Five windows on suffering – knowing and celebrating who we are

Winter 2015
William House

William House is Chair of the BHMA, GP researcher, and also Chair of an experimental community development organisation. Here William introduces this article and himself, for he is the toddler illustrated with ‘Window 4’, as he prepares for a life as an artist!
Now that I have retired after 30 years in general practice I am trying to understand what I was really doing all that time.This article is some of the fruit from this task: I am being the pathologist to my career. Of course, I tried hard to understand while I was still working as a GP, but some explanations reveal themselves only at the post mortem examination. So now, like all those who dissect the past, I have the last word. But I can do little more than chide or cheer younger hapless clinicians as they struggle with the cut and thrust of real raw life and do or do not make sense of who they are and what they are doing.

Summary

This article is based on a talk given to the Ethics and Philosophy Special Interest Group of the British Pain Society in June 2015. Chronic pain is a major problem in developed societies and can provide insights into deep issues affecting health services in these countries.The five windows refer to five points of view that I have selected: five ways of understanding suffering. There could be many more. Of course, we can also use windows to look in from the outside, to inspect the viewer. In the case of the dominant point of view, the medical diagnosis, this article is very inquisitive.This issue of the journal is themed on ‘Peak Medicine’ – the notion that the way we think about and manage illness is unsustainable, that we must diversify our vision and our actions or face disastrous consequences.This is surely a time to be a very critical friend as we look back through the window of medical diagnosis. It is also a time for finding alternative windows through which to look.

First Paragraph

A few months ago I was at a meeting in the town where I practiced as a GP for 27 years. I was approached by a woman in her 50s who I had got to know in my new role in community development. She reminded me of a time about 25 years ago when I had been in my GP practice for about 10 years. She had rung me late at night about her daughter, Jenny (not her real name) aged seven. I began to remember. I was just getting ready for bed. In those days we five partners shared the 24-hour emergency medical cover for our patients and it was my evening and night on call. The phone rang and I heard an anxious mother. I knew her vaguely but she was not a frequent attender. She was worried about Jenny who was very hot and seemed quite ill. I put on my clothes over my pyjamas and went to see her. She had a high temperature and was listless but quite lucid and
I couldn’t find anything else on examination. So I gave my usual advice and went home to bed.