, both in body and mind, are far more complex than the science of western medicine can account for. In practice this means that human beings experience a huge variety of symptoms, signs and health concerns that western medicine simply doesn’t fully understand or know how to treat. Unless you happen to be suffering from a condition it is “good at” it is unlikely that western medicine will be able to help you to completely recover.
At the end of the episode we reflected on how Western medicine is especially good at extremely serious illnesses, such as heart attacks and strokes, but the majority of the time patients are not having heart attacks or strokes.
In today’s episode I want to pick up where we left off and ask – if the majority of my patients are not suffering from heart attacks and strokes, what are they suffering from?
In my day to day practice as a GP in the NHS, patients come to see me, and they feel like somethings just not quite right. People describe feeling tired all the time, feeling exhausted and sleeping poorly. They are suffering from anxiety and low mood, or physical symptoms such as aches and pains, tummy upset and nausea. Often they have been to see multiple doctors with their symptoms, and had multiple tests. Sometimes their symptoms have been going on for months or even years, seemingly without explanation. People might have tried multiple western medical treatments such as omeprazole, mebeverine, pain killers or antidepressants, without improvement in their symptoms.
And when I see patients that feel really washed out in this way, for me the most common reason for this is poor wellbeing.
These are the kinds of problems that western medicine is just not very good at treating. The underlying cause of the symptoms is not just one simple thing, like too much acid in the tummy, or too little thyroid hormone. It is because of a combination of hundreds of thousands of processes which are all interacting within the most incredible and complex machine you could possibly imagine.
Physical processes; mental processes; psychological processes; and social processes, all interlinked and inseparable, in a fantastic, individual, unique creature. Even if a team of scientists studied a single person for a thousand years, they wouldn’t be able to map out and describe the intricacies of the systems and processes that make them who they are, let alone design a pill that will make them run better. Lack of wellbeing is to western medicine what the butterfly effect is to weather forecasting.
And yet all of us secretly hope that our GPs will come up with a solution to these problems in 10 minutes flat. We kind of feel annoyed when they don’t. We wait weeks for our appointment, only to feel it’s a bit of an anticlimax. We feel a little bit cheated, a bit short changed. I’m not blaming you. I’ve been to the GP too. I’ve felt it. It’s completely understandable.
And It’s all because of our faith in western medicine, on our health beliefs, and our whole concept of self.
But it’s not helpful to us. In fact in many ways our excessive faith in western medicine to deal with problems that are outside its ability can be quite harmful. It stops us from being able to seek alternative, more helpful solutions. It blinds us to the truth of what we really need to do to be healthy as we look deeper and deeper to find “the disease”.
It causes excessive health anxiety as we worry about what unthinkable process must be going on in our bodies to produce the unpleasant sensations we are experiencing.
I believe that as GPs we often fail our patients, because we don’t have the time or the space, and maybe to some extent the expertise, to really deal with the root cause of the problems we see day in day out. Namely, to address a lack of wellbeing.
But this isn’t the GPs fault. GPs generally understand that people are far more complex than anything they learnt in a text book at medical school. That symptoms and diseases rarely fit into neat little boxes, and that many of the ailments they see are fundamentally due to a lack of balance in the body and mind, and are unlikely to get better with a prescription of omeprazole. But they feel powerless to do anything about it.
Here is the Rub. Not only is western medicine predominantly what doctors are trained to sell, western medicine is also what patients predominantly want to buy.
The western concept of health is so ingrained in our collective psyche that many patients feel disillusioned with anything but scientific medical solutions. We want a scientific explanation of which single body process has gone wrong, and a pill to correct it, so that we can go back to living exactly the same way as before, but without the unpleasant symptom.
We don’t want to be told that our symptoms are because we smoke, or work shifts, or are stressed, and that we haven’t been looking after ourselves properly. That fundamentally the reason we feel unwell is due to our lifestyles, and the way we interact with ourselves and the world around us.
