Abstract
Should the heir to the throne comment on medicine and health? Should those views appear in a medical journal? Prince Charles has angered some medical professionals with previous contributions to the healthcare debate. Perhaps he will do so again? But he is a prominent and influential voice. When he sets out his vision for health, something he clearly thinks deeply about, speaking directly to medical professionals is the best way of allowing a constructive debate to flourish. This is the first time Prince Charles has written for a medical journal. It is an important article and the Prince's vision for health is engaging. 1
You might disagree, in which case let us know, but as the Prince argues for health professionals to rediscover ancient wisdom, Simon Wessely and colleagues review historic and recent accounts of people rejecting modernity. Ask yourself these questions: Do you have a problem living in modern society? Do you have a compulsion to flee? Do you have a sense of persecution? Is your head filled with ideas of fighting for an under-recognised cause, for example, protecting dolphins from nitrogen pollution in Florida? 2 Answer yes to these questions and you might wish to take refuge from modernity and live your life as a 21st century hermit. 3
Most people, especially the elderly, do not choose isolation. Our modern world, with reduced inter-generational living, greater social and geographical mobility, and a rise in single-person households, is an ideal environment for older adults to become socially isolated. Loneliness and isolation are increasingly part of the experience of growing old, say Nicole Valtorta and Barbara Hanratty yet we remain uncertain about the extent of the public health challenge and the potential health gain from intervention. 4
The way forward is a renewed research agenda, an approach that James Lind, whose story dominates this issue and rediscovered portrait adorns the cover, would surely have approved of. Lind's treatise on scurvy included a rudimentary systematic review, an account of his trial of interventions, including oranges and lemons, to treat scurvy among sailors on a sea voyage to blockade the English Channel in May 1747, and a somewhat muddled conclusion—thus pioneering the importance of fair tests to evaluate interventions and showing that even the sharpest brains struggle to communicate their research findings and make a difference.5,6 Forty-two years after publication of Lind's treatise, the British Admiralty ordered lemon juice to be issued to sailors. Lind's struggle is a sobering lesson for any commoner, knight, or prince seeking to influence the ancient wisdoms of the medical profession, and a lesson for hermits everywhere: realising any dream, obscure or popular, is within the grasp of any man, woman, or dolphin.