A visit to the Doctor
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A visit to the Doctor
by Mary Aspinwall
I
first met Stephen Gascoigne and his wife Hilary six years
ago, when they invited me for afternoon tea. They and their
huge black cat Jigme were newly arrived in Ireland and I was
plotting our family’s escape here from London. From
the time we arrived they were great friends and now they are
also neighbours, recently having bought a beautiful old rectory
and coach house just down the road from us. Stephen practices
from the coach house. It has two treatment rooms, a herb preparation
area and a lovely welcoming reception with a wood-burning
stove.
Over the past few months Stephen has been revising his large
blue “Bible” for Alternative Practitioners and
I have edited it, adding homeopathic cases. The new edition
is due out in March (under the new name “The Clinical
Medicine Guide – An Holistic Perspective”) and
so Lelia Doolan asked if I would do an interview with the
good doctor. It felt strange interviewing someone that I know
well and I half-expected to know all the answers…but
I am happy to report he is still able to surprise me.
Why did you choose to come and
live in Ireland?
I came here to have a quiet life because I was living in London.
I’d just finished training in herbal medicine and I
was looking around for somewhere pleasant and rural to live
where I could garden half the week and see patients a couple
of days a week. We looked at France and Ireland, but decided
on Ireland because we’d been here on holiday and loved
the place.
… and what became of the
gardening?
I found that…well, I made a decision that…because
of the number of people that wanted treatment that I’d
concentrate on that and the semi-retirement option isn’t
happening at the moment (laughs).
How do you find working here differs
from Britain?
In many ways its actually quite similar particularly the last
four or five years, where things in Ireland have speeded up
and people are busy, they have a lot of responsibilities and
financial pressures …
Still, there is something different about treating people
in Ireland because no matter how busy and frantic peoples’
lives are they are still, fortunately, fundamentally more
stable.
This is a massive generalisation, but I do feel people respond
to treatment quicker than in London. That might be an urban/rural
split.
I do find people in Ireland much more open to alternative
medicine, both as an idea and a practical solution. Part of
the reason for that is that here people have to pay for healthcare,
whereas in England people think it’s free because they
don’t have to pay at the point of delivery, so a lot
of people see alternative medicine as a luxury.
Conventional prescriptions are also subsidised in England
so they cost about £5, but I saw a patient yesterday
who has ulcerative colitis. Her prescription here costs £48
and she’s been told she’ll be on it for life.
That is a powerful incentive to consider alternative medicine.
Culturally I think people here are more open, less dislocated
from their past and haven’t lost contact with traditional
herbal and folk medicine and although I’m practising
Traditional Chinese Medicine they understand the essence of
it. They know it works.
… to go into your dark past
when you were a GP…
How did you know it was dark … who have you
been talking to?
I read the Foreword of your book
… I wondered what the experience of being a GP was like…
It was interesting (laughs). I mean I think I’m busy
now seeing 50 –60 patients a week, but I used to see
250 people a week not counting on-call duty … it was
just incredibly hard work. I hardly had time to see people;
I’d see them for five minutes… so I found it very
frustrating. It was a great opportunity to see people as people,
rather than as in hospitals where they are isolated from their
homes and families, you’re seeing them in realistic
situations. The frustration of general practice is the methods
you use just don’t work or they actually make people
ill. I found I was surviving on trying to give sympathy to
people. It was only when I was talking to patients about their
experience with acupuncturists, osteopaths and homeopaths
that I recognised one could actually get help from healthcare
practitioners.
…so when you say you relied
mostly on sympathy, do you mean you were reluctant to prescribe
any medication?
Well increasingly so, in fact, at the end, because I worked
in general practice for three and a half years, I got to the
point where I could not actually write a prescription, because
I felt it was damaging people. I mean to begin with I was
losing faith in it, but eventually it was more than that,
I felt I was causing more problems than I was solving. If
you are a GP who can’t write a prescription there’s
not much use for you (laughs). I was somewhat redundant.
