Archive for May, 2021

I was sitting in a cafe in Kyoto, looked out of the window and noticed that the reflection of one of the lamps was sitting right in front of one of the trees outside, so I took this photo.

Right from the start this has seemed a metaphorical photo to me.

I know the light is not “in” the tree but the image seems to capture that idea.

Every time I look at it I start to muse about “the light within” which is in us all. Sometimes I think of that light as being a manifestation of Life, of the presence and flow of the life force. It’s a strange thing, that life force. In fact, it’s not really a “thing” at all. It can’t be directly observed. It can’t be measured. But it’s a concept or phenomenon that few would deny.

I’ve seen people die right in front of me. I’ve seen some go suddenly, and others fade away over longer times. I’ve had to examine the newly dead to confirm that they are indeed dead, and to issue the “death certificate”. But death has always been a mystery to me. I don’t fully grasp it. I know about the shutting down of body systems and of organs ceasing to function. I know about “brain death” and I know that heart can just stop beating. But there is a distinct boundary between life and death. One moment someone is alive, and a few minutes later they are dead. It can be pretty straightforward to know which of the two states they are in. But I get caught up in a sort of Zeno’s paradox as I try to discern exactly the moment someone has moved from life into death. There is no “off and on” switch, yet sometimes it seems instantaneous. Organs fail, but more often than not, they do so over a period of time…..years, months, weeks, days, or even minutes. But our bodies are not machines and life doesn’t disappear the way a machine switches off, or a computer hangs.

So, many times I’ve wondered what brings about this “presence of life” which seems to shine like a bright light, and which goes out? Where does it go? If it isn’t even an “it”, does the question even make sense?

When I studied homeopathy I learned that Dr Hahnemann described something we call “the vital force”. He lived in days before we knew what we know now, and the objectification of “the vital force” into a material reality which nobody ever managed to find, directly observe or measure, led to the dismissal of the concept. But it still seems to me that there is indeed a “vital” phenomenon, a living “presence” or “flow” which we only find in those who are still alive.

Is this light within a sort of energy? There’s another hard word to pin down – energy. We can identify certain clear energies in physics, and even measure them. But the energies we humans experience are harder to define.

Not to know, but to define.

What do I mean by that? Well, imagine a scale from 0 to 10, where 0 represents the lowest energy you can imagine experiencing, and 10 represents the greatest amount of energy you can imagine experiencing. Tell me, right now, what number would you apply to represent your current energy level?

You managed to do that didn’t you? I have never met someone who couldn’t come up with a definite number when asked to do this.

But here’s my question, whether you said “5” or “8” or “2” or whatever you said, how did you do that?

You didn’t measure anything. You didn’t check your blood pressure, your oxygen saturation levels, or you blood sugar level did you? In fact you neither selected out a single organ or system of your body to assess, nor did you use any kind of measuring equipment at all, but you did it. You holistically, intuitively, know what your current energy state is. Nobody else can do that for you.

Let’s expand that idea and apply the scale now to “mental energy”. What number would you give for that currently? Is it the same number, or a different from the previous one? What is mental energy? Where might you find it? How could someone else measure it for you?

Challenging, huh? But, at another level, not challenging at all…..in fact, it’s utterly straightforward and easy to do. In fact, sometimes we can even pick up the energy level of someone else, can’t we? We can know that someone is “not on form”, is in a state of “low energy”. How do we do that? Not by using any measuring equipment either.

So sometimes this “light within” seems like the presence or the flow of Life to me, and sometimes it seems like an energy.

But I think there’s a third path to consider. Something to do with brightness. I don’t mean intelligence. I mean brightness – alertness, awareness, presence. You know that old saying that “the lights were on but there was nobody in”?

There’s a light in your eyes tells me somebody’s in

And you won’t come, the cowboy with me.

…..sang Kirsty Maccoll

So, this light apparently shining from the middle of this tree sets me off on all this routes – the life force, subjective energy and presence.

All subjects which I have dealt with almost daily, all subjects of which I am very, very familiar, and all subjects which I still don’t fully understand!

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One of the biggest changes wrought by the pandemic was the mass shift of work away from big offices in city centres out to peoples’ own homes. I heard many and varied stories about that and I’m sure you’re hearing them too. For some people it’s been a whole series of revelations. Freed up from long uncomfortable commutes every day they’ve been able to enjoy more time with family and friends than was their norm. For others working from home has become something of a scourge with no boundaries….work has invaded their homes, blurring both start and finish times, and increasing the extent to which their work is monitored by managers. Some are discovering the delights of local shops, cafes and parks. Whilst others are missing the camaraderie of their work colleagues.

