Feeds:
Posts
Comments

Archive for the ‘from the reading room’ Category

“Words were originally magic”

Have you ever read that sentence before? It was coined by Freud in 1915, and used by Steve de Shazer as the title of his book about his “solution focussed approach” to brief psychotherapy.

Do you think writing “freedom” repeatedly over the front of this office block works some magic? Who decided to write this in this particular place? Were they being ironic? Pointing to the fact that offices are actually soul-less, regimented places of control….the antithesis of freedom? Or were they trying to cast a spell….to make people feel more free by presenting the word to them?

I don’t know. I don’t know the history of this office block in Malmo.

We are told we now live in a world of “post truth” where words are used to confuse, misdirect, obscure, lie and evade…..where words are used to persuade and manipulate……where words are propaganda….ways to influence and control whole populations one three word slogan at a time. “Take back control”, “Get Brexit done”, “Build, build, build”………

Well it seems that words are losing their magical power when they are used so cynically and when they aren’t backed up with actions. But still, they work a magic over millions of people who voluntarily give up their freedoms and quality of life for the sake of a privileged few (just as Montaigne’s friend, Étienne de La Boétie, described in “Discourse on Voluntary Servitude” back in 1577)….inequalities are increasing massively, wealth and power is becoming ever more concentrated while “strong men” narcissists bewitch large numbers of people into supporting them.

Ok, political rant over! Back to health care….my specialist subject! As a doctor you have to be really careful about the words you use. Telling someone they have X months to live can become a self-fulfilling spell. People give up, or gain hope, depending on the words the doctor uses….and how they use them (by which I mean the contexts in which they use them, and whether or not they are used within already established relationships of trust). In a good consultation the doctor is on the alert for specific words which the patients might use, words which might hold the key to both diagnosis and prognosis. Which words does the doctor pick up on, and ask you to say more about?

We have to be especially careful of using words as labels…..such labels can put people into boxes. It’s a danger in health care, but also in wider society….the fast track path to prejudice and injustice.

Words are still magic. They still have enormous power. It’s worthwhile staying aware of that……

Be a hero, not a zombie!

Read Full Post »

I’ve had a couple of days thinking about beginnings, so it seemed kind of obvious to have one about endings!

This photo shows a number of berries, all part of the same plant, even the same part of the same plant, but each in a different stage of maturation. Some are still green, some have turned yellow, some red, and some are even beginning to get wrinkled (like me, ha! ha!) and so appear the most mature.

When I think about beginnings, I realise that they are all pretty arbitrary – a beginning is where we begin – if you pick a thread or two you’ll always find your way back to an earlier beginning.

I don’t think that means there are no beginnings. I think there are. All the time. Every day. Every moment of every day. There are beginnings. There are phenomena and experiences which have only this moment come into being for the first time ever. It’s pretty great to notice that.

Endings have exactly the same quality. It’s not that there aren’t any. There are endings all the time. Every day. Every moment of every day. There are endings. There are phenomena and experiences which have only this moment slipped into the past. You’ll never have them again. It’s pretty great to notice that.

Outcomes, targets and goals

In Medicine, there is a lot of focus on “outcomes”, sometimes called “clinical outcomes”, which, somehow are a bit different from “patient reported outcomes” (“PROMS”). These are all endings. They are points to be reached. Measurements to be attained, or ratings to be completed. But when your working life is that of a family doctor, (a “GP”), then you’re never done with outcomes. The patients don’t reach the intended outcomes then go away. Life, it turns out, goes on. What was an ending today, turns out to be just another chapter in an ongoing story, just another time and place sensitive reading in the midst of a flow of a whole life.

Oh, yes, you’ll say, but there is one outcome which isn’t like that isn’t there? Death. The final outcome. The ultimate ending. Except it’s not really, is it? Well, it is for the physical body of the person who has died, but we are more than physical bodies aren’t we? We are experiences, stories, events and memories, aren’t we? And those continue long after the physical body has gone. Are the people you loved who are no longer alive completely gone from your life? I don’t think so. Their life continues to influence our lives. The experiences we shared, the memories we made, whatever we created together, the stories told, the photographs taken, the objects held…….

Have you ever seen a BBC TV programme called “The Repair Shop”? I love it. People bring old objects to a workshop of artisans. The old objects are usually in a poor state of repair, but they mean something to the person who has them. Once restored by the craftsmen and women, the person comes back to reclaim the object, and time and time again, it is an immensely emotional experience. They are put in touch, deeply, and significantly with a loved one, long gone. It’s lovely to watch and it shows how a person, an individual, continues to influence others long after they’ve gone. How their “presence” I suppose you could say, is made more real through what they’ve touched, what they’ve handled, what they played with, or made.

