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Logo of bmjThis ArticleThe BMJ
 
BMJ. 2007 June 2; 334(7604): 1168.
PMCID: PMC1885350
Outside the Box

Barefoot doctor

Trisha Greenhalgh, professor of primary health care, University College London

Nothing is more flattering to the precious academic ego than being asked to be the subject of someone's dissertation. I have had walk-on parts in several MSc theses—chiefly in the role of (assumed) “opinion leader” in some topic or other, and an enlightened PhD student from the Netherlands once gave me a star part in her study of female role models in medicine.

Here's the latest request. My brother in law, an enthusiastic gardener with retirement looming, has signed up for a distance learning course on horticultural design. His thesis must describe the makeover of a garden along a theme of the candidate's choice. My garden (our garden, reminds spouse, who keeps the weeds at bay) has been selected from a short list of a dozen on the sole criterion of “room for improvement.” The theme, announced the brother in law, will be medicinal plants that will help me in my practice.

He came round for tea, armed with a pair of jumbo-sized tape measures, his soil analysis kit, and some grandiose ideas. The dampest and dingiest corner could be devoted to cardiology (“perfect climate for digitalis”). Over here, perhaps, the respiratory section (sage, garden myrrh). A raised bed against the back fence (to be built when we've uprooted the prickly bush that serves as the left half of the rugby goal) could be the dermatology department—lemon balm, camomile. And we'd need some neurological cures over here in the sun: nettles (really?), feverfew, angelica.

Quaint, isn't it? Every morning, before setting off to the surgery, I would refill my set of little brown bottles with fresh, scented leaves. Instead of worrying whether a borderline cholesterol level justifies an expensive statin, I could offer garlic, one clove t.d.s. Who needs topical non-steroidal anti-inflammatory drugs when I can formulate Tincture of Arnica in my trusty pestle and mortar? And all those stamped addressed envelopes from sedentary old people requesting “something for constipation” could be filled with a generous handful of senna pods.

I hate to admit it, but the project has got me thinking seriously about home grown remedies. Has anyone ever done a randomised controlled trial of Gaviscon versus peppermint tea for non-specific dyspepsia, or dock leaves versus chlorpheniramine for hives? Someone has certainly shown significant benefit over placebo for St John's wort in depression, and for ginger in hyperemesis gravidarum—and that was without the additional therapeutic benefit of nurturing the plant.

We're talking early days here. The thesis is yet to be written, and the kids are protesting against anything that might “stink.” But maybe, just maybe, I'll junk the British National Formulary and go barefoot for a while.


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