You’re days were numbered…
My days were numbered (laughs). I was in a practice where
there were six of us and I think my five partners heaved a
huge sigh of relief (laughs) when I left. That tension in
the practice must have been quite something … certainly
it was for me, but also for them.
Did any of them ever question what
they were doing?
Not that they ever discussed with me. They would often question
what I was doing (laughs).
I can imagine...In terms of your
work now what do you see as the advantages of having trained
as a doctor?
Well one thing is that people have more faith in you, whether
that’s realistic or not is another matter, but they
do come with that degree of trust. The downside of that is
they expect you’re going to ‘fix’ them,
like doctors are supposed to ‘fix’ people.
Do you mean the ‘quick fix’
idea?
Yes, please give me a pill doctor ‘cause it’ll
make me better. Please give me some herbs doctor ‘cause
it’ll make me better. What I try to do is to encourage
people to support themselves, make changes themselves, because
that’s where improvements in health come from.
I suppose the main benefit (of my training) is I’ve
actually seen conventional medicine in action and I just do
not believe that it works. As Westerners we all emotionally
feel on some level that conventional medicine does the business,
this is what we are brought up to believe… but actually
when I check it out from my own experience in hospitals and
general practice I’ve seen it doesn’t work.
That’s not to say it’s not sometimes necessary
for life-threatening situations, but those numbers of situations
are actually extremely limited. So I have no problems with
offering something else to people because I know conventional
medicine isn’t going to do the trick anyway …
And the other thing is I’ve seen very serious illnesses
and whilst I do get worried about people …but I’ve
also seen it before, often, so that experience does give me
a certain confidence, knowing what is OK and what isn’t.
Whereas if you don’t have that experience you worry
if things are OK or not and worry about how sick the patient
actually is.
Apart from the ‘doctor fix
me’ problem do you see any other disadvantages to having
had a background in conventional medicine?
I think it’s difficult at the beginning when you’re
trying to learn a different way of looking at people and ill
health. Speaking to other doctors who’ve “turned”,
as it were, I think we all have the same difficulty …how
do you actually look at things, what model do you use? What
most of us do is to try and put the new way (be it Chinese
medicine or Homeopathy) on top of what you know already, which
most people, myself included, realise that you can’t
do. It is actually one or the other. You can’t mix these
things, so if you put your conventional training on one side
and just concentrate on alternative medicine it actually works
quite well…Whereas when you try and mix the two or sit
on the fence … a lot of medical practitioners try to
keep a foot in both camps …well I tried to do that for
a while and I know, personally, it was a very uncomfortable
position to be in. You have to do one or the other.
So how would you react to the term ‘complementary
medicine’?
I think it’s a term used to placate conventional practitioners
who feel threatened by alternative approaches like Homeopathy
and Chinese medicine that do help people.
On the subject of having a foot in both camps, when
it comes to issues such as immunisation, how would you deal
with enquiries like that from your clients?
What I try to do is give people information so that they can
decide for themselves, which generally means I recommend a
book like “Dispelling Vaccination Myths” by Alan
Phillips or I give them print outs from my book and give them
the opportunity to discuss it with me. What I generally find
is that if someone asks me about something, then already they
have a lot of doubts about it. By pointing them in the direction
of alternative information it gives them the background on
which to base an informed consent. When I was in general practice
I never had access to this kind of information and the issue
of immunisation was never even discussed.
Are there other issues where you
feel people need access to information to enable them to make
a more informed choice?
Many subjects: Cancer; Women’s health; Childbirth; Pregnancy;
Children’s health… On all sorts of issues people
need access to a wider source of information than just the
conventional view. In the West, most people only think about
their health when they’re ill and it’s a bit like
thinking of death when we’re dying …in some respects
it is a little too late. Say a mother comes to see you whose
child has had problems with a vaccination… to then to
talk about vaccination, it’s a little too late. People
don’t ask those questions first. I think that is a big
cultural problem that we’re trying to get over.
