Lifestyle Choices

If you have read most of this book so far, you probably know far more about depression than most GPs. Most doctors have surprisingly little training in mental illness and handling people, though some are naturally good at it. This is partly because medical education tends to lag behind society and discovery. Though it is now well known that at least 50 per cent of people who see their family doctors do so partly or wholly for social or emotional reasons, and though medicine is gradually accepting Pasteur’s belief that the host and its resistance or susceptibility is much more important than the bug, it is likely to take medicine at least 50 years to catch up. This is because:

• Medicine is basically conservative; this is sometimes useful in an institution which has such power over important decisions, often those concerning life and death.
• Medical educators were themselves educated with the old medical model of an outside agent causing disease and the patient being largely irresponsible. Also, those doctors, trained before any basic change in training, may use the teaching they learned for up to 60 years.
• It is an enormous task to change not only a doctor’s but a whole institution’s emphasis, that is, to switch from an overridingly technical emphasis to a mode that combines technical expertise with an approach of sensitivity, human understanding and equality between doctor and patient.

If you regard your doctor as an ordinary person with a limited education, but with some knowledge that may be useful to you, that may help you frame your questions with more authority. Make sure you know the basic function and side-effects of any prescription before you take it. Don’t be afraid to ask “Why?” The professional before you is a servant in the best sense and is being paid by you either directly, orthrough taxes or insurance premiums. Together, you are tackling you and your problem.

Just as you have the right to choose your doctor, your doctor has the right to choose the kind of medicine he wants to practise and may or may not prefer a more technically orientated approach. You may find your doctor is naturally warm, sensitive and understanding, in which case you will find that you can talk openly about what you want and need. If he does not have time to discuss your problem at length, he may well be able to refer you to someone else. If, on the other hand, your doctor is not so interested in emotional problems,he may be able to help you with drugs or through knowing where you can get further help.

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