Archive for July, 2010

Here’s an interesting study. Apparently people who have a good social network of friends and neighbours are likely to live longer.

In their study, which looked at over 300,000 people from four continents over a period of seven years, those with the strongest social networks fared best in terms of health outcomes and lifespan. They were nearly twice (1.5 times) as likely to be alive at any given age than those who were lonely.

The protective benefit from good relationships applies at all ages. It’s not just something which is good for the elderly.

These findings shouldn’t be a surprise. Human beings are social creatures. We need to love and to be loved to really thrive. As Christakis shows well in his “Connected” our social networks powerfully influence our lives. This study shows that this influence can mean the difference between life and death.

The dominant health paradigm seems to be take drugs – drugs to keep you well, drugs to make you better, drugs to keep you alive. We need a better paradigm than that. We need one which instead emphasises the importance of living and living well. Just as a recent study showed the importance of the living environment on health, this study shows the importance of the social environment. These studies shift the emphasis away from a mechanistic understanding of health to one where networks, context, relationships and the environment take centre stage. But there’s not profit in that for drug companies, is there? –

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The Master and His Emissary

Thank you, Iain McGilchrist. This is not only a brilliant and comprehensive work, not only utterly convincing and erudite, but it shines the bright light of understanding on so many aspects of life. I can’t remember a time I enjoyed a book more than this one. I can’t remember a time I felt so enthralled by a book as this one. I’ve been busy underlining, making notes, looking up references and reflecting since I opened up this immense text. I haven’t rushed it, but I’m still a bit sad I’ve finished it. I’d have read more!

Iain McGilchrist is trained in both the Arts and Science, having taught English at Oxford University and worked as a Consultant Psychiatrist. The Master and His Emissary begins with a review of the science of the brain. Why is our cerebral cortex split into two halves with only a thin connection between the parts? Do the two halves do the same job? And if so, why have two halves to do the same job? This is no simplistic idea of “right brain versus left brain” however. He does make the claim that the two halves are NOT the same. In fact we can see that in the gross anatomy, but we’re also seeing it in the functions revealed through clinical experience (what changes for a person who loses the function of a certain part of the brain?), and through both neuroscience experiments and imaging work.

Put simply, he claims that the two halves of the brain are used to engage with the world in two different, but essential, ways. While the right hemisphere has an open and wide focus on the world, noticing connections, or the “between-ness” of things, the left has a narrow focus, noticing the parts. Both of these forms of attention are important to us.

Things change according to the stance we adopt towards them, the type of attention we pay to them, the disposition we hold in relation to them. This is important because the most fundamental difference between the hemispheres lies in the type of attention they give to the world.

He postulates that the brain has evolved this way to allow us, first of all, using our right hemisphere, to be aware of life as it is, or in its wholeness, then the left hemisphere selects some of that information from the right in order to focus on part of life in order to exert power over it. In other words, the left has a focus on utility to allow us to interact with specific parts of reality. Having focused on part of reality, the left then sends this information back across to the right, for the right to incorporate it in its over all understanding. Drawing on an old tale of a Master and his Emissary, he identifies the right hemisphere as the Master, who sends out his Emissary (the left hemisphere) to do specific work for him.
He then goes on to show how dominance of either the right or left ways of engaging with the world create the culture of the time. Having done so, we come to the final part of his thesis. By describing the culture of different eras, examining everything from philosophy, art, music and writing of each time, he shows how there has been a progressive shift in power from the Master to his Emissary, so that by now we are experiencing a world created by the left hemisphere as if the right is either redundant, or doesn’t exist.

Let me be clear here. He is not simplistically saying right side good, left side bad. Rather he continually reminds us that we need a healthy integration of both of these ways of understanding and engaging with the world.

Ultimately we need to unite the ways of seeing that are yielded by both hemispheres. Above all the attention of the left hemisphere needs to be reintegrated with that of the right hemisphere if it is not to prove damaging.

He gives us plenty of evidence that the dis-integrated dominance of left hemisphere thinking is damaging ourselves and our planet.

Here’s one of his many summaries throughout the book of the differences between these two approaches.