Targets are a kind of outcome. They are useful as ways of getting you to somewhere you want to get. For example if you want to save up a certain amount of money then setting a target of that amount is a good aid to getting there. The trouble is that targets are used inappropriately. Whose targets are they? And are they the same, most important targets, which others want to achieve? Because the selection of targets is an individual, value-based, subjective, exercise of choice. But if they are set for others then they direct the efforts and lives of others towards those targets instead of others. I’m not a fan of targets. At least, not ones I don’t have a say in the creation of!

Goals are a bit like targets. I’d say the same about them. They can be helpful to get us to places we want to get to. But they are aspirations, not predictions. And they are not endings. Or at least, they are not final endings. Are they?

I think this unique and unpredicted pandemic is forcing us to face up to the reality of beginnings and endings. It’s making us more aware of connections, of webs of influence, of the non-linear, multifactorial, dynamic, ever flowing, ever changing nature of reality.

This morning I read an article in Le Monde about how management methods are already starting to change in the light of this experience. Here’s the main point I got in that article – management is having to move away from “control” to “coaching”. Three things have come to the fore – the need for individual autonomy, the need for good team working and relationships between workers, and the need for transparency.

Well that all seems pretty good to me! I look forward to seeing the end of de-humanising “Taylorism” and “command and control”, and the beginning of an emphasis of autonomy, relationships and transparency. Imagine if we governed countries according to those principles?!

Read Full Post »

Here in Europe the school year is starting and for most children they haven’t been to school since about March or April because of this pandemic. Although we know now that children under the age of 14 seem to be almost unaffected by COVID-19 there is a lot of anxiety about children spreading the virus through the community, and, perhaps more specifically, to the adults who work in the schools. So each country has been making cautious preparations for the re-opening of its schools, looking at everything from cleaning regimes, the use of hand gels and masks, and the way children spend their time in the school buildings.

Out of all this, at least in the UK, has emerged a concept of “bubbles”. The idea is to have children spend most of their school day with a small group of other children and teachers…..often much smaller than a regular class size. The same concept of “bubbles” has also been used for the wider community in the UK, with lockdown rules easing gradually to allow slightly more people to interact on a daily basis – two households meeting up, then three perhaps; limitations to the number of people who can gather in any one place but allowing particular groups or families to meet up and spend regular time together.

I think it’s an interesting idea. And, as this photo shows, a potentially beautiful one. This photo is of breaking waves on a beach in Western France where the land meets the Atlantic. The bubbles forming in the surf are just gorgeous, aren’t they?

It strikes me that this bubbles idea highlights a major issue for our societies and the way we organise our daily lives. It’s the issue of size. Mass gatherings, mass transport, mass tourism, have been shown to be amongst the most vulnerable points for us…..the circumstances which lead to most infections. The social distancing measures that each country has brought in have been based on the understanding that the more you keep people together in closed spaces the more the disease spreads.

So now we are seeing a huge increase in “home working”, and, it would seem, a large number of people find they actually prefer that to spending time every day packed onto buses or trains with hundreds of strangers, then working all day in the shared spaces of offices. People are learning to live locally, enjoying their local parks, shops, cafes etc now, instead of traveling long distances to share time with masses of strangers in huge workplaces, shopping centres and so on.

I’ve decided to re-read a book which made a huge impact on me when I young – “Small is Beautiful” by E F Schumacher. It’ll be interesting to revisit it in the light of what we’ve learned since it was written in 1974, and in the light of our experience of this pandemic. What I remember of the book is the key point that big is not best…..that we should try to create societies at human scales instead of around mass production and mass consumption.

Maybe the “new normal” will involve a lot less “mass” anything – maybe we will move towards a more human scale everywhere, overturning the industrialised principles of the last century to abandon so called “efficiencies of scale” (which have probably only ever been useful in the manufacture and delivery of products). Maybe we will start to create smaller schools, smaller classes, smaller hospitals, smaller communities. Maybe we will move towards more diversity and less uniformity.

We are more able to do that now. We now understand that complex systems are like vast interconnected networks of nodes and links. We know that the most robust and most resilient systems are diverse and adaptable. We know that distributed power and responsibility produces more sustainable systems and organisations than hierarchical, command and control, massively scaled ones.

Integration is the creation of mutually beneficial bonds between well differentiated parts. It’s how the body works. Not with a command centre, but with interconnected, responsive, open networks. It’s how Nature works, through inter-dependent, diverse elements within ecosystems.

Is this our model for a “new normal”?

