Here is the full transcript of Dr. Victoria Sweet on Slow Medicine: The Way to Healing @ Talks at Google conference
REBECCA MOORE: Good afternoon. Welcome to Talks at Google.
My name is Rebecca Moore. I’m Director of Google Earth. And I’m very pleased to welcome my dear friend, Dr Victoria Sweet, who just published a new book called, “Slow Medicine, the Way to Healing“. I’ve known Victoria for several decades, since nearly the start of her journey as a physician, including her 20 years practicing at Laguna Honda Hospital in San Francisco and taking time to get her PhD in the history of medicine.
During this period, she’s been on the front lines of dramatic change in her profession, as practicing medicine has transformed into delivering health care, and not always for the better. Her first book, “God’s Hotel,” won widespread awards and acclaim, leading to a Guggenheim Fellowship. And the time — pay attention to that word because you will hear it today a lot — the time for her to synthesize and develop her ideas further, around what she calls slow medicine and fast medicine and how these two approaches are both complementary and necessary. Googlers will particularly appreciate that. Victoria got her undergraduate degree in mathematics from Stanford. Go Stanford.
So please join me in welcoming Dr Victoria Sweet.
VICTORIA SWEET: Thank you. Thank you very much, Rebecca, for that introduction. Thank you all for being here today. And thanks to Google for doing something this — really unusual for a big for-profit company to be willing to sponsor books and speeches by authors. It’s a really wonderful thing, and special I think. It tells a lot about Google.
I would like to add that not only did I get my mathematics degree at Stanford, it was my major. But my minor was classics. And that is a stream, as two things have woven their way through my life. So what I would like to do this afternoon — I’ll speak for about 40 minutes. And I’ll be explaining kind of how I actually got right here. That’s the first part of the talk.
And the second part of the talk, I want to talk about what’s gone on with medicine during my career and what I think we can do to make it better. So I’m going to start with my – yes. So the first thing you should know about me is that I don’t consider myself a natural-born doctor. And by that I mean growing up I never watched doctor shows or went to volunteer in a hospital. And if somebody was sick, I didn’t want to hear about it or have anything to do with it.
And, in fact, the first time I had to draw blood in medical school, I passed out. So definitely not a natural-born doctor. What happened was at the end of college, I was looking for a way to synthesize these two parts of myself, the mathematics, the classics, the history, the humanities, and the sciences. And I ran into the writings of Carl Jung, the psychiatrist. He’d written a memoir called “Memories, Dreams and Reflections.” And I ran into it by accident in the library.
And I found myself enthralled. I was enthralled, first of all, by the meaning he expected from his own life and also by the kind of life he set up for himself. This is a stone house he had built himself on Lake Zurich. And this is where he saw patients in the morning, neurotic, well-paying patients in the morning, and illuminated manuscripts and studied alchemy in the afternoon. I thought this was a great life. And that’s what I wanted to do when I grew up.
And that’s how I got to medical school because I was going to be a union psychiatrist. Then it turned out I liked medical school a lot more than I thought I would, especially the last two years of medical school, when you finally get a chance to see real patients. I loved what’s called the work-up. I loved the history, taking the history, trying to figure out the patient’s story because there was so much psychology to it.
Hearing what the patient said and didn’t say, seeing what — the way he said or she said, the answer to the question. And then I was examining the patient. And it turns out I actually liked touching people. I particularly liked the physical exam because there was so much I could learn from that about what the patient had and didn’t have. And then there was putting it all together in a diagnosis, and the treatment, and the plan. It was a logical, brilliant method.
Nevertheless, I continued my first idea. And I went into a psychiatric residency. And I was a little bit naïve. So my psychiatric residency took place in the only locked psychiatric ward in our county. So consequently, the patients were not Jung’s well-paying, neurotic, articulate patients. They were severely psychotic. And they responded a lot more to the, um, medicines we used than they did to the talk therapy I tried. So after I got my license, after that first year of internship, I just went out and practiced medicine for several years in various clinics. And it was fascinating.
Because the county clinics and the community clinics would get waves of immigrants every time there was a war or a rumor of war. And they would bring with them their diseases and also their different way of looking at the body. I saw everything in those clinics. I saw three cases of leprosy. And this is right around here, when I did this. I saw most every parasite there was and saw many unusual diseases.
And I was also interested in these different ways of looking at the body. And so after a while, I decided that I might as well admit that I liked medicine. I went back and did three years of a regular medical residency. And then I went back to the community clinics.
And the longer I practiced medicine, the more impressed I was by the logical method of writing out a diagnosis and a treatment. But I was also more and more impressed by what this medicine, modern medicine, left out, which was, of course, anything that wasn’t logical.
So after a while, I started reading alternative medicines, naturopathy, homeopathy, Chinese medicine, and Ayurvedic medicine. And for a while, I even thought about learning Chinese, so I could understand Chinese medicine from the inside; or Sanskrit, so I could understand Indian medicine from the inside. But eventually, I decided that even if I did get to that point, that I could understand them, their cultures were still too different from my own to understand their different ways of looking at the body.
It was this rather discouraging moment that I discovered the writings of a very unusual 12th century woman. Her name was Hildegard of Bingen. And she was a mystic. She was a composer. She was an artist. She was a theologian. But she also, as it turned out, was a medical practitioner. And she’d written a book on her medicine. And as I stood there and read her book, in the library again, I was impressed by the medicine that she was recounting. Because it wasn’t the medieval medicine I’d expected, the tongue of newt, eye of frog medicine I expected from a medieval medical text. It was real medicine, for real patients, with real diseases I could recognize.
But it was based on a completely different model of the body from our modern medical model. I couldn’t quite put my finger on how it was different. But I decided then and there that I was going to go back to school and get a PhD in medical history, with Hildegard as my focus. But I didn’t want to stop practicing medicine.
I wanted to do this half-time. And I spent a couple of months looking around for a half-time position, which was rather difficult at the time. Until finally I discovered — I was offered a position at a very unusual hospital in San Francisco, which was called Laguna Honda Hospital, in San Francisco. And when I drove over for the first time and saw it high on that hill, I was taken aback. This was about 20 years ago now.