Feeds:
Posts
Comments

Archive for the ‘from the reading room’ Category

The phrase “everything is connected” immediately appeals to me and strikes me as true.

The first thing I think of is the human being.

Although I was taught Medicine in parts, learning about cells, tissues, organs and even systems separately, it was an almost unspoken given that all the parts were connected. In Second Year of Medicine at the University of Edinburgh, one of the main subjects was Anatomy and we were put into groups of six to spend a year dissecting a human body. Our guide was a three volume textbook, “Cunnigham’s Manual of Practical Anatomy”, along with “Gray’s Anatomy” (probably the most beautiful textbook I ever possessed). I was a bit overwhelmed with the sheer number of pages in these texts and asked one of the tutors “Which bits of this book do we need to learn?” He replied, “Which bits of human beings do you think patients will ask you about once you’re qualified?” “Ah, you mean we have to learn it ALL?” He smiled and walked away.

It would be a full two years after that before I met an actual live patient, but, hey, they don’t teach Medicine that way any more do they?

I don’t remember a single lecture about holism, but somehow it was a core value for me right from the start. However it was over a decade after graduation before I came across “Psychoneuroimmunology” and “Psychoneuroendrocrinology” which were fields of study looking at the connections between the Mind, the Nervous System, the Endocrine System and the Immune System. I think that’s where I first encountered a more holistic science, one focused on “systems” not “parts”.

It was much, much later when I encountered “Complex Adaptive Systems” and both “Chaos Theory” and “Complexity Science”. Somehow I think we are still in pretty early days of developing the sciences of the connections. But it sure still excites me!

As a GP I also had to be aware of the individual patient’s connections between themselves and the rest of the world….their relationships, their work, their housing, their family and so on. Those are threads you never quite get to the end of. I think that makes us humble, that knowing that we will never know all there is to know.

Sometimes it seems to me that our minds are like fractals, vast webs of mirrors reflecting similar patterns of reality to each other. Actually, as I write this I remember “Indra’s Net” – where every drop reflects every other drop. I think we humans are great at spotting patterns, and regularities, and that, combined with our ability to use metaphors and symbols enables us to appreciate the incredibly rich, dense nature of reality.

When I saw this shape on the surface of the water I wondered if it had been caused by a boat, or was it something lying on the river bed? But look at the shape drawn by the farmer who has been working this field. What a gorgeous echo of the shape on the river. One of the things that happens when we appreciate these connections is an experience of beauty and wonder intimately entwined.

One time when flying over the English Channel, I looked down and saw the shadows of the clouds on the water’s surface just before the coast. Ooh, that still pleases me so much to contemplate this image! I love the fragility and impermanency of the little clouds. I love the even more ephemeral nature of their shadows on the Channel. And I love that transition of density of the clouds from the area above the water to the area above the land, how you can see in that the dynamic, ever moving dance of the land and the water and the air. Magic!

What connections have you spotted today?

 

 

Read Full Post »

Do you do that “word of the year” thing? Where you choose a word at the beginning of each year, a word which will be some kind of touchstone, theme or “north star” for you?

This year, I’ve decided to choose two…….because I received two books as presents for Christmas and it immediately struck me that between them they lay a foundation for a way of living I highly value.

These are French books, so here’s another innovation for me…..up until now my Word of the Year has been an English word, but, hey, I’ve been living in France for the last five years and I’ve read a LOT of French, so, I reckon it’s high time I choose a couple of French words.

Here’s where things start to get interesting, because I can’t find direct, single word translations of these two words into English. Perhaps, more accurately, I should say I can’t find any direct translations into English which I find satisfying. I think that’s a great example of how learning a second language can both widen and deepen your world.

If you’ve read other posts on my site here you’ll have come across my use of the term “émerveillement” already. The first time I read the phrase “l’émerveillement du quotidien” I was entranced by it. It sort of means “the wonder of the every day”. The word “émerveillement” captures my core value of curiosity, of amazement, of awe and of wonder. I adore those moments when you notice something and it stops you in your tracks, where you pause, savour, and reflect. The more that happens in my life, the better my life seems to me. To really experience “émerveillement” you have to be open minded. You have to be curious, aware and non-judgemental. So the pursuit of “émerveillement” every day brings along with it a whole set of other attitudes and behaviours which I value.