For some this is a moment of pause. A time to stand back and reassess their lives and their values. In France there has been an explosion of interest in city dwellers seeking to relocate to smaller towns near the city – places where they can find and afford a house with a garden, instead of an apartment with no outside space, and where they can establish a mix of “tele-travail” and commuting.

New patterns of work have appeared, where some of the week is spent on home working while some is spent in offices, so the towns which are less than a hour away from the main cities have become the most sought after.

The small businesses around office blocks and travel hubs, such as train and bus stations, have suffered enormously. I can remember wandering through the streets of London on a Sunday morning and finding every single cafe was closed. I’ve had the same experience in Tokyo. The office zones emptied of their workers just closed down for the day – no commuters, no customers – well, I imagine that’s extended well beyond Sundays now.

How much of this is the beginning of change which will last? Only time will tell.

What’s your own experience? Has your working life (and family life) changed a lot because of this closing down of office work? Has it led you to reconsider your values and your life path?

By the way, I took this photo from the airport bus as it made its way into the centre of Tokyo from Narita one night. That’s why the picture is quite dark and why most of the windows have the blinds down. Every time I look at it, the first thing I think of is a cage. Or a prison. But I guess I’ve never been a fan of massive offices! The other thing I’ve just noticed is that there is only one single human being visible in this photo. Can you see them? Isn’t that an interesting observation? I wonder what will happen to the occupancy rates of offices as societies and cities begin to open up again?

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What are some of the core characteristics of being human?

Well, this photo reminds me of two of them.

Observe and create.

We are great at observing. When we slow down, take our time, and really pay attention, then we notice details, see connections, discern patterns, understand underlying themes and aspects of reality. I think this is one of our key powers. Yet, too often, we are too busy, or too distracted and life passes us by.

This is maybe one of the best ways I know to improve the quality of every day life – observe – just notice – just pay attention – just become aware. When we interact with whatever we pay attention to, we develop a deeper understanding – a deeper understanding of what we are observing, of reality, and of ourselves.

We have tremendous powers of observation, which entwine perception with analysis, re-cognition and imagination. Observation can spark insights, connect us to meaning, purpose and sense, and so enrich the every day.

We just have to slow down, set our intention, and raise our awareness. And like all strengths and abilities the more we practice those the easier they come to us.

This man is sitting on his traveling chair with paper on his knees, and he is drawing, or painting (I can’t quite remember which). In other words, he is doing more than observing. He’s creating. We are creators. We create all the time. We bring memories and imaginings together to express ourselves, to solve problems, to invent, to make art. We humans have painted on cave walls, constructed great stone circles, and buildings, developed tools and shared our knowledge and skills with each other right from the beginning of our lives on Earth.

I know sometimes we think of creativity as being the reserve of great artists, musicians, poets and so on, but it’s more than that. It’s something we all posses and something we all use every day….whether that’s in cooking, caring, dressing ourselves, nurturing and nourishing, communicating and connecting, or in our ways of thinking. We engage with the world creatively. We make each day, each experience, each moment our own. That takes creativity.

So, here’s a good place to start if you want to increase the quality of your every day life – observe and create.

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I took this photo in a tea house when visiting Japan a number of years ago. That tea house was one of the most peaceful places I’ve ever been, and I think part of what made it feel such a positive, healing place, was that they slid back the paper screens over the windows to reveal a terrace with an awning, and then all you could see were trees, bushes, and grass.

I was very fortunate to spend almost half my career working in Glasgow Homeopathic Hospital, which became the NHS Centre for Integrative Care once it moved into new, purpose built premises. Although the location of the new build was at the back of a major hospital site, just next to the railway station, the architect designed the L-shaped building around a garden. All the patient care rooms and spaces faced into the enclosed garden, which could be accessed by stepping out onto decking once you’d slid aside the French windows. Everybody commented on it. Patients and staff. We all felt the peace, the calm, the comfort, and the security which seemed to come from such closeness to green nature.

There’s pretty famous research into that phenomenon in the world of architecture. We know that patients recover more quickly, with less complications and less need for painkillers post-op if their hospital room has a view of green nature (as opposed to having no window, or a view of a wall).

We know, too that there are social as well as health benefits from the “greening” of cities.

