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Archive for the ‘from the reading room’ Category

The Angel’s Game

Posted in books, from the reading room on December 14, 2009| Leave a Comment »

Just read Carlos Luis Zafon’s “The Angel’s Game” [ISBN 978-0753826447]. I quite enjoyed “The Shadow of the Wind” but I actually enjoyed this more. Maybe I’ll go back and re-read “The Shadow of the Wind” now. Both books are set in Barcelona (which I’ve never visited but is definitely on my wish list….) and both have a strong flavour of mystery about them.

At times I found “The Angel’s Game” a bit confusing, but it’s that slipping into magical realism, and interweaving of imaginary and “real” even within the context of fiction that brings both the confusion and the dream-like quality. There’s plenty of evidence that this is exactly what the book’s “about”…

All interpretation or observation of reality is necessarily fiction.

and

Everything is a tale, Martin. What we believe, what we know, what we remember, even what we dream. Everything is a story, a narrative, a sequence of events with characters communicating an emotional content. We only accept as true what can be narrated.

That first quote is provocative of course, but it does remind us that all of our experience of “reality” is a creative act. Michael Frayn’s “The Human Touch” describes this beautifully. How do we experience reality without our subjectivity? We don’t. Our senses, our imagination and our memory and perpetually active in creating what we observe, what we know.

The second quote reminds me of Richard Kearney’s “On Stories“. This point often pops into my mind when I encounter someone who thinks rationalism is about “data” or “facts” and fails to acknowledge the narrative they tell to convey their interpretation of reality.

One more…..

It is impossible to survive in a prolonged state of reality, at least for a human being. We spend a good part of our lives dreaming, especially when we’re awake.

Hear T S Eliot there? “Human kind cannot bear very much reality”

To sum up, I like a book which makes me think. I like one which is well written and really stimulates my imagination so that I “see” the places and events. And I also enjoy a page turner. “The Angel’s Game” hits all three buttons for me!

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The Selected Works of T S Spivet

Posted in books, from the reading room on November 26, 2009| 4 Comments »

The Selected Works of T S Spivet is quite unique (ISBN 978-1-846-55277-9). It’s a novel by Reif Larsen and tells the story of 12 year old T S Spivet who maps everything he comes across. He draws the most illuminating, enlightening and thought provoking diagrams and maps and the novel is liberally illustrated with them down the margins of virtually every page. I can’t remember the last time I was so delighted by a book. Utterly engaging, charming, thought provoking, funny, and, in places, intensely moving.

The novel uses the device of the innocence of the child observer to great effect. You begin to look at the world anew after reading a book like this. The ordinary seems less ordinary. The world seems more full of wonder.

Here’s two or three short passages to illustrate something of the novel. As T S looks out over the landscape he spots a bird –

A red-tailed hawk swooped down into the rippling rapids of the river. It was gone for a full two seconds, completely submerged in the cold mountain water. I wondered how it felt beneath the surface, a creature trained for the air but now surrounded by liquid. Did he feel like a clumsy visitor as I did when I was underwater, staring at the minnows that lurked like flecks of light on our pond’s bottom? And then the hawk was already tearing back up into the air, droplets exploding off its pumping wings. There was a tiny silver fish in its beak. A perfect slip of a thing. The bird circled once and I strained to watch it move against the cliffs of the canyon, but it was already gone.

What I love about this observation is not just the detail which conjures up such a vivid image in your mind, but this kind of observation is special. It’s empathic observation. T S doesn’t just see, he uses his imagination and his memory to connect with the bird far more deeply than a simple description would do.

As the Montana born and bred T S reaches Chicago he is amazed by the cityscape. The passage is far too long to quote here but within the description is this –

As I watched I fell under the city’s spell of multiplicity and transience.

Wow! The “city’s spell of multiplicity and transience”! Goodness, that hits the nail on the head!

Finally, here’s what one of the characters says about maps –

A map does not just chart, it unlocks and formulates meaning; it forms bridges between here and there, between disparate ideas that we did not know were previously connected.

Absolutely. T S believes we all have a complete map of the world engraved into our brains when we are born and we spend our lives creating maps of what we see and experience and trying to figure out how to access that map.

Read this. It’s lovely. Really, it’s a sheer delight. It’s also unique. You’ll never have read a book quite like this one.