On the one hand we want to treat people when they’re
sick, but on the other we want to try and encourage people
to be healthy. The question is how to get to people early
enough so that they are already aware of those issues and
debating those issues is a challenge, because a lot of people
just don’t want to know.
When people first come what they want is to get rid of their
symptoms, whereas the process of healing is very much about
bringing awareness into the situation. Why has it come? Why
am I in this situation? What can I do to change the situation?
That is a long and involved process to reach that point of
awareness and to begin with people don’t want to know
about causes of conditions…”just make me better
please”. It’s a big challenge for our professions,
both Chinese medicine and Homeopathy.
In your book the “Chinese
Way to Health” you do cover what Chinese medicine has
to say on the subject of preventative healthcare…
Yes, exactly, the Chinese say there are eight methods of attaining
health Acupuncture and Herbs are the last two resorts. People
need to incorporate the other six methods: meditiation, diet,
exercise, astrology, Feng Shui and massage into their lives
and if you live according to those principles, in harmony
with Nature, the environment and the climate you tend to be
healthy, if you then become ill you use acupuncture and herbs.
Of course in the West that’s the first thing people
use or come for, so we’re doing things back-to-front.
I read in one of your books that
the Chinese would pay their doctors for as long as they were
well and only stop paying them when they became ill…
Yes, the investment is in health not in disease. The Chinese
say to seek treatment when you are ill is like digging a well
when you are thirsty …it’s a little too late.
So as we treat people we need to also bring up that basic
level of education.
To change subject a little, you’re
a practising Buddhist …
(laughs) Well…I’m a Buddhist.
Sometimes practising, so…can
you tell us how that has helped you either personally or professionally?
Well it has helped me, tremendously…it’s actually
very difficult to put into words.
It’s a big question, may be I could narrow it.
In your day-to-day practice is your experience of the Teachings
of Buddhism helpful when you are working on cases?
One of the most important things I’ve got from it is
an attitude, a way of looking at things. In the Teachings
they talk about motivation being all and when I was in China
training in acupuncture I asked the doctor there what advice
he could give me to be more effective in helping people. He
said the most important thing is to treat patients as if they
were members of your own family, which in the West sometimes
produces a reaction because in a family where we have difficulties…(laughs)
but I know what he meant was that quality of care that we
bring to close relationships needs to be brought to your care
of patients then whatever you do will tend to have a good
outcome.
Also on the subject of attitude, very often what we see seems
very real. If we see someone suffering we very much identify
with their suffering and pain, whereas Buddhist teachings
show that we are more than just this present situation, there
is a part of us that is beyond this suffering, which I find
quite hopeful.
In my work I try to encourage people to disconnect somewhat
from their pain and not identify with it too much or take
it too seriously and this can create tremendous freedom. You
see that in people who have had curative treatment they might
come back for a follow-up with the same symptom, but they
are somehow much more relaxed. There is a space in their mind,
although the original physical symptom might not have changed
at all and they have more energy, something has shifted. Hopefully
the physical symptom will improve too, but there is this awareness
that how you look at the symptom has a bearing too.
Another teaching that comes to mind is on the preciousness
of this life, but the teachings are so vast…
In terms of practice Buddhism uses meditation to calm the
mind and awareness practice to develop a contemplative attitude.
The more grounded and present we are (as practitioners) the
less distracted we are and the more able to give our full
attention. It also helps us to avoid burnout.
Frank Ostazeski who runs a Zen hospice in the US very much
encourages his carers to have some sort of contemplative practice
(yoga, Tai Chi, meditation). He won’t take anyone on
his training course unless they have already established some
sort of practice for at least three or four months. That’s
the basis. Traditionally in China there was not a separation
between doctor and priest, that is very much a Western idea.
