Heroes Not Zombies

Life is tangled.

Every one of us is a multitude. Check out Bob Dylan’s new release “I contain multitudes” for a very recent expression of this idea. In fact, as he sings it, maybe we are multitudes, plural.

The Scottish psychologist, Miller Mair, coined the term “community of selves” back in the 1970s. It remains a powerful metaphor for the complexity of an individual personality. That idea made a lot of sense to me, and helped me to understand not only my patients but also myself. We all have that experience of at very least tapping into different strands of our lives when we act within our different roles – parent, child, friend, neighbour, employee, professional, artist, consumer etc etc. We know all those roles are just a part of who we are but it can be very hard to untangle them, to see how they inter-connect.

The French philosopher, Deleuze, wrote about “multiplicities” as a way of understanding the complex universe, and described any particular instance as a “singularity of multiplicities”. I liked that idea the moment I read it. I happened upon his writings at the same time that I was exploring the new “complexity science”, and in particular the concept of the “complex adaptive system“, which fundamentally changed how I saw our lives and our world.

I once spoke to a “Chef de Service” at a Parisian Homeopathic Hospital and he described to me that he saw each patient as like a diamond, with multiple facets shining, each one different, but together all part of the same individual. He saw his therapeutic strategy as being based on addressing several of the most prominent of a patient’s “facets”. A rather poetic way to think of the same underlying issue.

What is the underlying issue?

Life is messy.

On the “inside” and the “outside”. I put those words in quote marks because I’m pretty sure that frequently there is no clear boundary between the two. I think wherever we look we can find multiple threads to follow. We can identify particular paths, storylines, themes, chains of cause and effect, which run through a lifetime.

And, here’s the important point, brought back to the front of my mind by this photo today, all those paths, storylines, threads or whatever, are entangled. They are connected. They are inextricably interconnected, astonishingly woven together to create a unique, beautiful tapestry of a single life.

I’m not a fan of labelling a patient with several different concurrent diagnoses then sending them off to separate specialists to have each disease treated as if it exists in isolation. In Medicine this is referred to as “silo-ing“, a strange word which means separating out someone’s problems into separate baskets, boxes, or “silos”, then treating each one separately. Most of the evidence used in “Evidence Based Medicine” comes from trials where patients have been selected on the basis that they have only the single disease which is under study, and that they are receiving only the single drug which is being trialled. But the real world isn’t much like that. Much more common is the finding that an individual patient will have several different diagnoses active at the same time and that they will already be on a cocktail of drugs. Medicine is more messy than some people would have you believe.

So what? Is this a counsel of despair? Am I saying life is too complex and entangled to make any sense of it? No. Absolutely not.

What I find is that this complex entangled life is beautiful. That it manifests in the most unique, most varied, most astonishing individual narratives you could imagine.

What I find is that when you look for the connections between the parts, you get insights and understanding which you’d miss if you kept your attention only on single parts.

What I find is that it’s best to use your whole brain, not just half of it, as Iain McGilchrist, author of “The Master and His Emissary“, would say. It’s not enough to separate out the threads and elements and study them. You have to weave them back together to see the contexts, the contingencies and the connections. In other words, you need both your left hemisphere ability to see the threads, and your right hemisphere ability to weave them together into a whole.

What I find is that when you look at life this way, then you encounter the “émerveillement du quotidien” – that you find yourself wondering and marvelling every single day. You find diversity and uniqueness. You find infinite trails of connections. You find that curiosity is constantly stimulated and never ends. You find that you are humbled by how little you actually know. You find that you doubt predictions and develop a distaste for judging people.

You find that Life is astonishingly, endlessly, fascinating.

What a delight!