Archive for November, 2010

If you’re a more regular reader of this blog, you might be wondering why my posting rate has plummeted this month……well, the answer lies in that little winner’s badge here.

nanowrimo is National Novel Writing Month. It happens every November and the deal is you sign up to write a 50,000 word novel in 30 days….that works out at a steady 1,677 words a day. Of course, you’re not expected to produce a fully crafted novel by day 30, just to have the raw text of a novel to spend the next few weeks or months, editing, revising and developing.

I signed up on November 1st, and completed my 50,000 words on November 27th and it’s been one of the most amazing experiences I’ve ever had. I write a lot. This blog is part of my writing output, but I’ve written almost exclusively non-fiction so far (I have a collection of about 80 or so small fictional clinical cases entitled Dr Cannyman’s Casebook to accompany my course in Patient Centred Homeopathy). I’ve had a dream to write fiction as long as I’ve had a dream to be a doctor and I’ve been doctoring some 32 years now, but a novelist for none of them! After all this time, I’ve wondered, could I actually do it? Do I have it in me? I’ve read a few books about creative writing and the one thing they pretty much all say is you have to actually turn up and write. I know. Sounds obvious, huh? But it just isn’t easy. And one of the things that always stopped me from getting started was I might have the germ of an idea, but I sure as hell didn’t have characters or a plot. Surely, I reasoned, you need ALL of that AT LEAST before you start.

I was wrong.

The nanowrimo experience is an experience in motivationally supported daily writing. Yes, I’ve done daily writing for long periods, but never daily fiction writing. Nanowrimo is about daily fiction writing. You sign up online, get your own user page, a box to enter your daily word count and a graph to show you your progress along with stats encouraging you to write a little more by telling you how much more you need to write today to get the 1667 daily target, and what date you’ll finish if you keep on at the rate you’re going. In addition to that you get regular emails encouraging you and they are just brilliant. Liberating messages from other participants and writers saying things like “OK, you’re several days into this now and you’ve probably no plot and no idea where it’s going. Welcome to writing fiction! This is how it is. Keep going. You’ll find your characters and your plot emerging as the month progresses”. Well that was news to me. I had no idea that an approach like that could work.

So here’s what I learned. First of all I learned it really took a LOT of discipline to write those 1667 words a day, but I was more determined the more I progressed. Second I learned that although on the vast majority of days I would have no idea what I was going to write, an idea would emerge, I’d start with that, and before I knew it these characters appeared, this dialogue occurred, these events happened. I found things coming together in ways I hadn’t planned (because I hadn’t planned anything!) and I found little remnants of stories of my life and of people I’ve met turning into brand new elements of other stories under my fingers as I typed. It was a total revelation. Thirdly, this comment from one of the emails “It’s so strange how our mind knows more than we are aware of it knowing.” hit me right between the eyes. That is exactly what I’ve discovered in doing this writing exercise. It’s all in there. Even when you don’t consciously know it.

So here I am. The proud owner of a nanowrimo 2010 winner badge. A writer with a new habit. The owner of 50,000 words to work on, words I feel which have a good chance of turning into a proper novel. I’ve only shared with others some of what I’ve written so far, but the feedback has been so positive I am thoroughly encouraged.

I think that’s what nanowrimo is all about – enabling you to get to the place where you can say to yourself “I believe I can do this”.

It’s been quite a month!

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ben ledi misty autumn

ben ledi winter

…taken exactly two weeks apart I think these photos show the change of the season from autumn to winter

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New solutions

Seth Godin, spot on, as ever…….


If it’s a new problem, perhaps it demands a new approach. If it’s an old problem, it certainly does.

How true. Yet how often have you actually followed through on a thought like this?


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autumn colour



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Mary Midgley is an English philosopher whose latest book, The Solitary Self [978-1-84465-253-2], develops a case she has laid out in previous books. I first read Mary Midgley in her Science and Poetry, which was so clear, readable and thought-provoking. In that book, she argued that the concept of atomism when applied equally to the parts of a person and to individuals within society didn’t make sense. She develops that argument here in a brilliantly focused attack on neo-Darwinists such as Dawkins, who, she argues, have reduced Darwin’s thought to the principle of survival of the fittest. Dawkins’ Selfish Gene being a classic example of such a world view – the world view that competition and fighting for individual advantage is the way of Nature, the way of human beings, and the way society should be run. The values they promote are the values of selfishness. She elaborates in detail, quoting from Darwin’s own writings, how humans are actually intensely social creatures.

