How our minds control our bodies
Head First : A Psychiatrist’s Stories of Mind and Body
By Alastair Santhouse Atlantic Books £16.99
MENTAL HEALTH, Mancunian Jewish author Alastair Santhouse observes, is fashionable. Even the Royals are keen to confess their interest. But mental illness — not so much. Patients prefer any unlikely diagnosis rather than one that centres their suffering in their own mind. This is tricky for a gifted psychiatrist whose thoughtful conclusions his patients utterly reject — initially. The miasma of prejudice against psychiatric explanation still hangs over society.
The core of this brilliant book is simple, summed up by its opening instruction to doctors from Sir William
Osler, 1849-1919: “Ask not what disease the person has, but rather what person the disease has”. In other words, it is the concerned individual who translates a medical condition.
Our emotions are in lockstep with our physical well-being; our minds shape the way we respond to any symptoms we develop. Most of us acknowledge this to be true – but it takes a physician with decades of experience and thousands of patients treated, to drive this home. In one revealing anecdote after another, the highly subjective nature of good or ill health reveals how shackled we are to our own nature and how dependent we are on our personal outlook.
This applies to all conditions. Even heart surgery recovery is linked to what kind of attitude we have towards it. The all-important “ejection rates” — the flow of blood from the heart — vary after surgery according to the way we think: with a positive slant, stronger, better, healthier; with a negative one, slower, poorer, more debilitating.
This has to be the most absorbing book I have read in years. Studded with references to medical theory and packed with philosophical insights – the reference pages are breathtakingly expansive — you’d think it would
This scholarly tome is more compelling than a thriller
be tough-going. But, in fact, this complex scholarly tome is harder to put down than any thriller I’ve read recently.
And given Professor Santhouse’s credentials — consultant psychiatrist at Guy’s and Maudsley hospitals and former president of the Psychiatry Section at the Royal Society of Medicine —
I was ready for a technical onslaught packed with medical minutiae. Instead, Head First is a compelling read from solid hardback cover to cover, and confronts some basic truths told simply but suffused with the profound meaning of what human beings, sick or healthy, are all about.
Alastair Santhouse is a superb storyteller but, much more than that, he is a compassionate and humble doctor. Each of his tales opens another intriguing case history. Often, his patients have been shunted from one medical specialism to another, sometimes over years, without discovering what is in fact wrong.
And, virtually unique in today’s medical practice — he listens to his patients, without interrupting, and with a deep commitment to what they tell him.
It is a rewarding experience throughout to read, not just about medicine but also Santhouse’s colourful tales, his own life and his vast case-book.