Archive for the ‘from the consulting room’ Category


Peter Brabeck-Letmathe, the outgoing chairman of Nestlé’s intention is for Nestlé to develop food scientifically – synthetic food which will be better than “natural food”. He rejects the notion that food grown in the ground is best for us. He says

Nature is not good to human beings. Nature would kill human beings. The reason why homo sapiens have become what we are is because we learned to overcome nature.

What do you think when you read this?

Is “Nature not good to human beings”? Does Nature seek to “kill human beings”?

I was pretty astonished at this claim because I think human beings are part of Nature, not something outside of “it”. If we want to learn what’s good for us my own feeling is that we should look to the rest of Nature. As Idriss Aberkane says of “biomimicry”, Nature is a library, a source of knowledge, not a source of repository of fuel to burn.

So where does this idea that Nature is trying to kill us come from?

Well, as chance would have it I read an interview with the French philosopher, Michel Onfray, at the weekend, and he mentioned the definition of life given by Bichat, the physiologist

Life is the sum of the forces which resist death

That’s an interesting definition of life – life is resistance. Is death constantly attacking life? I think that’s a pretty miserable and negative understanding of life. But I think it might come from the notion of entropy. You know about entropy? Entropy is “the gradual decline into disorder”. The second law of thermodynamics states “entropy always increases over time”. You can probably see how this observation can lead you to think that we are only alive as long as we resist death, disorder, and decline. But is that enough to lead you to conclude that Nature is trying to kill us?

It seems to me that this entropic force in the universe is only one of the major forces at play. What Thomas Berry referred to as “wildness” is another way of thinking about this force. It’s the chaotic force. If this was all there was, or if this was the dominant force, what would the universe look like? Would there be stars? Would there be galaxies of stars moving together? Would stars have planets? Would there be any complex living organisms? How could there be? There is a second force. One Thomas Berry calls “discipline”. It’s the ordering principle, the structuring principle, which contains, limits and holds together. But what if that was the only force in the universe? What would the universe look like then? Would it be any more than a dense ball of energy? Would it be expanding? Would it show diversity? Or would whatever existed by “more of the same”?

I think there is a third force at work in this universe, because it seems to me, without it, there is a tendency for the first two forces to cancel each other out, or for there to be a significant tendency towards either chaos or uniformity.

That third force is creativity. The creative force is a force of integration – it integrates the two forces of wildness and discipline to produce astonishing levels of complexity. Look at the history of the universe. Is it a history of endless decline and degeneration, or one of stasis and constriction? Or is it a story of ever increasing complexity and diversity?

It’s this latter, isn’t it? The universe is on a course of increasing complexity. We humans, with our bodies, our brains and our consciousness, are the most complex phenomena the universe has produced so far. But we haven’t been about for very long.


(the cosmic calendar)

The universe is on a course of increasing diversity. Not just the rich diversity of species and life forms on planet Earth, but in the diversity of unique human beings. Not one of us ever repeated. No single experience of a whole life ever duplicated.

So is Nature a threat to us? Or is Nature a manifestation of the creative force of the universe?

I’m opting for the latter view. And I’m going to continue to enjoy the fruits of that rich creative diversity, just like you see in my photo at the start of this post. I won’t be swapping “real food” for synthesised, chemically “enhanced” stuff any time soon!

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In the Spring of 1784, Armand Marie Jacques de Chastenet, marquis of Puységur, discovered that Victor Race, one of the peasants who worked on the marquis’ land, had pneumonia. The marquis had become interested in the work of Mesmer and “animal magnetism” so decided to see if he could help Victor back to health using this new method.

Victor fell into a trance and began to speak. But to the astonishment of his master, he didn’t speak in his usual patois, but in perfect learned French instead. Not only that but he talked about subjects that an illiterate peasant couldn’t have known about.

What happened next is even more astonishing. The marquis and Victor became a therapeutic couple. The marquis would ask an ill person about their symptoms….he’d “take the history of the patient”, and, in trance, Victor would pronounce the diagnosis and prescribe treatments.

Neither of these men were able to carry out the acts of healing by themselves, but together, they could.

