Robert Burns and Holism

Jan Smuts coined the phrase ‘holism’ at the beginning of the last century. Robert Burns was a great example of holism a 150 years before that.

Rabbie died at the age of 37yrs from complications of Rheumatic fever (sub acute bacterial endocarditis). His physician at the time advised that he bathed every day in the cold River Nith. We are not told if this was an alternative therapy or a common prescription for his condition. However like any good patient he followed instructions despite his deteriorating health.

He had an acute sensitivity to the fine balance in nature and his environmental awareness was centuries ahead of its time Just read these verses of ‘To a mouse’ to really appreciated his simple genius.

Wee, sleekit, cowran, tim'rous beastie,

O, what panic's in thy breastie!

Thou need na start awa sae hasty,

Wi' bickering brattle!

I wad be laith to rin an' chase thee,

Wi' murd'ring pattle!

I'm truly sorry Man's dominion

Has broken Nature's social union,

An' justifies that ill opinion,

Which makes thee startle,

At me, thy poor, earth-born companion,

An' fellow-mortal!

But Mousie, thou are no thy-lane,

In proving foresight may be vain:

The best laid schemes o' Mice an' Men,

Gang aft agley,

An' lea'e us nought but grief an' pain,

For promis'd joy!

Still, thou art blest, compar'd wi' me!

The present only toucheth thee:

But Och! I backward cast my e'e,

On prospects drear!

An' forward, tho' I canna see,

I guess an' fear!

Check out that last verse again of his mindfulness of being in the present and not looking back or forward. He must have studied Zen practices.

As Scotland’s national bard he promoted a brotherhood of all men through his poem ‘A Man’s a man for a that.’ He was a liberal in his thinking and a socialist in action.



Robert Burns is truly an international figure as I learnt when teaching a group of doctors in Beijing last year. I asked them what was their favourite song and one participant said ‘Auld Lang Syne,’ as it gave him a feeling of friendship and good memories.

Many of his poems were love poems such as ‘A red red rose,’ yet he showed his feminine side by writing from a woman’s perspective with the beautiful song ‘Ye Banks and Braes of Bonny Doon.’

The holistic consultation

A holistic consultation is like sitting on a beach talking to a friend.



People often ask me, ‘How can you practice holistically in general practice when you have so little time?’ I think they mean attend to all the physical ailments and include their mental and emotional well being, while also taking into account the social and environmental factors.

Firstly, it is good to be in the mind-set that 10 minutes is plenty of time. It helps me feel relaxed and comfortable.

For patients it is important they feel that they have time to tell their story. So an opening question like, ‘Tell me what can I do for you?’ allows them to go through things in their own way. I listen, attentively without interrupting. Curiously most patients will complete what they want to say within 3 minutes.

I will then ask some specific questions about their condition so I can begin to formulate what the problems are. They may need examining to help with a diagnosis.

I will have already checked on the computer their past medical conditions and drug medication before the consultation. In most cases I will know something of their family and social situation as I have been in the practice for 30 years.

I can now think how to manage their issues and give information and advise.

When all this is done I may ask how they feel about what is happening, or why they feel this may be happening to them now?

And perhaps some time for social conversation, the weather and news.

All done in 10 minutes. Well it is possible, but if not I can ask them to come back for another appointment.

Often for difficult emotional consultations I say nothing and just listen. Often when leaving they will say, ‘Thanks very much doctor for all your advise.’ -a very satisfying consultation for both of us.

Asthma and Hyperventilation

The last patient in the morning surgery was a lady with asthma who said she was not any better despite the treatment she was given last week.

She had been an asthmatic for 12 years and took her inhalers regularly. She had a recent chest infection and had completed a course of steroids and antibiotics and was worried she was still short of breath.

An acute attack of asthma can be terrifying and as breathing becomes more difficult- it can feel like drowning. No wonder people panic when it happens and are fearful it can recur. If you wish to view click

When I examined her chest was clear and her lung function had not deteriorated-I checked it on her peak flow meter. However I saw that her breathing was rapid and shallow, and when I pointed this out to her she said it was worse when she was anxious and sometimes her lips and arms started to tingle. This was not a worsening of her asthma but she was hyperventilating. These are classical symptoms of hyperventilation.

The remedy for hyperventilation is to slow the breathing and take deeper breathes from the belly. It sounds simple- and it is when you are calm. But it needs practice.

Lie flat on your bed with the palms of your hands resting on your belly. Try and relax, then watch your breathing. Breathe through your nose slowly and find your own natural rhythm to your breathing. Concentrate on your breath. Your hands should rise up when you breathe in, and fall when you breath out.

I do this if I find it difficult getting to sleep at night. It is like counting sheep-you rarely get beyond 10 before you are asleep.

I showed this lady how to do this and referred her to a physiotherapist to encourage her to practice. This will not only help her when she is hyperventilating, but the deep breathing will directly help her asthma.