For many years, I have been an avid gardener. Not only does gardening have numerous health benefits related to breathing fresh air, touching mineral-rich dirt, and eating the bounty of the earth, but it also provides an inspirational model for living in sync with the natural rhythm of life. Against the backdrop of our hi-tech, post-industrial era, when we feel entitled to demand everything we want, the way we want it, when we want it, and fast, it is both refreshing and relaxing to know, in a tangible way, that I simply cannot rush the growth of a tomato plant, eat berries from my garden in the middle of a New York winter, or otherwise impose my own will on the order of things. What's more, it is downright awe-inspiring to be a frequent witness to the miracle of life and the power of regeneration.
As a physician, being a gardener feels not only like a privilege, but also like an imperative, as gardening is perhaps the ultimate model of practicing medicine: I am not the one who gives life or activates healing; rather, I am the one who supports the plant or patient, respectively, in the process of growth and transformation. Victoria Sweet, M.D. -- Associate Clinical Professor of Medicine at the University of California, San Francisco and author of God's Hotel -- also values the gardening model of medicine, as indicated by our recent phone conversation:
In the conventional medical model, she said, the body is the machine, and the doctor is the mechanic. "In that mode," she elaborated, "as your doctor, I'm looking for what's wrong, what's broken, and how I can fix it." By way of contrast, she noted, the slow medicine model "is much more of a gardener's horticultural approach, where the body is a plant." The key difference between body-as-plant and body-as-machine, she explained, is that "someone else has to fix the machine, but the plant can heal itself."
Recognition that the "plant," i.e. patient, can heal herself, leads to an entirely different approach to medicine -- one where the physician's role is to provide the education, tools, and supportive environment that activate the body's healing response mechanisms. Contemporary doctors, however, are trained to approach the body "as a walking time bomb," as noted by David Bresler, Ph.D., in a blog post on preventive medicine and natural pain relief -- routinely leading doctors to throw pharmaceuticals at symptoms, without understanding the cause of the problem; to rush medical treatment, instead of allowing time to reveal what is and is not a necessary procedure; and to prescribe cutting out body parts through surgery, instead of prescribing lifestyle modifications enabling those body parts to regenerate.
Dennis McCullough, M.D., associate professor of community and family medicine at The Giesel School of Medicine at Dartmouth University and author of My Mother, Your Mother, and Katy Butler, a journalist, educator, and author of the New York Times bestselling book, Knocking on Heaven's Door, have focused their work on the geriatric applications of slow medicine because, as Butler noted in our recent phone conversation, "everything is thrown into very high relief when you are old ... If there is any single population that slow medicine is needed for, I'd say it's for the elderly."
Butler emphasized that slow medicine is helpful for and applicable to every stage of life, especially in the case of "any chronic condition where your lifestyle contributes to your illness." Echoing my own observations, she noted that in about 80 percent of cases for the general population, a conventional medical response may be anywhere from ineffective to "downright dangerous."
Still, as McCullough noted in his book, the elderly population is like the proverbial canary in the coal mine -- the first to show incontrovertible signs that our medical model is failing us."Every older person understands that being rushed seldom, if ever, helps the process, except in the rare emergency," he said in our recent phone conversation.
"The vast machinery of modern medicine, which can be heroically invoked to save a premature baby, when visited upon an equally vulnerable and failing great-grandmother, may not save her life so much as torturously and inhumanely complicate her dying," he additionally stated in his article, "Slow Medicine."
The bottom line for Sweet, McCullough, and Butler, as well as for other slow medicine proponents, is that modern advancements in medicine are extraordinary, praise-worthy, and entirely appropriate when applied judiciously, but that they are over-used and inappropriately applied much, if not most, of the time. As medical professionals, we need to collectively take a deep breath, take a step back, and take the time necessary to understand what McCullough referred to as the "content, context, and community" involved in any medical situation.
Or in the language of a gardener like myself, we need to look not just at the seeds of medicine but also at the soil of the patient.
Fortunately, physicians do not need to choose between conventional medicine and slow medicine. As beneficiaries of the modern era, we can take a both/and approach, offering the best of each world -- giving what Sweet calls "the right medicine to the right patient at the right time."