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How we heal after illness is not a matter for science alone | Letters



How refreshing to hear a GP recognising that recovering from illness may depend on going “off-piste”, leaving “the well-trimmed paths of textbook solutions” in favour of “something wilder, more unscripted and perhaps more effective” (‘We need to respect the process of healing’: a GP on the overlooked art of recovery, 4 January).

My perspective is hospital medicine and surgery, in which many patients never reach their potential after illness. NHS trusts, eager to empty beds, often invest in specialist rehabilitation units where a small proportion of patients with especially complex needs are put through multi-disciplinary, goal-directed programmes. The vast majority of ill people, by contrast, are hurried home in the expectation that spontaneous healing will somehow work its magic.

Even though I devoted my medical career to rehabilitation, I suspect that poor outcomes among NHS patients are due less to a shortage of equipment or therapy than to a failure of imagination. As the article’s author, Dr Gavin Francis, says, the meanings of illness and wellness differ vastly from person to person. Rehabilitation protocols are no substitute for imagination, and nor are routinely prescribed discharge care-packages. In healthcare’s rule-bound culture, it is hard to find the courage to stray from well-trimmed paths.
Christopher Ward
Emeritus professor of rehabilitation medicine, University of Nottingham

Dr Francis sounds like an intuitive and creative GP. He likes to describe illnesses as stories of the mind and body. He lists many non-medical solutions that help medical problems – to which I would add the benefits of talking, particularly sharing stories with people with similar medical problems.


Royal Stoke university hospital and former patient volunteers run such a group for oesophagogastrostomy patients and their carers/partners. The meetings are a safe place where stories of the mind and body of one person help the convalescence of another.

My husband, who had such major surgery three years ago, gains much from being able to share anecdotes with those at an earlier stage in their treatment, and from talking to those who had the operation many years before him. It is striking that many surgeons see the benefits too, as usually one or more of them attend the meetings.
Annie Coombs
Nantwich, Cheshire

As a retired GP, Dr Francis’s piece is music to my ears. I’ve long felt that general practice is an art – the art being when to use the science.
Elaine Yeo
Enfield, London

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