The world of the left hemisphere, dependent on denotative language and abstraction, yields clarity and power to manipulate things that are known, fixed, static, isolated, decontextualised, explicit, disembodied, general in nature, but ultimately lifeless. The right hemisphere, by contrast, yields a world of individual, changing, evolving, interconnected, implicit, incarnate, living beings within the context of the lived world, but in the nature of things never fully graspable, always imperfectly known – and to this world it exists in a relationship of care.

I wish we had a course based on this book. A course which ALL health care professionals would complete. If we did, we’d counter the increasing objectification of patients as examples of diseases to be manipulated on the basis of abstracted and generalised research as if they are objects without individuality or context. We’d counter the increasing fruitless or delusional pursuit of certainty. We’d have a chance of increasing empathy, a respect for difference and individuality, of increasing our understanding of patients as people in a holistic and contextually embedded way. We’d move from agendae of “management” and “productivity” to ones of care and experience.

This book has taught me so much. The discussion of the relationship between music and language was a complete eye opener to me. I’m learning a lot about neuroscience just now as I’m taking Dr Dan Seigel’s “Mindsight” course, and his focus on “integration” fits right in with this thesis, as does Dan’s definition of mind – “an embodied, inter-relational, process of regulation of energy and information”. It connects to other books I’ve read, such as Daniel Pink’s “Whole New Mind”, Richard Ogle’s “Smart World”, Robert Solomon’s critique of the “thin-ness” of much philosophical thought in “The Joy of Philosophy“, and Lakoff and Johnson’s “Metaphors We live by”.
It helps me to make sense of both “scientism” and “scientific materialism” and gives me insights which clarify why I find those approaches to life to be so profoundly lacking and unsatisfying.

Guess what I’m going to do now? Yep, I’m going to start to read it again. I’m convinced this is an important and much needed book published just when the world needs it. We need to prioritise integrative approaches to life, and certainly to health care, and, I believe, we need to increase the amount of empathy and understanding in the world. Iain McGilchrist has shown us how to enrich life with the rewards which can come from a reactivated right hemispheric approach to reality.

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Have you ever seen the video where you’re asked to count the number of passes between basketball players, then you’re asked a surprise question which shows you don’t see what seems (with hindsight) obvious?
Well, check out this new video. Try it out. I incorporates the original experiment and conducts a new one one you.

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I love how light on water constantly changes. As the clouds move across the face of the sun, or the sun’s rays flicker through the leaves of the trees, flashes of colour and light dance on the surface of the water. If the water is flowing over rocks of different colour, the show is just amazing. Here’s what I saw as I stood upstream and looked down through a little stone bridge.

red water

The water flowing down from the falls, was richly peaty, which added another range of colour entirely.

colour falls

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There’s an interesting piece of research published recently studying the effect of living conditions on cancer. Jonah Lehrer has written about it here. It’s a study conducted on mice, not humans, but the results were pretty dramatic.

In short, the paper demonstrates that mice living in an enriched environments – those spaces filled with toys, running wheels and social interactions – are less likely to get tumors, and better able to fight off the tumors if they appear.

Having injected all the mice with melanoma cells, all the mice raised in the standard cages developed the cancer, but 17% of the ones in the better cages showed no cancer, and those which did had tumours 75% smaller than the other mice. These are hugely different outcomes. The researchers highlight a hormonal pathway in mice which could explain the connection between living conditions and tumour production. Jonah concludes –

It strikes me that we need a new metaphor for the interactions of the brain and body. They aren’t simply connected via some pipes and tubes. They are emulsified together, so hopelessly intertwined that everything that happens in one affects the other. Holism is the rule.

Hear, hear, yet again, Jonah Lehrer!

