Thought for the Day

'We must...resist the doctrines of progress and emancipation that undervalue the task of helping one another to live well and truthfully with situations when, frequently, there are no cues or answers. This is the task of the pastor which early Christians termed 'sustaining'...'

Elaine Graham (1999), 'Pastoral Theology: therapy, mission and liberation?'
Scottish Journal of Theology, p. 448.

Thought for the Day

'In nothing do men more nearly approach the gods than in giving health to men.'

Cicero.

The Dawn of a New Renaissance

Within the past week an avid reader of this column kindly let it be known that her husband calls me ‘Renaissance Man’. For someone whose internet blog describes himself as ‘an aspirant polymath’, such an accolade was very flattering indeed. For a few hours I basked in the delusion that I had finally joined the ranks of Leonardo da Vinci, Frances Bacon, Galileo and other erstwhile figures, until my wife recognised the danger symptoms and rescued me by the simple reminder that I still hadn’t accomplished the task of getting the flat battery out of her MG, and had yet to remove a radiator from the wall without the need to call an emergency plumber.

With my feet firmly back on the ground and putting my practical failings to one side, I attribute my interest in so many areas of life to my time spent at one of the country’s foremost grammar schools (St Olave’s in Kent). An Ofsted inspector recently described the school as having ‘a focus on scholarship and cultural enrichment with a vibrant approach to intellectual curiosity’; another said ‘it is a school which aims at success and succeeds’.

A major aspect of life at St Olave’s was the sense of competition. Competition ran through every activity of the school as much as ‘Brighton’ runs through Brighton Rock. If you were not competing to ensure that your ‘House’ won the most points in that academic year, you were striving to be in the 1^st rugby team, squash team, tennis or fives team. In between the omnipresent sports fixtures, you polished up your musical scales in order to secure your place in the school orchestra, brass band, wind ensemble, jazz band, barbershop quartet, choir or whichever musical group was performing in the near future; and amidst all of that, you aimed to ensure that your academic grades would secure you a place at one or other of the country’s top universities. Quite simply, you aimed to be the best…at everything. What is more, it was always understood that you had either ‘succeeded’ or you ‘hadn’t succeeded yet’. Failure was not recognised. Everything was possible.

The 2012 London Olympics has profoundly demonstrated the sense of endeavour portrayed by an enormous number of people; men and women who, day in and day out, have pushed themselves to the limit to excel at their sport; to be the best. Often, during the long hours of training, the only driving competition has come from the inner strength and desire to beat their personal best; to excel for the shear unadulterated joy of achieving something worthwhile.

If we think we have already witnessed drive and enthusiasm, the London Paralympics is sure to make us think again. I have no doubt that in one week’s time we will witness human endeavour beyond the personal comprehension of many. If the Olympics have been inspiring, let the drive and enthusiasm of the Paralympics teach or remind each one of us that success is all about competing with, and overcoming, our own personal limitations; whatever they may be.

As one commentator reflected, the Olympic Games have shown that there is nothing we (the British) cannot do well if we set our hearts and minds to it. The re-introduction of a sense of competition to school life is an important component of future adult success; whether it is on a national or international level, or simply for personal satisfaction. Ultimately, we can all be 21^st century Renaissance people if we wish to. Now, wouldn’t that tell the world a thing or two about the British?

(First published in the Scunthorpe Telegraph, Thursday 23^rd August 2012)

Art for Heart and Mind's Sake

‘When I was a child I spoke as a child, I understood as a child, I thought as a child; but when I became a man, I put away childish things.’

So wrote St Paul in his letter to the Corinthians. For the majority of us, such is the case with most aspects of our child and adult lives. However, in my case there was a flaw in the process and it is called ‘art’; or to be more precise, the ability to draw and paint. Words were never a problem; neither was music; but as a child I was lost with a pencil or a paint brush. Throughout my adult life, I have found it difficult to break away from the childish representation of a tree or house that I learned to draw when I was about three years old. It may have worked for L S Lowry, but I am not even sure that I can reach his standard of depiction. 

