Episode 4 – What is Progressive medicine? Why lifestyle is the key to health.

Hello and welcome to episode 4 of the Cambridge progressive medicine podcast series.

So far in this series we have discussed that, whilst it is a fantastic thing, western Medicine has limitations in its ability to afford us good health and happiness.

We have suggested that if we are feeling unwell what we have been doing up until now to make ourselves feel better isn’t working for us. If we want to feel better than now, that means we need to make a change. We need to do something different.

If we want to change how we feel and what we do, we have to change how we think. We need to change our ideas about what is going to make us feel better. The reason we have been doing what we have been doing up until now, the things that have failed to make us better, is that we believed that they would make us feel better. Otherwise why would we have been doing them?

But the human brain does not like to change its mind about things. Once it thinks it knows something it will try to hang on to that belief and defend its position. That is how human brains work. It will hang onto its beliefs even if all the evidence suggests otherwise. In fact the more evidence that you present to someone that their belief is incorrect, the stronger they will hold on it. Think about discussing Brexit with someone who has the opposite opinion to you – it’s pretty rare that either person ever changes their mind, and normally both people go away from the discussion feeling even more convinced of their opinion than before. There are hundreds of psychological studies demonstrating this effect, and various different theories trying to explain why it has arisen.

I like to think of it simply that we don’t like to be wrong. It is an attack on our self-esteem, on our self-worth, and it makes us feel bad about ourselves. It also threatens our sense of self. Our beliefs make up who we are, and so an attack on our beliefs is an attack on us. So we try to protect ourselves from feeling bad, by defending our position. Automatically dismissing new ideas out of hand, and hanging onto the old ones.  This is why we fear change, and might struggle to accept people that are different from us.

But actually it is not really important why humans think this way. It’s just important to recognize that all of us do it. This unfortunate human trait is the reason why it is so hard to make positive change, and why so few of us do.

But if you are aware of it, and recognize it in yourself, you can learn to suppress the natural instinct to automatically dismiss new ideas out of hand. To dismiss them as nonsense. Without taking the time to consider if they could benefit you. Without at least giving them a try. You can understand that new ideas are not an attack on you. They do not diminish your sense of self. Actually they are exactly the opposite. New ideas can be a nurturing stroke that enable you to heal and grow and flourish. New ideas are always our friend and never our enemy. If we are fluid in our beliefs they can’t really harm us, because if it turns out that a new idea is unhelpful, if it fails to serve us, we can simply let it go and choose another one. But if we are stubborn, as all humans naturally are, and hang on to our old ways, even though they are not helpful to us, even if they are harming us, we will never be able to make the changes we need to find a better path. We will carry on feeling and acting the same old way.

I want you to hold onto to this concept of change, and to keep an open mind, knowing that change is good for all of us. It is not a dreadful attack on our very being, but an incredibly exciting opportunity. Be kind to yourself, and keep an open mind. Allow yourself the freedom to learn, and experiment, and experience and grow.

So with an open mind I want to explore a different way of thinking about health. If western medicine has failed to make us healthy, what will? What can we do to take control of our own health and happiness?

The answer is progressive medicine.

Progressive medicine is all about focusing on health rather than disease. Traditional models of western medicine look for illness; they are focused on diseases, on identifying malfunctions in the body and correcting them. But if we want to feel healthy surely we should focus on health, not disease? We need to study and think about what makes us well, rather than fixating on what makes us ill. Progressive medicine focuses on the person, on the individual, not the disease.

In episode 3 I suggested that many of my patients’ feel unwell because they have a lack of balance in their lives, that they have a fundamental lack of wellbeing. But what does this really mean?

The issue with western medicine is that there are too many variable. Humans are just too complex for a scientific model of health to account for. But this doesn’t mean that we can never be healthy.

