Recovery: The Lost Art of Convalescence

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A Covid patient in Spain recovering with the help of two health workers. Photograph: Pierre-Philippe Marcou/AFP/Getty Images When travelling he is most interested in the way that places shapes the lives and stories of the people who live in them. Clinicians such as doctors, nurses and physiotherapists drop in and out of patients’ lives so fleetingly that for most people in recovery, the majority of caring work is done by family and friends. Some of my patients over the years have found it difficult to remember the needs and the frustrations of loved ones who are doing the bulk of that work. But the contributions of those around us to healing are irreplaceable, and their resilience is something to be cherished and protected. It, too, may hold the key to recovery. More of the work that is needed, it turns out, is up to us and it is likely to be slow going. Often, the field in which we have been left alone is vast and the ground is churned and the few green shoots growing there stand far apart and hardly seem worth gathering. Most powerfully of all, he describes how recovery is possible even if the biological causes of illness cannot be fixed The word “doctor” comes from docere, meaning “to teach” or “to guide”, and just as every teacher you’ve ever had works with a different style, so does every doctor. The idea that there’s a universal approach every practitioner should adopt is false, and would be a terrible way to offer medical care. In the 30 or 40 medical encounters I have in the course of a normal working day, there must be several that I misjudge, guessing wrongly which kind of doctor that particular patient needs me to be.

What seems to be missing in our contemporary culture, writes Francis – a culture which is so clever at diagnosis and treatment – is our respect for the complexities and subtleties of recovery, when the crisis is past. In the revolving-door ethic of modern day hospitals, there is no place any more for this one essential component of healing: simple convalescence. The patient is often left to her or his own devices, to figure out how to recover after their illness: and this is at the cost of the well being of us all. Recovery can feel like a second crop, something to be welcomed because we have survived, but an unpredictable and strange new phase in our healing. The medical professionals who have guided us through the harvest of treatment have usually moved on, replaced by different kinds of responders to the changes in our health. We find our questions about what is happening to us are answered more slowly, with what seems like a lower priority than before. This book is the first place I've heard of mind and brain being separate entities and it resonates with me so much. The book offers many ways to enable recovery and ideas for how to recover - including time in nature, travel and rest. Here, GP and writer Gavin Francis explores how - and why - we get better, revealing the many shapes recovery takes, its shifting history and the frequent failure of our modern lives to make adequate space for it.Just over a year ago, I reviewed Dr Gavin Francis’s Intensive Care, his record of the first 10 months of Covid-19, especially as it affected his work as a GP in Scotland. It ended up on my Best of 2021 list and is still the book I point people to for reflections on the pandemic. Recovery serves as a natural sequel: for those contracting Covid, as well as those who have had it before and may be suffering the effects of the long form, the focus will now be on healing as much as it is on preventing the spread of the virus. This lovely little book spins personal and general histories of convalescence, and expresses the hope that our collective brush with death will make us all more determined to treasure our life and wellbeing. I cannot think of anybody - patient or doctor - who will not be helped by reading this short and profound book' - Henry Marsh I’m not sure this kind of intuition is something that can necessarily be taught. But what can be taught is the confidence to act on the small voices of conscience and experience that suggest when a therapeutic relationship will benefit from going off-piste – away from the well-trimmed paths of textbook solutions into something wilder, more unscripted and perhaps more effective. Within modern medicine, this creates a conflict, between an idea of a clinical encounter that should be measurable, reproducible and thus open to professional regulation of standards, and the idea of the clinical encounter as an alchemy that combines the experience of two human beings in an unrepeatable moment that changes both of them. Gavin Francis was born in Scotland in 1975, and has travelled widely on all seven continents. He has crossed Eurasia by motorcycle, and spent a year in Antarctica. He works as a medical doctor as well as a writer. Even with all the frustrations of working in the NHS in 2022, Francis can’t imagine wanting to do anything different, as long as it is balanced with enough breathing space. “It’s a wonderful job as long as you can keep the pressures of it within certain bounds. It’s immensely satisfying, no two days are the same and you have this wonderful opportunity to meet all kinds of people and have sometimes transformational, sometimes quite mundane conversations with them and do something often quite modest, small and realistic about making their lives a little bit better… You can’t ask any better than that.”

Not everyone has the option to be so flexible in their work choices, but perhaps more of us do, than we might think. If the pandemic has taught us anything at all, then it is surely to question the driving inhumanity of the modern ‘work ethic’, which pushes many to the brink and beyond, and leads increasingly to a sense of disillusionment and burnout. There must be another way, thinks Dr Francis – and we must each play our part in finding it, for the good of ourselves, and of the community. bu atmosferde İyileşme kitabı, biraz absürt, biraz bu dünyadan değilcesine, manevi bir nahiflikte. Kanlı, gri-siyah, acımasız bir savaş sahnesinde, ordular birbirlerine çığlıklarla saldırırken kameranın yere dönüp (henüz basılıp ezilmemiş) ışıklı, renkli bir çiğdem çiçeğine zoom yaptığı bir film sahnesi canlanıyor kafamda (Sauron’un parmağının koptuğu savaşı düşünün mesela).

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When it comes to illness, sometimes the end is just the beginning. Recovery and convalescence are words that exist at the periphery of our lives - until we are forced to contend with what they really mean. If we can take any gifts or wisdom from the experience of illness, surely it’s this: to deepen our appreciation of health … in the knowledge that it can so easily be taken away.