My mother in law gave me The Tao of Pooh by Benjamin Hoff for Christmas, I suspect because she thought my mentality was suited to the cuddly toy of the title. I dutifully added it to my collection of books to read while on holiday, intending to have a complete break from books and journals about medicine. However, when I settled down to read it, on a sunny beach far from my consulting room, I was struck by its relevance to my work, and The Tao of Pooh has made a greater change to my practice than much of my regular medical reading.
Hoff uses the characters from A A Milne's Winnie the Pooh books to illustrate and explain the basics of Taoist philosophy, showing how Pooh himself is the epitome of the Taoist thinker, enjoying life with simplicity but not stupidity. The author explains that Taoists try to appreciate, learn from, and work with whatever happens in life, whereas, in contrast, Confucians seek to impose order on a chaotic world and Buddhists see life's tribulations as obstacles to be overcome before achieving Nirvana. He describes how Tao is the Way, which can be understood but not defined, and illustrates key elements of Tao such as P'u, the uncarved block, and Wu wei, going with the flow. In case you should think that this book is altogether too simplistic, I should add that Hoff touches on the writings of Lao-Tse (author of the Tao Te Ching), Chuang-tse, the poet Li Po, and other Taoist philosophers, giving his own translations of passages from their writings.
While reading the book, I began to see how the NHS is governed by a Confucian hierarchy of rules and regulations that do little to contribute to the harmony of life in general practice. Mischievously, I thought of general practitioners as Buddhists overcoming the trials and tribulations of the New Contract in a bid to achieve the Nirvana of 1000 quality points. I realised, however, that general practice is a chaotic discipline far more suited to the Taoist approach of going with the flow—the Wu wei. In Hoff's descriptions of A A Milne's characters I could see myself striving to be like the learned Owl, whilst actually being a mixture of the busybody Rabbit and the pessimistic Eeyore.
Hoff has shown me how the ideal is to be a simple character such as Pooh himself, the eponymous P'u, the uncarved block—accepting life, work, and other people as they are rather than trying to impose order on them. I now seek to accept and move with events as they occur, preferring not to try to impose change nor viewing change as an obstacle to be overcome. This approach spills over into consultations, keeping them simple, letting the patient direct the flow. “Shades of Balint,” I hear you say; well, maybe Balint was a Taoist. I use Confucian protocols and guidelines, but I try to mellow them, fitting the protocol to the circumstance rather than the other way round. Above all, I keep things simple so as not to lose the Wu wei.
There is a long way to go yet, and I cannot see the NHS, general practice, or myself ever becoming wholly Taoist in approach. However, any dilution of the increasing complexity and disharmony of NHS general practice with a little Taoist thinking must be a good thing. Learning is not wisdom, and wisdom is not learning: however, through reading this book, I think that I have gained a little of both.