Lessons Learned: Go on learning from life

In my first 75 years I’ve often been perplexed. How did I get into this predicament and what and where is the way out? I have then tried to make sense of my actions, feelings, thoughts and body signals. When qualified as a doctor patients’ have consulted me either with symptoms of disease or dis-ease. My main role is to diagnose the early signs and signals of disease and yet 50% of consultations to general practice consist of these medically unexplained or functional presentations. Conditions such as fibromyalgia, unexplained pain, some forms of irritable bowel syndrome, some forms of headache, and persistent fatigue, where medical investigations are negative. I then endeavoured to create the time to explore the patient’s situation, affecting the symptom complexity, and provide a whole person approach and recovery plan.

Result

Further training in mind body medicine: Group psychotherapy (Robin Skyner); Diplomas in Obstetrics (Lewisham); Child health (Guys Evelina); Rheumatology (Guys and Kings); Membership and then Fellowship of the College of Physicians; Balint Group; Research Fellow SW England;

Chairman Lewisham Triangle Neighbourhood Group- successful urban aid grant for Family Centre;

School Governor (Kingshill). The Hill Paul Regeneration Group prevented its demolition (Stroud)

Author: Science and the Holistic approach IN The Bristol Approach (Edited by Helen Cooke);

Author and Editor with Alistair Tulloch, & Michael Denman of Community Care of Older People (1998) Radcliffe; 2015 Establishing reclaim health as a web resource for patients with chronic fatigue syndrome and other functional somatic illnesses – www.reclaimhealth.org.uk

Avoid Prolonged Stress

Stress signals occur when an individual is at the limit of their tolerance and anxiety for their situation. These stress signals are no less real and distressing but thankfully without pathology. For everyone, when affected by prolonged stress/overload, their psycho-neuro-endocrine (PNIE) balance is disturbed. For some the hormone cortisol remains diminished; for others the adrenaline levels are too high, and the immune system has switched to an inflammatory state. The breath often become over breathing with lowered carbon dioxide levels and changes in body chemistry. The symptoms need understanding, interpreting and treating. The remedy is in helping the individual make sense of whatever is distressing them whilst restoring balance within mind-body and spirit. Teaching how to self-calm, breathe, stress management; CBT and understanding emotional conflicts restores equilibrium. The lack of confidence and persistent fatigue, after a protracted period of raising children, may need educational guidance rather than antidepressants. We added the service to our practice linking with the local tertiary college.

Result

Further training in Psycho-neuro-immuno-endocrine disturbance; Diploma in breath regulation and Capnograpy training. Further development of integrated services to patients.

Chief medical officer Bristol Cancer Help Centre 2000 – 2002. Diploma NLP (2017)

Education: Reflective Learning

I’m grateful for a wonderful education at Guy’s Hospital qualifying in 1967.We were part of a firm. There was a clear hierarchy with the consultant leading his team and us medical students from bed to bed. We had enough time to take a proper history and get to know the individual before being asked to present to the consultant. You were expected to know everything about that person. What was going on in the 30-year-old woman lying as if paralysed in her bed with a diagnosis of severe autoimmune disease – systemic lupus? Her illness developed after falling in love again after being jilted at the altar six years previously. Threat and fear caused a major flight and freeze response. She was helped to recognise her double bind dilemma. As her new partner confirmed his love for her she got better and sent the staff pieces of the wedding cake as a thank you.

Result

Remember I/we are part of the whole’. Has modern medicine sometimes forgotten the Art of listening and whole person medicine: I gave the first lecture and became a tutor for the University of Bristol Medical School ‘Whole Person Medicine course.

Personal history taking is not seen as important in medicine. Notices appear, on the GP’s door, saying: ‘Limit your time to 10 minutes and present only one problem per consultation?’

I aim to create the time and space to lobby for personalised medicine and continuity of care.

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