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The wonders of modern anaesthetics


Knowing your patient
Harold Lambert Physician
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I, truthfully, am a bit suspicious of the word 'holistic' medicine which is roughly what we're talking about here and the reason I'm suspicious is this: that I think when people say a holistic approach what they basically mean is taking an account of the social and psychological and societal issues as well as the 'scientific' in quotes one you know, who's looking after the cat, as I say, that sort of thing and all much more no, not more important. Anyway, other issues of that nature, but they use the word as if you could see the whole thing in a unified way. Well, I don't think you can. At least I can't. It's true that you... you do have often a feeling, or sometimes, a feeling with a patient of how their, their life in some way relates to their illness. I think you do have that, but I think to claim that you can really see it as a unified thing, I mean, you'd be God or something, wouldn't you, really? I mean, I just don't think you do. I think what you do and I really do believe in the scientific basis of medicine is a reductionist thing, which people rant about, they're against it. But you think about, the elements in the illness, the pain in the big toe and the worries of the patient, all these things, as items, but I personally have to think of them in individual bits which need tackling maybe together, but maybe individually in their own right and that actually is the only way I can tackle it. So 'holistic' to me is a slightly suspect word. I know what we were talking about, but I don't think in the way, the literal meaning of the world... of the word, I think it's too large a claim for most people to undertake really.

[Q] Wholes with a 'w' rather than with just an 'h'?

Yeah, that's right. Yeah.

[Q] Do you... do you think you've learnt from being a patient at all about...

Yeah, I think I have actually, and I think there's some things which you can't learn without being a patient. Everyone can feel pain and, you know, you can see if the patient but that... I don't think anyone couldn't feel that, but there are lots of things that patients suffer, which... I mean, some people have got more imaginative insight into others... than others, but I think there are lots of things patients can suffer which, at least I can only know at an intellectual level. You can't really feel that. I can't really feel it.

As regards being a patient, I think, I had a heart operation some years ago, and the chap, the surgeon, who's now sadly dead, an extremely good surgeon, John Parker, you know, a wonderful guy. So they went into... he went into it all with me and he said he thought that I ought to have a coronary bypass and he was, you know, certainly didn't terribly like going into sort of... kind of emotional things and stuff, but he said, you know, what the chance of dying was and what the chance of serious complication and I thought that's really about all you want to know pretty well: how likely you are to die, you want to know pretty well you're likely to have some awful complication, but then when you get into more detail, like on a drug sheet the basic thing - do you trust the guy who's treating you, and you can go and see somebody else if you don't. I... I didn't think myself, for me, that this wouldn't apply to everybody of course, that knowing a vast amount of detail, the nth degree of the 20th possible complication would do me much good. I mean, I wanted to know the main things and whether I trusted him.

British doctor Harold Lambert (1926-2017) spent his career tackling infectious diseases, helping in the development of pyrazinamide as an effective treatment for tuberculosis. He also published work on the rational use of antibiotics and was a trustee and medical advisor for the Meningitis Research Foundation.

Listeners: Roger Higgs

Roger Higgs was an inner city GP for 30 years in south London, UK, and is Emeritus Professor of General Practice at Kings College London, where he set up the department.

He gained scholarships in classics at Cambridge but changed to medicine after a period of voluntary work in Kenya in 1962. He was Harold Lambert's registrar for 18 months in the early 1970s, the most influential and exciting episode in his hospital training. He set up his own practice in 1975. He helped to establish medical ethics as a practical and academic subject through teaching, writing and broadcasting, and jointly set up the 'Journal of Medical Ethics' in 1975.

His other work included studies in whole person assessment and narrative in general practice and development work in primary medical care: innovations here included intermediate care centres, primary care assessment in accident and emergency departments, teaching internal medicine in general practice and establishing counselling services in medicine.

He was made MBE in 1987 for this development work and now combines bioethics governance, teaching and writing with an arts based retirement.

Tags: John Parker

Duration: 3 minutes, 47 seconds

Date story recorded: October 2004

Date story went live: 24 January 2008