Remodelling Medicine Jeremy Swayne Saltire Books £39.98 (978-1-908127-00-6)
THERE are consultations in UK general practice every day. Many of us will be grateful for our doctor’s skill and humanity in diagnosis and treatment. As patients, we present an extraordinary mixture of symptoms, which are shaped by many factors, not least our religious lives and spiritual selves.
As a society, we continue to be baffled about how best to provide for our shared well-being. Limited resources, advancing technology, and (perhaps) our increasing expectations may make the task of medicine and its practice ever harder. Finding wisdom on this journey is a challenge.
Important ingredients of wisdom are time, perspective, and ex-perience. Jeremy Swayne brings nearly 40 years’ experience in general practice and the National Health Service to this fascinating book, which reflects his skill, humanity, careful attention to detail, intelligent organisation, and capacity to open up and develop an argument.
There are 20 chapters, organised into five parts. Among the areas discussed are the natures of disease and medicine, and their inter-relationships with society, the individual, science, and the patient. Swayne is clear that medicine is in crisis as it is faced with scarce resources, as well as a more important loss of its core vocation and morality.
The second half of the book argues for change, as Swayne asserts that medicine needs fundamentally to be remodelled. The text achieves a high quality of synthesis between philosophy, ethics, empirical evidence, and the author’s own experience. Here we have a critically self-reflective medic demanding that we look more radically at medicine, in order to achieve more for the whole person.
Swayne paints a picture of medicine as both art and science, where the humanity of the doctor is at the heart of the nurture and promotion of health and well-being. This provides a radical and counter-cultural alternative to what some have viewed as an over-managed health service, where too much political change has lowered morale. We Christians would do well to ask what contribution we might make to thinking and action in the nurture of health.
Swayne’s work deserves to be widely read; it demands action for change. I wonder what it would take for some of his ideas to be translated into social, cultural, and economic action. Although this would have made this particular volume impossibly longer, these debates need to be placed within a global perspective.
The Revd Dr James Woodward is a Canon of Windsor.