This year our essay competition was entered by a record number of students, which made choosing our winners very difficult indeed. We were inspired by the quality of the essays and found many excellent passages which we are inspired to share with you.

Our top 4 essays are published on our Student Essay Competition page, some of the following extracts come from these and other essays and were chosen by our 2 Junior Doctor Ambassadors.

Angus Grant, University of Birmingham

“Finally, when the COVID-19 pandemic ends, the deep-seated health inequalities responsible for the higher death rates in Black men and women will still exist. Asylum seekers will still be five times more likely to have mental health needs than the general population and be less likely to receive support. The life expectancy for people who are homeless will still be over 30 years less than the general population. These health inequalities will not be overcome without a commitment to understanding and combatting the societal issues with which they are built upon. In the fight to improve the health of the population, we must never ignore, or allow others to ignore, the vital component that is social wellbeing.”

Anna Winthrop, BHMA Student Ambassador from Cardiff University

“Historically, pandemics provided some of the greatest environmental reforms: The Plague led to more parks and open spaces and the cholera outbreaks of the 19th century led to reforms for urban sanitation. In the current pandemic we have seen significant reductions in air pollution – as much as 40% in some cities. Burke, an environmental economist, predicted that two months of improved air quality in China alone might save the lives of 4000 children under the age of 5.”

Charlotte Leung, University of Birmingham

“Countries cannot face the pandemic alone, and the UK’s high mortality partly reflects an insular mentality and reluctance to learn from other nations, such as joining Costa Rica’s proposed WHO Covid-19 technology access pool. The failure to see merit in international cooperation is misguided, as the landmark eradication of smallpox in 1980 – which incidentally had a last case in Birmingham Medical School – owed its success to a determined global eradication programme. (10) As global health challenges intensify due to the pandemic, we must think holistically beyond the scope of one nation to create multilateral cooperation for sustainable global health.”

Freya Rhodes, University of Sheffield

“Holistic medicine is entangled with diverging utilitarian and deontological principles, responsibility to the population and to the patient. Public health emergencies such as the COVID-19 pandemic require intervention at a population level. Such interventions commonly favour utilitarian ideologies: maximising utility and resources whilst saving the greatest number of lives. As the focus shifts from individuals towards a population-based approach, we may perceive the rise in utilitarian discourse as a threat to the prime position of holistic medicine. But what if COVID-19 itself is not the threat, but a spotlight illuminating the real barriers in the delivery of holistic healthcare.”

Isabel Allison, Runner-up in the competition, University of Birmingham

“In conclusion, while these debates are not new, the pandemic has highlighted deficiencies in the implementation and prioritisation of individual treatment preferences. There is a need to destigmatise these holistic measures and incorporate them into routine care. In addition, we need to prioritise research into methods of enabling and destigmatising discussions concerning treatment goals, and recording the outcomes of such discussions, as this will enable us to improve the alignment of our practice with patient goals. The pandemic has been a source of great tragedy across the world, but we must use the discussions it has created to scrutinise our practice and become more compassionate in our care.”

Ishika Ali, Queen Mary University, London

“Nature has an important place in holistic healthcare. Not only are there benefits in an active engagement with our natural environment, an ecosystem which is able to thrive is also able to provide nutrition, water and other natural products. Furthermore, as a result of deforestation, contact between humans and wildlife increase. The coronavirus pandemic as well as outbreaks of yellow fever and malaria demonstrate how a new interconnectedness between natural habitats, animals and humans is causing an increased risk of animal-borne infectious diseases.

One property that is traditionally referred to in holistic medicine is that a patient cannot be reduced to a sum of parts. They are whole, and this inherently brings about a new level of understanding that could not otherwise be achieved. Typically, this approach reminds us that efforts to diagnose disease should run parallel with an attempt to understand physical, mental and social factors. Freeman (2005) extends this idea and describes how “in various contexts [holism] might mean the whole person, the whole community, the whole of society, or the whole planet.” To learn from a pandemic, we must therefore consider holism not just on an individual scale of a patient but on a far-reaching scale. Lessons from pandemics serve to illustrate already established principles of hygiene, diet, housing and access to clean water. Studying the causation and consequence of various pandemics teaches us the importance of practicing holistic models.”

