I attended a lecture yesterday evening and was monumentally out of my depth. The speaker was Dr Havi Carel who lectures at Bristol University and is a British Academy Fellow. She was addressing an audience of knowledgeable people who meet monthly to discuss philosophic issues, which was why I felt like a fish out of water. But her theme interested me. Having been seriously ill herself she has become fascinated in the experience of ill health as more than a physiological, more than a clinical condition but also about learning to live in a new way.

‘Phenomenology’ is the philosophical study of the structures of subjective experience and consciousness and Dr Carel’s interest is to define illness as a way of experiencing the world rather than a physical dysfunction and social label. She has written a book (‘Illness-Art of Living’) in which she explores how the physical, emotional and social worlds of a person change when they are ill and asks if there can still be well-being for them.

In her book she claims that too often illness is viewed as a localised biological dysfunction while ignoring the actual experience of the ill person, their fears, their hopes, the way they interact with others and, ultimately, experience life. Very much influenced by the German philosopher Edmund Husserl (1859-1938) for whom experience is the source of all knowledge, we were encouraged to see illness as the disruption of our ‘lived body’ as well as our biological body and reject the idea of mind/body duality. Illness can involve the loss of wholeness, the freedom to act and our relationship to the world but within that context, happiness or a new evaluation of life is both desirable and possible, she claims.

I am visiting someone in hospital just now who is very much reduced in health. An independent person, I hate to see him as he is now, confined to his bed or the seat beside it.

There is fear in his eyes and his speech is muddled, as much about the past as the present, clear to me sometimes, irrational it seems at others. He is in an unnatural environment, and the free spirit he has always been is confined in a regime dictated by others.

It’s this loss of liberty that is so disturbing about hospital culture, with patients the object of medical care rather than the subject. My friend and I are of the same age and my reaction – and this has always been the case when I’ve visited people who are ill – may be a caricature of how it really is for him. Perhaps there is some happiness and revaluation going on for him behind his visible distress. I do hope so.

Hospitals, sadly, are not structured to facilitate such a process.

Bryan