These whole systems approaches valued balance and the belief that the body is a vital, energetic and expressive organism whose illness is communicating distress. As a palliative physician I was used to managing symptoms so difficult that they needed conventional measures, while at the same time having to understand how emotional, psychological, spiritual and social factors were playing a part in how symptoms are experienced. In homeopathic practice, symptoms are a gateway to a deeper understanding of vital disturbances and I have found that they can direct an individual to connect in unfamiliar ways with themselves. Homeopathy views materials – plant animal or mineral – as signature substances that may help the body restore harmony and flow: as if nature and human were indivisible. Some of these approaches have more evidence to support them than one might imagine. The diploma’s critical analysis module reinforces the need to understand, critique and communicate existing experimental evidence dispassionately, while also valuing the qualitative and quantitative research that provides a balance.
A community of like-minded colleagues
Integrative medicine is also about building a community of like-minded colleagues and our open clinical days, held three times a year as part of the face-to-face intensives, have been filled with doctors, nurses, CAM practitioners, medical students, researchers and the public. The feedback has been ‘it’s great to be in the same room!’. When we first set up the diploma, we had entry criteria about being a statutory registered healthcare professional and many irate CAM practitioners contacted to say ‘why can’t we join the diploma?’. This year we have opened it up to those with a diploma in their chosen CAM practice and two years’ clinical experience. We have had a record number of applications, the majority being statutory registered healthcare professionals plus a healthy mix of CAM practioners. We are embarking on this new academic year with excitement and the added challenge of holding community, while delivering all our teaching including the face-to-face intensives, online in this time of Covid.
The human factor
IM isn’t just about a diverse range of interventions. At its heart is holistic consulting and sensitive inquiry and we have also been building clinical services and the new holistic doctor service. The holistic doctor team at NCIM can worry about their lack of knowledge when anticipating their clinics, with questions like ‘What will I do?’ ‘What will I recommend?’. Our impulse to fix things is strong as doctors, but the consultation is that safe place where people, in putting their complexity on the table, sometimes find the pieces coming together so they find their own solutions. The hope for us as clinicians is that somewhere in a diverse model there will be something that can be done. And naturally we can also harness the ‘placebo’ – better called the self-healing response – and activate our client’s power of hope.
If we are fortunate, the scientific evidence may help our decision-making, always in the light of patients’ preferences, the cost and any potential harms and benefit. Several times in my life’s work in integrative cancer care I have been able to help someone to decide not to spend their hard-come-by £10,000 to fly somewhere far away for a ‘cure’ for their cancer which had clearly spread too far through the body to ever be cured. However, the diversity and inclusivity of the IM model still allowed me to stay in connection with the person whatever their choices. This highlights the need for thorough record keeping and clear letters to colleagues, to make it clear that supporting someone’s choices in the light of frank discussion about their clinical condition and the evidence, does not mean
advocating treatments that are expensive and ineffective. As well as one-to-one consultations, we at the NCIM have also developed a range of courses: Mindfulness for Cancer, Food for Wellbeing, Food for a Healthy Heart and Voice and Creative Writing for Wellbeing. The team is building and maybe one day soon we will find a building for our home, a physical manifestation of the Centre for Integrative Medicine.
The Covid-19 pandemic
I find it curious that all Covid mainstream scientific messaging aligns exclusively with the biomedical interventionist model: ‘the only way out is a vaccine’. Pasteur’s cry to humanity to care for the soil or the terrain of the body is all but forgotten even though susceptibility to the virus is strongly correlated with underlying chronic persistent lifestyle-related health issues such as diabetes and obesity. Covid is revealing just how unhealthy we are in the UK. Many of us are measuring our waistlines and finally finding the impetus to lose weight and get active. For some people this could mean curing their diabetes through dietary change and exercise. Covid has impacted our mental health enormously, so it was really good to see an article about food and mood in the BMJ with an increasing focus on lifestyle change (Firth et al, 2020).