Human scale. Small. Diverse, open and healthily inter-connected? Can we see a future way to live in this beautiful image of bubbles?

Read Full Post »

Yesterday I wrote about new beginnings, about choosing what and when to start, but I’ve been thinking about it since then and I realise beginnings are paradoxical. They are both easy to find and impossible to find. Why do I say that?

Well they are easy to find because every action, every thought, every experience is, in fact, brand new. Life moves and flows continuously. This present moment has never existed before, not for you, not for anyone you know, not for the planet, not for the universe. So every present moment is a beginning (and, yes, it’s an ending too, because no experiences are exactly repeatable)

They are also impossible to find because everything is connected. We human beings are “complex adaptive systems”. That is we are massively interconnected, both in our own being, and in our contexts, relationships and environments. We are “open systems”. That is there are no impermeable barriers between an individual and the rest of the universe. The atoms, molecules and cells which make up our bodies are changing all the time, as we breathe in, ingest and absorb new materials, and breathe out, expel and excrete other ones. Energy and information flow into and through us continuously.

So what? Well, all this means it can be very hard to trace back from now to a “start point”, or a “beginning”. For example, when a patient would come to see me and complain about a particular problem, and I diagnosed a certain disease, where did that disease start? With the first symptom? With the first symptom which was troublesome? With the pre-conditions before the first symptom began? I was taught to explore a patient’s “past history” to see how this illness might fit in the trajectory of their life. I was taught to explore their “family history” to see if there were family patterns or dispositions. I was taught to explore their “social history” to find out what was happening in their work and social life. I could go on……

A beginning is pretty much arbitrary. It’s where we choose to begin. Think how you would tell your life story to another person. What would you say first?

As I progressed in my work experience I changed my introductory question to each patient, from something like “What’s the problem?”, or “How can I help you?” to “Tell me your story”.

Yep, “tell me your story”. Sometimes a patient would be a bit taken aback with that beginning, but I’d just maintain eye contact, show I was listening and wait. Sometimes I’d have to say a little more to get things going, for example to explain that I wanted to understand what they were experiencing and how it might have come about so I’d like them to just tell me about it in their own way, but usually, people would just start to speak.

Where a person chose to start, and how they told their unique story, was always interesting and relevant. As the consultation progressed I’d often ask another question “When did you last feel completely well?” This was a particularly useful question to be followed up with “Tell me about the weeks and months leading up to that time”.

Those were beginnings. Different beginnings. All useful and all relevant.

I came across this photo of the seed head of a poppy the other day and it’s so beautiful that I just decided I’d like to share it with you. How does it fit with today’s thoughts about beginnings? Well, all plants live cyclical lives, with phases passing through seed, germination, growth, perhaps blossoming or fruiting, and scattering the new seed before dying back for the next cycle. Does the beginning of that cycle start with the seed in the ground, or the seed in the seed head waiting to be dispersed? Or somewhere else?

So, back to beginnings. Whatever you want to begin, begin today. Even if its a habit, a routine, a task you’ve experienced before and stopped, because even when you stop, you can start again. You can start today. After all, you’ve never lived this day before.

Read Full Post »

Yesterday I shared a post about two forms of growth….unfurling (unfolding, opening, flourishing or blossoming) and connecting (reaching out to make bonds, relationships and links).

Today I came across a couple of photos from my garden which show both of these processes occurring at the same time. In this first photo you can see how the tendril or creeper which is reaching out is doing so in a kind of spiralling or un-spiralling way. It doesn’t consider that a straight line is the shortest distance between any two points! Perhaps there is something to learn from this – a sort of melange of meandering and spiralling around.

But what really struck me was this photo because I took a close up of these beautiful spirals and because I was focussing on the near distance the background has gone nicely blurred (something photographers call Bokeh I believe!) – but, wait! Look more closely! Look at the centre of the spiral which is in the bottom left corner of this image!

Through that spiral the distance suddenly becomes clear as crystal.

I don’t know what you think, but that reminded me of my favourite “And not or” theme – when you take BOTH of these processes of growth together suddenly you can see the world more clearly!

If you’re interested to read more about “And not or” check out my book.

Read Full Post »

I’m pretty keen on creativity. I have an eye for what’s new. In fact, I’ve been pretty impressed with the old philosophy which says to treat every day as if it’s the first time you’ll have experienced it. Because it is. Each patient who came into my consulting room was coming in to tell me a new experience, a new story. Even if I already knew them quite well they’ll still come and tell me something I hadn’t heard them say before. Everyone had the capacity to surprise me.

