By Jane Keep, London, UK
Look at any headline in the news, or on social media and you will likely see that the NHS and other healthcare services world-wide are under continuous pressure due to the ever-growing demand from rising illness and disease in their local populations. And more and more we are learning that illness and disease is linked to lifestyle. Given this, what is the trajectory looking like? If it continues to increase as it is, due to the way we are living our lives, the rising tide of illness and disease will overwhelm healthcare and bankrupt governments, reducing the productivity of our cities, nations, and the world as we become a society dependent upon needing care for our ailments and woes.
There are definitely times when we need to call on the support of healthcare, and my observations of working in the NHS for 38 years now, show that healthcare professionals work exceptionally hard to deliver the best services they can.
One of the issues healthcare professionals face is the tiny amount of time they have with each patient. Often appointments are booked on a continuous conveyor belt of one in, one out, with little time to discuss anything beyond the presenting issue. All the while during their busy days, healthcare professionals will observe patients and they will likely be aware of some lifestyle factors that may be contributing to their patients’ lack of health and wellbeing.
In this, it is highly likely that doctors, nurses, dentists, and all healthcare professionals will observe time and time again patients in whom there is a level of self-disregard. This self-disregard could show in many ways – let’s take an example:
A hygienist in a dental practice I know sees a lot of self-disregard in the mouths of her patients. She feels that that information – her observation of what she ‘reads’ in the mouths of her patients – is not ‘hers’ and when the mouth of her patient is showing something, she raises the issue gently by asking them a question about the way they are living to get a sense of whether the patient is aware of what is going on. Where there is an opportunity, she will also gently discuss how self-disregard is impacting on their mouth/dental care, and overall sense of wellbeing. She leaves it with them to consider, no force, just sharing what she observes. The only time when she is firm is when she sees something serious in their mouth and she needs to refer them on for further care (e.g. potential mouth cancer). She has seen young people in their 20’s with potential mouth cancer and she is more and more concerned about the way we are living, and the level of self-disregard she observes in patients’ mouths.
In this, we could say self-disregard is any number of things, e.g. not cleaning our teeth regularly, eating foods that do not nourish our body, drinking beverages that do not truly support our hydration, grabbing food on the go with little or no time to digest it, pushing our body to the extremes on over-rigorous exercise or not partaking in any exercise whatsoever, ignoring our body and the signs and symptoms it gives us, not wearing warm clothes on a cold frosty day. All of which affect the quality of our health, our hair, skin, teeth, eyes, posture, all aspects of our anatomy and physiology, and our general sense of wellbeing.
This raises a question: if we observe self-disregard in a patient, as a practitioner, who does that information belong to? Is it for us only, to know but to ‘live and let live’, or is it something to be expressed to the patient? Where does a duty of care begin and end in this case?
And what if part of that duty of care also lies with us as citizens, as patients – are we open to receiving those observations and to discussing self-disregard, with a view to understanding that the way we are living can lead to illness and disease or true wellbeing, and making true changes to our daily life?
What if the topic of self-disregard was a much-needed conversation amongst us all – whereby we started to look at and understand not only how much self-disregard we are currently living in, but also the impact this way of living is having on our health, on our healthcare services and on our world?
Maybe in time to come we will choose to live openly, transparently, and honestly – where we appreciate the observations of others including our healthcare practitioners about our self-disregard, or where we feel we can openly talk about this not just in our healthcare appointments, but also in our daily lives.
In the end it is us who turn the tide of change, and we have to start somewhere – where better to start than with self-disregard? When we start to heal the level of self-disregard we have been living with, and begin to regard ourselves as truly worthy of tender love and care, and treating ourselves with this deep self-regard, we will collectively turn the tide of illness and disease that is currently threatening to overwhelm us.