So when do we introduce education into our treatment planning ? “If I were summing up the qualities of a good teacher of medicine, I would enumerate human sympathy, moral and intellectual integrity, enthusiasm and ability to talk, in addition, of course to knowledge of the subject” Anonymous
Health, education & wellbeing, three words often found in public health literature. Plenty of research supports a link between the wellbeing effect of good education Researchers analysed data from the British Social Attitudes Survey, the British Household Panel Survey and the International Social Survey Programme. Findings indicated a clear association between education and wellbeing. Their evidence briefing published in 2014 states that “Education has become one of the clearest indicators of life outcomes such as employment, income and social status, and is a strong predictor of attitudes and wellbeing. ”
Back in 2010 Dr Margaret Chan Director-General of the World Health Organization, speaking at the MDG Summit: Roundtable 2: Meeting the goals for health and education in New York said ” Education and health go hand in hand. The evidence demonstrating the links is overwhelming.
We know, too, that the education of girls brings an especially high payback for health. In this sense, education and health are a sisterhood.”
But, what about when an individual is experiencing a health problem, what about education at that timing ?
Can introducing education at the wrong time be the wrong key ? Could wrong timing be a key that locks a block?
The question of when and even whether, to introduce education is a topic I’ve mused around on many an occasion.
‘Old wives tales’, stories, modern myths, yarns, fables, whatever you want to call them, are plentyful in relation to health & wellbeing.
Most stories have a traditional historic element, words handed down through generations. A story that began some long time back and passed round by many mouths probably over group gatherings. Layers and layers of beliefs, and loops added at every recounting so that eventually these intertwining narratives become ‘truths’. Everytime the story is told another small embellishment here, another supporting fact added there. An article in a magazine, a throwaway comment at a party, they all add to the value of the story and become incorporated.
However, when many of these stories are unpicked, science clearly shows that there is no truth, its not correct
But the story is so deeply part of culture, folklore and like every good story everyone knows it.
So how can you tell someone their story, the one they tell. is not true?
If we are being humanly sympathetic, acting with integrity & knowledge, how can we marry that with telling someone their knowledge is wrong ? Even if we do will the weight of our words cause a shift or will it be that after the ‘health incident’ will they resume their purple meme of tribal being and beliefs in magic, stories and spirituality ?
As a clinician, when I ask someone how they feel and they find words for their subjective experience, my place is to honour the value of their spoken sounds. When they are at the epicentre of their health state may well not be the best timing to input education that conflicts with their deep held legends.
However there is another way, which is to create a space that is somewhere to one side. Somewhere we can both place some work that we can review together. This way provides a safe space, a place to take risks and explore solutions and ideas, including ideas about themselves and their future.
Sometimes when working I use poetry, a photograph, paints or painting. We can talk together about the written words and then write some ourselves and explore. Bringing this form of narrative medicine into their management is safe and helps them to evolve their own new thinking.
Jill Wigmore-Welsh MSc GDPhysMCSP HCPC