Here are a couple of pages from the book which give you a flavour of why it entrances me –

The second word is “bienveillance” which could be translated as “well-meaning” but again, that direct translation doesn’t quite cut it for me. It is used to cover well-meaning and well-wishing, but also kindness, gentleness and care. So, another set of values and behaviours I really rate and aspire to every day.

Here a couple of pages from that book which might stir the same feelings in you. If they do, then, yet again, a picture will have proven to be worth a thousand words.

That quote in the middle image is from the poet Felicia Herman and it translates as “Happiness doesn’t grow in the gardens of anger”, which is an interesting line to consider in these days of conflict and polarisation.

Read Full Post »

For the last five years I’ve lived just south of the town of Cognac (that’s Cognac in the distance in this photo).

I’m on the edge of a village surrounded by vineyards.

If you look closely at this photo you’ll see there are actually multiple vineyards covering the landscape. Here’s another view

Here you see at least three distinct vineyards in the foreground to the mid-ground, with several others stretching as far as the eye can see.

One of the things which struck me straight away when I went for my first stroll through the vineyards was that there are no fences, no walls, no hedges between them. Yet, from what I’ve learned, these different vineyards belong to different people. Another thing which struck me was that anyone can wander freely amongst them. There’s even a map of different trails posted up on a large panel outside the village church, and wayfarer wooden signposts with coloured markers to guide you along the different routes.

I’ve made a number of road trips to Spain and Italy since moving here, and every time I’m amazed how I can just drive over the border into, and back from, those countries without showing a single document, or even speaking to a border guard.

Last month I flew to Copenhagen, spent a few days there, then flew on to Edinburgh to visit family. Although I had my passport our of my bag and ready to join the queue for Passport Control when I got off the plane at Copenhagen airport from Bordeaux, I was struck by the fact there was no Passport Control. Instead I just picked up my bags from the conveyor belt and walked out of the airport to the taxi rank. Needless to say, it wasn’t the same flying to Scotland where I had to join a queue and use the automated passport check gate to be allowed in.

I am definitely no expert on the pros and cons of borders and border controls but these experiences get me wondering about both what such procedures and laws are supposed to do, and, whose life is made better and/or safer by imposing them?

Rutger Bregman, who wrote “Utopia for Realists” makes an argument for open borders throughout the world, but it’s hard to find much support for such an idea. Will Hutton’s broadly positive review of Bregman’s book writes –

I understand that open borders and being welcoming to strangers is a great statement of common humanity – and that immigration is an economic benefit. But no society on earth can welcome unlimited numbers of strangers, keen to enjoy the benefits of whatever civilisation, without having made a contribution to it. Human beings believe that dues should be paid. Far better to manage our borders and let in as many immigrants as we can rather than open them indiscriminately.

Caroline Lucas’s review in The Independent doesn’t even mention his promotion of the idea of open borders even though she seems to rate the book highly.

Britain is still in the midst of Brexit with a prevailing rhetoric of “control immigration”, “bringing back control of our borders”, and forcing EU citizens in the UK to apply for “settled status”, even if they’ve been “settled” in the UK for decades.

So, what do you think?

I’m not suggesting anything utopian or fantastical here, I’m just reflecting on what it feels like to move around a countryside without obstructions and boundaries, and to move back and forth between countries without border controls versus travel into and out of countries with strict controls. Is it better to have the queues and checks at the UK border for people arriving from Denmark, France or Spain? Or better to allow the free movement of people across each others borders as the 26 “Schengen” countries do?

What are the real life consequences of these policies and procedures?

As I travel around the “Schengen” countries without border controls I feel free, welcome and even that I belong in each of these different countries. It’s life enhancing!

Sadly, with the anti-immigration, pro-border control policies of the UK now a lot of EU citizens no longer feel welcome there and UK citizens are about lose the freedom to live, study and work in the other 26 countries. It’s not at all clear yet what bureaucracy will be introduced once the UK leaves the EU, but how will any extra application processes, fees and documents make life better for the British? Just asking……..

Read Full Post »

I don’t deny there is a beauty in fog.

But when I looked out the window this morning and saw that the vineyard covered hillside had disappeared, the word “obscured” popped into my head.

