Telemedicine consultation

Book review: ‘The Distance Cure: A History of Teletherapy’ by Hannah Zeavin

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How technology has transformed traditional doctor-patient encounters into a new relationship that has flourished in the Covid pandemic.

When I mentioned to a couple of friends that I was reviewing a book about teletherapy, their reaction was the same: “Ah, telepathy... When will they stop writing about this paranormal nonsense?”

My learned friends could not be blamed for confusing ‘telepathy’ - communication from one mind to another by extrasensory means (according to the Merriam-Webster Dictionary) with ‘teletherapy’ – a social and scientific phenomenon, the coherent definition of which is hard to come by. It remains conspicuous by its absence in the seemingly omniscient Wikipedia, which refers instead to ‘telehealth’, defined rather clumsily as “the distribution of health-related services and information via electronic information and telecommunication technologies.”

The latter definition, to my mind, ignores one key element of ‘teletherapy’ – an approach to medical treatment, which – from time immemorial – has used mail, radio, printed word (books and articles) and other technologies to diagnose, advise and (hopefully) even cure patients from a distance. (Contrary to what many people assume, the prefix ‘tele’ doesn’t necessarily imply ‘electronic’, or ‘digital’; originating from Greek, it simply means ‘distant’ and ‘far off’.) With that in mind, I would venture to define ‘teletherapy’ as ‘a remote medical therapy with the help of technology’.

‘The Distance Cure’ The MIT Press, $35, ISBN 9780262045926), an enticingly written and thoroughly researched monograph by Hannah Zeavin – a lecturer in the Departments of English and History at the University of California, Berkeley - is the first ever academic foray into the history of modern teletherapy – from Sigmund Freud’s psychotherapy-by-mail to numerous phone hotlines (or ‘helplines’, as they are known in the UK) and the latest digital platforms: Skype, Zoom , WhatsApp, Viber and such like, made vital by the ongoing Covid-19 pandemic.

“Before the pandemic,” writes Zeavin, “...reactions to teletherapy were, on a foundational level, about the... fantasized freedom from meditation: the purity of two bodies in the room... the reaction against technology in the therapeutic scene is the reaction against the intrusion of an unknown – third – media – and its effects on the communication it makes possible.”

The publication of ‘The Distance Cure’, which chronicles and celebrates the transformation of the classic medical doctor-patient duo into a new doctor-patient-technology triad, while the pandemic is still raging across the globe could not be timelier. The main (if not the only) positive effect of the Covid-19 catastrophe is the massive acceptance of technology as one of our lives’ main essentials and the universal transformation of its image from an unwanted intruder to our best friend and indispensable helper. And not only in the traditionally strictly private medical matters, but also in virtual meetings and parties, distance learning, online dating and so on.

My own experience speaks for itself. As someone with a serious cardiological condition, I am supposed to have regular medical consultations and tests that would normally involve frequent visits to my GP and a consultant cardiologist. For nearly two years now, I haven’t been inside a hospital or a surgery except for a couple of blood tests. Instead, all the necessary consultations have been conducted over an iPhone and with the help of the sophisticated NHS software which, among other things, allows me to email to my doctor the photos of the parts of my body and skin he is keen to examine... I am sure many E&T readers have had a similar experiences of teletherapy of late.

It would be a mistake, however, to regard ‘The Distance Cure’ as ‘propaganda’ in support of the advantages of remote treatment and counselling over the good old face-to-face doctor-patient contact which is, and will always remain, the most effective and the most humane way to proceed. This book is but a powerful reminder of the importance of communications technologies - alien and impersonal as they may appear to some - in our survival. It is the history we all have to learn in order to face the future.

As I was writing the last line, my phone rang. It was a receptionist from our local surgery, still closed to visitors due to the pandemic, telling me the date and time of the approaching annual health review.

Just like last year, it will be conducted remotely – by phone!

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