I love the Spring time of the year because I love to see the new seeds pushing up the first green shoots, love to see the buds beginning to form and unfurl, love to see the first sight of the migratory birds returning from their winter travels.

But Autumn is sort of opposite to that. It’s a time of a certain paradox – a time of fruition and therefore harvest, but also a time when the world begins to wind down, go to sleep, or even die off. It’s a time you might call the “down cycle”. I love that too. I love to see the leaves turn yellow, red, brown, golden. I enjoy sweeping up the leaves that fall from the mulberry tree.

This photo reminds me of the down cycle. Here’s a piece of iron. Some large, once strong panel or plate which someone created. But it’s been cast aside for a long time, and Nature has begun to break it down. The once smooth and shiny surface is breaking up into these little chips and flakes. The chips and flakes will, finally, turn to dust.

Does that seem like a loss?

I suppose viewed from one perspective it is. But Nature has down phases as well as resting phases, waking, growing phases, and maturing phases too. Could anything exist if any of these phases didn’t exist?

I think we need to remember that sometimes, and not get too upset and anxious about change. Nothing stays the same. And because nothing stays the same we are able to start each day as if we had never lived it before….because we haven’t. Imagine! How much there will be to discover today. How many new experiences and sensations you will have. How many new thoughts and feelings you will experience.

Life is dynamic. As Carlo Rovelli, the physicist says

A stone is a prototypical “thing”: we can ask ourselves where it will be tomorrow. Conversely, a kiss is an “event.” It makes no sense to ask where the kiss will be tomorrow. The world is made up of networks of kisses, not of stones.

I think an awareness of the phases and cycles of life reminds us of that. There’s beauty in every phase.

Read Full Post »

Sheer beauty.

What is it that I love so much about this world?

The wonders of the everyday. Or “L’émerveillement du quotidien”. It’s normal for me to find myself wondering about something I’ve just seen or heard.

I suppose for most of my working life my days were filled with patients. I never tired of that. I never got bored of that. Every day each patient would present to me a unique a story, a new, and singular problem, puzzle or conundrum to unravel. Each patient would be asking me to help them make sense of what they were experiencing and to support their abilities to heal, to cope, to adapt. Maybe they didn’t quite use that language but that’s always what I heard.

Before I became a doctor, way before, right back as early as I can remember I was driven by curiosity. I wanted to learn, discover and explore. It strikes me now that it isn’t a long way from curiosity to wonder.

People have always amazed me. They still do. Life has always amazed me. This Earth, this planet, the solar system, this universe which we all live in have always amazed me, filling me with an infinite supply of curiosity.

But there’s something else.

Beauty.

Look at this photo of a glorious, immersive sunset, where every single element of the sky and the Earth changes colour. Look at the palette! It is just breathtakingly gorgeous.

I see beauty everywhere. Which isn’t to say I find everything I see beautiful, I don’t. But there is “so much beauty in this world” (do you know what movie that comes from? Here’s the answer).

I am a very visual person. I think visually. I sketch and diagram as I think. I love photography and I think I “have an eye for it”. I see what I find amazing, curious or beautiful and I try to take a photo or two. Then I return to those images again and again, year after year, and I find that, like with this one, the delight, the pleasure, the amazement in beauty like this never fades.

Of course there are other senses and I don’t just experience beauty visually. I love music. I collected “records” long before people starting calling them “vinyl”. I still have them. I still play them. I spent hours and hours ripping CDs onto iTunes and I don’t even know where those libraries are any more! But I stream music now. Every day. Several times a day. I used to discover new music on the radio. I took the back off an old radio when I was a teenager, attached two wires to the speaker using clips, and fed the audio directly into a cassette recorder. I still have some of those recordings…..studio sessions on John Peel’s programme on Radio 1.

I’ve long had a love for movies. I love them for their stories and for their beauty, oh, and I often love them for their music. I compiled short clips of about a hundred movies to teach doctors and other health care workers about our unique human strategies for coping and adapting. I could have taught those strategies without movies but the beauty, wonder and emotional engagement which came with the movies made them much easier to learn and to remember. I probably have a whole vocabulary of coping and adapting based on movie characters, scenes and plots.

There is beauty all around us. I delight in images. I delight in music. I delight in movies.

Where do you find beauty? Where did you find beauty today?

Read Full Post »

Emanuele Coccia, the Italian philosopher who brings a new and refreshing perspective to the life by considering plant life says that what plants do so well is capture “extraterrestrial light” and turn it into energy and forms.

Two things struck me when I first heard him say that – “extraterrestrial light”? What’s that? Well it’s the light which comes from outside of the Earth isn’t it? Natural light. The light of the Sun, and the light of stars. The light of the moon is reflected light, so is just another dimension of the light of the Sun.

