Francis thinks it’s not quite that negative or judgmental (though he accepts it’s “typical NHS: one form for everybody whether you are 80 or 20”). “You’re in this predicament and here are some ways we’ve seen to be effective to get out of your predicament. I wish there was a pill for this but there isn’t.” He’s acutely aware how scary Covid has been for many sufferers: “I’ve had 25-year-old marathon runners take weeks to recover, have weeks where they were struggling to walk up their first-floor stairs. It’s frightening to be reminded of your mortality and how fragile we can be.” Here, GP and writer Gavin Francis explores how - and why - we get better, revealing the many shapes recovery takes, its shifting history and the frequent failure of our modern lives to make adequate space for it. I’m not sure this kind of intuition is something that can necessarily be taught. But what can be taught is the confidence to act on the small voices of conscience and experience that suggest when a therapeutic relationship will benefit from going off-piste – away from the well-trimmed paths of textbook solutions into something wilder, more unscripted and perhaps more effective. Within modern medicine, this creates a conflict, between an idea of a clinical encounter that should be measurable, reproducible and thus open to professional regulation of standards, and the idea of the clinical encounter as an alchemy that combines the experience of two human beings in an unrepeatable moment that changes both of them.

For many of us, time spent in recovery—from a broken leg, a virus, chronic illness, or the crisis of depression or anxiety—can feel like an unwelcome obstacle on the road to health. Modern medicine too often assumes that once doctors have prescribed a course of treatment, healing takes care of itself. But recovery isn’t something that “just happens.” It is an act that we engage in and that has the potential to transform our lives, if only we can find ways to learn its rhythms and invest our time, energy, and participation.

When I was eight years old, I woke one autumn morning with a hammer-blow headache and a churning in my stomach. My GP was called for – a kindly man of the old school who took one look and, suspecting meningitis, sent me urgently to an infectious diseases hospital an hour’s drive away where the diagnosis was confirmed. I spent eight days and nights in that hospital, in a room with large windows that gave on to trees and bright afternoon sunshine. I love practising medicine,” he says. “And I can’t imagine stopping, but it’s quite emotionally exhausting. I discovered early on that a really wonderful way for me to do medicine that made me more effective as a doctor and also helped me flourish, I suppose, as a human being, was to do a full intense day and then to have a day off to think about it and contemplate it.” Because it takes energy, respect and people have to take care over the environment in which they're recovering and there’s lots and lots of ways of recovery, even when you have a condition itself which isn’t curable or terminal.

Never has the publication of a book been more timely and welcome than this short but sagacious volume by GP and author Dr Gavin Francis. At a moment in our human history when so many people worldwide are suffering from the privations of the Covid pandemic – whether that be on a mental, physical or emotional level – there is an urgent need everywhere, for a tender and uplifting message from somewhere. Recovery offers just such a message. In clear and humane language, Dr Francis sets out a manifesto for health, by emphasising the importance of a simple but highly neglected art: that of taking the time, patience and fortitude to become fully well, after a period of ill health. In other words, true healing. As he says, “(Illness) is a place that all of us must visit, sooner or later; from time to time we all need to learn the art of convalescence.” The word “rehabilitation” comes from the Latin habilis, meaning, among other things, “apt” or “fit”, and carries the sense of restoration: “To stand, make or be firm again.” The aim of rehabilitation, then, should be to make someone as fit as they can be – to stand on their own feet if they’re able, and to recover as much mobility and independence as possible if they are not. I worked once as a junior doctor in a unit dedicated to rehabilitation from brain injury, and learned there that convalescence is anything but a passive process. Though its rhythms and its tempo are often slow and gentle, it’s an act, and actions need us to be present, to engage, to give of ourselves. Whether it’s our knees or skulls that need to heal from an injury, or lungs from a viral infection such as Covid-19, or brains from a concussion, or minds from a crisis of depression or anxiety, I often have to remind my patients that it’s worth giving adequate time, energy and respect to the process of healing. Sweet’s book God’s Hotel: A Doctor, a Hospital and a Pilgrimage to the Heart of Medicine explains how, after reading about the medieval healer Hildegard of Bingen, she came to the conclusion that, to better describe the aims of recovery, we should resurrect Hildegard’s medieval concept of viriditas, or “greening” – to be healed is to be reinvigorated by the same force that gives life to trees as much as it does human beings. She, too, observed that the work of the physician is much more like that of a gardener than it is like a mechanic. A sense of loss pervades much of the book, which starts by describing Francis’s own childhood experience of illness and recovery – once with meningitis and once with a badly fractured knee. He remembers lying in a hospital room with “large windows that gave on to trees and afternoon sunshine”. He remembers how long it took to regain the use of his leg and to recover from the profound fatigue that followed the meningitis. When he was training as a doctor years later in Edinburgh, he had the good fortune to work in two hospitals that had been originally established as convalescent hospitals, and which embodied all the principles of access to fresh air and light which Florence Nightingale had emphasised in the 19th century. I had exactly the same experience myself of training and working in what had once been a convalescent hospital. The tall windows, the gardens and the sense of community were a real joy, appreciated by both staff and patients, and in profound contrast to the huge and soulless modern hospitals where most medicine is now conducted. There are few, if any, of the convalescent institutions left – they have all been sold and turned into gated, high-end residential estates. Anessential book for our times, full of wisdom, compassion and sound advice. Every patient needs a copy of this gem.”–Katherine May, author of Wintering and EnchantmentFor all its irritations and frustrations, its agonies and humiliations, illness is a part of life that may teach something of value, even if that thing is only to cherish health when we have it... doctors and nurses are more like gardeners than mechanics, and healing happens thanks to the same force that greens the trees and pushes bulbs up through the earth. Be kind to yourself."