This was one of the first recorded episodes of “lay mediumship” in Western civilisation.

I think that’s a remarkable story and I know of other instances from within my own lifetime where such astonishing collaborations occurred.

But even setting aside the somewhat “supernatural” aspect of these tales, isn’t there something like this going on in every therapeutic act? Isn’t every therapeutic act a collaboration between the patient and the therapist. Without each other they can’t achieve healing, but together, they have the chance to become something unique and greater than either of them. Together they can gain a greater understanding, and together they can find answers they couldn’t find alone.

I think we forget that in modern medicine, thinking that the doctor can do it all by him, or her, self. Thinking that one person has all the answers, ready made, so to speak.

There can be some of the most astonishing examples of magic happening when two people form a bond and work together for a common purpose.

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When I worked at what’s now called the NHS Centre for Integrative Care in Glasgow, every patient attending for the first time had a sixty minute appointment. 60 minutes doesn’t seem a lot in the context of a life time but to receive a whole hour of undivided, focused, non-judgemental attention feels like a gift.

My colleagues and I would frequently have patients tell us “You’re the first doctor to have actually listened to me.” I don’t think that feedback ever lost its power to shock. How did so many people get so far into the health care service and not have the experience of being listened to?

We all need to be heard. We all have the right to be heard. All of us.

The recent EU Referendum in the UK, and its political fall-out has made it even clearer to me that, politically, we are not being heard. There is a disenchantment with politics and politicians across the so called democratic world. Maybe one of the reasons for that is that our democracies are not enabling people to be heard.

In the UK there is a whole chamber of government, the House of Lords, which is 100% unelected. There is nothing democratic about it. Nobody voted for them and they aren’t accountable to the electorate.

The electoral processes based on simple majorities lead to government after government which does not represent the majority of the electorate. In the recent referendum 52% of those who voted, voted Leave and 48% voted to Remain. About 30% of the electorate didn’t vote. The 52% of the 70% are heard (on this question). The rest of the population are ignored. Parliamentary elections are like that too.

Is handing power to the largest minority the way to ensure that most people in the country are heard?

How can it be?

Most people don’t have the experience of being heard and, in consequence, don’t feel the elected governments represent them.

There’s an additional problem and that is that politics, as currently practised, is about power, not consensus. Those minorities who are elected believe they have the power to act according to their own beliefs and values. They act to exert power over others. If politics was about creating consensus, rather than wielding power over others, it would be an entirely different kind of politics. It would be more democratic. More people would have the experience of being heard.

Being heard isn’t enough.

We need to be cared about too.

Whilst it’s a good thing to listen to someone, to give them the time and attention to enable them to tell their unique story, it’s not enough. The response to that story, the doctors’ responses, the politicians’ responses, need to show that they give a damn. They need to show that the individual human being matters.

If we don’t have a system based on the principle that every one of us is unique and valuable then we get what we’ve got – politics, economics, education, health care, as if people don’t matter.

Isn’t it within the capacity of we human beings to create something better? What would the world look like if we did?

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Karol Sikora, a well-known “cancer doctor”, just said this

It doesn’t make much difference whether you are one of the people who get cured or not

He was talking about cancer care in “the NHS” (as a Scot, it bugs me every time when people refer to “the NHS”, as if there only was one). I suspect he was saying things in a controversial way to promote his new book, but this particular sentence really caught my attention.

He’s referring to how organisations and systems can be managed to work “efficiently”, and I think this probably applies to most health care systems around the world. We’ve developed a way of delivering health care as if individual patients don’t matter. Protocols are created based on the statistics from research into the experiences of groups of patients. I’ve even heard a young doctor say they were told that if a patient takes an evidence based drug and it doesn’t work, then either they haven’t taken the drug or they are lying. These are the kinds of things which happen when doctors take their eye off the ball.

When we base health care on management systems designed for industries which produce physical objects to sell, then, it seems, statistics become king.