Without this “extraterrestrial light” from the Sun there would be no Life on Earth. Plants are THE way of transforming light into energy. We get all the energy we need by consuming other life forms at different stages on the food chain, but all of what we eat has plant life at its core. We fundamentally consume the light of the Sun through plants. Maybe through some animals we eat, but they do didn’t capture the energy directly from the Sun. All animals get all the energy they need AFTER the plants have captured it from the Sun.

The second thing which came to mind was Richard Feynman’s observation that trees make themselves “out of thin air“. That startling observation was based on the fact that trees capture carbon dioxide from the air, turn it into carbon based structures and emit oxygen as a “by product”. They also capture all the energy they need directly from the Sun using photosynthesis (a trick no animal ever managed to acquire!)

Then a third thing came to mind….the fact that we are all made from the atoms created in the stars. All the natural elements we find on Earth didn’t originate here. They originated in the great furnaces and explosions of distant stars millennia ago.

All of Life pursues this “extraterrestrial light” – all the plants, all the animals, all living creatures get the energy they need either directly from the Sun or indirectly through the consumption of other creatures which have already captured the sunlight.

Isn’t that a startling thought? That we are ALL light-seekers! All of us surviving and growing by finding and consuming the “extraterrestrial light”.

Read Full Post »

“Now, Life is living you”

This sign is on the wall of a buddhist temple smack in the middle of Kyoto city.

Just take a moment and contemplate it.

Ever since the moment I saw this phrase and it stopped me on the pavement outside this temple, I often think of it, and the more we learn about Life on Earth, the more true this statement seems to me.

As best we know, planet Earth was formed from atoms which were created in the great furnaces and explosions of distant stars. Every single one of us has been created from those atoms. Nature doesn’t create new atoms, it recycles and rearranges the existing ones. So the atoms which can be found in your body were once found in other bodies, other species, other members of other kingdoms on this Earth.

Our bodies are Star Bodies. We are the children of the Stars.

Emanuele Coccia, the Italian philosopher challenges us to think about the Plant Kingdom differently. He has a new book out, “Métamorphoses” (I’ve got it in French…..you’ll need to wait for an English translation if you don’t speak Italian or French). One of the central themes of this book is that we are One….that there is only One Life which never ceases to change forms whilst never changing its substance. In other words, there are only the atoms which made up the substance of the Earth at its creation, but Life turns these atoms, continuously into new forms – new species, new individuals within each species. The process of evolution is a kind of sculpting, produced by the vast complex web of all that exists, to create ever more adapted forms of Life.

We are each like the individual waves on one great ocean of water, every one of us unique and transitory, emerging for brief periods of time before dissolving back into the vast sea.

It’s Life which fashions each of us, and each of us, in turn, interacts with, metabolises and changes the other forms of Life. So, as Emanuele Coccia says, once we understand the one-ness of everything, all ownership and frontiers lose their significance.

Life is living you.

Read Full Post »

The other day the bees were going crazy for the pumpkin flowers. Each flower had two or three bees tumbling around in its depths, covering themselves with yellow pollen, and staggering as if they were drunk.

It was an amazing sight. Every single flower was filled with powdered bees. It was hard to photograph, but, I think you’ll agree, persistence paid off.

Strangely, (well, I never really understand how the universe does this), I had just read an interview in “Le Monde” with the Italian philosopher, Emanuele Coccia. He has a new book out, “Métamorphoses”, where he lays out his insights about the unity of Life, and the prime importance of plants. I read his earlier work, “La vie des plantes” some time ago and was hugely inspired by it – he gave me a whole new perspective on the world, teaching me to consider life from the perspective of the plant kingdom. In his interview he said a few things which came flooding back into my mind as I photographed these bees.

I’ll paraphrase what he said because the original is in French…..

Flowers contain the sexual organs of the plants but in order to reproduce they need the intervention of third parties – primarily insects or the atmosphere. So, what we learn from this observation is that flowers involve agents from other kingdoms in their individual sexual acts. This means that plants place their genetic and biological destiny into the hands of other species.

That’s quite a thought by itself, but he then goes on to ask “How do the insects choose which flower to pollinate?” The answer is, not by rational thought and logic, but by TASTE and AESTHETICS. So the evolution of plants is based on the tastes of other species.

Isn’t that a stunning idea? Or, rather, observation?

He has much more to say, but this is the part which I thought was most relevant to my experience of witnessing the crazy desire of the bees and the massive spread of pollen which was the result.

Life based on desire and taste……well, what do you know?

Read Full Post »

Older Posts »