But the other thing which occurred to me when I was remembering my trip to the tea room, was that those moments of peace which we all need, don’t have to involve learning any special techniques. There’s no doubt that various forms of meditation, and of cognitive behavioural exercises can be helpful, but there’s something powerful, even necessary, about just taking a pause.

Maybe not even just pausing by sitting and looking, which I’ve recommended before, but sitting with a cup of tea, or coffee, or some other favourite beverage, sipping, gazing, and contemplating freely.

I think it add to the quality of life. It’s a way of slowing down.

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A few years ago, during a visit to friends in South Africa I saw these nests hanging from this tree. They are weaver birds. The nests they build hang like balls from the branches, and the entrances are at the bottom. How strange is that? You’d think that even if they didn’t make open nests like most birds, that they’d have an entrance in one of the side walls, a bit like the nesting boxes you can buy and fix to a post or tree in your garden, but no, these birds build this unique design of a nest with the entrance at the bottom. How they don’t all fall out remains a bit of a mystery to me, but I’m sure some ornithologist could explain it to me.

However, it wasn’t just the unique design of the nest which struck me, it was how many there were all hanging together in the one tree. I’ve found several birds nests in the garden here over the years. The great vine which used to cover the high stone wall (which has since collapsed, taking the vine with it) used to be a bit of a community hub for nests. But the mulberry tree and the buddleia bushes have only ever had single nests in them. There is a noisy flock of sparrows living in a mass of wild creepers and ivy on the wall of an old barn just along the lane a bit, but I haven’t managed to actually see their nests. However, I bet they are in there.

So, I’ve seen different densities of communities of nests and that got me wondering about the whole concept of community.

What communities do we humans live in?

I live in a pretty small village in rural South West France. I used to live in a moderately sized town in Central Scotland, and before that I lived in the great city of Edinburgh. Each of those environments enabled both different lifestyles and the opportunities to belong to very different communities.

This pandemic with all the restrictions in movement, and the months of confinement to our own homes has highlighted a couple of important things about communities, and I was thinking about them when I looked at this photo this morning.

One is that we can think of communities as the active, live, web of relationships in our lives. Whether we’ve been connecting over zoom, messenger apps, email, telephone or by letter, we’ve been more connected recently to our communities of relationships than ever before.

When we live in one place and work in another, our time, attention and energies are divided between different communities by geography. My daily commute on the train between home and work used to take over an hour and I used that time as a sort of personal time between the home/family community and the work one. Maybe there was even a kind of commuter community on the train. Certainly over the years I became familiar with a particular number of fellow travellers, but I didn’t really interact with them, so I probably can’t call them a community.

But that leads me to the second insight which the pandemic has made clear. We all share this one small planet. The virus knows no boundaries, no borders. The decisions taken in one country affect millions of people living in other countries. Scientists around the world began to co-operate more intensely and more openly than perhaps ever before. The scientific community, you could say, helped the scientists to discover new ideas, to learn lessons from each other and to problem solve together at speeds never seen before.

The truth is, that just as the “self” is in fact multiple, so in the “community”. We exist within a multilayered hyper-connected web of communities….plural. Maybe that realisation is a reasonable source of hope for the future. Because if we all retreat into separate, closed communities, we humans, are going to fail. The pandemic could be the least of our problems. If we don’t work together to deal with diversity loss, climate change and pollution, then we aren’t going to survive as any kind of community at all.

Well, in fact, I’m hopeful. I’m hopeful because I’ve seen the distributed global communities of personal and professional relationships thrive during these lockdowns. We can learn from that. Yes, maybe even home-working has started to revive some local, physical communities too, and maybe it’s starting to change the nature of larger communities in cities too, but, in particular I’m hopeful because we’ve rediscovered, or re-valued the importance of our communities of relationships and we now have the tools to enable us to grow them.

Maybe we are on the cusp of major change here…..maybe we are about to learn, or re-learn, the importance of understanding that reality is about us living together….sharing one planet, sharing one planet with all forms of life, sharing one planet with one environment.

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I’ve seen goldfinches flying through the garden from time to time. They tend to appear in noisy, busy, small flocks, making a lot of noise, bringing a splash of bright colours, and after a few seconds, or maybe a minute, they are gone.

So, I was very surprised to look out the window the other day and notice this one sitting in one of the buddleia bushes. I was even more surprised when he stayed there for a long time – I mean, maybe half an hour or more – just looking around, all by himself.

He came again the following day, and sat in exactly the same place.

I haven’t seen him since.

Apparently, in some traditions, a goldfinch is a good omen, a sign of abundance and prosperity. It symbolises diversity, creativity, joy and simplicity.

