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The Hedgehog and the Fox

Apparently there are two different kinds of people; people who are like hedgehogs and people who are like foxes. People who are like hedgehogs organise their lives around one big idea, one central theme; whereas people who are like foxes hold many divergent ideas and beliefs, some of which might even contradict each other. Having discovered this, I remarked to someone that I thought one of my colleagues was definitely a hedgehog. This got back to him, and he took the trouble of telling me that he thought he was not a simple hedgehog, but also had fox-like tendencies.

This is an example of how we generally do not like to be pigeon-holed (or, in this case, hedgehog-holed). We resist being categorised and over-simplified. This morning on the radio there was a news item about the DSM classification of mental disorders, and how this is being revised, and I noticed in myself an immediate hostility to the very idea of such a classification. Like my colleague, I am wary of even the suggestion of being categorised and classified.

Nowhere more than in the field of healthcare, perhaps, do we need to be more aware of this issue. In fact when people complain about poor experiences of healthcare, often this is what they are complaining about – not being seen as a unique, individual, really quite complex, person, but being shoe-horned into this or that medical category. And when the treatment itself more or less ignores our unique individuality and is just prescribed for the category we have been stuck in, then we are right to worry.

In Chinese Medicine we have the saying “Different diseases, same treatment; same disease, different treatments”, which reminds us that just because two people have the same disease – the same label – we do not necessarily give them the same treatment. In our practice at The Sean Barkes Clinic, we always endeavour to get beyond the label and understand just how the person in front of us, the patient, is not as healthy as they could be.

Take tennis elbow (lateral epicondylitis) as an example. This basically refers to pain on the lateral elbow, the outside of the elbow. There is no way that there can be a standardised “one-size fits all” treatment for what might be thought as a relatively simple condition. In some people, for example, tight muscles in the neck may be partly responsible, as they can obstruct the nerve supply to the elbow from the spinal chord. In many people, some of the various muscles of the upper arm will be involved. Often there is inflammation where the extensor muscles of the forearm connect to the elbow. If someone has impaired digestion, or poor circulation, the muscles and tendons involved will not be, perhaps, getting the nourishment from the blood that they need to stay healthy. In some people the pain feels hot and inflamed; in others it is worse in cold weather. This list could go on and on, and what the patient needs is a skilled therapist who can identify, the often quite complex, set of conditions which have given rise to the pain; not just a bog-standard “tennis elbow treatment”, whatever that might be.

Written by Vimalaprabha

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