When I say a patient has a lack of balance, a lack of wellbeing, what I mean is that something they are doing, or thinking, or feeling, is not working for them. It is putting the body and mind out of kilter, and making them feel unwell. And because they are so complex, because there are so many factors that can contribute, physical, biological, nutritional, emotional, psychological, and social factors, western medicine alone cannot come up with a solution for this lack of balance.

But that’s OK. We don’t need to understand every single possible process in the body to find good health. All we need to do is to think about the things humans need to grow and flourish. In episode 2 I proposed that the human body is better at healing itself than doctors are. We don’t always need to understand why we have been feeling unwell at a biological level. We do not need to know the specific molecular processes, or chemical imbalances that might be producing symptoms, we don’t have to understand the “disease” at all.

All we need to know is how to create the right environment in which the body can heal itself. We need to cultivate a healthy setting in which to live and heal and develop, and let the body take care of the rest.

Imagine a gardener and a scientist both decide to enter a flower show.

The Scientist grows his flowers indoors, under artificial light, so that he can closely control the environment. He calculates the exact amount of light and minerals and water they will need using scientific first principles. He decides to grow them in semi-darkness so that they will grow taller and more efficiently.  He takes multiple samples from his plants so he can monitor microscopic processes, so he knows that he is providing the exact conditions he has calculated they need. He digs them up and replants them every 3rd day to accurately monitor the mineral and moisture levels in the soil.

When his flowers start to look straggly and weak, he assumes they must have contracted a disease. To try to identify the problem he doubles the number of samples he takes, and decides to dig them up every other day to monitor more them closely.

Now let’s suppose the gardener knows nothing about the biology of plants, about the microscopic processes that allow them to grow. He has never heard of chlorophyll, or photosynthesis, he can’t draw Krebs cycle and doesn’t understand about phosphorylation or decarboxylation. But he does know what type of soil a particular flower requires, what time of year it should be planted, how much sunlight or shade it likes, and how much water it needs. He provides a healthy environment for it, but he allows nature to take care of the rest.

Who do you suppose is going to produce the heathiest flowers?

When you are stuck in traffic on the motorway, if you take the time to look, you may see beautiful, healthy flowers growing in the central reservation, without any assistance from scientist or gardener. Sometimes in Medicine, just like in life, less is more.

Imagine you buy a new laptop and you want to keep it running well. You don’t need to get a degree in computer science. You don’t need to understand its internal workings. But you do need to know how to look after it. You need to keep it dry and not allow it to get too hot. You might want to run some antivirus software, and be careful which pop-ups you click on. You can keep it charged up, install new updates, and turn it off properly. And if it does develop a fault, you might be better off trying turning it off and on again before taking screwdriver to it! Often things will look after themselves better on their own than if we start interfering with them.

Humans are just the same.

As a GP I may not know every single biological process that may be producing health or illness in my patients. But I do know that there are certain conditions that all humans need in order to thrive.

We need shelter, and warm clothes. We need clean water and good food. We need regular exercise, good quality sleep, and rest and relaxation. We need friends, and family, a sense of community and belonging. We need to feel productive, to have a sense of purpose and self-worth. We need to do things that we enjoy doing, to swim in the sea, or paint, or sing, to smile and laugh.

My dog Tahuna loves to run, just for the joy of running, and if she didn’t get to run, if she was kept in all day, she would soon become unhappy and unhealthy. Humans are no different.

It is when these conditions are not met that people develop poor wellbeing, and with it physical and mental symptoms.  If we have a lack of balance, and a lack of wellbeing we soon become unhappy and unhealthy.

When people are feeling tired all the time, and washed out with no energy; when they are feeling low or anxious; when they are troubled by multiple physical symptoms in different parts of the body; tummy ache and muscle aches; headaches and nausea; the root cause of all of these symptoms is a lack of balance in the body and mind. Something they are doing, physically and mentally, isn’t agreeing with them, and it is making them unwell. Their bodies and minds are not functioning as they should because the environment they find themselves in is not allowing them to thrive.

