Review

Mixed greens, little meat

THE GREENING OF MEDICINE
Patrick Pietroni
Gollancz, 1991

Pietroni describes the ‘greening’ process within medicine as ‘the acceptance of limits, the sharing of power, the demystification of the professional expert and the emergence of the consumer interest group’. He argues that the ‘revolution’ in ideas brought about by greater awareness of ecological issues has made this process inevitable. Medicine must either address these issues and embrace a holistic, rather than mechanistic approach, or risk losing its pre-eminent role within society.

As a critique of current medical orthodoxy, this book offers little that has not been said before - and said much better - by other commentators. The thread of this argument often seems to get buried under a mass of detail, factual digressions and extensive references which makes it difficult to follow. The breadth of knowledge and information which Pietroni has drawn on is considerable, but it is a pity this is not matched by depth of analysis.

At times the book seems to gallop through the history of ideas which have shaped medical theory and practice, without stopping to engage too long in debate. Passing reference is made to Marxist and feminist critiques of medicine. However, social and economic influences on health are referred to solely in terms of their ecological impact - their ‘connectedness’ - and while Pietroni is keen that medicine should embody the ‘feminine principle’, he is equally keen to denounce the contribution of ‘militant’ feminism - ‘the vulgar attitudes of dirty dishevelled women’.

It is not until the final chapters of this book that its potential begins to be realised. The influence on orthodox medical thought of developments such as the hospice movement, the anti-psychiatry lobby and the Peckham experiment, as well as Pietroni’s own holistic health centre in London, is thought-provoking. Nevertheless, this section could still have been expanded to include other contemporary issues. For example, there is no mention of the WHO Health for All 2000 programme, which would appear to embody the principles of the ‘greening’ process. Nor is there any mention of the impact of HIV and AIDS on current attitudes to health and illness.