I always thought we’d let the term ‘holistic’ get away from us. As a GP I just thought being holistic was just what we did, another term for generalism, or even for holistic medicine’s close cousin, integrative medicine. Somewhere along the line holistic medicine has been claimed as a special expertise in addition to what we, as mere GPs, do. Holism considers ‘the whole body, mind, spirit, and wider environment’ according to the British Association for Holistic Medicine and Health Care. I can’t argue with that. Only this week I have had conversations with patients about the Grand Final they just won, and the physical and psychological benefits of playing in a team of supportive people, while managing their minor sports injury, and had a discussion about grief — ‘what do I do with this sadness?’ — which rapidly turned to a theological discussion after I had raised Wandavision’s beautiful description — ‘what is grief, if not love persevering?’
Yet the descriptions of natural remedies, superfoods, and yoga seem to be a terribly superficial version of holistic care. This isn’t my patient losing weight because they can’t afford to eat, or my patients who repeatedly need housing forms filling out to convince housing agencies that the mould is bad for this person.
Could it be that holistic care has become neoliberal? Is the subject of holistic care an atomised individual, where holism stops at the skin? Are our relations with other people only valuable in as much as they promote our wellness? Are people who specifically seek out holistic care all rich enough for the healer–client relationship to be a financial transaction that includes the upselling of selenium, and our own blend of vitamins and minerals? Patients who can’t afford this just want a compassionate, listening ear who will welcome them precisely for being just who they are. There’s nothing more whole-person than that, surely.
To my surprise, I came across an observation Julian Tudor Hart made in passing in one of his footnotes in The Political Economy of Health Care.1 Though the idea that a system (including a person) is more than the sum of its parts is obviously true, Tudor Hart then says, ‘it does nothing to get us beyond banal observation.’ He goes on to describe holism as ‘a soapy term which evades necessary conflict’, which does suggest how easily holism can be adopted into the individualism of neoliberalism without challenging it.
Tudor Hart points out that the origin of the word holism comes from Jan Smuts, a South African who fought in the Boer war, and became South African Prime Minister, a supporter of segregation and the white supremacy of the time. Holism, for Smuts, was a theory of evolution used to describe and explain his observations of white supremacy, not to challenge it.
Maybe holism doesn’t carry this baggage with it, but I’m not sure I can usefully use a concept that is comfortable with the status quo when so many of my patients need the system to change. You can keep your holism then. I’m a person-centred radical, also known as a GP.
- © British Journal of General Practice 2024