Body, mind and spirit are all inter-connected so unless you
have the basis of some sort of contemplative practice, or
in my case an aspiration to some form of contemplative practice
(laughs), it’s very difficult to have a basic ground
from which to work. The Mind is being distracted so much anyway,
when you see people who are ill this can be just another source
of distraction. It won’t solve all ills, but it’s
definitely very nourishing to have some form of practice.
You mentioned ‘burn out’.
Are there any particular kinds of cases that you find most
difficult, which lead you to feel more stressed or ‘burnt
out’?
I think it’s where there are a lot of mental and emotional
issues …
No, actually, I’ll tell you what’s the most tiring
…it’s when I try to get the patient to follow
my agenda or to slot into whatever I’ve decided they
should do. Say someone comes, who is in a personal or work
situation that they are finding very difficult and I have
a certain idea of how that could be resolved… that’s
what causes problems, because as soon as I think I have the
means to resolve something, then I am completely out of touch
with the patient. My intention or rather my presence is distracted
by the conceptual idea of what should and shouldn’t
happen. That’s why the practice of meditation is helpful,
because it’s about trying not to manipulate things,
letting the Mind sit, be quiet and find its own place.
Do you see parallels between that
and Hahnemann’s ‘unprejudiced observer’?
Absolutely, yes… so generally the two things we need
to give people, and ourselves, are time and attention. If
we can’t give ourselves that time and attention, through
contemplative practice, how on earth can we give it to others?
The more we can be that unprejudiced observer the more healing
will occur in that space.
I think some people might be surprised
to know that you trained as a Homeopath for a couple of years…
I did, yes, I did a couple of years to The Northern College
of Homeopathy in England in the early Eighties, just before
I went to China. Eventually I chose to study Chinese medicine
because I felt I had a much closer connection with Eastern
philosophies.
Was there anything that you took
from your homeopathic training that you find useful?
I found the homeopathic training very helpful. I started it
six months before I left General practice.
Ah …was that why it got harder
and harder to write prescriptions?
I think so. I’d done the weekends at the London Homeopathic
Hospital and realised that there was a little bit more to
Homeopathy than they’d talk about. I wanted to explore
the possibilities of it as a system of healing.
Can you remember what most struck
you in those first six months of training?
It was a lecture by Michael Thomson on Apis. For an hour he
just talked about the behaviour of the honey bee. I never
took any notes … I was just completely spellbound. It
was an account of how bees lived, related to the remedy. The
other thing was the philosophy, particularly the accounts
given by Kent.
I notice in your book you refer
to Hering’s Observations on Direction of Cure…
Yes, similar observations are there to be found in Chinese
medicine, but it’s not stated explicitly and so a lot
of Chinese medicine practitioners aren’t aware of it.
It’s so astoundingly simple, yet profound. It states
everything very clearly in about three or four lines. It’s
a description of healing, whatever the means. The flip-side
is, if you connect it with what normally happens in (conventional)
treatment it is shocking. Once you become aware of those things
there is no way you can write prescriptions.
Do you see Chinese medicine and
Homeopathy as being able to work together in a particular
case?
Absolutely. I find the two work very well together…my
feeling is that they work on different levels in that Homeopathy
has this ability to shift patterns at a very deep level. However,
because it is so deep it can rake up a lot of stuff. That’s
not to say that Chinese medicine doesn’t do that. Who
the hell knows what levels these things work? Every therapist
tends to think their therapy works on a deeper level, but
actually it doesn’t matter if it’s deep or superficial
the important thing is, is it appropriate? I do find that
because Chinese medicine and Homeopathy work on different
levels they do very much complement each other. The only difficulty
some homeopaths have, if I’m treating the same patient
with herbs, is can they read the case. If it’s OK with
the homeopath I find that people generally get better quicker
using both. The application of a well-selected remedy with
Chinese herbs I find unstoppable…
Killer bee! (laughs)
African Apis (laughs). Also I find that some people might
go and see the homeopath and they might have a few remedies,
but the picture’s not clear and the remedies don’t
seem to work. Then they come and see me for a while then go
back to the homeopath and the same remedy or a different remedy
is prescribed and the case just flows… and vice versa.
