In her latest book, Slow Medicine: The Way to Healing, Dr. Victoria Sweet returns with her familiar style of straightforward, compelling prose and well-crafted anecdotes, artfully stitched together to form a tapestry of 40 years of medicine.
In Slow Medicine, Dr. Sweet writes with the same relatable voice we discovered in her first book, God’s Hotel. After several conversations with Dr. Sweet, we found her tolerant observations seem to fit her approach to life, leaving her open to new experiences, which others might discount or overlook. Dr. Sweet also accepts insights that some doctors might view as beneath them. These attributes are once again evident in her latest work.
No Shortcuts to Experience
As with her prior book, God’s Hotel, Dr. Sweet uses a comforting, direct language to describe complex ideas. Her approach leaves the novice reader with an informative education, while offering the advanced practitioner the joy of jumping to conclusions. Nurses play a central role in many of Dr. Sweet’s anecdotes, indicative of her genuine belief in the value of experience in serving the highest cause.
Dr. Sweet employs a narrative using Carl Jung’s theory of enantiodromia, where the confrontation of opposites first results from identifying the opposite within each thing. Much like a good portrait, Dr. Sweet brings us closer to understanding the subject, Slow Medicine, by first describing its reflection, Fast Medicine.
Slow Medicine, a Retrospective
Slow Medicine is a retrospective that fittingly resembles the medical definition: an examination of the patient’s history and lifestyle. Dr. Sweet guides us through a constellation of her life experiences that culminate in the illumination of some of the most pressing issues of modern medicine.
She curates from her experiences such that we don’t merely watch her transformation with distant fascination, but are instead pulled into the examination ourselves, where we experience the power that slowness has to change many things, not the least of which is the perspective of the observer.
Message of a Hero’s Journey
This perspective, gifted to us from such an experienced practitioner of medicine, is a fascinating body of work on its own accord. Slow Medicine is, however, far more than an autobiographical story marked by well-planted signposts of insight along some forgotten path of medicine; it is a narrative discovery, both personal and universal.
Slow Medicine explores questions about life that transcend medicine without being pretentious; a testament to Dr. Sweet’s authenticity, undoubtedly honed through her experience healing the long-suffering and forgotten souls of Laguna Honda Hospital. An experience she chronicled in her first book, God’s Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine.
Admiration for the Craft
Dr. Sweet has a gentle, but confident voice. She avoids excessive jargon and the swagger of inflated self-regard so common in those with her expertise. Her gift for descriptive parsimony draws us into the corners and corridors of hospitals and the lives of her patients with a gentle hand, leaving room for our own imagination and contemplation.
She writes for the human reader, not just those in her craft. The story is hers but the message is for all, patients or practitioners, for those are the very boundaries she seeks to explore. Slow Medicine will challenge the practitioner, inspire the patient, and remind us all that to heal is to be human.
“The craft of medicine is a beautiful thing, very human, very much about body, not only the patient’s real bleeding body, but through and in your own body.”
Considering Several Alternatives
Slow Medicine will make you think – and feel, and question your own perspectives about more than just medicine. Dr. Sweet achieves this without being overly prescriptive, a defining affliction of modern medicine itself.
“…medicine, above all, is a craft…It takes a warm human energy, a commitment, a struggle, a giving up of a piece of yourself to attain that craft.”
Accordingly, Slow Medicine is not a manifesto or a panacea for all of what ails medicine. Nor is it an unwieldy indictment of modern “fast” medicine. It does, however, propose that there is a different way, a “…way of seeing, doing, and being” that re-unites doctor and patient in the craft, art, and science of healing.
Der Weg ist das Ziel (the path is the goal)
We join her story as she begins her own journey. Not just into medicine, but into adulthood. Once again Dr. Sweet’s gift of storytelling shines as we are drawn into situations from her past. Dr. Sweet shows us how a compelling path in the life of a doctor unfolds by saying yes to new experiences.
As these experiences build upon one another, we come to see how the dichotomies of doctor/patient, fast/slow, healthy/sick, and even life/death are far more nuanced that we tend to believe.
“And yet it was as if underneath the modern model of the body I had been taught there was something, some other kind of body, with a less defined boundary, a body in which we all participate, a body of energies and connections, of invisible causes with visible effects.”