Reif Larson has an accompanying website – http://www.tsspivet.com/

 

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Metaphors of illness and healing

Posted in from the reading room, health, narrative, tagged , on October 30, 2009| 2 Comments »

BBC Radio 4 broadcast a really interesting programme this week entitled Metaphor for Healing. I don’t think you’ll be able to listen to it (unless it’s still on the BBC iPlayer) but they’ve put up a good page about it on the bbc website. There’s obviously a link between issues of metaphor and those of visualisation. In fact, in some ways metaphors are tools for visualisation aren’t they? The programme talked a bit about Jan Alcoe, who used visualisation to both cope with both her disease and her treatment. It’s not hard to think that every patient should have a session about this before undergoing chemo and radiotherapy. I’ve read a lot about visualisation in cancer settings before so although her story is a particularly impressive one, it didn’t tell me anything really new. However, the rest of the programme was about the conscious use of metaphor in consultations, and I’ve not heard that discussed so clearly before.

Dr Grahame Brown, a musculo-skeletal specialist at the Royal Orthopaedic Hospital in Birmingham, claims he is able to save hundreds of patients from the need to have spinal surgery every year simply by “reframing the negative metaphors that have been unwittingly used by their doctors that can lead to a destructive and self-fulfilling cycle”. Many of the patients he sees have been referred for surgery after becoming convinced their spine is ‘crumbling’ or that they have ‘degenerating’ disc disease, when in fact they have a prolapsed disc or other normal wear and tear that is common in most people. Yet anxious patients latch on to these suggestions and become convinced that things are only going to get worse.

Now this really is fascinating. By becoming aware of the metaphors used by the patient (typically those given to them by other doctors) which make it harder for a patient to break free from chronic pain, then giving them different metaphors, he helps them change the way they think about, perceive, and, ultimately, experience their pain. He claims that this can have such a dramatic, quick effect, that many escape not only the need for surgery, but also escape from their pain.

It’s an impressive outcome.

There is specific mention of two techniques, or approaches, based on metaphor, used by people in this programme – the Human Givens method, which is a fascinating counseling technique, and the Clean Language approach, which is based on a technique developed by a practitioner inspired by “Metaphors we live by” written by Lakoff and Johnson, one of the books which have changed the way I think about the world. Fascinating to see these ideas turn into practice.

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The colour of water

Posted in from the dark room, from the living room, from the reading room, perception, photography, psychology on October 27, 2009| 2 Comments »

Look at the colour of this water. It’s an amazing colour isn’t it?

water green from reflected leaves

Why is it that colour? It’s the effect of all the leaves on the trees of the forest through which the stream is flowing. On another day, in another season, this very water (well, actually, this very stream, not this very water!), looks an entirely different colour. In fact, a few hours earlier, or a few hours later, it looks completely different.

This got me thinking. Not just thinking how beautiful it is. It is stunningly beautiful. But how change is a such a constant, and, how whatever we see is the result of many factors, and how everything needs to be understood in it’s context, and how nothing can be reduced to some simple set of data, or simple description, without, in fact, obscuring its reality.

Maybe it’s just the way my mind works, but it also got me thinking about the interactions between the environment and the elements of the environment. I’ve just taken out a subscription to a new journal titled Ecopsychology. I’ve never come across this term before, but its the area of study which looks at the interactions between behaviour and the environment. I love it when I come across these whole new fields of human exploration and knowledge.

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Pharmakon

Posted in books, from the reading room on September 9, 2009| 1 Comment »

Pharmakon, by Dirk Wittenborn, ( ISBN 978-0747598107), is a good read. It’s a novel which tells the story of one American family, starting with a focus on the father, a psychologist, then following the story of his youngest son. The territory of the book is the treatment of mental health, and in some ways, that reminded me of Sebastian Faulk’s “Human Traces“. However, despite the fact that both novels make you think about psychiatry as a therapy, it’s a more modern novel than Human Traces, taking a focus on drugs. You could tell that from the title I’m sure! In fact, by focusing on drugs taken to alter mental states, Wittenborn explores and entwines both “therapeutic” and “recreational” use of drugs.

Dr. William T. Friedrich wonders if it is possible to find a drug which will produce human happiness. The idea that this might be possible is prompted by two things. Firstly, he is horrified by the contemporary 1950s psychiatric treatments, finding psycho-surgery barbaric and psycho-analysis ineffective. Secondly, he comes across the use of a plant by tribes in New Guinea to alter mental states. He persuades a colleague to set up a clinical trial of this plant extract and see if they can prescribe happiness. Things, of course, don’t go according to plan, and one of the volunteers, a deeply disturbed young man called Caspar, after an initial apparently astonishingly good response to the drug, turns homicidal and sets out to kill the two researchers.

