Published in JHH17.2 – Mind-body self-care

However strange I felt at times, and however fragmented my medical education was at times, I think I have always understood myself as a whole person. This person, who is me, like all other persons, has many parts and as I learned about these parts in medical school, the more wondrous it all became. It is perhaps because of these early impressions that I puzzle over the very notion of ‘mind–body medicine’. ‘Whatever does it mean?’ I asked myself. How can we join up the mind and the body when they are already parts of a wondrous whole? How much more wonderful can we humans be?

But, of course, things are not quite so simple. Let me tell you a story from my youth – which prevails amidst nostalgia. I was enthusiastic about Austin 7 ‘box saloon’ cars. These were very small and quite primitive vehicles made in the early 1930s. I was the proud owner of a 1934 model. One day, I was standing next to my car at our local shopping centre when a man came up and said, ‘I’ve got one of these’, pointing to the car, and he asked me if I wanted it. It was in a garage behind the shops and he was asking £2 for it! So, I was soon the proud owner of two Austin 7 cars. The ‘new’ one was a 1931 model and in a very poor state. But I saw this car as a ‘wondrous whole’ – it was indeed complete in the sense that nothing was missing. I was a medical student at that time, so the car occupied my
weekends which were not used up with studying in the early part of the course.

Now, how does this old car business fit in with the story so far? Let’s say that the car was ill and I had to dismantle and reassemble much of it in order to effect the repairs and get it going again. My job, then, was something like a cross between an orthopedic surgeon for the engine and chassis, a cosmetic surgeon for the
paintwork and upholstery, with a bit of neurology for the wiring circuits. Of course, I needed to seek advice about parts of this big repair job. For this, the local Austin 7 club was ready and willing. It’s perhaps not surprising that I chose general practice for my medical career: just as the car was a joy to rebuild (at least most of it), so it was a joy to be a GP – at least most of it; and there are NHS parallels to the Austin 7 club for advice and support.

So how does mind–body medicine fit in with this story? After all, the human is infinitely more complex than a car, especially a very old car. There seem to me to be two ways in which my story above might shine a light on the mind–body issue. Firstly, the literature I have found concerning mind–body medicine focuses mostly on the treatment techniques that can be helpful to patients, but are either not known about or not available within the NHS, or perhaps both. This amounts to a large ‘can-of-worms’. There are political, financial, industrial and academic obstacles. Threaded through all of this are overlapping vested interests in all of these fields. Unfortunately, (and unlike Austin 7 cars) there is a lot of money to be made from healthcare and we know what money is the source of – as they say!

It seems to me that the second key issue is the importance of the person. Here I mean particularly the person who is the patient or patient’s relative, the person who is the healthcare professional or therapist (perhaps would-be therapist), the manager, the cleaner, whether or not an owner of an ancient car! For all of these people it will matter very much how they are seen and recognised, especially in ways that transcend the label they may have. This is about humanity. The
personhood must be allowed to shine through the formalities of their particular role, whether very senior or very junior.

When the Austin 7 was my main means of transport I was aware of the attention it attracted. I liked the image of non-conformity. I never liked being a ‘pillar of the community’, and I believe it helped me to be an ordinary bloke who did his own thing; to be the ‘doc’ you could talk to. I like to think that in several ways, having that car made me a better doctor. It was certainly popular with patients, especially, but not exclusively, the men. I was often asked: ‘Have you still got
that old car, doctor?’ I would nod and smile and make some remark like … ‘I don’t think I could ever part with it.’ Sure enough, I do still have it – the older one, shown in the picture above. At this moment it’s in a repair workshop in Bristol having the engine reconditioned. Sadly, I’m not up to doing that any more. The mechanic has had it for a very long time – he said that having it there in his workshop is good for business!