HEAD FIRST

Alastair Santhouse is a consultant psychiatrist at a couple of large London hospitals, and this books draws largely on his work at the intersection of  physical and mental health, with many stories of individual patients as well as his thoughts and ideas on health and illness.
Sometimes people are referred to him when the mainstream medical model fails,when after scans, blood tests, X-rays and examinations, there is no infection, disease, injury or cancer to be found. Or when, if some disease or cause is found, the patient’s health does not improve.
Santhouse writes, “Understanding the science of an illness often tells you little about how successful the treatment of an individual will be.”
He compassionately and skillfully teases out the social and emotional factors that can exist along with chronic pain and fatigue, obesity, anorexia and non-compliance with essential treatments (for instance, diabetes) as well as the more obviously ‘psychological’ problems of depression and anxiety. He’s kind, humane, humble and endlessly curious.
He began his journey from hospital doctor to psychiatrist because he realised, after many years  of practice, that while one heart attack had come to seem like another, each overdose was an individual human drama unfolding. He continues to be fascinated with the way our personalities, beliefs and attitudes affect our lives at every stage. His approach is to try “to listen and understand ordinary people”.

I actually read this book twice, quickly and then slowly. Though not a self-help book or guide, there’s so much here that is useful or thought-provoking. Like the idea that we all have all sorts of symptoms – such as headaches or dizziness – all the time. And mostly they don’t mean anything other than we have a headache, or we feel dizzy. Going down every rabbit hole for tests, scans, screening programs, investigations and wellness checks can seem like a reassuring course of action, but according to Santhouse it can be the reverse. He quotes Benjamin Franklin in the 18th century: “Nothing is more fatal to health than an over care of it.”