Lauren Wheeler, Winner of the competition, Imperial College, London

“Aside from age, some of the main risk factors associated with death from COVID-19 are pre-existing health conditions, such as diabetes, obesity and cardiovascular disease. The majority of these conditions fall into the category of non-communicable diseases (NCDs), which are defined as conditions which are not transmissible and which tend to have a long duration and slow progression. This observation is strikingly similar to trends observed in the UK in the recent past, with 89% of all deaths attributed to NCDs and premature death accounting for 2.6 million years of lost life in England and Wales each year.

Given that a large proportion of NCDs are preventable, it is not unreasonable to suggest that a large number of lives lost during the coronavirus pandemic could have been avoided too. However, as it stands, our healthcare system is centred around a model of treating patients once they become acutely ill, responding to problems rather than preventing them. The patient-centred, lifestyle-focused approach which holistic healthcare advocates for is undervalued in time-poor primary healthcare settings, even though interventions, such as education to enable people to make dietary improvements, increase their physical activity and get sufficient sleep, can be provided at essentially no cost.

Whilst the NHS has said it intends to put a greater emphasis on combatting these conditions through lifestyle interventions, according to its most recent long-term plan, similar promises have been made before and have not been fully realised.

In terms of how we approach healthcare going forward, the pandemic has demonstrated that we cannot rely on modern medicine to solve all of our problems. We have, and will again, face pathogens which we cannot destroy with synthetic drugs or scientifically-engineered treatments. This time we must follow through on a commitment to improve the health of society as a whole, not just those who are seriously ill.

It seems ironic that the main strategy adopted to combat the pandemic, prevention, is one which proponents of holistic medicine have been advocating for in the healthcare system for years. In the aftermath of the virus, we must stress the importance of this message and ensure that the integration of preventative medicine into the NHS is made a priority.”

Simran Sehdev, Runner-up in the competition, University of Southampton & King’s College London

Our ambassadors could not choose one quote and feel the whole essay ‘All Lives Can’t Truly Matter Until Black Lives Matter‘ should be included. However here is the conclusion:

“If we wish for the NHS to live up to its founding principles of fairness, equality and compassion for all, we must urgently take action to address all facets of racial discrimination; in healthcare, institutions of medical education and most importantly, within ourselves.”

Angus Lawson, University of Edinburgh

“The COVID-19 pandemic and its subsequent lockdowns upended the daily lives of all. It instilled fear and isolation among all groups, breaking apart fledgling lovers, old friends and limiting access to the natural world. The lockdown also gave many people something which in a bustling capitalist economy seems to be perpetually scarce; time. While these measures were an essential step in ensuring our population’s health, something became apparent that can be forgotten in the medical environment — that there is more to healththan the absence of symptoms. The World Health Organisation defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” While global lockdowns have rightly safeguarded the physical wellbeing of the masses, they have risked detriment to our mental and social wellbeing. Yet, while the implications of lockdown have been momentous for some, for others, it seems everybody has arrived at their version of normality. For our elderly in care homes, reduced freedom, acute awareness of the fragility of one’s health and an abundance of time with diminishing options to fill it are the normal state of affairs. I believe the pandemic has provided us with a lens with which to refocus our outlook on health to a more holistic viewpoint, bringing particular emphasis to the importance of community, access to nature and the essential value of a sense of purpose in maintaining long term mental and physical wellbeing. It has also provided us with an empathic tool with which to reconsider how we treat those who are in the later years of their lives.

An open survey conducted by mental health charity, Mind, recently stated “More than two-thirds of adults with mental health problems reported that their mental health got worse during lockdown” and that “22% of young people and adults who have not experienced mental health problems prior to the pandemic said that their mental health was poor or very poor during lockdown.” These statistics are startling, yet they should not come as a surprise. It has been known for years that people under the same circumstances – our elderly in care homes – experience a rate of depression up to twice that of the general population. A large scale report by Alzheimers UK also found that in dementia patients, overall quality of life is significantly lower in care homes, often due to a lack of funding for wellbeing activities and opportunities for social interaction. It seems we are depriving our elderly of the things we only deprive ourselves of in the case of global pandemic, and we all suffer greatly because of it.”