The Lost Art of Convalescence

It’s been a tough two years since the pandemic took hold, but that doesn’t mean we need to go into 2022 too downheartened that COVID-19 is still ever-present in our lives. In his new book, Recovery: The Lost Art of Convalescence, Gavin Francis explores how time, rest and recuperation is vital in rejuvenating ourselves.

Extract taken from Recovery: The Lost Art of Convalescence
By Gavin Francis
Published by Wellcome

The word rehabilitation comes from the Latin habilis, ‘to make fit’, and carries the sense of restoration: ‘to stand, make, or be firm again’. The aim of rehabilitation, then, was to make someone as fit as they can be, to be able to stand firmly on their own two feet. And though recovery was the clinicians’ ultimate aim, it’s curious that the words ‘recovery’ and ‘convalescence’ are generally absent from the index of medical textbooks. As long ago as the 1920s, in her essay ‘On Being Ill’, Virginia Woolf wrote that we lack a mode of writing about illness, that it is ‘strange indeed that illness has not taken its place with love, battle, and jealousy among the prime themes of literature’. A century on, her assertion no longer holds true: we do have a literature of illness. But I’d argue that we still lack a literature of recovery.

The medicine I was trained in often assumes that once a crisis has passed, the body and mind find ways to heal themselves – there’s almost nothing more to be said on the matter. But after nearly twenty years as a GP I’ve often found that the reverse is true: guidance and encouragement through the process of recovery can be indispensable. Odd as it seems, my patients often need to be granted permission to take the time to recover that they need. Illness is not simply a matter of biology, but one of psychology and sociology. We fall ill in ways that are profoundly influenced by our past experiences and expectations, and the same can be said of our paths to recovery. I have learned much from those other clinicians – the nurses, physiotherapists and occupational therapists – who have most helped my patients, and am always being reminded of how much there is still to learn.

The therapists in the brain injury unit knew that convalescence is anything but a passive process. Though its rhythms and its tempo are often slow and gentle, it’s an act, and actions need us to be present, to engage, to give of ourselves. Whether it’s our knees or skulls that need to heal from an injury, or lungs from a viral infection, or brains from a concussion or minds from a crisis of depression or anxiety, I often remind my patients that it’s worth giving adequate time, energy and respect to the process of healing. We need to take care over the environment in which we’re attempting to heal, celebrating the importance of nature and the natural world and recognising

the part it can play in hastening recovery. Many patients I’ve known over the years have found a way to make sense of even a very difficult illness journey. When an illness or disability is incurable it can still be possible to ‘recover’ in the sense of building towards a life of greater dignity and autonomy.

There is no hierarchy to suffering, and it’s not possible to say of one group of conditions that they deserve sympathy while another group deserves to be dismissed. I’ve known patients whose lives have been dominated, for years, by the grief of a failed love affair, and others who have taken the most disabling injuries, pain, indignity and loss of independence in their stride. Though it can be tempting to resent someone whose illness appears to be less serious than our own, or to judge ourselves harshly when others seem to be coping with more challenging circumstances than we are, comparisons are rarely helpful. Neither should we be anxious to set out a timetable of recovery: it’s more important to set achievable goals.

As a doctor, sometimes all I can do is reassure my patients that I believe improvement of some kind is possible. The recovery I’m reassuring them of might not be biological in nature, in terms of a resolution of their condition, but rather an improvement in their circumstances. What follows is a series of reflections on recovery and convalescence gleaned from my own experience of illness, and of thirty years in training and in practising medicine. It contains much that I wish I’d known when I set out on my career, while acknowledging that there is always more to know. Every illness is unique, which means that all recoveries must also be in some sense unique, but I have tried to set out some principles and waypoints that have proven helpful over the years to guide me, and my patients, through the many landscapes of illness. It’s a place that all of us must visit, sooner or later; from time to time we all need to learn the art of convalescence.

Recovery: The Lost Art of Convalescence by Gavin Francis is published by Wellcome, priced £4.99.