Dr. Sweet’s unique journey through medicine reveals how the practice of Slow Medicine, which some may consider a new-age phenomenon, was in fact always a part of medicine. We come to see that the slowness within medicine is not just as a counterpoint to the fast, but is in fact an inextricable quality of medicine itself. To become a doctor is an act of deliberation that systematically employs slowness to instill the apprentice with the foundation necessary to become the journeyman.
Past is Prologue for Progress
As she takes us through her experience of American healthcare, which on a broad scale appears flawed, but on an individual scale still preserves the intent to cure, Dr. Sweet’s retrospective illustrates how, like the frog who fails to realize the water boiling all around him, our medical system has been steadily changing such that those within it fail to see its radical shortcomings.
“This is what is so detrimental about algorithms, regulations, requirements, and mandates. They lift the mantle of responsibility off the doctor and turn him or her into a provider, a middleman, someone who takes the box of healthcare off the truck and delivers it.”
The Challenge of Business Over Healing
Enter the “health care provider.” Through her own confrontations with Fast Medicine, Dr. Sweet shows us both the subtle and not-so-subtle ways in which medicine has come to abandon its slow roots. She distills decades of progress for us to see how the invasive tendrils of Fast spread. At first, as benign encroachments into the vernacular of titles and procedures, then as malignancies of bureaucratic bloat, power hierarchies, and frailties of the human ego.
The author illustrates that despite vast technological improvements and efficiencies, the practice of medicine has moved closer to business and farther from healing, rendering the actual work of healing subordinate to that of the actuaries and administrators.
In contrast to this, Dr. Sweet’s own experiences evidence how the human body responds positively to antiquated methods of Slow Medicine – and that the craft of healing cannot always be explained, nor can it be administered through the lens of economic efficiency.
“I thought about the strange deep relationship between doctor and patient. Of what I got from my patients, of what they got from me. That was not ever talked about, neither its diagnostic usefulness nor its therapeutic meaningfulness.”
The Antiquated Basis for Healing
Dr. Sweet shares how the mystery of touch, the power of watching and listening, and our natural interconnectedness come together within the “invisible structure” that are the roots of slow medicine. She comes to this realization, in part, by way of Hildegard and her notion of the micro and macrocosm, i.e. each of us simultaneously occupies the universe, and possesses it within us.
It is not until late in Dr. Sweet’s career that she seems to fully grasp the very thing that was slipping away, that at its root, medicine represents a two-party contract, an agreement between doctor and patient with an explicit mandate to heal.
“The foundation of Medicine is the doctor and the patient.”
In her observation, the agreement has refracted through the economic lens of Fast Medicine into several different stakeholders, now firmly entrenched between the doctor and patient. Further, the very science of medicine is continually thrust into the resulting chasm in the name of efficiency; to improve financial results for investors first and foremost, but which just as often seems to result in greater costs – to all parties involved.
Enter Hildegard of Bingen Medicine
In the midst of this chaos, presented by the so-called improvements of fast medicine, Dr. Sweet traveled to a time generally known for unbearable conditions, Medieval Europe, where she found a spiritual healer, ahead of her time.
Almost 900 years earlier, Hildegard of Bingen preached the very things that a small California subculture was prepared to embrace. Eat less, exercise more, and take care of the whole organism, not just its parts. Through Hildegard, Dr. Sweet rediscovered the healing power of nature and viriditas.
“If nature were a medicine, she would be patented and sold for quite a bit of money.”
Among her discoveries of ancient healing and Hildegard of Bingen, Dr. Sweet found traditional German medicine lacked the standard cost benefit analysis. Instead, these centuries-old practices appeared motivated solely by the goal of healing. And, though Hildegard appears late in this book, we share in the realization that Hildegard medicine was nothing more than a name given to the techniques Dr. Sweet found had actually worked throughout her own medical career.
“Thus arose Hildegard’s implicit idea, which for me was revolutionary, that as a doctor I should be not only a mechanic of the body, looking for what is broken and trying to fix it, but also a gardener of the body, nourishing viriditas, and removing what is in its way.”
We are left contemplating the idea that Slow Medicine and Fast Medicine are not opposing forces that must battle for territory within medicine, but that their relationship reflects something much greater. And through this perspective, Dr. Sweet provides us with a way to reunite what has been divided, regain what has been lost, and perhaps progress toward a future that in some ways might end up looking a little bit more like our past.