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Slow Medicine: The Way to Healing

de Victoria Sweet

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692381,277 (3.8)12
"A radical new understanding of how medicine is best practiced, from the award-winning author of God's Hotel. Over the years that Victoria Sweet has been a physician, "healthcare" has replaced medicine, "providers" look at their laptops more than at their patients, and costs keep soaring, all in the ruthless pursuit of efficiency. Yet the remedy that economists and policy makers continue to miss is also miraculously simple. Good medicine takes more than amazing technology; it takes time--time to respond to bodies as well as data, time to arrive at the right diagnosis and the right treatment. Sweet knows this because she has learned and lived it over the course of her career. Here she relates unforgettable stories of the teachers, doctors, nurses, and patients through whom she discovered the practice of Slow Medicine, in which she has been a pioneer. Medicine, she makes us see, is a craft and an art as well as a science. It is relational, personal, even spiritual. To do it well requires a hard-won wisdom that no algorithm can replace--that brings together "fast" and "slow" in a truly effective, efficient, sustainable, and humane way of healing"-- "The award-winning author of God's Hotel offers a radical reimagining of how we practice medicine"--… (més)
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I loved her previous book, God's Hotel, exploring the care of the most vulnerable in a dying breed of hospital. Intelligent, erudite, insightful, and deeply humane, Sweet tells a slightly more personal story this time, how she came to medicine, how she learned it, and the serious moral, intellectual, ethical and spiritual question her career path led her to investigate. I will confess, my heart sank when she revealed her profound admiration for Carl Jung, the Nazi-sympathizing, dishonest, creative and utterly flaky developer of the pernicious personality theories that have tainted Human Resource Departments everywhere with the likes of Myers-Briggs and its bastard offspring "Total Insights," dumbed down to the point where you don't even get to use words for the types, only colors. But I digress.

I still liked this book a lot. She opens with the harrowing and unconscionable mistreatment of her elderly father, subjected by the hospital to days of inappropriate and even dangerous treatments for a condition he did not have, that his attending-physician-of-the-day knew he did not have, and yet was unable to change the diagnosis in that new Bible of medicine, the electronic medical record. Only by pretending his family was removing him for hospice care (God love the hospice folks, who supported them) were they able to get him out of there, feed him and allow him to recover. Sweet muses on the intersection of, conflict between, and potential synergy of "fast" (high-tech, multiple-labs, treat-every-single-thing-that-shows-up-no-matter-what) medicine, and a "slow" medicine, led by relationships, caution, setting priorities, and looking at the patient as a complex living organism in their own unique environmental "niche." She considers and applies elements of other models of medicine: Chinese traditional, Ayurvedic, and that of the medieval nun Hildegard of Bingen, to add value and alternatives to the mechanistic clinical basis of modern medicine. She ponders on what being a doctor does to a person, what sort of doctor she herself has become, and how she got there. And - most worryingly - her picture of the future of American medicine is a bleak one indeed: corporate, money-focused, treatment decisions being made by "quality managers" and other "Upstairs" types who write themselves 15% raises while refusing a raise above minimum wage for the medical assistants downstairs for years on end.

If there were more Victoria Sweets, I would be less fearful. Her portraits of patients are humane, dignified, and warm, and she seems truly grateful to them for all she has learned from them. Ironically, staff at the hospital who treated her father so badly had read her earlier book in their book club; she had presented to them at the invitation of the medical staff. Apparently, not much of what she said made it into a checkbox on the EMR, and languished unheeded. A cautionary tale. ( )
  JulieStielstra | May 17, 2021 |
In this memoir, the author provides her perspective on slow medicine and its importance in today's practice of medicine. As technology has changed every aspect of our lives in the last several decades, medicine is no exception. Today's electronic medical records, diagnostic algorithms, and treatment protocols are the fast paced means of providing medical care in the name of efficiency and uniformity. The problem is, the human body is not a machine and nor are we a uniform as current medical practice would have us believe.

The author is no Luddite and she expresses appreciation for the advances technology has brought to medical care. But patients are individuals with their own histories. Often there are multiple conditions requiring medical intervention. What is often missing is the time and skill for the physician to step back and assess the patient with a larger perspective and a longer view in mind. It takes time to understand the patient's narrative, communicating with other doctors, and reviewing reports and lab tests to avoid misdiagnoses and over treatment.

As in her previous book, [God's Hotel], her fascination with medieval medicine and how it was likened to tending a garden has informed her counterpoint to the modern mechanistic view of treating the human body. The book is written as memoir, and each chapter has one to several patient anecdotes which demonstrate a lesson Dr. Sweet has learned along the way. Many of these stories build upon the narrative in her previous book [God's Hotel]. She is not proposing a revolution, but a complementary path as a type Ecomedicine to be systematically applied to the treatment of patients. ( )
  tangledthread | Jan 27, 2020 |
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"A radical new understanding of how medicine is best practiced, from the award-winning author of God's Hotel. Over the years that Victoria Sweet has been a physician, "healthcare" has replaced medicine, "providers" look at their laptops more than at their patients, and costs keep soaring, all in the ruthless pursuit of efficiency. Yet the remedy that economists and policy makers continue to miss is also miraculously simple. Good medicine takes more than amazing technology; it takes time--time to respond to bodies as well as data, time to arrive at the right diagnosis and the right treatment. Sweet knows this because she has learned and lived it over the course of her career. Here she relates unforgettable stories of the teachers, doctors, nurses, and patients through whom she discovered the practice of Slow Medicine, in which she has been a pioneer. Medicine, she makes us see, is a craft and an art as well as a science. It is relational, personal, even spiritual. To do it well requires a hard-won wisdom that no algorithm can replace--that brings together "fast" and "slow" in a truly effective, efficient, sustainable, and humane way of healing"-- "The award-winning author of God's Hotel offers a radical reimagining of how we practice medicine"--

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