For the rest of the novel, Caspar haunts the Friedrich family. His crimes result in him being committed to secure psychiatric care for the rest of his life, and to Dr Friedrich and his wife having another child, Zach. Zach’s story leads into recreational drug use and its sorry consequences. Friedrich himself goes on to become a successful consultant to major drug companies helping them to create and market a number of anti-depressants and other psycho-active products.

As you might imagine, this is not a happy story, but it’s engaging and it also makes you think not only about psychiatry and drug companies, but also about human happiness – what is it and can it ever be achieved by using chemicals?

The drug company thread of the narrative echoed some of the themes of Popco but this is not a novel about drug companies. It’s a novel about life, mental health care, the place which drugs (prescribed and illegal) play in our society, and, ultimately, it’s a novel about families and happiness.

I found the last paragraph of the book immensely satisfying. I won’t spoil the story for you, but suffice it to say that at the beginning of the story, Friedrich wonders if its possible for a drug to produce happiness, and at the end, he’s wondering if it’s possible to find a drug which will produce tears.

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Popco

Posted in books, from the reading room on September 7, 2009| 1 Comment »

I enjoy books for different reasons. Popco, by Scarlett Thomas, (ISBN 978-1847673350) is one of several novels I’ve read this summer and which I’ve thoroughly enjoyed. It strikes me the novels I’ve read are all very different and I wondered if maybe I enjoyed such diversity in the same way I enjoy the company of diversely different people.

When it comes to a novel my main prerequisite is that it’s a good story. I love a good story, and this one drew me in right from the start. Popco, is an imaginary multinational toy company, supposed to be the third largest in the world, and the narrative takes place in a country retreat out in the wilds in southern England, where a select group of Popco employees are receiving classes in the mindsets of teenage girls to try and come up with some new products to crack this notoriously difficult sector of the market.

The narrator is a quirky, bright, highly intelligent young woman. She heads up one of Popco’s sections related to producing kits for children who want adventure – spy kits, code kits, survival kits and so on. She’s not someone who really fits in very easily with others, and I imagined her to be a bit like Chloe O’Brian from “24” – geeky, socially clunky, very bright, and interesting! The novel interweaves the story of her early life brought up by her grandparents, one a maths genius, and the other a professional code-breaker, with her present day experience on the idea-generating retreat for Popco.

I think it was the rich and varied subject matter which really hooked me in this novel. I loved all the explanations about code-making and code-breaking (took me right back to my early teenage years), and I enjoyed the discussions about prime numbers and mathematical patterns. Also, almost as an aside, I loved the way she used homeopathy for self-care and explained the homeopathic method so clearly but modestly. What disturbed me most about the novel was the way the company worked. I don’t mean the structure. I mean the way it operated in the world, dividing children into demographic segments, codifying them according to their interests, desires, and maturity, then producing marketing campaigns to sell loads of branded merchandise and toys to them. I found that all scarily believable. It was all so manipulative, and slick. I think it’s the fact that it was a toy company targeting children that made it especially uncomfortable. I’m pretty cynical about marketing anyway, but this book just made me wake up again a bit, and see behind the TV schedules, comic and magazine tie-ups and marketing campaigns.

There are a couple of interwoven plots which drive the book along. One about a treasure map (yes, really!), and one about a  fightback against globalisation and consumption. I enjoyed both of those plots, and I’m not going to reveal any detail about either of them (in case you decide to read the book)

I like novels which make me think, and ones where I learn something too, but I mostly like novels where the author tells a good story.

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Strange things happen…..

Posted in from the living room, from the reading room, life, narrative, tagged , on September 1, 2009| 1 Comment »

The other day Ian sent me an email with a link in it (he does this quite a lot!). It was to a book which he thought would interest me. I followed the link and, yes, it sounded really up my street. The book was called “Friends in Low Places”, by James Willis and it seemed to be a plea for a human approach to medicine, instead of a protocol-imprisoned one. I clicked “buy’ from one of the amazon marketplace resellers (I do that quite a lot!). I then picked up a book from my bookshelf as I walked out of my front door. I wanted something to read on the train and I’d just finished reading “Popco” by Scarlett Thomas (VERY enjoyable). The book I picked up was “Pharmakon“, by Dirk Wittenborn, and I’d read a review of it in the BMJ about a month before, thought it sounded like just the kind of novel I’d like to read, and clicked “buy” from one of the amazon marketplace resellers (I told you I do that quite a lot!)