It was therefore a great honour and an eye-opener to spend twelve days recently in the company of five of the world’s greatest living artists; to study their work, listen to them speak about their styles, watch them at work, and to receive the occasional tuition from them. In no particular order, they were Viktor Shvaiko, Bill Mack, Michael Godard, Gary Welton and Adam Scott Rote. If you are not already familiar with their work, I recommend spending some time looking at their official websites in order to gain a deeper perspective on what I am writing about. What you will see is that they all have very different and distinctive styles. Some of them have additionally had very difficult and troubled pasts (as reflected in the books, ‘Journey to the West’ by Shvaiko, and ‘Don’t Drink and Draw’ by Godard).

Watching them work, they make it all looks so easy. However, all five men are masters of their art and have spent decades at perfecting their styles. Nonetheless, there is much to be learned from them, and the greatest lesson I brought away with me is just how cathartic the process of producing a piece of art can be. It doesn’t matter whether it is a simple pencil sketch, an abstract colour-filled vision, or a moulded lump of clay; it is the process of producing the end-product that is of immense personal value.

Art Therapy has long been an unsung hero in the world of medicine. Funding for such treatment is often very limited, and the ability to access formal courses is frequently restricted to a few places through psychotherapy departments. That aside, it forms a valuable resource for the treatment of many different types of disorders, from depression and post-traumatic stress disorder, to autism and other complex communication disorders. Artists may be interested in the website of the British Association of Art Therapists (www.baat.org); alternatively, Wikipedia provides an article of general interest on the subject (www.en.wikipedia.org/wiki/Art_therapy).

For me, fine art will no doubt prove to be an elusive skill. However, after my time recently in the company of the aforementioned five men, my eyes have been opened to the benefits art in general has to offer for even the most juvenile of artists. As the Swiss painter, Paul Klee (1879- 1940) said ‘Art does not reproduce the visible; rather, it makes visible’. As a doctor, and from a psychological perspective, I can only concur.

(First published in the Scunthorpe Telegraph, Thursday 9^th August 2012.)

The Rise and Fall of the Silly Season

August has long been known as the silly season in terms of newspapers publishing low-key or humorous stories to fill the otherwise empty news columns. This year, possibly owing to global warming, the season started early, with the publication of articles at the end of July trumpeting research promoting the Polypill.

The Polypill was first postulated in 2003, so the story is not exactly new.  The pill contains three drugs to lower blood pressure and a statin to lower cholesterol (amlodipine, losartan, hydrochlorothiazide and simvastatin for those who are interested). The concept is to make the Polypill available without prescription, at a cost of 50p per day, encourage everyone to buy it and thus halve the number of people who die of cardiovascular disease.

Now, that sounds like a meritorious aim; a magical pill to halve 200,000 deaths per year in the UK. So where are the flaws in this argument? Well, to start with, to gain that saving effect everyone, I repeat, everyone in the UK would have to take the Polypill; all 56.1 million of us according to the 2001 census. That is 56.1 million annual monthly sales to save 0.1 million lives. Making the assumption that some sensible person out there has patented this latest version of the Polypill, then that is a lot of profit for the pharmaceutical industry.

Then, of course, there are the side effects of the medication. Anyone who has been prescribed some of the constituent medicines will know that side effects are common. I grant you that most are minor, but nonetheless, many are inconvenient and sometimes very troublesome. Swollen ankles, gastric upset, urinary frequency, impotence, muscle pain and weakness, rashes, confusion and memory loss are just a few of the unwanted features. It is therefore bad enough trying to comply when your doctor believes that you need to consider such therapy; does anyone truly think that those who have not identified themselves as unwell or at risk will put up with such effects? I suspect not.

And what about lifestyle? Where does the enthusiasm for five portions of fruit and veg per day, low fat and low calorie foods, reduced meat consumption, reduced alcohol consumption, stopping smoking, exercises at least three times per week, and reducing weight to sub-obesity levels fit in? All of them are no longer necessary, or so it would seem. Forget the healthy lifestyle and simply pop a pill every day to compensate. A late 16^th Century proverb declared that ‘the age of miracles is past’. Apparently, the declaration was premature.