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I recently read a great piece by Jonah Lehrer where he ponders about the way we pursue science. It’s worth reading the whole article, but here’s the paragraph which really grabbed my attention –

Karl Popper, the great philosopher of science, once divided the world into two categories: clocks and clouds. Clocks are neat, orderly systems that can be solved through reduction; clouds are an epistemic mess, “highly irregular, disorderly, and more or less unpredictable.” The mistake of modern science is to pretend that everything is a clock, which is why we get seduced again and again by the false promises of brain scanners and gene sequencers. We want to believe we will understand nature if we find the exact right tool to cut its joints. But that approach is doomed to failure. We live in a universe not of clocks but of clouds.

rain clouds

UFO clouds

sun through clouds

sun setting below clouds

I think clouds are beautiful, don’t you? Their variety, their constantly changing shape and colour and size…..their unpredictability. Astonishing. So, yes, I agree with Jonah, (and with Karl Popper), the mechanistic view of the universe has brought certain understandings and certain powers, but the networked, complex view of the universe will bring us a new understanding of reality, with quite a different concept of power. Jonah sums it up this way –

So how do we see the clouds? I think the answer returns us to the vintage approach of the Victorians. Right now, the life sciences follow a very deductive model, in which researchers begin with a testable hypothesis, and then find precisely the right set of tools to test their conjecture. Needless to say, this has been a fantastically successful approach. But I wonder if our most difficult questions will require a more inductive method, in which we first observe and stare and ponder, and only then theorize.

I think it’s about learning to use the whole brain again. Read Ian McGilchrist’s “The Master and his Emissary”. He explains more clearly than anyone else just what these two ways of seeing the world are about and how we might recapture our ability to use both halves of our brain!

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What’s your vision for health care?
I remember once hearing a spokesperson for WHO (the World Health Organisation) being asked that question and he said his dream would be that every child in the world was vaccinated against every known disease at birth. I wondered what planet he was living on.
One vision is based on “mapping the genome”. When I heard the idea that one day we’ll all be given a map of all the diseases we might expect to suffer AND a predicted age of death, I had this image in my head of some 30 year old walking out of the laboratory clutching his gene certificate telling him he would live to 102, so engrossed with the result that he doesn’t notice the bus heading towards him as he steps out into the road……
The main vision for health care currently doesn’t involve much in the way of direct interventions to improve health, but rather, is about “managing” diseases – which means drugs, and more drugs.
One in ten of over 15 year olds in Scotland now take daily antidepressants, and look how the number of prescriptions over all is rising……

Is this the big idea? More drugs?

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gormley edinburgh

gormley edinburgh

gormley edinburgh

gormley edinburgh

I found four of the six sculptures on one day’s walk, but I’ll need to go back and try and find the other two.
One thing which really struck me about these figures is how different they are in their individual contexts……not just a bit different, but VERY different.

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Here’s a scenario to try with any health care professional you know –

Imagine a patient presents with an infection in their bladder (cystitis), with burning pain passing urine, frequent need to pass to urine and some blood in the urine. You send a sample of the urine to the lab and they grow “E Coli” (a commonly implicated bacteria) sensitive to “Trimethoprim” (an antibiotic). You prescribe the recommended “Trimethoprim”. What does it do?

The only correct answer is that it kills the bacteria.

So, how does the inflamed, swollen, bloody bladder wall return to normal?

Only through the body’s natural healing system.

Drugs have effects. Antibiotics in particular can kill bacteria which might otherwise cause us great harm. But prescribing a drug is only part of the job needing done. If we only prescribe a drug and do nothing to support or stimulate self-healing, then we leave healing to chance……as if healing isn’t part of a health care professional’s job.

So, here’s something I wonder about. Why don’t they teach how to heal people at medical school? Why do they only teach how to “manage” diseases, remove diseased tissue, or suppress symptoms?

There’s the BIG gap in biomedical practice – how do we encourage and develop healing?

Shouldn’t we be using approaches which focus on healing as well as those which focus on disease?

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The first time I saw Antony Gormley’s “The Field“, I was transfixed. The room filled with those hundreds of small terracotta creatures all gazing at me gazing at them!

It’s an image which has stayed with me ever since and it’s one I think all health care professionals should expose themselves to.

Every patient I see has something in common with some other patients I’ve seen. That’s the basis of “diagnosis” in the way biomedicine considers disease. But every patient I meet is different. No two have the same experience of this disease. No two tell the same story. And here’s another aspect to that…….nobody stays the same, the story constantly evolves and changes. Without attention to the present, without an open-ness to difference, we fail to see what makes every single human being unique and special.

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