Sacred Connections Scotland
The following article has been quoted from Issue 55, 2002, of Caduceus Magazine
The Big Picture of Health by Dr. Peter Davies, BSc., MBChB, MRCGP
So, Gordon Brown has announced an extra £1,000,000,000 for NHS spending. This is on top of this year’s NHS budget of £40,000.000,000. And he has pledged generous increases in years to come, if necessary paid for by raising taxes. As a doctor I should be pleased about these increases. I might moan that ‘they’re not enough’, or that ‘they’re too late after decades of under-investment’. I should be pleased that more money would mean more doctors, more nurses, more operations, more scans, more tests, shorter waiting lists, and better treatments all leading to more health for my patients. I am not pleased. I am despairing. Not because I don’t want extra money or a properly funded illness treatment service. I am despairing because the debate on health in this country has been reduced to a battle on NHS Funding. I am despairing because false linkages have been made between an illness treatment system (the NHS), illness treating professionals (doctors and nurses), and health.
The average doctor has had about three hours teaching about health in five years study at university. We are trained to treat illness, and deserve respect for our abilities at this. Our training therefore makes us illness professionals, not health professionals. And health is not just the opposite, or absence, of illness. To make matters worse we have a public health concept that says you can measure health by measuring death rates. In other words if people are not dying they are healthy! Yet all of us have to die of something and so the death rate is always one hundred per cent. Is it healthier to die of one disease than another? Cancer or stroke, which would you choose? (Apply here now and as a new NHS service we can organize this for you). How have we reached a situation where experts in diagnosis and treatment of illness have come to be seen as experts on health? A situation in which every so-called health programme has a tame doctor on it advising on anything and everything. And even worse the public are apparently lapping this up. Our media acts to spread bad news and anxiety. The hidden message lies in answering the question ‘Isn’t the world depressing? You really should be worried about this, shouldn’t you?’
Are doctors models of health?
Are doctors particularly healthy themselves? Are they well rounded, well-balanced individuals? If you were looking for a model of health would you choose a doctor as your example? You would not, and for good reason. Firstly medicine is a deeply unhealthy profession. (I could explain why but that’s another article). Secondly doctors spend so long around ill people that we become so tuned into illness and ill people that we struggle to raise our thinking up to questions of health. One doctor summarized his role as follows, ‘Our patients spend most of their lives drowning in excrement. Our job is to direct them to the shallow end’. Health is not the shallow end of a cesspool. The best any doctor can tell you is how to avoid getting ill, and even at that we are only partially accurate. Even the language we will use to tell you this information will speak of the ‘determinants‘ of health. The idea that your health is determined by something else is deeply pernicious as it makes it appear as if your health is determined by outside forces acting on you. This allows patients to see themselves as passive ‘victims’ of disease. It also allows doctors to indulge in ‘rescuer’ fantasies as they ‘advance’ to ‘attack’ disease. It also discourages patients from looking for ways in which to improve their own health. We need to get away from allowing my profession to define the concept of health. We need to choose to be healthy. We need to do this for ourselves. To start with we need to mobilize the prerequisites for health. This is a positive concept and I suggest the following as appropriate prerequisites for health. (The list is not exhaustive):
Prerequisites for health
Starting at the environmental level we need clean water, clean air and good food. Good food grown in good soil free from unnecessary fertilizers or pollution. We also need warmth and shelter. Many houses in this country are in poor condition, cold and under-heated. Is the health service tackling this? No, yet how do you expect people to be healthy without this? We need to look at personal and group behaviours and see how we could alter these in such a way as to generate health. Moving onto the level of skills and capabilities we need to empower people with the belief that learning is fun and that we all can learn. Too many of my patients were ‘dim at school’ and have now given up on learning. I have to try to demolish their false belief of learned helplessness (after all they learned how to be helpless in the first place, didn’t they?) before I can give them any concept that they themselves may be able to learn about health improvement. The power I run on is all about my belief that I can alter my beliefs and so the world. If I did not have this belief I would not even start to write this article. How can I help my patients to rediscover their own power? Our beliefs are shaped by our identity, how we see ourselves in relation to others, and more importantly to ourselves. As a society, whether deliberately or unconsciously, we have multiple ‘ready to wear’ dysfunctional beliefs and roles for ourselves and others, such as ‘the black sheep of the family’ and ‘the victim’. We need the power to go beyond these false beliefs and stop confusing roles with identity. I work as a doctor. I am who I am. To reinforce the power of our individual, and group, identities we need to draw on the power of spirituality and connectedness. Religion initially meant a process of binding back together and this connectedness is exactly what spirituality can give. An identity not nourished by a sense of being connected in to itself or others cannot be healthy. The close verbal connection between salve and salvation can be re-established.
Too many people in our world can be see living in a poor environment, pursuing dangerous behaviours, belittling their abilities, believing lies about themselves, and having a poor sense of who they are or how they can be connected to others. These people are deeply unhealthy at many levels and yet to medical science they are normal ‘humdrum people living ordinary lives of quiet desperation’. Medicine does not get involved until diseases arise as a result of the prerequisites of health being absent. As my colleague Seth Jenkinson says, ‘we deal with end stage social pathology‘. To move towards being health workers we need to be involved long before medically recognized diseases show up. As individuals, as communities, as a political system we need to establish the prerequisites of health. If we want more health we need to put the money into ensuring that these are present and not into treating disease. And we must work at all levels. It is no use providing a good environment if our basic belief pattern is saying that we do not deserve this. With a belief like this we will simply act in accordance with it so that the environment will soon be degraded again. So we must act at all levels. At a political level we must realize that every government department has the capability to act to improve health. Health is not the sole function of the Department of Health. At a community level we must celebrate the many things that bind us together and use the common ground from these to reinforce spirituality and connectedness. At an individual level we must improve our relationships with ourselves and so with others. The second commandment says, ‘Love your neighbour as yourself’. If you do not love yourself how can you love others? Self-esteem would become one of the planks of the Health of the Nation plan. When we love ourselves and others better our behaviour towards others will improve. We will then enjoy better relationships and this of itself will generate greater health. We will use our beliefs to avoid damaging our environment in the first place and to mend any existing damage. We will have enough confidence to accept the occasional illness as part of life. Indeed many people who have an illness are healthier than those with no apparent illness. We must learn to accept death. (And maybe only spirituality really lets us do that.) And we will rejoice in our health as a basic part of our lives. And it is so much more than the mere absence of disease we currently aim for.
- If you need to see a doctor to confirm that you are healthy you are sick indeed!
- You can have an illness, and still be healthy.
- You may have no illness, and still be unhealthy.
- Doctors treat illness and deserve respect for this.
- The NHS should be renamed the National Illness Service, for that is what it is.
Full health will emerge when we pay attention to making improvements at all the levels of health. The levels are (going down):
As Einstein says, ‘A problem at any level can be resolved provided that it is addressed from a higher logical level.’ When we enable the prerequisites for health to be available at all the levels, then the big picture of health will inevitably emerge.”
© copyright Dr. Peter Davies
Dr. Peter Davies, BSc., MBChB, MRCGP, is a GP in Mixenden, Yorkshire, England, a deprived and challenging area of Halifax. He is fascinated by the behaviour of patients and his colleagues and the beliefs lying behind their behaviour. He uses NLP techniques to help him in this exploration.