ABSTRACT
In general practice, strict application of the biomedical model can lead to mismanagement, dissatisfaction and harm. In this chapter we articulate an alternative ‘cosmology’ which may be more appropriate for general practice. First, we suggest that general practice is about helping persons who are beings with a sense of ‘self’, interpreting their lives in narrative terms within a social and cultural context. Second, that persons are embodied entities and that embodiment and selfhood are two inseparable aspects of personhood. Third, that persons cannot be reduced to their body, nor to their narrated self. To understand each aspect, one needs to see it in relation to the others. Only then is it possible to help the patient who is always more than the sum of the parts. We illustrate our cosmology by reference to three case histories having to do with the epidemiology of disadvantage and the risk epidemic; medically unexplained symptoms and violations of subjective integrity; and people’s need for professional help to establish whether they are healthy or ill. These stories draw attention to limitations of the biomedical model and support our argument that a theory of embodied selfhood can enable practitioners to provide better care for their patients.
