orange clouds

Montaigne wrote –

Except for old age, which is an indubitable sign of the approach of death, in all other ailments I see few signs of the future on which to base our divination.

When I read this I immediately remembered a conversation I had with a patient one day. She’d just told me that her husband had been diagnosed with cancer and had been told he had six months to live. I asked her how she felt about that.

“I’m angry”.

That’s not such an uncommon response when people hear such bad news, but I don’t take anything for granted so I asked her to say why she felt angry.

“How come he gets to know how long he’s got, and I don’t get to know how long I’ve got?!”

Well, that surprised me! I hadn’t heard a response like that before.

So I took some time to explain that having a particular disease did not bestow any certainty about the future. Prognosis is a tricky a practice. When speaking statistically about groups or “cohorts” in studies we can say one thing, but when speaking about an individual, it’s actually much, much harder.

The diversity of human experience undermines predictions every day. I think that was one of the best lessons I learned as a doctor. Beware of false certainties!



Just by being alive we affect those around us.

When I woke up the other day and saw the frost on the grass, and how, under the mulberry tree, in addition to it dropping an attractive circle of yellow leaves, the grass was unfrosted. I don’t know if that is because the leaves on the branches create an invisible zone of warmer air preventing the frost from forming, or whether its warmth from the activity of the roots under the soil, but it’s striking isn’t it?

It made me think how just by living we affect the world we live in. What we breathe in, what we breathe out, what we eat, what we excrete, and all the actions we take.

I reckon even our thoughts start to ripple out into the universe. Our thoughts affect our the metabolism of our bodies, our immune and inflammatory systems (our defences), what we say to others, and our actions. In all these ways the environment around us changes. Maybe just a little, maybe quite a lot.

None of us live in a vacuum or a bubble. The world is different today because you are living in it. Guess it’s worth taking some time to reflect and wonder what kind of ripples we are sending out, what shadows we cast.

The COP21 conference in Paris comes up next week. A good time to consider how our choices and our lifestyles affect the rest of the world…..


Montaigne had strong views about health and doctors. He disparaged those who claimed to be better able to tell him what was good for him than he was.

He trusted his self-knowledge more than what others said or wrote about such matters, saying, for example, “I would rather be an authority on myself than on Cicero”. That strikes me as an admirable goal – to become an authority on yourself – to know yourself!

He said of medicines – “If it is a pleasant medicine, take it; it is always that much present gain. I shall never balk at the name or the colour, if it is delicious and appetizing. Pleasure is one of the principal kinds of profit.”

He said of “advice”, or rules for living prescribed by a doctor, “The disease pinches us on one side, the rule on the other. Since there is a risk of making a mistake let us risk it rather in pursuit of pleasure.”

One of my teachers said “Your patient’s life shouldn’t be harder for them when they leave your consulting room, than it was when they came in.” That struck me as wise advice. Montaigne would have agreed!

His issues on this subject weren’t just about doctors and medicines however. He was concerned about people telling others how to live. He gives examples of the diverse lifestyles of shepherds and fishermen and asks if it is sensible to give such different people exactly the same advice.

That’s an issue which troubled me throughout my career. Over the years we’d hear that fat was bad for you, fat was good for you; milk was good for you, milk was bad for you; hormone replacement therapy should be offered to all women, hormone replacement therapy should be avoided at all costs…..and so on.

As advice moves from how to recover from, or “manage” an illness, to prevention, the whole situation becomes infinitely worse.

Is there really any point in living a life of avoidance as a core principle? Avoid this, avoid that, don’t eat this, don’t drink that, don’t do this, don’t do that…..Montaigne quotes the sixth century poet, Maximianus, to back up his stance.

Obliged to wean our souls from things on which they thrive,

We give up living, just to keep alive.

“We give up living, just to keep alive”. Wow! That’s the heart of it. Surely there’s a seed of something wonderful in that one line?

Life’s for living. Death avoidance has a 100% failure rate…..eventually!


dawn frost

The other morning the sky turned pink as the sun was getting up out of bed and it cast a delicate rosy hue to the frosted grass.

The pink had faded away within minutes and the frost was gone by the end of the morning.

Transience is held in high regard in the Japanese aesthetic of “wabi sabi”. I’ve written a few times about the phenomenon of the annual cherry blossom festivals in Japan, but that’s just one of the most prominent expressions of this admired quality.

What is it about transience that makes something so special? Isn’t our instinct to want to hold on? To grasp at whatever pleases us? To try to resist change?

