The trouble with reading books by doctors like Otis Brawley, Atul Gawande, and Victoria Sweet is that you want them to be your doctor. The lesson, ultimately, is that you have to find your Otis, Atul, or Victoria where you live, yet there aren’t enough Otiss, Atuls, and Victorias to go around.
Slow Medicine is a memoir tracing Sweet’s unique development as a doctor, scholar, and muse. One resource physician authors have that civilian authors who write about medical matters don’t is a deep store of stories in the form of patient vignettes, whereas civilians drawing on their own experiences have—hopefully—only a few. Sweet opens Slow Medicine with possibly the most horrific story I’ve encountered throughout the approximately one-hundred books I’ve read on end-of-life and medical matters. She describes her father’s recent hospitalization that almost became terminal—not because he was but because the records were wrong and no one involved would or could treat the actual problem. Instead they treated a false problem, and that treatment was inexorably killing Sweet’s dad. The year’s not cited but Sweet describes her peers in this facility asking her to autograph God’s Hotel, which was published in 2012 so we know that the horror story she shares is contemporary and too recent for comfort; something like it could happen to any of us. That it happened in a facility where her impeccable credentials as a physician were well-known chillingly sets the frame: the need for Slow Medicine.
Sweet shares the important milestones of her career, explaining the lessons that, over time, brought her to understand a particularly effective approach to diagnosis and medical treatment. In Slow Medicine, “slow” refers more to a frame of mind and an approach rather than to a temporal pace. I once posed a question in Facebook’s Slow Medicine group, asking how members might describe slow medicine in only several short sentences. Of course the discussion veered this way and that; it’s hard to make it an elevator-pitch-length summary. Sweet does not try to condense the definition or the description of her pathway toward slow medicine mastery. Quantifying slow medicine is not the point of this book, understanding the genesis of this re-newed approach, the only approach possible centuries ago, is. Sweet carefully conveys the compatibility between slow and fast medicines and how, paired together, they benefit doctors and patients alike.
Although Sweet closes with a chapter titled “A Slow Medicine Manifesto”, Slow Medicine is a memoir, not a manifesto. I would welcome a future Sweet book that functions entirely as a manifesto. Through it I would hope to receive guidance from a wise doctor for how to find slow medicine medical professionals, and how integrate the slow medicine path as a lay person.
My one complaint is that Victoria’s description of her dad’s almost fatal late life hospitalization refers to but does not describe her own interactions with those treating him. I am left with a host of questions and astonishment that a doctor of her caliber could only get her dad out of that hospital after many weeks, and save his life, [SPOILER ALERT] by pretending that the family was enrolling him in hospice (they did, and hospice promptly kicked him out as they knew it would; he recovered over two months back at home). As one who has written about how to advocate when hospitalized, I really want to know in great detail what she said, tried, thought, and more beyond the snippets she included in the introductory story; to map her efforts to my experiences, insights, and abilities.
Slow Medicine offers a glimpse into this nascent medical movement. Every bit of input helps, and my hope is that some of Victoria’s essence may rub off on me as I, newly of Medicare age, seek Slow Medicine for my last quarter of life.