Jeremy Swayne BA(Oxon) BM BCh MRCGP FFHom
As the adventure of being exposed to clinical medicine and the challenges of life as a junior hospital doctor wore on, certain aspects of the ethos of hospital medicine made me uneasy. These could be crudely summarised as the tendency to treat people as cases, and the preoccupation with the achievements of modern medicine, however desirable, over the broader well-being and interests of the individual patient. These criticisms reflect the untruth as well as the truth of all generalisations, but will probably be as recognisable today as they were to me in the 1960s.
They prompted me to look to a career in general practice, from which I gained immense job satisfaction. Nevertheless, I experienced again a growing uneasiness with a tendency that I saw in medicine as a whole to focus on the mechanics of illness rather than the person who was ill; a tendency to control or manipulate body function and disease processes rather than to understand the dynamics of the illness, which are almost always multi-factorial; a tendency to seek out and fix the fault in the machinery, rather than to address the underlying discord, physiological or psychological, and restore better equilibrium. That is not to undervalue medicine’s ability to control and manipulate body function, often to our very great advantage. But the distinction between mechanistic medicine and what I came to understand as holistic medicine troubled me, and was reflected in the title of an article I wrote for New Society in the mid-70s, ‘Medicine and Healing: A broken marriage?’
Becoming increasingly aware of the many dimensions and mixed dynamics of illness in individual patients, I realised how little I understood them, and how little my medical education had equipped me to understand them. This realisation included an awareness that the health needs of the person as a whole sometimes included the spiritual dimension of their lives. The need to understand these things better, and to learn to respond more appropriately and more effectively to them, prompted me to find a way of practising that allowed me to spend more time with fewer patients, to be more attentive and to reflect more.
This lead me to set up a new practice in an ‘open area’, where I was able to ‘put up my plate’. The new practice provided routine 15-minute appointments, compared with the usual average of 7-8 minutes in most practices. This allowed for more thorough examination or enquiry, or for more attentive listening, which in turn both taught me and allowed me to deal more adequately with the true nature of the patient’s problem.
It was in this more favourable practice situation that I first became acquainted with homeopathy. Initially its appeal was not so much the method, which, although intuitively attractive was scientifically peculiar and difficult to learn, but the evident quality and good sense of the doctors who were teaching it, many of them experienced GPs. Quite soon, however, I was observing astonishing clinical outcomes in patients treated with homeopathy. And the homeopathic method and approach, with its insistence on detailed and respectful attention to the patient’s whole experience of the illness and its biographical context, richly complemented my natural style of practice.
The homeopathic approach is an excellent ‘vehicle’ for a good doctor-patient relationship that is not pre-emptive of any exclusive diagnostic pathway, but open to whatever exploration of a problem the patient’s need and experience dictates, which might be narrowly circumscribed or deep and wide-ranging.
General practice never lost its satisfaction, but having used homeopathy as part of my GP repertoire for five years, because it provided such a good vehicle for my style of practice, and because of my continuing desire to understand illness and healing better, after 14 years I left full-time general practice, took the qualifying exam for the Faculty of Homeopathy and embarked upon the precarious adventure of private homeopathic practice alongside other part-time medical work. The results have been a continuing source of insight into human nature, illness and healing, of scientific challenge and clinical satisfaction for me, and, I believe, of greater well-being for my patients. Homeopathy has remained just one part of my repertoire as a doctor, but without it that repertoire would have been much diminished.