Interesting, huh?

Whatever the symbolism (and we meaning-seeking, meaning-creating, humans can’t avoid seeing the symbolic values in everything we perceive), spotting this solitary goldfinch, at peace with the world, just taking his time to look around, was a powerful example of that value which I place so highly in my life – “l’émerveillement du quotidien” – the wonder/marvel/amazement of the every day.

What I find is that my life is enhanced by two things – awareness and curiosity. If I notice something, then give some time and attention to it, it often delights me. It also sparks my curiosity – what is that? what’s it doing there? – and sends me off to explore on the internet which deepens my experience and makes it even more meaningful.

I recommend it…….noticing and enquiring.

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Sometimes it’s easy to spot the uniqueness in whatever it is we are looking at. Like this flower here, it is SO unusual to me that I could hardly have missed it. I’ve never seen petals forming this towering, layered shape before. And, of course, the reflection, as always at least doubles the impact of the flower.

In all my years working as a doctor I found that every single patient was unique. Everyone had a singular, personal, different story to tell. No two people had shared the same life, had identical experiences, responded to whatever they’d encountered the same way. No two patients had the same memories, the same imaginings which formed their fears, anxieties, hopes and expectations. Nobody had exactly the same beliefs and values. Nothing was black and white.

Every life was nuanced, shaded differently, shaped uniquely.

But superficially, it wasn’t like that. Superficially, patients were classified and categorised according to their diagnosis. Too often their pathologies were the sole presentation.

I even found that despite having an open, questioning style, when I asked patients to tell me their story, many simply told me their diagnosis, perhaps what treatments they were receiving, perhaps what interventions they had undergone already, but then they stopped. In other words they told me about the shared, common features of the disease they’d been told they had.

It could take a little more prompting to get them to describe their symptoms and their suffering and it could take a little more to get them to tell me who they were, to share with me their life story, their beliefs, values, expectations, fears and memories.

But the more personal the story, the more obviously unique it would be.

Sometimes I have to remind myself of that. It’s easy to judge and dismiss people we don’t know – celebrities, politicians, strangers – to put labels on them and then to look no further. But the truth is, the more we get to know someone, the more unique we realise they are, and the more unique we realise someone is, the more we have the chance to understand them.

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I took this photo at a wine farm in South Africa several years ago. Isn’t this the most incredibly diverse collection of lemons? I bet you’ve never seen a display of lemons like this at the supermarket. I know I haven’t it.

Fortunately there’s been a bit of trend in recent years to offer us “ugly” fruit and veg – by which the marketers mean fruit and veg which isn’t all uniform in appearance and size. The thing is, some people like that, but others don’t. We’ve been trained by corporations and governments to not simply accept uniformity but to even seek it.

But it’s not natural.

Nature is not uniform.

In fact as biodiversity decreases, which is what is happening now in the world, thanks to climate change and our industrialised, money-focused societies, our collective, and personal, security is under ever greater threat. There’s good reason to think that loss of diversity, erosion of soils, destruction of rainforests, and urbanisation are contributing to the rise of new pathogens, of which COVID is our more spectacular example so far. How many more are on the way? There are already worrying reports about other “novel” coronaviruses and influenza viruses being detected in different parts of the world.

I know that for many people when traveling from place to place they find a reassurance in the presence of the same fast food outlets, the same hotel chains, the same shops, the same brands. But, seriously folks, I think we have to break free of that false security. Because that’s what it is. False.

To shift our values from standardisation to uniqueness might turn out to be one of the best things we can do….not just for ourselves, but for the planet.

The lockdowns forced a lot of people out of offices, commuting and city centres, into their homes, streets, neighbourhoods, and for many people it’s been a bit of an eye-opener. For many there is now a desire for more flexibility at work, a desire for more local shops and services, a desire to connect and build within local communities.

I hope that grows.

Because, hey, when life gives you diverse lemons, make unique lemonade!

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At one point in my life I was reflecting on what I was trying to achieve as a doctor. Maybe that seems an odd statement to you, but I think we fall very easily into routines and paths which we then “live” largely unconsciously. That’s what’s behind my “heroes not zombies” blog title. Whether it’s about saying “an unexamined life is not worth living”, or it’s simply about wanting freedom and autonomy, I’m wary of the automatic pilot approach to life. I want to be aware, to understand and to consciously choose, as much as I can. I want to move from being a zombie, controlled by hidden, and some not so hidden, forces, to being the hero of my own story – the main character, the subject, the one who is living this life.

