Have you recently had Covid? Then you must read this
When your body stops working – for any reason from cancer to a car accident – it can be scary, dramatic, intense, traumatic, painful, debilitating, disorienting and disruptive. And then you feel better and everything is ok again. This is the model we recognize.
But in the past there was a middle phase between crisis and normality – recovery. Florence Nightingale got in touch Nursing Advice 1859 on the importance of “fresh air, light, warmth, cleanliness, rest and proper nutrition”. There is a beautiful old building near where I live with large windows overlooking the sea. In the 1800s it was a convalescent hospital for long-stay patients. Today they are luxury apartments. We don’t do convalescence anymore – instead we learned to take prescription pills and move on.
Until long Covid. No amount of pill-dropping and cracking can induce those in its grasp to do much at all except cold-move daily and surrender to a long, slow process of recovery. Overriding the body’s need for gentle recovery at a snail’s pace only serves to set everything back; If you rush it, the Snakes and Ladders recovery model emerges.
dr Gavin Francis, Edinburgh-based GP and author, reminds us of this in his new book Recovery: The Lost Art of Recovery. Like Nightingale, he recommends “space, light, cleanliness, green, tranquility”. Instead, we have modern infirmaries, which he describes as “windowless boxes with no view.”
Family doctor and author Dr. GavinFrancis
And then you’ll be released and it’s business as usual. “My patients often need to be given permission to take the recovery time they need,” he writes. “Disease is not simply a matter of biology, but one of psychology and sociology.”
And convalescence is not a passive process: “It’s an act.” A conscious demarcation of time and space in which you allow yourself to heal. “Recovery insists that we acquire a new language of the body.”
Like love, there is no hurry.
Via Zoom, Dr. Francis on how convalescence has ceased to be an integral part of the healing process.
“We lost it in the 1960s when we started discovering and researching the effectiveness of antidepressants, antibiotics, steroids and inhalers,” he says. “They’re phenomenal and they changed medicine, but people started to think that’s all it takes.”
This change continued through the 1970s and 1980s, particularly within the psychiatric services; the closure of convalescent hospitals and beds accelerated.
“I don’t want to go back to the pre-1960s world,” says Dr. Francis. “But I also think there was respect for the process of recovery and recovery in those days that we lost. We would do very well to revise that. Unfortunately, for many people, home is not a good place to rest. As a doctor, I want my patients to have another option.”
Also, prospective doctors spend about as much time studying convalescence as they do nutrition—that is, not much time at all.
“The focus is on the crisis aspect of a medical intervention, with the idea that the patient will recover on their own,” he says. “And some do it without guidance and rush back to work. But my experience is that these people are the minority.
“People need time and space to recover. In the 25 years that I have been practicing, there are fewer and fewer safety nets.”
He is an advocate of sick leave, which can give that time and space to those who need it, and rejects societal attitudes about its abuse. (The fraudulent use of sick leave is calculated at 1.7 per cent in the UK, a third of which is ‘claimed as a result of a ‘genuine error’).
However, a well-run workplace will not pressure an employee to return to work early – meaning employees will return with renewed vigor and perhaps a greater sense of loyalty. But he says, “If you’re being squeezed, rushed and harassed, you’ll come back early if you’re not ready and feeling bitter and frustrated with your job.”
The book Recovery: The Lost Art of Convalescence by Dr. GavinFrancis
He adds that health care cannot solve problems such as housing, welfare, education and poverty. “If people don’t know how to eat healthily or can’t afford decent food, it’s not a medical problem,” he says. “People have to vote for the kind of health care system they want.” (Have you ever tried recuperating with hospital food? I was offered instant pudding while lying half-dead in the ICU. Dr. Francis mentions fried carbs on one Cardiology Ward. Florence Nightingale would have gone insane.)
Anyone who has ever slowly recovered from an illness will recognize that in addition to nutrition, care is also a crucial element of recovery – yet we consistently underestimate both the importance of care and the importance of caregivers. dr Francis sees two reasons for this.
“For us, care is a natural part of everyday life, so it’s reluctant to see it more professionalized,” he says. “Another reason is the terrible ongoing sexism in our society. Traditionally, it has been women who have done care work and there is an ingrained sexism that believes care should be less adequately remunerated. What I do as a GP is caring, but it has a relatively high priority – the vast majority of my patients’ care is provided by nurses and it’s heartbreaking how undervalued they are.” Right now we’re living for such a long time – as an aging society we are much more dependent on care.
“We’re struggling to catch up,” he says. “Most people today are living in an age of frailty and dependency, and we need to recalibrate our society to reflect that.”
dr Francis thinks the WHO’s definition of health – “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” – is somewhat unrealistic. “If we take that as the goal of recovery, none of us stand a chance,” he writes.
Instead, he urges us to think of recovery not as a goal, but “as something dynamic, just like life—a direction of travel.”
He says recovery can be as much about accepting who you are as it is about returning to your pre-illness state, and shares how two former patients suffered life-threatening heart conditions. Both recovered after medical surgery. After that, you were energized and excited to live your best life; the other was traumatized and terrified that they would die at any moment.
“People react very differently to the same challenge,” he says. “An identical near-death experience produced two diametrically opposed reactions. We all hope that we are the ones who benefit from this, realizing that life is short, but the other reaction is probably more common – being scared of realizing the fragility of life and feeling really vulnerable.
Health and medicine is a “very messy organic world of nature” in which doctors are gardeners rather than mechanics.
“A cardiologist once told me that engineers are the hardest thing to take care of,” he says. “You see everything in technical terms – why can’t a pump like the heart be repaired like a machine? But it is living material.
“What we do as doctors and nurses is push natural processes in the right direction instead of fixing broken things. And when you nudge nature, you’re much more like a gardener. I would very much like this view that medicine is part of nature and influences natural processes to be more in the foreground in our training than the dogmatic engineering view, which in my opinion does not really fit the reality of the disease.
“The truth is that we cannot cure most diseases. We can only help mitigate and offset the impact they are having on people’s lives.”
Recovery: The Lost Art of Recovery by Dr. Gavin Francis is published by Profile (€5.85)
The art of rest
INSTANT RECOVERY
⬤Plan regular breaks.
⬤Don’t hurry.
⬤Keep meals small.
⬤If you’re out of breath, learn it
control your breath.
⬤ Get some fresh air.
⬤Sit down often – place seats
strategically around the house.
⬤Use props to avoid bending over
and achieve.
⬤Push, don’t pull. Slide, don’t lift.
⬤ Set achievable goals, little and
often, every day.
Longer Term Recovery
⬤Acknowledge your suffering,
Avoid false positivity.
⬤Make your surroundings so bright
quiet, green and clean as possible.
⬤ Get all the sick notes you need.
⬤Take a sabbatical if you can.
⬤Don’t isolate or withdraw either
a lot — still see people.
⬤Think about your diet.
⬤Find a doctor you trust.
⬤Be nice to yourself.
⬤Don’t just rely on drugs – try
walking, sitting in the sunlight.
https://www.independent.ie/life/health-wellbeing/health-features/have-you-had-covid-recently-then-you-need-to-read-this-41463550.html Have you recently had Covid? Then you must read this