Emily Mayhew is historian in residence at the department of bioengineering, Imperial College London Karanlık hislerimi bir tarafa bırakacak olursak :) hem hastalar (bu herkes demek oluyor sanırım) hem de doktorlar için kıymetli bir okuma diye düşünüyorum. Bazen bir durup düşünmek, bazen bir durup bakmak gerekiyor. Durmak gerekiyor. Yavaşlamak gerekiyor. Fakat biz vahşice bir hızla talep ve tüketim içindeyiz. Bu gürültü içinde talep ettiklerimize, bazen başkalarının hakkı pahasına ulaşabiliriz. Peki talep ettiklerimiz gerçekten ihtiyacımız olan şeyler mi? İhtiyaçlarımız neler? Ruh, duygular, acı, deneyim, zaman… Hız bir sıfır çarpanı gibi yutuveriyor her şeyi… The great 19th-century German doctor Rudolf Virchow – a giant of modern medicine – wrote that doctors are “the natural attorneys for the poor”. Francis describes how for so many of his patients, recovery – and he correctly makes no distinction between physical and mental illness – is inextricably tangled up with their work. The pressure to be ever more productive and the inequality that disfigures our society have a real impact on people’s health. This has been known for many years, especially from Michael Marmot’s work showing that life expectancy is closely correlated to your position on the social ladder. In his own GP surgery, Francis and his partners have sensibly agreed that they should each have a three-month sabbatical every few years. I remember very clearly when I was still working full-time, I could always tell when my colleagues had been away on holiday – their eyes and faces were so much brighter. John Maynard Keynes’ famous essay “The Economic Possibilities for our Grandchildren ”, written 94 years ago, in which he envisioned a future where we would only work three hours a day and could devote ourselves to leisure, seems charmingly quaint. The word “doctor” comes from docere, meaning “to teach” or “to guide”, and just as every teacher you’ve ever had works with a different style, so does every doctor. The idea that there’s a universal approach every practitioner should adopt is false, and would be a terrible way to offer medical care. In the 30 or 40 medical encounters I have in the course of a normal working day, there must be several that I misjudge, guessing wrongly which kind of doctor that particular patient needs me to be.If we can take any gifts or wisdom from the experience of illness, surely it’s this: to deepen our appreciation of health … in the knowledge that it can so easily be taken away. A Scots doctor who has written a book on his experiences of the pandemic has said the last two years have caused people to lose "the art of getting better slowly". His first book, True North: Travels in Arctic Europe, explores the history of Europe's expansion northwards from the first Greek explorers to the Polar expeditions of the late 19th and 20th centuries. It was nominated for a William Mills Prize for Polar Books. Of it Robert Macfarlane wrote: 'a seriously accomplished first book, by a versatile and interesting writer... it is set apart by the elegance and grace of its prose, and by its abiding interest in landscapes of the mind. Francis explores not only the terrain of the far North, but also the ways in which the North has been imagined... a dense and unusual book.' At one level, convalescence has something in common with dying in that it forces us to engage with our limitations, the fragile nature of our existence. Why not, then, live fully while we can? It was on 31 December 2019 that the Chinese government alerted the World Health Organization to a new and dangerous strain of coronavirus that was infecting people in and around Wuhan. Humanity has learned an enormous amount over the subsequent two years – new ways of managing the pneumonia caused by the virus, as well as how to build a suite of vaccines proven to be effective against it. We move into this new year still struggling to contain a pandemic many thought would be over by now. New, more transmissible and more dangerous strains of coronavirus are still emerging. As they put our powers of recovery to the test, it’s worth thinking more deeply about what convalescence really means.