Head First by Alastair Santhouse review – a medical memoir with elegance and integrity

In a passionate blend of anecdote and evidence, a consultant psychiatrist shows how the mind and the body are irrevocably connected, despite medicine’s desire to separate and specialise

It seems counterintuitive when a medic tells people that taking very great care of themselves is actually a bad thing, but Dr Alastair Santhouse quotes Benjamin Franklin in the opening chapter of Head First, his compelling collection of clinical stories. “Nothing is more fatal to health than an over care of it,” Franklin said, and Santhouse uses this wry 18th-century observation to set a series of interesting challenges for his readers: to appreciate the huge influence our minds exert over our bodies, to understand that the way we think and the way we react to our environment will determine how we experience illness, and to acknowledge that the symptoms we describe so earnestly to our GP might, in fact, only occur as a response to the landscape in which we find ourselves. “Symptoms are part of life,” Santhouse writes, “and … most of the time, tiredness, pain, dizziness or backache don’t indicate any disease at all.” A rational conclusion (although I’m sure it would come as quite a shock to the many thousands of people sitting patiently on the plastic chairs of doctors’ waiting rooms, eager to discover a medical cause for all of their problems).

Santhouse, himself a consultant psychiatrist, also puts his own side of the consultation room under scrutiny. The creation of many subspecialties within medicine, and the move away from generalisation, means perspectives have become narrowed and more focused. While this ensures the specialist you see will have an incredible depth of knowledge within his or her own field, it also means your other body parts (and mind parts) are in danger of getting short shrift. However, your chosen organ will be treated to a vast array of complicated (and often intrusive) tests and investigations – most of them, Santhouse argues, unnecessary – before it is declared fit for purpose and you are freed up to be passed, like a medical parcel, on to the next specialist. “There’s nothing wrong with you!” your consultant will gleefully declare, although this congratulatory phrase is not quite as reassuring to a patient as it might first appear.

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