{"id":45924,"date":"2019-10-23T13:58:39","date_gmt":"2019-10-23T12:58:39","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=45924"},"modified":"2019-10-29T11:27:58","modified_gmt":"2019-10-29T10:27:58","slug":"peter-brindley-nature-still-the-best-life-support","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2019\/10\/23\/peter-brindley-nature-still-the-best-life-support\/","title":{"rendered":"Peter Brindley: Nature\u2014still the best life support?"},"content":{"rendered":"<p><span style=\"font-weight: 400\">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 \u201ccivilization\u201d or leaving it.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">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\u2019s (and my society\u2019s) 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.<\/span><\/p>\n<p><i><span style=\"font-weight: 400\">Nature Deficiency Disorder<\/span><\/i><span style=\"font-weight: 400\"> (NDD) was described in <\/span><span style=\"font-weight: 400\">Richard Louv\u2019s<\/span><span style=\"font-weight: 400\">\u00a02005 book, <\/span><a href=\"https:\/\/en.wikipedia.org\/wiki\/Last_Child_in_the_Woods\"><i><span style=\"font-weight: 400\">Last Child in the Woods<\/span><\/i><\/a><span style=\"font-weight: 400\">. In brief, <\/span><span style=\"font-weight: 400\">just like friendship, nature is the oldest form of \u201clife support\u201d<\/span><span style=\"font-weight: 400\">. <\/span><span style=\"font-weight: 400\">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\u2019s 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\u2019t need to medicalised, but sometimes we do need to be <\/span><span style=\"font-weight: 400\">reminded that tweets actually originate from birds, and facetime is better without a screen.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Alongside NDD is the &#8220;<\/span><span style=\"font-weight: 400\">biophilia hypothesis;&#8221; <\/span><span style=\"font-weight: 400\">popularized by <a href=\"https:\/\/en.wikipedia.org\/wiki\/Biophilia_hypothesis\">Edward Wilson in his 1984 book<\/a><\/span><span style=\"font-weight: 400\">. His argument is that humans possess an innate tendency and need to connect with\u00a0<\/span><a href=\"https:\/\/en.wikipedia.org\/wiki\/Nature\"><span style=\"font-weight: 400\">nature<\/span><\/a><span style=\"font-weight: 400\">. The same is true of connecting with animals, <\/span><span style=\"font-weight: 400\">and is why emotional support animals mean so much to so many. It is also why so many families have pets. Regardless, <\/span><span style=\"font-weight: 400\">this inbuilt love of nature <\/span><span style=\"font-weight: 400\">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.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Pet therapy is increasingly popular in hospitals, and more <\/span><a href=\"https:\/\/www.bmj.com\/content\/359\/bmj.j5627\"><span style=\"font-weight: 400\">hospitals are building patios and gardens<\/span><\/a><span style=\"font-weight: 400\"> so that staff, and especially long stay patients, can get fresh air and fresh perspectives. Family doctors can even write outdoor exercise prescriptions: \u201c<a href=\"https:\/\/www.nytimes.com\/2019\/05\/10\/world\/europe\/uk-prescription-bikes.html\">take two bikes and call me in the morning<\/a>\u201d. <\/span><span style=\"font-weight: 400\">Another &#8220;treatment&#8221; that could save both lives and cash is not a drug, nor surgery, nor that Monty Python medical machine that goes \u201c<a href=\"https:\/\/www.youtube.com\/watch?v=tKodtNFpzBA\">bing<\/a>.\u201d Instead, it is \u201ccommunity\u201d, and \u201csocial connection\u201d. <\/span><span style=\"font-weight: 400\">Data from a Somerset village <a href=\"https:\/\/www.theguardian.com\/commentisfree\/2018\/feb\/21\/town-cure-illness-community-frome-somerset-isolation\">(the Compassionate Frome Project<\/a>) suggests that when isolated people are supported by community groups then emergency admissions fall and erstwhile patients (why can\u2019t 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.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">We are electronically connected and socially disconnected. It\u2019s too easy to wholly blame the internet, and so I won\u2019t. 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. <\/span><span style=\"font-weight: 400\">It is tough to know where to start, but, I suggest we take a hike.\u00a0<\/span><\/p>\n<p><i><span style=\"font-weight: 400\"><strong>Peter Brindley<\/strong>, Professor of Critical Care Medicine, Medical Ethics, Anesthesiology at University of Alberta, Canada. He is on twitter <a href=\"https:\/\/twitter.com\/docpgb?lang=en\">@docpgb<\/a><\/span><\/i><\/p>\n<p><i><span style=\"font-weight: 400\"><strong>Competing interests<\/strong>: None declared<\/span><\/i><\/p>\n","protected":false},"excerpt":{"rendered":"<p>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 [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2019\/10\/23\/peter-brindley-nature-still-the-best-life-support\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":45925,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18895],"tags":[],"class_list":["post-45924","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-peter-brindley"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Peter Brindley: Nature\u2014still the best life support? - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2019\/10\/23\/peter-brindley-nature-still-the-best-life-support\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Peter Brindley: Nature\u2014still the best life support? - The BMJ\" \/>\n<meta property=\"og:description\" content=\"I recently returned from backpacking through Alaska and Northern British Columbia. 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