It doesn’t make much difference whether you are one of the people who get cured or not


In what way does it not make much difference? To the individual it makes all the difference in the world. To the doctor? Shouldn’t it matter if this individual gets cured or not? Isn’t that an irreducible fundamental of all medical codes of behaviour? It’s always this patient, this very patient I am dealing with right now who has the right to the best possible care I can provide.

I struggled a bit to find a photo to go with this post then stumbled across this one of a sculpture I saw recently in a garden. It seems to capture that sense of caring for the individual. And it seems the character’s hair is standing on end. Maybe the little bird just told him what Karol Sikora had said!

We can’t accept this way of delivering health care, can we?

This story also made me think of those pretty pointless statistics you can see every day on billboards at railway stations, telling you what percentage of trains arrived on time this week. Should we deliver health care by aiming at percentages of patients properly cared for? Or should we deliver health care by always, I mean always, giving the very best care and attention to every single patient in every single interaction?

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I happened across this little snail in a tree the other day. It immediately caught my attention and got me thinking.

Look at it…..

Doesn’t it look a perfect fit for that space? Doesn’t it look like it fills the space it’s living in quite completely? Doesn’t it look like it’s adapted well to where it’s found to live?

So what about you?

Hans Georg Gadamer, in his “Enigma of Health”, discusses ideas of health and refers to the concept of “fitness” – but not just the fitness of an athlete – the overall concept of “fitness” – when something is just right, when it just fits well. There is something in that idea which speaks to us of health. When we are in the groove, in the flow, in harmony….when everything falls into place……

What would you say about the fitness of your life? How well do you fit your life? How well does your life fit you?

Then I thought about how this snail seems somehow to be living fully or completely within its niche. And I wonder what you’d say about that?

We all live with certain boundaries, limits, “the hand we have been dealt”, influences from Nature and nurture, from the past and from the future, which set the parameters of our potential lives. Aren’t those parameters immense? Aren’t they almost infinite? But do we stretch ourselves out to fill our available life-space as well as we can? There’s something there about flourishing I think. Not just growing and developing, or being “the best you can be”, but of constantly expanding, flexibly adapting, to manifest ourselves, to express our uniqueness in our own vast life-space.

Adaptation. That’s such a good word. I find some people use it in a negative way as if adapting is about compromise and being less than you could be, but I don’t see it that way. Adaptation is how we grow, how we develop, how we live. Adaptation is how all of Life emerges and flourishes. I think we can get caught up in military and/or capitalist metaphors too much, thinking about the world in terms of competition, territory, power, and aggression. But actually, although all those things do exist, seeing the world that way often goes hand in hand with ignoring the co-operation, collaboration, compassion and kindness which also exists.

And when it comes to adaptation, there’s a lot to be said for negotiating your life-space, rather than killing for it!

If integration can be defined as the creation of mutually beneficial bonds between well differentiated parts, then adaptation becomes a process of a living in a way which maximises the abilities of you and I to explore and inhabit our personal, unique, life-spaces.


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last leaf

There’s a growing body of evidence that using your brain is good for your brain. Who’d have thought it?!

There’s also a growing body of evidence that what is good for your brain is good for you. The old mind-body duality is breaking down in the light of neuroscientific findings about the connections between the brain, the rest of the nervous system, and the rest of the body.

Using your brain is one of the key themes of this blog. I believe it’s just too easy to drift through life in zombie mode, influenced by others, manipulated by others, controlled by others. And yet, I also believe it very, very possible to make our own choices, to become “self-directed”, conscious creators of our own, unique stories and, hence, lives.

One of the most commonly promoted ways to use our brains is “mindfulness“. A sort of clumsy word which describes a certain state of awareness.

You can practice “mindfulness” by learning certain meditation techniques, and/or, you can do what Ellen Langer says, and “seek novelty”. 

I find that choosing to be aware, stoking the natural curiosity for the day, seeking “l’émerveillement du quotidien” is one of the easiest, and most delightful ways, to achieve this – this is the main way I try to be “mindful”.

There are two related techniques which help me to live this way. They both date way back thousands of years but both work just as well here and now.

Here are two photos to illustrate the techniques.