Well, there’s no doubt we have those qualities, but just as all human life is filled with paradoxes and opposites, we have this attraction to transience too.

I knew instantly that the pink in the sky would be gone within minutes. And I was pretty sure the frost wouldn’t last all day either! But that drew me right in to being fully present. And that’s what I think this quality of transience does for us. It heightens the experience of now.

The pre-socratics used to say start every day knowing that whatever you experience today will be for the first time ever, and knowing also that whatever you experience today will be for the last time ever. Every moment is unique. Every day is special. No two experiences are exactly the same.

So whatever you encounter today, savour it, relish it, enjoy it to the full.

There are moments…

sun on vines

There are moments when the universe catches your attention.

Hey, says the universe, look at me! Look what I can do!

And you look and you see sunbeams pouring down onto the surface of the Earth from so high in the sky, and you see the flourishing of millions of years of evolution as trees and vines and grass reach up and capture these rays.

And you know that with apparently no effort at all, they are turning the sunlight into colour and oxygen and nutrition for Life.

And you see the fruits of years of human toil and imagination stretching over the hills, working with the elements of fire, earth, water and air, collaborating with the plants and nurturing them.

It looks, and, it is…….wonderful.

L’Émerveillement du quotidien.


paris corner

Montaigne wrote in one of his essays that he once met a wealthy man who he found studying in a corner of his great hall, with only cloth hangings partitioning him from the noise and bustle of his servants. He told Montaigne

that he derived profit from this racket, as if, battered by this noise, he withdrew and concentrated in himself better for contemplation, and that this storm of voices drove his thoughts inward. While studying at Padua, he had for so long a time a study exposed to the rattle of coaches and the tumult of the square that he trained himself not only to disregard the noise but to use it for the benefit of his studies.

Have you had that experience? I’ve read of several writers who would write in cafes, but others who find such a buzz too distracting. Montaigne himself was one of the latter –

I am quite the opposite; my mind is sensitive and ready to take flight; when it is absorbed in itself, the slightest buzz of a fly is the death of it.

Since Montaigne’s day we could add another scenario – studying, or reading, while listening to music. Again I think there are some of find this beneficial, and others who just find it too distracting.

When I was studying Medicine in Edinburgh there were two places where I studied best. One was in the Botanic Gardens, and the other was in the Anatomy Museum! Well, what does that say about me??

How about you? Do you need peace and quiet? Or do you find a hustle and bustle around you conducive?


Judgements and opinions


Here’s a passage from Montaigne –

Never did two men judge alike about the same thing, and it is impossible to find two opinions exactly alike (about the same thing) not only in different men, but in the same man at different times.

I’ve been passing a spectacular tree recently. It’s in the corner of somebody’s garden in Chateaubernard on the way into Cognac, not far from the Biocoop. Here’s a photo I took the other day. I think this is a “kaki” tree. Certainly that’s what the fruit looks like. It inspired me to buy one of the fruits and taste it. Mmmm….delicious. Or was it…..?

Montaigne says, it isn’t possible to find two opinions about the same thing exactly alike. You might taste a kaki fruit and think “yuk!” Yet, what can we do, other than say truly what we experience?

This passage of Montaigne’s made me think about all the reviews which surround us. The well established reviews of movies, music, theatre, and books which appear in most newspapers at the weekends have been added to enormously by reviews online. Amazon, for example, allows anyone to post reviews and it’s not at all uncommon to find widely divergent views on the same book – just as Montaigne said. But they also use their algorithms to show you what other books, other people who liked this one, liked (or bought). At least this second method helps you to find people with some tastes in common to yours. There are sites like Tripadvisor which let people review and rate restaurants, bars, hotels and so on. Again, there you’ll see reviews of any particular establishment which range from fabulous to awful. What do you do with that?

Add into the normal range of opinions and tastes, those who deliberately post positive or negative reviews for commercial or malicious purposes – making up reviews to try to affect the rankings.

So I wonder, what do you do? How do you find books to read, movies to watch, music to listen to, places to go? How often do you read the reviews and how do you find the reviewers you trust? Maybe you get familiar with a particular blogger and find you share a lot of their tastes. That can help.

Montaigne’s final point takes us back to the fact that everything changes. We all find that what we loved or hated in the past can turn the other way as we get older. Maybe there’s a certain kind of food you used to hate, and now you love? Or maybe there are authors or musicians who just don’t do it for you any more (or alternatively, who previously didn’t interest you, but now that you look again, you fall in love with them!). Have you had that kind of experience?



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