We don’t like it because it doesn’t fit with our belief systems, and it makes us feel bad about ourselves. It can feel like we are being dismissed, and that our symptoms are not being taken seriously. Maybe we don’t believe we can change and so worry we won’t get better, or feel like we are being blamed for our symptoms, that we are being told that it’s all our own fault.
But, Just like it’s not the GPs fault, this isn’t the patients fault either. No one is to blame. It’s just the way we have come to think about health in our society, because western medicine is so good at the things it’s good at, we have learnt to trust it, and have extended that trust beyond its true capabilities.
Now I want to make a very careful distinction here. I am absolutely NOT saying that there is nothing wrong. That people with these symptoms are not unwell. It is not a dismissal of the symptoms, and there is no blame and no value judgement.
Frequently when I see patients who are suffering from a lack of balance and poor wellbeing they tell me that they have seen multiple doctors, had multiple tests and have been told that “there’s nothing wrong”. Well, I’m telling you right now, there is something wrong. 100%, undoubtedly, there is something really wrong. If you are feeling tired, anxious, tearful, or are in pain, if you are unable to live the life you want to live, something has definitely gone wrong.
When a doctor says “we can’t find anything wrong” what they really mean is: “we can’t find anything that we know how to fix.” This absolutely does not mean that there is nothing wrong. But it probably does mean that you are not suffering from a condition that western medicine is very good at.
And just because someone is suffering from a condition that western medicine isn’t good at, does not make it their fault. It doesn’t mean they are to blame. It does not mean that the symptoms are any less serious or debilitating. In fact in many ways its worse, because there is no quick fix – no pill to take to make it better. However, it does mean that we need to take a different approach to treat it. It means that it is going to be a lot harder work.
The problem is that your symptoms probably are because you smoke, or work shifts, or are stressed, and you probably haven’t been looking after yourself properly. Fundamentally the reason we feel unwell often is due to our lifestyles, and the way we interact with ourselves and the world around us.
But your GP knows that in order to change this, in order for you to feel better, they would have to fundamentally change how you think.
To change your beliefs about health, about lifestyle, about yourself, about who you are.
And that is an incredibly difficult thing for humans to do. Humans do not like to have their fundamental and basic beliefs challenged. It makes us feel terrible. It gives us nausea, a sense of dread, and our brain will do anything to defend and justify the beliefs it already holds.
So what options does your GP have in the remaining 2 minutes? Prescribe some omeprazole and hope the symptoms get better on their own? Tell you to make some lifestyle changes, knowing that you probably won’t, because you haven’t changed what you think? Change the subject, and hope you will forget about it?…..
……No wonder we feel short changed……..
………………Or maybe they could write a podcast?
So where does that leave us? We are nearing the end of episode 3 and all I have told you so far is that I might get the diagnosis wrong, and what I have to sell, what you want to buy, is unlikely to help you.
Not a great sales pitch. Not a great way to win friends and influence people.
But there is hope. Once we can recognize how western medicine can help us, but also when it can’t, we can clear the way for a better system. A system that can actually have an impact on our health, and help us to feel better, where western medicine has failed.
When I discuss this with my patients they are almost always skeptical. Of course they are, I am challenging their belief systems. If we are asked to think about things differently this is always a challenge, because it suggests that what we are currently doing is wrong – and by extension that we are somehow wrong. And we don’t like it. That is why change is so difficult.
I often ask my patients to keep an open mind and in doing so to remember this simple truth. Whatever it is you have been doing up until now to manage your symptoms, to improve your health, just isn’t working for you. If it were you would be feeling better by now. So where’s the harm in trying something new?
If you want to feel differently you need to think differently, otherwise you will always just carry on the same.
So, I want you to try to keep an open mind, I want you to stay with me and listen to episode 4. We have hopefully cleared away some of the old structure, some of the unhelpful ideas that have been holding you back. Now it’s time to start laying the foundations of a new better, brighter more powerful system, that puts your health and happiness back in your control. A system that will enable you to choose health.