Many of us who have been supporting a transformation of healthcare for decades, now see a lot of positive change, with an increasing number of IM centres and courses popping up all over the world. We have had more applications than ever before for the diploma so we feel the wave of change is building. As a small social enterprise hit as other organisations have been by Covid, we are trying to stay on the surfboard as the IM wave builds. We moved quickly to online learning and consultations, set up the NCIM Integrative Health and Scientific Network and delivered a series of Covid-19 live webinars around building personal, organisational and planetary resilience. We also set up our NCIM Friends free members page and the Holistic Doctor Webinar Series to get key messages about health and wellbeing out there to the public. We have also been teaching new IM courses to Bristol University medical undergraduates. They have enjoyed these courses and we have enjoyed supporting their natural leaning towards nutrition, green care and the healing arts.
As ever, I continue to be over-busy of course. But as we build the NCIM team I hope to step back and focus on my role as vision-holder and CEO. I am still striving for a work-life balance that takes me out of the precarious zone and into feeling resilient with a bit of doing nothing time available! I have a lot to be grateful for and very many people to thank in the co-creation of NCIM. Do get in touch with us if you would like to learn more about our courses. You can email email@example.com for a prospectus and check out the NCIM Integrative Health and Scientific Network on our website www.ncim.org.uk – we would love to hear from you!
I remember falling
Comrades scattering at the sight of Him
Dropping like stones
The flame I held dimming
And then darkness
For a few centuries I lay stunned,
Another couple, realising what I had been capable of
Shame and Blame resting with me
And then Despair at my side
Questioning why I drew breath
I remember falling
For an aeon, the sudden jolt on impact
Slicing the root of my wing
Pain like a mighty rose, thrust to my shoulder.
My finger edging the wound
Impossible to heal
Undaunted by my lament
Soft hands surprised me
Filled the wound with herbs
Prepared a fire
Cast it with Frankincense
Burning yellow blooms of Gorse
For meaning making, in this barren time
And again, I remember falling
Weapons first, then armour,
The heart-shaped encasement,
Rusting where it tumbled away
And there a glinting sword,
Reminiscent of the fire that burned
My armour spoke of glory and power
So, I shook away the rust
Heaved it over my head
And forced myself to fly
The wing root smarted with the effort
But soon the arch was following
Warm air sucking beneath me
Moments later, I was spent
The pain searing through
This unbearable feathered weight
That had carried me so high
Loneliness swept through
And too many questions
Where could I fly, where I would not follow?
Everything I had dreamed of,
To take action when He looked on
To intervene where He watched over
To illuminate what had been left in darkness
Anger bloomed in me
The fire, left by formless friends, I rekindled
Dragged the burnished defence on to it
And waited for it to burn away
It leapt toward me copper flame,
Begging to break the mould
I drew it to me, still hot
Tended it and shaped it
Making a rounder thing of it
Spaces where light and air could move
Fashioning fur and feeling things
Silent helpers still gifting
Olive for the soul
Myrrh for surrender
Jade green jewels left at my feet, for new growth
I remember rising
Not the exact day, but I knew I could fly
My wings unfurling
Moving into the abyss which had so filled me with dread
Neither heaven above nor hell below
But something beyond both
To take my place anew
My once armoured heart, now a tender thing
My sword sharpened
In my cloak the precious chalice
And lifted off into the view
This poem reflects an image that emerged for me in various therapeutic settings and in my dreams. I realised that part of my struggle was to make sense of a God who had not intervened to save my brother who died aged 26 from a very aggressive cancer and many of my patients who also longed for life. Then came an understanding that I was trying to intervene in impossibly difficult clinical cases, and I found myself connecting to Lucifer, the light bearer, who had become angry with God and wanted to do things differently. As you know he has had a bad press, but I found myself exploring whether even he could find a new way of being, hence my poem The Fall.
- Chodron P (1997) When things fall apart: heart advice for difficult times. Shambala Publications.
- Firth J, Gangwisch J, Borisini A, Wootton R, Mayer E (2020) Food and mood: how do diet and nutrition affect mental wellbeing? BMJ, 369. Glouberman D (2002) The Joy of burnout. Skyros Books.
- Hahnemann S (1810) The Organon of Medicine.
- Maizes V, Horwitz R, Lebensohn P, McClafferty H, Dalen J, Weil A (2015) The evolution of integrative medical education: the influence of the University of Arizona Centre for Integrative Medicine. J Integr Med, 13(6) 356–62.
- Sabbage S (2016) The cancer whisperer. Coronet