Dr Phil Hammond, broadcaster and GP turned hospital doctor

My favourite cartoon is by the Pulitzer prize-winning cartoonist, David Horsey. It shows a group of blinkered zombie school children stuck in a classroom and wired up to exam-testing machines that are sucking the life out of them. One girl has escaped to the window and is marvelling at the glorious view outside. Her teacher is saying: ‘Come away from the window! You don’t want to be a child left behind, do you?1

Just as we test kids to the point of breakdown, there’s a danger we can test our patients to death through their anxiety. Increasingly, we spend our lives over-testing, over-diagnosing, and over-treating on the basis of risk factors. The intent is honourable, to stop killer chronic diseases in their tracks, but how often do we do more harm than good? There is a danger of medicalising people’s lives and fostering doctor dependency, when people have to find their own answers, both from within and outdoors. Do we even measure if we make our patients’ lives happier by putting them on the medical treadmill?

Recent scandals in the health service, the church, the banks, the media, and among politicians, are making people look outside the four walls of the establishment for the answers to how they should live their lives and stay healthy. I recently spent some time with Noongar Aboriginal leaders in Western Australia. Some were the stolen generation, forcibly removed from their parents at a young age in an act of cultural genocide that finally ended in 1969. The aim was to breed out the blackness from Aboriginal people, and the blacker you were, the further you were taken from loving parents and into ‘care’, where too many were abused. The legacy of this lives on, with alcoholism, depression, ill-health, and anger. Adults die 20 years before their time and 80% of the juvenile prison population comprises young Aboriginal men. There has to be a solution other than building more prisons.

Aboriginal elders are trying to break this vicious circle with learning circles, taking boys and young men of all races out into the bush to learn about Aboriginal culture and how to live in harmony with their minds and the earth. Sitting around a fire in a learning circle, I discovered that, in common with many indigenous people, self-responsibility is at the heart of being an Aborigine. And once you have learned to care for yourself, you take on the responsibility of being ‘a carer of everything’. This includes the earth and everything that inhabits it. I also learned that the best therapy is sitting under your favourite tree, letting bad thoughts go, and figuring things out in your own time. Then you ‘walk things through’.

There’s a lot we can learn from indigenous cultures. We need to get people away from the chaos of their lives, let them reconnect with nature, and slowly figure out the answers for themselves. Crucial to wanting to be healthy is feeling your life has some value—that it is worth living for. Without this, life is rotten and no amount of testing will improve it. So why not try and hold your next practice meeting outdoors, sitting on the grass in a circle. Everyone is equal, every view is valid and the power of the learning circle is surprisingly large. The one thing the NHS needs to do to rediscover its values: stop blaming, leave the institutionalised stress behind, accept self-responsibility, and widen that circle of compassion. As the poet Edwin Markham says in the wonderful ‘Outwitted’:2

'He drew a circle that shut me out—
Heretic, rebel, a thing to flout.
But love and I had the wit to win:
We drew a circle and took him in!'

  1. Seattle PI website. blog.seattlepi.com/davidhorsey/2010/10/07/encore-cartoon-dismal-learning-is-not-the-path-to-success/
  2. Markham E, Knight A. Outwitted. 1927. G