I settled down on the train and started to read it. I got to page 21 and this little piece of dialogue hit me between the eyes

“But how did you get it here?” “Friends in low places.”

The identical phrase. Twice in the same morning. No, twice in the same hour! What are the chances of that? Have you ever even come across that phrase before?

Spooky?

This story isn’t finished yet. Pharmakon is a great novel. I thoroughly enjoyed it. The following day, before leaving for work I was browsing through my rss feeds in googlereader and came across this astonishing video –

Go on, watch it. It’s amazing. It’s about how the Hubble telescope was pointed by scientists at a part of the sky where they could see nothing. Nothing at all. Just darkness. Watch the video to see what they saw when they looked where there seemed to be nothing……! Then I left for work, got on the train and continued reading Pharmakon. Page 95. Here’s what I read…..

Caspar tried to distract himself by looking out of the window in the direction of galaxy clusters not visible to his human eye

Well, I don’t know about you but it sent shivers down my spine. How does that work?

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Patterns

Posted in from the dark room, from the living room, from the reading room, life, music, perception, photography on August 10, 2009| Leave a Comment »

Whether its due to synchronicity or something about focus, attention and awareness, I find that I often have the experience that something I’ve been reading about crops up in all kinds of places. At the moment it’s pattern-spotting. In fact, this pattern-spotting theme is a fundamental one for me. I think it’s an important part of the way I work, but sometimes it just becomes a more conscious issue. Last week I had to conduct a training session for a junior doctor about consultation technique and one of the things I mentioned was how doctors are trained to spot patterns. We do that to make a diagnosis for example (“Oh, I know what this is. This is a thyroid problem”) In parallel with this I’m reading the novel “Popco” by Scarlett Thomas (and thoroughly enjoying it by the way!), and the part I’m reading just now is about the links between code-breaking, mathematics and music – the link being patterns and the ability to spot patterns. While I was driving at the weekend I caught the end of a discussion in a programme on Radio 4 about musical scales, and Pythagoras’ view of harmony. Didn’t hear enough of it to understand what it was about, but then, last night the chapter I read in the novel explained exactly the role of Pythagoras in the connection between music and mathematics (subject of another post I feel!). How strange, isn’t it?

Here’s a photo I took recently. What I noticed here was the pattern of the flowers. I thought it looked like a constellation of stars in the sky.

flower constellation

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Infectious disease

Posted in from the reading room, health, science on August 8, 2009| Leave a Comment »

The treatment of infectious diseases is often presented as one of the great success stories of modern medicine. There’s no doubt that antibiotics have the potential to kill many bacteria in life threatening situations and so have saved many lives. Antivirals don’t have as good a success rate as antibiotics (despite the strange current craze for dishing out Tamiflu). However, the story of infectious disease is not so simple. I came across a feature about this on the BBC site the other day, headed “Are we losing the war on bugs?” This is typical language about the issue of infection – it is presented as a war, which is about as helpful a metaphor as the “war on drugs” or the “war on terror”. If these are wars, then when could we reasonably expect them to be over? In fact, the BBC article is the most heavily war metaphor laden article on infectious disease I’ve read for a long time.

And indeed our battle to outwit the bacteria which have caused death and decimation down the centuries has revealed just what a formidable foe they can be.
It is a war of attrition. There have been points where we have been advancing, and points when we have had to beat a retreat.
In part is the ability to keep people alive for longer which has enabled some bugs to find a chink in our armour
Influenza is seen as the most wily of viruses, constantly adapting to thwart our attempts to combat it.
We will always be at war with microbes. Their genetic promiscuity is impressive, but we are learning more about them all the time. They are versatile and enduring – but so are we

Many of those phrases are direct quotes from scientists working in this area, so it isn’t only the journalist who has bought into this metaphor. Is this a helpful way to think about infection? I don’t think so. The clue lies in that last quote about microbes being “versatile and enduring” and the admission that it isn’t the kind of war which can be won.

Bacteria and viruses are part Nature, just as we are. We have a complex relationship with them. We couldn’t live without them and sometimes we can’t live with them. So what exactly is the situation? Having invented antibiotics have we discovered how to control infectious disease? Because that’s what the war metaphor is all about. It’s that dominant scientism belief that Man can conquer and control Nature. Scientifically, and philosophically, I think that’s a foolish stance.

