The Case for Slow Medicine

Published In Caregiver Advice and Resources

“I don’t consider myself a natural-born doctor,” Victoria Sweet recently told a group gathered at San Francisco’s Institute on Aging. She then described her unlikely scholastic path to physiciandom: a major in math, minor in classics — and an awakening to Karl Jung while browsing in a bookstore one day. “I was taken by the way he lived life: in a stone house, a medieval hideaway,” she says. “But I liked medical school more than I thought I would. I liked taking patients’ histories — and I loved examining them.”

That Jungian attraction explains a lot about Sweet’s current cause: promoting the understanding and practice of “Slow Medicine,” which she says is particularly important for older patients, who are most frequently overdiagnosed and overmedicated.

In fact, she’s recently penned a tome on the topic titled Slow Medicine: The Way to Healing. In it, she takes the current healthcare system to task, pleading with practitioners to switch from considering human bodies as machines with themselves as mechanics to a more holistic view of bodies as plants to nurture and “garden.”

Roots in ‘God’s Hotel’

It’s not Sweet’s first star turn as something of a medical heretic. She gained quite a bit of local notoriety in 2013 when she wrote God’s Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine. That book shined the light and then the dark on San Francisco’s unique Laguna Honda Hospital, built in 1867 as an almshouse providing community along with medical and spiritual care to city residents who could not support themselves.

Sweet took a post as a doctor there, intending to stay two months. But she stayed on for twenty — smitten at first by the kindness and camaraderie of the place, where patients were encouraged to visit the farmhouse and tend the gardens on the grounds, and doctors took the time to sit on their patients’ beds and get to know the people they were charged with healing. Then came “modernization” in all its forms: state and federal inspectors who did away with the animals and gardens, instituting forms and computers, electronic records, and regulating doctor/patient time on an efficient new formula. It was then that Sweet finally left the place.

And though she already harbored a healthy disdain for the bureaucratization of medicine, the reality of modern healthcare hit home, quite literally, when her own father was misdiagnosed with a stroke and hospitalized: sedated, catheterized, placed in restraints, rigged up with IVs and oxygen. He was freed only after family members convinced the staff hospitalist to let him go home and receive hospice care. Several hours later, he was dining on steak and beer, preparing to live on healthily for years to come.

The experience of current medical health care nerve-wracked Sweet, with its absence of “presence, attention, judgment, kindness, and responsibility,” and set her firmly on her current path of pursuing Slow Medicine. It’s not a new concept, she freely admits, having taken hold with healthcare critics and some practitioners in the U.S. around 2006 — a medical mimicking of the Slow Food Movement then gaining popularity that promoted sustainable, locally farmed food over McDonald’s fare.

The Roots of Slow Medicine

The definition of Slow Medicine can frankly feel a bit muzzy. But it commonly means taking the time to truly assess a patient and shed the shackles of metered and insurable doctor/patient moments. Most true believers add more: the need to evaluate a patient’s social context, reduce anxiety and give emotional support, prevent premature release from the hospital, refrain from overdiagnosing and overprescribing drugs and treatments.

In fashioning her own definition of Slow Medicine, Sweet took some early inspiration from Hildegard of Bingen, a 12th century nun, medieval mystic, visionary, and advocate of natural medicine and healing techniques — and became somewhat of a devotee. “My idea was to understand Hildegard and her medicine from the inside, by learning her language, her culture, and her history as she knew it,” Sweet writes, explaining to readers why she enrolled in classes in medieval Latin and German, paleography, medieval history, medical anthropology, and folklore. For a time while working on a PhD in history and social medicine, she even planted a medicinal garden and tried out Hildegard’s remedies firsthand.

And reading between the lines of Slow Medicine, we begin to see how Sweet’s curiosity and ability to adapt and change are what has allowed her to find positions throughout her career that mesh with her experiences and beliefs.

“Medicine is personal. And when it’s personal, it works. Both patients and doctors are happy,” she says. “It’s also more efficient and less expensive — not to mention all the wonderful things that happen when you take a patient off meds.”

By contrast, “Fast Medicine,” the kind we usually get, involves excessive technology along with care in the form of surgery, machines, medications — most of it expensive, much of it probably unnecessary. With its ready respirators and other apparatus, it can keep patients “alive” almost indefinitely.

“Fast Medicine works great for trauma; slow is good after surgery or when treating chronic disease,” Sweet says, underscoring the strides made in some common procedures such as hip replacements and cataract surgery. “They really work best if used together.”

Sweet sees the glass half empty — and half full — when it comes to medical training for present and future doctors. “Today’s medical students are learning more about prevention,” she says. “But they do not know how to examine patients, which is a great loss, especially keeping in mind the ancient medical adage ‘The patients’ diseases are written on their bodies.’ Med students now just see folks while they remain seated in front of their computers. And that’s getting way worse.”

Perhaps it’s just a sign of the times.

“The pendulum of health care has swung in my lifetime from the personal to the efficient, with its great emphasis on forms and paperwork,” Sweet says. “All around the country, we are now doing less with more.”

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