Fog “obscures”. It prevents us from seeing the world so clearly. It draws the horizon closer, sets a nearer limit to our perception.

Well, with that in mind, I spotted an article in Wired magazine……”To fight disinformation we need to weaponise the truth

Through social media, mainstream media and mass media, we are being manipulated on a daily basis. We are bombarded with propaganda and advertising, trying to get us to think what someone else wants us to think, to buy what someone else wants us to buy, to believe what someone else wants us to believe, to vote they way someone else wants us to vote.

When I started this blog over a decade ago I chose the title “Heroes not Zombies” because I had an idea that we tend to drift through life on autopilot, but that if we wake up, become aware, and claim the authorship of our own stories, then we become the heroes of our own stories. But, of course, it’s not just that we drift along on autopilot, it’s that we allow others to sit in the driving seat.

So, here, in that Wired article, is a wake up call, but also a kind of education. The author explains how we are being manipulated.

Cybersecurity researcher Ben Nimmo describes Russia’s approach in terms of the “4Ds”: dismiss critics, distort facts, distract from other issues, dismay the audiences. And indeed Russia has been leading the way in using disinformation-based warfare against other nations. But others are now joining them.

The article is worth reading but I thought I’d summarise the 4 “Ds” here. Just so they are nice and clear. Just so that I don’t forget them.

  • DISMISS critics
  • DISTORT facts
  • DISTRACT from other issues
  • DISMAY audiences

So, as you browse through your timelines on your social media accounts today, or read the headlines on the front pages of the newspapers, or watch the news on TV, why not write these four words down on a post-it and see what the messages you are reading look like in the light of the 4Ds?

Read Full Post »

I came across a Royal College of General Practitioners document recently – “Fit for the Future” – It is a vision of General Practice in the UK for 2030. There is a lot in it that I’d support but one of the statements is this –

An overhaul of the GP-patient record into a personalised ‘data dashboard’, accessible by healthcare professionals across the NHS, and that will draw on data from the patient’s genomic profile and wearable monitoring devices.
Now, maybe you read this and it excites you, but it made me stop and think “Hang on a minute! A ‘data dashboard’?”
I remember a line from the English philosopher, Mary Midgely, in her book, ‘Wisdom, Information and Wonder’.
One cannot claim to know somebody merely because one has collected a pile of printed information about them.
She wrote that back in 1989, and it’s clear that, since then, we have, to some extent, replaced the piles of printed information with hard drives full of data. But the point remains the same – you won’t know somebody just by looking at data.
One of my roles when I worked at the ‘NHS Centre for Integrative Care’ in Glasgow was to train young doctors in holistic practice. They’d be allowed to spend as long a consultation as they wanted with a patient then they would come to “present the case” to me. In other words, they’d consult their notes (often several A4 pages of notes) and tell me what they’d learned about the patient. At times what they actually communicated to me were detailed descriptions of the patient’s symptoms. Sometimes so many symptoms in such detail that the amount of information was quite overwhelming. By the time they’d finished I would find myself saying “Well, you’ve told me a lot but I don’t know who this person is'” I had no picture of the patient, their life, how illness came into it, how they’d coped, or the effects the illness had had on them, their family and their friends. A holistic case history is not a “pile of printed information”.
Data, or information, as Midgley pointed out, makes “much better sense when [it has] a context”. The context is revealed by the story. I don’t see how you fully understand a person without hearing their story.
Yet, one junior doctor told me she was being taught elsewhere “Never believe patients. They lie all the time. You can only believe the data” (meaning the results of investigations). That appalled me. What kind of Medicine can we practise if we think “patients lie all the time”? What kind of Medicine can we practise if we distrust their personal, unique stories, but trust only in “data”?
Now, I’m not saying that data isn’t useful. It can be. It would be daft to ignore that. But putting data up front and centre to the point where it replaces the relationship and the story? That’s my fear. That someone will think, “all we need is good algorithms and they will deliver all the right answers once we feed the data in.”
I’m sceptical. It doesn’t seem rational to me. It doesn’t seem realistic to me. And it risks shoving aside human values and the crucial importance of relationships.
Then, just yesterday the UK Health Secretary, Matt Hancock, put forward an aspiration for every newborn child in the UK to have their genome sequenced.  Interestingly, a poll of doctors revealed – “>2000 responses. Only around 10% of doctors would find genetic data more useful than postcode in planning the care for a newborn baby.”
I think we have to claim the ground for the importance of the unique human story. If, as doctors, we fail to consider the environments and circumstances of an individual life, we will fail our patients.
Data without contexts has some use, but it is not a full understanding of, or even a “knowledge of”, a patient.