I’m sure we all go through cycles and phases of self-reflection. For many people there is a peak of this around the age of 40, but, really it can happen any time and at any age. I believe it’s a good thing to pause and reflect from time to time. I think that’s essential to our personal growth.

So, as I reflected on that question which would appear to me from time to time – “what does a doctor do?” – I looked at a spider web like the one above, early one morning as the dew drops sparkled on it, making it all the more beautiful, and revealing both its presence and its structure. What struck me was that whilst there were many elements coming together to make this web appear as it was, that morning, one element, light, suddenly seemed the one I wanted to focus on.

As I played with the words we use which are based on light, I hit upon three which I thought captured some of the most important aspects of my job.

Lighten. In all cases, I saw my job as trying to lighten other’s load. Maybe this was the first, and most important, part of all that I did. My job was to alleviate suffering. When someone left my consulting room, their life should feel a little lighter than it was when they entered. Certainly, it shouldn’t feel darker, and it shouldn’t feel heavier. Even when I’d had to give news of a serious disease. Giving news wasn’t enough. I needed to lighten the burden of that news by increasing how much the person understood, helping them to make more sense of what was happening, and helping them to realise that they were cared for, that they weren’t alone with this.

In fact, “diagnosis” is a big part of that. To me, diagnosis is not simply an act of labelling and categorising. It’s an act of understanding. It’s taking the messy chaos of experience and saying “I recognise this pattern” “I know what’s going on here”. What I found, time and time again, was that the very act of diagnosis lightened the load. Almost universally people start to feel better once they have a sense that they know what they are dealing with. Understanding, in my experience, shines a light.

Brighten. But then I thought, that’s not enough. Well, maybe it’s enough for some people who will go off with their new understanding and deal with it in their own way, but for many patients, I could do more. I could start to relieve the suffering, but I could also begin to help them build the positives in their life. I could help to actually brighten their days, both by giving reasonable hope, and by establishing an ongoing relationship of care focused on identifying and supporting their inner strengths, and teaching, coaching and enabling them to begin to grow in the light of this illness. This was a kind of turning a negative into a potential positive, because I’d find that for many of us, an illness was telling us something. It was suggesting that we should change something. And that required a development of strengths and skills.

Enlighten. In some cases, that work went to a whole other level. Someone would get nothing short of a revelation. They would suddenly understand the origins of their suffering, and they would gradually become aware of their own thought patterns, their own behaviours, and of the conditions in which they were living which were impacting on them so adversely, and they would say “That’s it. I’m changing.” Not just they would change some habit or other, but they would change direction. Get out of a toxic relationship. Leave a soul crushing job. Enter into education or training, or take the leap to begin something their heart had longed for, for many years. It was like they had a sudden enlightenment and said “I’m not going to live my life this way any more. I’m going to choose this other path instead”.

So, there I had it. My three light-based verbs. Lighten, brighten and enlighten. And of course, what happened from there? I applied those same three verbs to myself. That’s how I made the biggest changes in my life…..seeking some understanding which would lighten my load, turning towards positives, strengths, and emotions like joy, awe and wonder to brighten my days, and thinking outside the box I’d built, to change direction in the bright light of enlightenment.

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This leaf is beautiful. When you look closely you see the incredible, fine web of thin fibres which make up its skeleton. With some leaves you can see this delicate, underlying structure when you hold it up to the sunlight, but with others the green of the leaf is too dense and you aren’t aware of this amazing support system which lies inside.

For me, the idea of a web, of a net, or of a network is fundamental to my understanding of reality. It’s a pretty simple concept at heart – it’s simply nodes and lines – connection points, and connectors.

Our bodies are like this. We are made up of trillions of cells which are all interconnected. Each cell a node, each relationship between one cell and another, a path, or bond, a connector. We function as whole beings emergent from this hidden structure of a network.

Our brains are like this. The specialised nerve cells we call neurones form intricate, flexible, ever changing patterns of connections, of nodes and connectors.

Our circulatory system is like this. Our lungs are like this. All our body systems are interconnected like this.

Our social networks are like this. Each of us is a node in a world-wide net spreading across continents, and back over generations of ancestors.

We might not see these nets very clearly on a day to day basis, but we can draw simplified maps of them – in fact, there is even a name applied to such maps now – “connectomes’ – diagrams of vast webs of connections.

I love all of this.

I love the beauty of the webs and nets. I love knowing that every one of us is connected through infinite interconnected webs like this.

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