They come and see me treatment doesn’t work very well
and then when they come back, from the homeopath there is
a definite change.
Something needs to shift first…
Yeah.
Just getting to the plug bit now,
which is to say that your book, with its rather groovy new
cover, is about to be launched on the unsuspecting practitioners
out there and one of the questions that comes to my mind is,
the original version came out in 1993, why did you feel the
need to bring out this new edition?
Mainly to bring it up-to-date because in eight years there
have been a few changes with treatments so I wanted it to
be current and it was also an opportunity to proof read it
(laughs).
I’ve added more case histories, including cases treated
by homeopathy as well. The whole book has been edited, professionally
typeset and indexed. It’s a much more polished production,
this time. The study guide has also been revised to match
the new content. The first time I did most things myself.
I’m still publishing it myself, because I can’t
get anyone to publish it, basically.
Is that because it serves a niche
market with small potential sales or because it’s contentious?
Well I tend to think it’s because it’s contentious,
but that might just be my argumentative side coming out. One
publisher told me they didn’t want it because there
was already a book like it on the market, but I don’t
think there is. One of the problems is it’s not conventional
and it’s not alternative, so it’s difficult to
categorise…although it may be easier to categorise now
that it has been re-titled. I mean what I’m trying to
do with the book now is to broaden it’s appeal so that
it’s something maybe nurses will read and the general
public might read if they were interested in getting hard
information about conditions with an holistic slant.
You mention on the cover www.drgascoigne.com
what’s that about?
The idea of the website, at the moment, is to offer information
for practitioners, such as homeopaths and acupuncturists.
It will offer a support and supervision service. It will offer
back- up for the book and study guide. People will be able
to ask questions about what they are studying.
What I’ve always tried to do through teaching pathology
and writing the book was to support people in their practice
so they can treat lots of patients and treat serious cases.
Do you have anything else in the
pipeline?
Yes “The Prescribed Drugs Guide” will be out in
the summer and there’ll also be information on the website
relating to prescribed drugs. What they are, what the side
effects are and how to get people off them safely and appropriately.
Later there will be information sheets on there for practitioners
to download to give to patients about diet, immunisation,
exercise, childbirth etc.
Eventually what I’d like is for the website to also
be a source of information to the general public. If you look
at www.google.com (a search engine) it says something like
1,310,000,000,000 checked … now out of those what is
any good? Nobody knows. I’m very keen on offering a
website that is a resource that filters information,
Say for example, someone’s uncle gets cancer they’ll
get information from the hospital, but where else are they
going to get information on what treatment is available? So
the website will have general information on cancer and then
ways in which alternative medicine can help in the treatment
of cancer and where to get more information on getting help.
Maybe that is what comes from having been a GP in the frontline.
Where do people go for information …usually it’s
their GP. The GP is obviously very much in the groove of conventional
medicine. There is very much a need for looking at all sorts
of other information.
What I’d like to do is write books for the general public,
following on from “The Chinese Way to Health”
I want to write books about say asthma or cancer with insights
from Chinese medicine to help people examine what caused their
symptoms. They will be very much self-help books and they
will also raise awareness that there are other approaches
to treatment.
So really this is the other side
of the coin. Most of the work you have done up to now has
been in supporting alternative practitioners to take on more
work and treat a greater variety of conditions. In the future
you’ll be encouraging the public to take a look at the
option of being treated by one of them.
Yes. I want to see holistic or alternative medicine become
mainstream and I want people to go to alternative practitioners
as their first port of call. What I’d like to see is
in Clonakilty, for example, there are something like seven
GPs …I would like to see at least seven full-time alternative
therapists in Clonakilty so that people can either go to their
GP or to an alternative practitioner…whether they want
treatment of cancer, the common cold, eczema or whatever it
is. So people have a straight choice, much as they do in China.
©Mary
Aspinwall
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