The answer to this problem is not to look harder and harder for the underlying disease that is making us feel unwell. It is to address the fundamental problem. To address the aspects of our lifestyle which are not benefiting us. Only when we can make changes to this environment can we hope to start to heal, to find balance, to find peace, to find health, and happiness.

So often when I discuss this with my patients they seem dismayed. I have spent a lot of time thinking about why this is. Partly I think it’s because it’s a challenge to their concept of health and their belief about what it means to be unwell. Maybe they worry they are not capable of making a change, and so won’t be able to get better. Maybe they just don’t want to change their lifestyle, it is certainly much easier to take a pill.

I think it is also partly because they feel that it implies blame, that their ill-health is somehow their own fault. This is totally wrong. There is no blame, and there is no value judgment. It just is what it is.

Here’s the thing, lack of balance and wellbeing is not only applicable to a handful of “super unhealthy” patients, who have “terrible” lifestyles, it applies to pretty much everyone. I see it in almost every patient I see, and I see it in myself too.  It isn’t our fault, and it isn’t because we are “bad people” who deserve to feel unwell. You are not being singled out for criticism and ridicule. Our society has developed such that most of us are now living in a way that is simply not conducive to good health.

We have not been socialized to take good care of ourselves, and are seldom mindful of our own physical and emotional needs. We often prioritize other people’s needs over our own, be that through work or family commitments, caring for children, parents or friends. Often we have little time for doing the things that we need to maintain good health, or for doing the things we really enjoy. We develop unhealthy habits to help us to cope with our lifestyles.  When I have a busy day at work the first thing I drop from my schedule is the gym, second to go is cooking a healthy meal. I drive to work rather than cycle, and pick up a ready meal on the way home. When I’m feeling exhausted I might use caffeine in the mornings to boost my energy, or have a beer in the evening to unwind.

When we are stressed and anxious we may not behave as we would like to colleagues and friends. We are not attentive to our emotional needs, or those of the people around us. Often we are just not that kind to each other, and especially we are not kind to ourselves.

Humans are meant to be running around naked in the woods. We are designed, just like Tahuna, to run just for the joy of running. No wonder we feel unwell, no wonder our bodies and minds are out of balance, out of kilter, when we are leading such frantic, stressful, unnatural lives.

Now, I’m not suggesting that you should go and run around naked in Brampton woods, and of course, all of us have commitments in life that need to be met. But if we shift our focus and energy away from thinking about illness and disease, we can create space to focus on aspects of our lives that might be making us unwell: On our sleep, rest and recreation; on our diet, nutrition and exercise; on our productivity, on mindfulness, on our relationship with colleagues and friends; on our sense of self and worth. There are techniques that can be learnt to live a better life in our modern society. We can learn to think better thoughts, to relate to others and to ourselves in a healthier and more productive way. We can learn to parent ourselves, and to be kind to ourselves and others. We can develop time efficient methods to cultivate a healthier environment in which to live and thrive, and avoid unhelpful coping strategies that are actually making us worse.

And the best part about it is that all of these things genuinely are in our control. We have the power to make real active changes and to get genuine results. By creating the correct environment we can restore balance to our bodies and minds. We can heal. We can reduce stress and anxiety, reduce tiredness and fatigue, and gain more energy. We can improve physical symptoms such as nausea, aches and pains and stomach upset.

If, after being on hold to the IT helpdesk for half an hour, we are told to “try turning it off and on again” we feel annoyed. It’s a little bit irritating. We feel like we have been fobbed off, not taken seriously, or that our concerns have not been listened to. And isn’t it funny that these feelings persists even after we do turn it off and on again, and the problem is resolved. Sometimes the best solution is to turn it off and on again, to reboot and reset. Progressive medicine is a bit like turning ourselves off and on again. Our instinct may be to distrust it, we may want a more scientific explanation and intervention, but sometimes in order to get where we want to go we need to reset and start afresh. This podcast series aims to provide you with the tools you need to reboot yourself, to give practical suggestions for making positive changes in your life, to help you to find your reset button.