Read Full Post »

See this large rock just above the harbour in Biarritz? How does the sea make it to the shore when this rock is in the way?

The most obvious way is to go around it.

And that’s what most of the water does. It makes it way towards the shore, and back out to sea again by breaking against the rock and flowing around each side of it.

That’s one way to deal with an obstacle, with something standing in your way…..find a way around it.

But, wait, look at this…..

…the water has found another way as well.

It goes THROUGH the rock!

I suspect this has taken a very, very long time for wave after wave to make its way through a small crack in the rock, widening the gap slightly every time it passes through. But look at it now. Sometimes when a more substantial wave hits the far side of the rock it flows directly through the gap. Doesn’t happen every time. Just when the waves are big enough.

So, there’s the other solution. Keep going. Keep pushing up against the obstacle, looking for a gap, an opportunity, a way through, and once you find it, come back again and again. Each time, it’ll get easier. Each time the gap will get wider, the way will become broader.

Something else…..this is just beautiful to watch. Mesmerising even. Over the course of a few minutes you can see how the rock and the sea sculpt each other. It’s a delightful relationship.

Oh, and something else……Michel Serres, a French philosopher who died recently, used to describe human beings as “anticipation creatures”. I recently listened to an episode of one of my favourite podcasts, Onbeing, where the science journalist, Erik Vance, talked about “the drugs inside our head”. He was discussing the poorly understood but fundamentally important phenomenon known as the “placebo effect”, and one thing he said was that our brains are “prediction machines” (well, I hate the metaphor of “machine” applied to living organisms, but you get the point…).

Both Serres and Vance are talking about our incredible ability to spot patterns, so that we can predict the future. OK, not too far into the future, and not with 100% accuracy, but we don’t just notice the world, we anticipate it.

As I stood watching this phenomenon of the white surf gushing out of the mouth in the rock, I was quickly captured by the experience of anticipation, watching the swells on the surface of sea further out, trying to predict which would turn into waves big enough to pour through the rock.

It was hard to stop.

It was delightful.

Read Full Post »

Do you get those experiences where something catches your eye, then when you stop to reflect on it, its significance gets deeper and deeper?

Last week I was in Paris, and on one of the rainy days was heading for a restaurant at lunch time but this scene caught my eye. Despite the fact it was raining, I stopped and took a photo. In fact, I took two….the first time my camera slipped as I pressed the shutter and I only caught the top of the scooter!

These electric scooters are everywhere in Paris just now. You can hire one using an app and drop it off anywhere you like. In fact, that’s become a bit of a problem. People are falling over them on the pavements and sustaining injuries, so the authorities are starting to consider new regulations to control them.

I took the photo because I thought it looked funny. To see this serious gentleman either looking down at the scooter somewhat disdainfully made me smile. Then I thought maybe he’s actually thinking about jumping down onto it!

When I got home, I decided to find out who this man is – turns out he is “The Marquis de Condorcet”, a leading Enlightenment thinker and writer, a mathematician and philosopher. One of his most deeply held beliefs was “progress”. He thought we humans, through learning and communicating with each other, would steadily increase our understanding of the natural, social and political worlds, continuously progressing and improving society. “However, Condorcet stressed that for this to be a possibility man must unify regardless of race, religion, culture or gender”

The wikipedia entry on him goes on to say this –

Condorcet was concerned with individual diversity; he was opposed to proto-utilitarian theories; he considered individual independence, which he described as the characteristic liberty of the moderns, to be of central political importance; and he opposed the imposition of universal and eternal principles.

He was a champion of diversity, equality and individual freedom. But he was also a champion of thinking – that progress required us to deepen our understanding of the world and of each other, comparing and reflecting on our individual experiences. He campaigned against slavery and for women’s civil rights.

So, it took an electric scooter to get my attention, but I’m glad I’ve discovered Condorcet. I think we could learn something from him about the importance of values, diversity and justice.

Read Full Post »

Older Posts »