I recently came across a research article from 2000, written by Mitchell Cohen, and published in Nature Insight (Volume 406(6797), 17 August 2000, pp 762-76). The article is entitled “Changing patterns of infectious disease” (no war metaphor, unlike the BBC piece)
Here’s the abstract

Despite a century of often successful prevention and control efforts, infectious diseases remain an important global problem in public health, causing over 13 million deaths each year. Changes in society, technology and the microorganisms themselves are contributing to the emergence of new diseases, the re-emergence of diseases once controlled, and to the development of antimicrobial resistance. Two areas of special concern in the twenty-first century are food-borne disease and antimicrobial resistance. The effective control of infectious diseases in the new millennium will require effective public health infrastructures that will rapidly recognize and respond to them and will prevent emerging problems

The author points out that at the beginning of the 20th century infectious diseases were the leading causes of death worldwide, and that average life expectancy was only 47 largely due to the number of children who died in infancy from infections. However, he then goes on to point out that from 1700 to 1900 life expectancy had risen in Britain from 17 to 52 and that the death rate from TB had fallen by 80%. Antibiotics hadn’t been invented yet.
The reasons for the change were “primarily decreases in host susceptibility and/or disease transmission.” After the invention of antibiotics infectious disease became even less of a cause of death “Between 1900 and 1980, mortality from infectious disease fell from 797 to 36 per 100,000” “By the end of the twentieth century, in most of the developed world, mortality from infectious diseases had been replaced by mortality from chronic illnesses such as heart disease, cancer and stroke” (war on chronic disease anyone?)
However, it’s a more complex picture, with new infections, and old infections now resistant to previously effective treatments. 13 million people died from infections in 1998, and the death rates from infectious disease have risen even in developed countries. Why? The conclusion reached by this particular author is interesting “The recurring theme throughout all of these factors that influence the emergence of infectious diseases is change”. What changes? Well, too many to cover here actually, but not least changes in demographics with increasing numbers of vulnerable people, from the elderly to the malnourished; changing patterns of human behaviour with more children being cared for in groups in nurseries, and more international travel; changes in the amount of ready-prepared foods being eaten placing food safety out of the hands of individuals and into industry and commerce; and the over-prescribing of antimicrobial drugs rises in resistance.

So the war metaphor doesn’t really work. The problem turns out to be more complex than beating the baddies. The best explanations for disease patterns emerge from understandings of how we live in this world. Yes, we do need drugs to treat life threatening infectious disease but the biggest advances will come from attending to our adaptability and our resilience. As a species we need to learn what influences these characteristics and to take measures to increase them. So here’s your challenge. What do you think can increase adaptability and resilience? At a personal level, and at a global level?

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What will change everything? – The End of Analytic Science

Posted in from the reading room, science on July 28, 2009| Leave a Comment »

Mihaly Csikszentmihalyi’s answer to Edge’s 2009 question is the view that it’s time now to start to focus on how branches of knowledge connect to, and influence each other, and to develop a new science which goes beyond the current complexity science by emphasising the relationships between phenomena rather than the phenomena themselves as discreet entities.

The idea that will change the game of knowledge is the realization that it is more important to understand events, objects, and processes in their relationship with each other than in their singular structure. Western science has achieved wonders with its analytic focus, but it is now time to take synthesis seriously. We shall realize that science cannot be value-free after all. The Doomsday clock ticking on the cover of the Bulletin of Atomic Scientists ever closer to midnight is just one reminder that knowledge ignorant of consequences is foolishness. Chemistry that shrugs at pollution is foolishness, Economics that discounts politics and sociology is just as ignorant as are politics and sociology that discount economics. Unfortunately, it does not seem to be enough to protect the neutral objectivity of each separate science, in the hope that the knowledge generated by each will be integrated later at some higher level and used wisely. The synthetic principle will have to become a part of the fundamental axioms of each science. How shall this breakthrough occur? Current systems theories are necessary but not sufficient, as they tend not to take values into account. Perhaps after this realization sets in, we shall have to re-write science from the ground up.

Note, that he not only emphasises connections and synthetic thinking, but twice in his short answer he mentions the importance of values. That’s because it’s actually not possible to fully comprehend natural phenomena without considering values.
This answer reminds me not only of one of the best books I’ve read in recent years – Linked, but also Prince Charles’ recent Dimbleby Lecture where he argues a similar case.

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