In fact, you can’t reduce Mary Midgley’s arguments to simple sound-bites in the way the neo-Darwinists like to promote their ideas. This is because she completely accepts the complexity of life, and the inescapable conflicts at the heart of every human being.

I think this little book is terrific at putting the case for an understanding of the importance of collaboration, as much neglected in recent decades. She is also very strong on the irrationality of using reductionism to try to explain complex wholes –

One way and another, then, it emerges that, in general, the reductive thinking that theorizes about large-scale behaviour from analogy with the behaviour of small parts is not reliable or scientific.

Here’s one paragraph from her book, which I think, really does capture her most important argument.

All this later became part of a much wider campaign, conducted by thinkers such as Nietzsche and the existentialists, to exalt freedom above all other ideals, isolating modern individuals in pure and heroic independence. Like all such one-sided advice, this campaign ignores crucial aspects of our nature. It assumes that we are independent items, isolated brains, intelligent billiard balls that need no sustenance and could choose to live anywhere. But we are actually earthly organisms, framed to interact continually with the complex ecosystems of which we are a tiny part. For us, bonds, are not just awkward restraints. They are lifelines. Although we all need some solitude and some independence, total isolation is for us a desolate and meaningless state. In fact, it is about the worst thing that can happen to us.

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Whenever I see a web I think about how interconnected everything is. The network model (networks are made up of nodes and links) really does help me to understand that. Our whole being is an amazing interconnected system of cells, organs and tissues. Our world is an increasingly connected world. What happens in one country quickly changes what is happening in another.
This particular web seems even more dense than most.

dense web

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the birds

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I looked up and the sun was setting, casting a red glow on the spire of the church. Over a few minutes the glow ascended towards the sky as the sun set below the horizon. A lovely effect

sun setting on church spire

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One thing that’s always surprised me about the way in which placebo effects are described is that they are portrayed as either the same as doing nothing, or as some kind of trick effect.

Clearly, giving a drug which randomised controlled trials show to be no more effective than placebo is not the same as doing nothing. Kirsch makes that very clear in the introduction to his book, “The Emperors New Drugs” where he shows the difference in depression between placebo groups and no treatment groups. But more than that, the placebo effect seems to be an integral part of the effect of any therapeutic intervention, whether that’s a drug or not. And, further, it’s not true that giving a chemically inert substance has no effect – it can produce what we call the placebo effect.

I recently read this article by Fabrizio Benedetti about the placebo effect and it’s one of the clearest articles on the subject I’ve ever read. He clearly maps out the chemical and neurological changes which occur in the body when a person is given a placebo. Here’s a small part of that description –

Placebo administration, along with verbal suggestions of analgesia (psychosocial context), might reduce pain through opioid and/or nonopioid mechanisms by expectation and/or conditioning mechanisms. The respiratory centers might also be inhibited by endogenous opioids. The β-adrenergic sympathetic system of the heart is also inhibited during placebo analgesia, although the underlying mechanism is not known (either reduction of the pain itself or direct action of endogenous opioids). Cholecystokinin (CCK) counteracts the effects of the endogenous opioids, thereby antagonizing placebo analgesia. Placebos can also act on serotonin-dependent hormone secretion, in both the pituitary and adrenal glands, thereby mimicking the effect of the analgesic drug sumatriptan.

Later in the article he points out that the chemical changes in the body don’t only occur in relation to pain pathways.

Although pain is the best known model to study placebo and nocebo effects, other conditions are now providing further insight into the biological mechanisms of placebos and nocebos. For example, patients who suffer from Parkinson’s disease have been shown to release dopamine after placebo administration [7] and also demonstrated changes in neuronal activity in the basal ganglia (fig. 5) [6]. Similar to the procedure in pain studies, patients were given an inert substance (placebo) and told they were receiving an anti-Parkinsonian drug that would produce an improvement in their motor performance. According to one hypothesis, the placebo-induced release of dopamine in Parkinson’s disease is related to reward mechanisms. In this case, the reward would be the clinical benefit.

This got me thinking. This is a good article for clarifying the REAL material changes which occur in human beings in response to the administration of inert substances. These changes are beneficial. Why don’t we study them more to understand them better, but, maybe even more importantly why don’t we stop thinking of these phenomena as something associated with trickery and deceit, but instead as important biological pathways in healing? The trouble is these pathways seem to be studied currently within the context of “dummy” and “pretend” interventions. Maybe we need to study them in relation to what are called “non-specific effects” – or in other words to the power of human care and interaction.

It’s time to change our priorities from a focus on technologies (drugs) to a focus on human beings (patients and practitioners)

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