Peter Brindley: Nature—still the best life support?

I recently returned from backpacking through Alaska and Northern British Columbia. My son and I had reconnected during seven days clambering through the mountains. We had been entirely sans internet and fully avec each other. We were gloriously tired, and I beamed with personal and parental pride. However, as soon as we were on our flight home, I slipped into my old ways, and searched for the latest news. I often feel the electronic lure even though current events leave me cold. As I read page after page of despair and anger, it made me question whether I was returning to “civilization” or leaving it. 

On this plane ride I had the twin gifts of time and distance. I could decide to be grateful for my life or despair on behalf of others. It mirrored how I feel during those rare times when I stop and reflect on all of the patients with overdoses, gunshots, injuries from domestic violence, and futile cases I have treated in the intensive care unti. I am deeply concerned with my profession’s (and my society’s) obsession with biomedicine and technology, rather than community and connection. A friend of mine compares this to driving ever faster even though there is an obvious warning light on the dashboard. Regardless, this trip was my metaphorical chance to pull off the highway and look under the hood. My northern exposure left me even more convinced that emotional connection matters more than electronic connection, pills, or devices.

Nature Deficiency Disorder (NDD) was described in Richard Louv’s 2005 book, Last Child in the Woods. In brief, just like friendship, nature is the oldest form of “life support”. NDD has not been medically sanctioned by the World Health Organization with an ICD-code, even though there are 14,000 other entries. NDD is also not in the psychiatrist’s bible, the Diagnostic and Statistical Manual of Mental Disorder: although that has ballooned to 900 pages and 350 disorders. In fact, after 20 years as a doctor I increasingly believe that not everything that matters needs a medically-endorsed diagnosis, warrants a pill, or benefits from our modern medical industrial complex. People avoid the outdoors because of fear, finances, access, and perceived lack of time. A lack of time spent connecting with nature doesn’t need to medicalised, but sometimes we do need to be reminded that tweets actually originate from birds, and facetime is better without a screen. 

Alongside NDD is the “biophilia hypothesis;” popularized by Edward Wilson in his 1984 book. His argument is that humans possess an innate tendency and need to connect with nature. The same is true of connecting with animals, and is why emotional support animals mean so much to so many. It is also why so many families have pets. Regardless, this inbuilt love of nature is why we adore babies, children, and just about any animal with large eyes or small features. In an increasingly urbanized, atomized world it will take radical efforts to rebuild empathy and connection. Fortunately, there is hope. 

Pet therapy is increasingly popular in hospitals, and more hospitals are building patios and gardens so that staff, and especially long stay patients, can get fresh air and fresh perspectives. Family doctors can even write outdoor exercise prescriptions: “take two bikes and call me in the morning”. Another “treatment” that could save both lives and cash is not a drug, nor surgery, nor that Monty Python medical machine that goes “bing.” Instead, it is “community”, and “social connection”. Data from a Somerset village (the Compassionate Frome Project) suggests that when isolated people are supported by community groups then emergency admissions fall and erstwhile patients (why can’t we just call them people) feel better. They come to understand that much of what truly matters is not likely to be found in a modern hospital, even if modern healthcare is a technological marvel. 

We are electronically connected and socially disconnected. It’s too easy to wholly blame the internet, and so I won’t. In fact, the internet may be the symptom as much as the disease. After all, I needed that other technological marvel to book my trip, to write this article, and for you to read it. Social reconnection is difficult, but, then again, so is any intervention that truly matters. What I read in the paper is depressing: period, full stop. Normally, I scan such stories, give myself a shake and move on. It mirrors what I do after each micro-dose of tragedy at the hospital. In contrast, a week with nothing to do but walk and think helped me slow down and reconnect. It is tough to know where to start, but, I suggest we take a hike. 

Peter Brindley, Professor of Critical Care Medicine, Medical Ethics, Anesthesiology at University of Alberta, Canada. He is on twitter @docpgb

Competing interests: None declared