My body is broken but my mind is recovering
Zac Hana is a medical student and a patient. In this blog, Zac discusses the effect chronic physical illness had on his mental health and urges the importance of integrated mental and physical healthcare, including how a course is set to arm patients, healthcare staff and carers with the rights skills to address the health of our minds and bodies.
Breaking a rigid system
As a medical student, we are traditionally taught a very rigid system whereby the physical body is treated in a separate reality to the mind. Who has the time to address a patient’s emotional wellbeing when treating a physical ailment?
This is reinforced the moment we open a medical textbook. Let us look at the infamous Oxford Handbook of Clinical Medicine. If you were to turn the page to any given cancer, you would get your list of complications due to the cancer. Nowhere does it mention that, depending on the cancer, almost 30-40% of patients with cancer will develop depression. So, how do you expect students and the future workforce to see the emotional wellbeing of a patient as integral to the patient’s success if it is not prioritised?
Physical illness and its emotional impact
I realised that this was fundamentally wrong after my diagnosis with ulcerative colitis in 2015. Yes, the condition is practically a physical ailment, but it is emotional just as it is physical. Physical symptoms are not a burden until they interfere with that person’s life. For me, it was the lack of stability. It was me rushing to the toilet upon waking, and the moment you step outside the house. Within the first waking hour, I would have gone to the toilet three times. And this is not an ordinary “I need to go to the loo, but it can wait” kind of feeling. Every time I needed the loo, I had to rush. I had a one minute safety net, anything beyond that one minute would result in me soiling myself.
Now imagine this safety net in the context of being confined in a train carriage between Wembley Park and Finchley Road, where there is a 10-minute gap in-between. You feel the urge. You sweat. You panic. Your gut is pinching and squirming. But you have no choice but to wait and endure. Sometimes you make it, other times you don’t and you have to return home to clean up. This has all happened within two hours of waking up. Now imagine this being extrapolated over 24 hours, seven days a week, 52 weeks a year. The anxiety, stress, and changes to your identity were not expected. The only way I could have survived my physical symptoms was to suppress my emotional awareness. After years of emotional suppression, the bottle full of toxins spilled over. Now, I knew something more was impacting me.
Driving the Mind & Body narrative
We understand that there is a problem with how our current healthcare system approaches mental and physical wellbeing as two distinct entities. The solution? Narratives. We, as patients, are not objective numbers: we are not patient number one, or two. We are stories. We are people with said condition: not the diabetic, or cancer patient. Our stories begin the moment we wake up and until we sleep. This brings me to Integrating Care: Depression, Anxiety and Physical Illness Massive Open Online Course (MOOC), run by King’s Health Partners Integrating Mental & Physical healthcare: Research, Training & Services (IMPARTS) project. The IMPARTS MOOC is about breaking down the conventional approach by incorporating patient narratives and objectivity so we better understand how we treat people with conditions. Even better, the course is aimed at healthcare staff, patients and carers alike. The course includes resources to help staff provide more integrated care, support for carers of people with physical illnesses, and self-care techniques to help patients better manage their healthcare conditions.
Visit the King’s Health Partners Mind & Body programme website to find out more about how we’re driving integrated mental and physical healthcare.