After exploring various medical specialties early in his career, Dr Alastair Santhouse (1986) found his ‘home’ in psychiatry, a field he’d become interested in as an undergraduate medic at Emma. In his upcoming book, Head First, Alastair draws on experiences and observations from a career straddling medicine and psychiatry, to show how our emotions are inextricably linked to our physical wellbeing.
I arrived as a medical undergraduate at Emmanuel in 1986 with a stack of curly brown hair on top of my head and fashionable turn-ups on my only suit. Coming to Cambridge from anywhere is overwhelming, no less so from provincial Manchester. The soul of academia inhabited the buildings, the timeless learning clung to the fabric of the place. It was etched into the steeply banked anatomy lecture theatre, the wooden floors worn out by generations of students. In the laboratories were the ghosts of great physicians and scientists past. William Harvey, the 17th century physician who discovered the circulation, Hans Krebs who described that iconic staple of our biochemistry textbooks the Kreb’s cycle, Watson and Crick, the discoverers of DNA, all of these, to name only a few, had preceded me, perhaps had even sat in the places I had sat in. I felt, as my late grandmother used to say, like a pimple on cheese, a nobody - a saying that seemed to be unique to her, although perhaps originated in the Russian Pale of Settlement from where our family came some generations previously.
That I was the only medic at Emma in my year interested in psychiatry did not surprise the Director of Studies. His comment when I told him my plan to become a psychiatrist was an enigmatic “That figures,” although it was said with a smile. Yet I did not immediately enter psychiatry when I qualified. It took me some years of meandering around different medical specialties, wanting to be true to the scientific principles of medicine, before finding my way home. I became a psychiatrist in a general hospital, Guy’s Hospital in London, and here realised how much of medicine is really psychiatry. I saw it in the huge numbers of medically unexplained symptoms, in the reactions to disease and illness, of self-induced symptoms, the how and why people came to see their doctors. I developed an interest in transplant psychiatry, and the psychiatry of obesity. I was drawn into the human interest as well as the medicine, and I came to understand what great physicians of times gone by had been trying to tell us, captured in the quote by Sir William Osler “Ask not what disease the person has, but rather what person the disease has.”
I came to write my experiences and observations of a career spent in the interface between medicine and psychiatry in a book, Head First, due to be published in July 2021. I do you hope you find it informative, and above all entertaining.
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