The first one is the one at the start of this post. It’s “the last leaf”. There’s a mulberry tree in my garden here in France and this is my second season of raking up and gathering the leaves as they fall. The first year I arrived here I wasn’t prepared for this phenomenon. This tree really sheds a LOT of leaves. I confess, I found that clearing up the leaves was a bit of a burden. But this year? This second season for me? I’ve loved it. Pretty much every other day I’d take the rake and gather up the leaves into huge canvas bags and every other week I’d make a trip to the “déchetterie” (“the tip”, we’d say in English). I enjoyed taking my time, rummaging through the different shapes, sizes and colours of the leaves. I enjoyed seeing the green grass again once the leaves were gathered, but quickly, of course, the grass would recreate a “wabi sabi” appearance with just two or three newly fallen leaves adding interest and attracting attention.

As more and more of the tree shed its leaves I decided I’d like to photograph the “last leaf”. That’s my first image in this post. And that’s the first technique – “live today as if this is the last” – that’s not as morbid as it first sounds…..due to the constancy of change, every day is unique, and the truth is, you will never have a chance to live this day, exactly like this, ever again. So it might be a good idea to savour it. To notice what you can, to hear what you can hear, touch what you can touch, smell what you can smell, take your time to taste and savour the food you are eating.

Because this will be your last opportunity to do so.

Here’s the next image –

first leaf

We have twin birch trees in this garden, and when the wind blows in the autumn, they shed, not only leaves, but lots of small twigs and branches. Yep, most of these head to the “déchetterie” too, but Hilary picked some up, finding their shapes pleasing and used a couple as a table decoration. There was a little water in the bottom of one of the vases she used, and look what happened! A few days later, there was a new leaf!

So, here’s the second image, “the first leaf”, and the second technique, “live today as if it’s the first”.

That’s true too. Due to the uniqueness of every day, of every experience, of every moment, whatever you encounter today, you encounter for the first time. Sometimes that’s not so obvious. Our habits and our routines deaden our awareness and we become oblivious to the small changes which can make a big difference.

You have never lived this very day before. So why not approach it with the sense of wonder, curiosity and amazement which you did so naturally as a child? (This is “l’émerveillement du quotidien” – the wonder of the every day)

I mean look at that little twig! It’s grown a leaf! A perfect, bright green, little leaf! Isn’t that amazing? I wondered a wee while ago about how difficult it was to know whether a seed was dead or alive, but I didn’t wonder about these (apparently discarded) twigs. They were dead as far as I knew. But add a little water, and, hey presto! Life magically emerges!

If you don’t stumble across something new, something for the first time, today, you’re just not looking.

So, there you go, two photos, two ancient techniques, “last and first”, and a step in the right direction from “zombie to hero“!

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lunch in paris

I wonder how many people are thinking about food at this time of year? Lots, I expect!

As a doctor, I was often asked for a “diet sheet” but I never had such a thing. I thought that just as every patient was a unique individual so there was no standard diet which everyone should follow. We’d have a chat about food and I’d suggest a good start would be to become aware of what the person was eating and noting any specific effects they experienced. For example, I found that if I ate a sandwich at lunch time, my energy would drop within the next hour or so. It was better to have soup, or salad, or sushi. In fact, I found that after sushi I’d experience a rapid boost in energy and alertness. I don’t expect everyone would have the same experience.

So the first part of my advice about food would be to keep an eating journal for a couple of weeks, noting what you eat and drink, and also noting anything you experience in terms of energy, mood, alertness, any physical symptoms etc. In other words see if you can learn for yourself what the effects are of different food and drink.

The second part, though, was something I read about a number of years ago in a French magazine. It was that food has a place in our lives which is far greater than nutrients or food groups. It’s not all about carbohydrates, omega 3, or dairy products, for example. What’s also important is where we eat, and who we eat with. In other words, the contexts (physical and social) of eating are important. It’s really quite a different experience to eat a sandwich at your desk, than to enjoy a “croque monsieur” on a Parisian street corner! (see the photo above).

Seriously, give some thought not only to the foods you are eating, but to how eating fits into your life. I have a hunch that the more you enjoy the experience of your meal, the more you’ll find what you’ve eaten is good for you!

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