Anna Donald: Mind and body

Thank you again to people sending such encouraging comments. I can’t tell you how uplifting it is to wake up to such lovely responses.

A few people have asked me to explain why I wrote that having cancer is “fascinating, humbling, and maddening.” So I’ll try to oblige. Not all in one blog.

Having life-threatening disease is fascinating because it plunges you into a new existential world. It feels as if you’ve been forcefully pushed into the engine room of human existence where you start to understand, before you die, what you’re made of. Physically, mentally and spiritually.

For me, this is rather exciting. The reason I did medicine was my much earlier interest in how the mind worked within, or alongside the body. A child of the 1980s, reading the likes of Fritjof Capra and being a maths-physics geek to boot, I nearly did theoretical physics to see if it held any insights into how human energy worked and therefore how we continuously arise as a whole unit (not as a mind vs a body). I quickly realised that studying quarks and the like might lead me a tad too far from the human frame, so I did medicine instead. At least then I was working directly with the subject matter of interest, albeit firmly framed by clunky old Newtonian physics.

From my early teens, I drove my poor friends bananas making them listen to my endless theories about how the mind and body worked together, or were perhaps one thing, or perhaps not. (Nothing’s changed; I don’t know why they all keep visiting me.) Which is why I was interested, at 22, in doing things like Vipassana meditation (see previous blog) which enable you to explore directly the mind-body continuum and see for yourself, as an observer, what it comprises.

I thought Descartes was not quite on the money – cogito, ergo sum – because it should have been “I think-feel, therefore I am.” There are no such things as thoughts isolated from feelings (try Vipassana if you don’t believe me – it becomes blatantly obvious that every thought is accompanied by physical sensations; they always arise together).

In any case, when I got caught up in evidology (EBM) I sadly put these questions aside, although not before spending a couple of years as a lecturer for Sir Michael Marmot at UCL, whose enormous Whitehall study of civil servants reveals how the mind and body are intimately entwined (more successfully than Flanders and Swann’s right-handed Honeysuckle and left-handed Bindweed – sorry, old joke). The Whitehall study (along with many other, less spectacular studies) finds a very strong, linear relationship between social position and morbidity and mortality, which is not explained by controlling for lifestyle factors like drinking, smoking and diet. In other words, you get sick according to how you perceive the world. It is an intuitive, yet riveting finding in a very well conducted study.

But, wanting to be socially useful and not wanting to ignore my economics and policy wonk training from Harvard, I turned my attention to more practical matters: evidology and how to use it to address technology inflation, an insidious force that is one of the main cost drivers of health care. Which I did for the next ten years (having initially become interested a few years beforehand, when I worked in Oxford for 9 months with Ruairidh Milne and Muir Gray). No more theorising and reading Wittgenstein and JL Austin, whose language theories help to deconstruct our clunky ideas about mind and body, but don’t come up with a solution to the difficult question of how our interpretation of the world affects our bodies, which it does. A bit like saying that the program on the radio affects the physical structure of the radio itself.

When, hey presto – cancer (again)! I can’t work as a chief executive (at least not at the moment)  and I’m landed right back in the middle of my original inquiry. This time I’ve got the time and space to be able to read, reflect, follow the trails of other people’s inquiries to see what holds together and what’s gobbledegook. I can do it all day, every day, just about. And I can try mind-body-spirit treatments for myself (meditation, dream work, body work, and so forth) on myself. No ethics committee approval needed.

In this way, I am a happy camper. I know I’ve included “spirit” in there without explanation. This blog is already too long; I’ll have to talk about that later.

I just wish this dry cough would go away. More scans looming, maybe. That’s where the humbling and maddening aspects of this condition come in.

Anna Donald’s Blog 5