Clinical practice
Long-term health conditions, autoimmune care and families living with complex health needs.
The Practice · Issue No. 1
Understanding what happens to people between diagnosis, treatment and living with illness
Nearly two decades of clinical practice, medical anthropology, qualitative research, patient involvement, teaching and writing.
Leader
The space between medicine and the patient
Healthcare is built around diagnoses, treatments and outcomes. Illness, however, is lived between appointments — in kitchens, in waiting rooms, in the sentences people rehearse before they speak to a clinician.
My work explores that space: how people understand illness, navigate healthcare systems, make decisions, live with uncertainty and adapt when a health condition becomes part of everyday life.
Research
Qualitative approaches to understanding how people experience health, illness and healthcare.
Patient voice
Patient & Public Involvement: bringing patients into the questions that shape research.
Departments
Where I work
01
Long-term health conditions
Understanding illness that unfolds over time—and the people who have to live with it.
02
Autoimmune care
Clinical experience with patients navigating complex and often uncertain health conditions.
03
Patient experience
Looking beyond the diagnosis to understand how healthcare is actually experienced.
04
Research & PPI
Helping research teams ask questions that are meaningful to the people whose lives they study.
05
Teaching & facilitation
Working with clinicians, patients, families, caregivers, young people and organisations.
06
Writing
Essays, books and reflections on health, illness, recovery and the human experience of care.
The Talk of the Clinic
Questions I keep returning to
Five questions, open one at a time.
A diagnosis arrives as a category, but it lands in a life already in progress — work, family, faith, money, habit. Much of what follows is the quiet negotiation between the clinical name and the person who now has to carry it. I keep returning to how rarely that negotiation is recorded anywhere in the notes.
In long-term and autoimmune conditions, the language of cure fits badly. People build something else instead: a workable life alongside an illness that comes and goes. Understanding that version of recovery asks for a different vocabulary than the one medicine usually offers.
Probabilities are not the material most decisions are actually made from. Patients weigh what they can tolerate, what they can afford, who depends on them, and what they have already survived. Sitting with that reasoning — rather than correcting it — is often the more useful clinical act.
Patient and Public Involvement fails when it arrives at the end, as review. It works when patients are present while the question is still being written — when they can say that the outcome being measured is not the one that matters to them. That is the part of the process I care most about protecting.
Measurement shapes attention. When a system counts only what is clinically legible, the effort of coordination, waiting, explaining and grieving becomes invisible work — usually carried by patients and families. The gap between what is measured and what is experienced is where most of my research sits.
✦For conversations about health, illness and care.
I work with individuals, families, clinicians, researchers and organisations interested in understanding healthcare from the human side as well as the clinical one.