The two central tenets proposed by Hanlon and his co-authors Carlisle, Hannah, Lyon and Reilly—that something is missing from our current approach to public health and that we are currently facing the prospect of radical change in the way we live—seem to me to be self-evident. The problem is that not all of us are facing this; some are inclined to look the other way. Public health professionals are probably the most experienced of all the professionals working in the health service in weathering change. We have become quite good at seeing the creative possibilities that change brings, as well as the chaos. But the changes that peak oil and climate change could bring are sufficiently scary to warrant a defence mechanism or two, and denial is a good defence mechanism, at least in the short term.
I agree that the main problem with current thinking in public health is over reliance on logic as a way of knowing and under reliance on intuition and creativity, what Hanlon and his co-authors describe as the ‘good’ and the ‘beautiful’. We seem to ignore what everyone knows to be true, that mankind's great leaps forward, even those in that most logical of disciplines—science—have been intuitive. That does not mean to say we can dispense with logic. We need it to test intuitive knowledge and to work out how it fits with other things we know to be true. But logic on its own is insufficient and this is why our randomized controlled trials and systematic reviews, useful though they are, will never provide us with the insights we now need. One way in which I might beg to differ from Hanlon and his co-authors is in calling science ‘truth’. In the scheme of things that I have suggested, it is only when logical thinking (science) is combined with intuition and creativity that we get to truth.
So what can we do about this? Hanlon and his co-authors suggest that we need to balance two things: our overly reductionist thinking with more concern for the holistic and our over emphasis on the rights of the individual with concern for social justice and ecology at a global level. They talk about becoming more connected, more playful, more integrated and more empathetic. They leave that great question ‘how’ hanging in the air. When was the last time you felt truly playful? When did you last experience a deep connection with others or with nature? I have personally found the key to these states in meditation and practices like qi gong and yoga which require me to be wholly in my body. In these states I have a quiet mind. My breathing slows, my heart rate falls. I sense that my parasympathetic nervous system has the upper hand and all sorts of other neuroendocrine processes are at work. Not only does this state offer my body the opportunity to mend itself, I am also often blessed with very useful intuitions.
The problem with the life we are now leading is that the challenges, the deadlines, the endless opportunities to fail and the penalties for doing so dominate our lives. In short we depend on our sympathetic nervous systems. The intuitive brain just does not function when we are under pressure. It is not possible under pressure to feel the way we are connected to each other and to nature, or to experience the interplay between mind, body and spirit. It is my experience that in states of quiet and peacefulness, empathy and social justice do not require work, they just happen. But while the great majority who try find the process enormously rewarding, the development of these skills take time and practice.
So, I wondered as I put together the papers for the audit of my continuing professional development returns last week, what would have happened if I had added all the hours I have spent learning to meditate and submitted them to the auditor? I have certainly learnt more about my health and developed a clearer take on the way forward for public health in this way than in any of the other activities which I have submitted.