In 1995, Ivan Illich published a book called Limits to Medicine. It was subtitled ‘Medical Nemesis: The Expropriation of Health’. In his book, Illich declared that ‘the medical establishment has become a major threat to health’. He was concerned that ‘the disabling impact of professional control over medicine has reached the proportions of an epidemic’. He was prescient to say the least. With the advent of the Polypill, we all become patients at the stroke of a medicine licence.

Not convinced that my cynical approach is the correct one? Then let me ask you a question. Would you subscribe to the idea of underpinning every house in the country in order to stop a few subsiding? I suspect not, and with that I rest my case.

Hopefully, autumn will come and the silliness will be forgotten for another few years. Meanwhile, I am off for a good walk in the fresh air, followed by a healthy fish dinner and, just perhaps, a small glass of red wine.

 (First published in the Scunthorpe Telegraph, Thursday, 2^nd August 2012)

Style Matters

For William of Wykeham, the 14^th Century Bishop of Winchester and Chancellor of England, the proverb ‘Manners Maketh Man’ became his motto. Later, in the early 15^th Century, another proverb developed to the effect of ‘Clothes make the man’. Moving forward to the 20^th Century, the English novelist, Angela Carter, writing in Nothing Sacred (1982), said ‘Clothes are our weapons, our challenges, our visible insults’.

What then, would any of the subscribers to these historic notions make of the appearance of many of our professional men and women in the 21^st Century? In particular, what does the dress of today’s doctors say about them and their attitudes to life, medicine and their patients?

Here, I must declare not only an interest, but a strong prejudice which, to those who know me, hopefully speaks for itself. Archaic notion though it may be, I subscribe to the idea that appearances matter. The 18^th Century provides us with another proverb to illustrate the case: ‘First impressions are the most lasting’, the saying goes.

As a younger person, a doctor for me (and I speak of male doctors in the main here), was somebody who at the very least wore a jacket and tie. Suits were once de rigeuer for daytime wear for hospital consultants and Harley Street GPs; with tweed suits and jackets the domain of particularly the rural GP. Evenings and weekends on call required, at the very least, that other scarce item in today’s young man’s wardrobe, a sports jacket.

However, my view is rapidly becoming an anachronistic one. Hospital doctors have witnessed their crisp white coats resigned to the recycling bin, as uninformed policies have blamed long sleeves for hospital-acquired infections, and ‘bare below the elbows’ has been become the enforced rule. Ties now dare not show their face in the hospital clinical setting, as though these and cuffed shirts were the enemy rather than the failure by administrators to ensure that their hospitals were regularly cleaned, and staff  remembered the simple expedient of washing their hands between patients.

So, how do you see your GP? Does it matter to you that he or she is in faded jeans, a slogan-bearing tea-shirt and training shoes; with straggling hair and, for the men at least, a couple of days growth on their chins? With allowances made for cultural differences (though the fact that such consideration should change our perception is witness to our fickleness), does it matter that your male doctor has a studded nose and ears, your doctor of either sex sports a lip ring, or medics of either sexes are happy to bare their strange and often indecipherable tattoos?

Laying my cards on the table, I think that it does matter. Standards of dress are slipping and, in my view, with that landslide of slippage goes a major chunk of professionalism. Doctors need to inspire confidence; wining the patient across at the very start is a major step towards assisting them with their complaint. The way a doctor dresses says a lot about their standards, attitudes and, in turn, how thy might apply those same principles to the care of their patient.

The early 20^th Century proverb states that ‘you can’t judge a book by its cover’. However, next time you are confronted by a scruffy looking doctor, you might wish to remind them that style does matter, and patients shouldn’t be made to feel insulted by the appearance of their physician. After all, if book covers really don’t matter, would publishing houses spend so much time, effort and money making them look so good?

(First published in the Scunthorpe Telegraph, Thursday 26^th July 2012)