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Archive for the ‘health’ Category

Look at this amazing pattern left on the sand by the action of the water after the tide has gone out again at the beach.

When you look at this you know immediately that the sand has been shaped by the water, although, to be honest, I don’t understand how water manages to make such intricate patterns like this on the sand. Maybe somebody does!

There are other striking patterns on the wet sand at the beach, some clearly made by plant material, seaweed I expect, and some obviously from the imprints of shells, some little worm-shaped piles caused by burrowing creatures throwing up the sand behind them, and often many footprints of birds which have run across the beach.

What impresses me most about all these patterns is that they are the traces left by some activities which occurred a little while ago. They are the evidence of the past imprinted on the present. That reminds me of how we are shaped by the events and experiences of our lives. Our encounters with others change us. Our experiences don’t just create memories, they set up patterns of chemical, electrical and cellular response in our bodies.

We can become aware of some of that in bodily changes, from tightenings of muscles, to changes in heart rate and breathing, to sweating and trembling, and so on, usually before we are even aware that we reacting to something.

I spent much of my career working with patients who had chronic, long-standing illnesses, and we could often make some sense of what was going on by teasing out the threads and themes which ran through their stories over many years. It certainly wasn’t always the case, but sometimes the actual disease and its precise location in the body was clearly related to the body’s responses to events or experiences long forgotten.

It’s pretty clear to me that just as the movement of the water shapes the sand in the way you can see in this photo, so do our experiences and relationships shape us. Realising that makes me want to be more aware of my own actions and words. It makes me want to choose to spread constructive, supportive and creative waves in the world. After all, whatever we do, whatever we say or write, has effects far beyond the limits we could imagine.

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Sometimes you come across a stone that just demands to picked up, turned over, contemplated and brought home. That was the case with this one which I still have with me. I like it partly for its almost heart shaped form, but I like it most for the pattern you can see on it.

When I look at this, I see a number of lines of varying breadths and lengths, criss-crossing the surface and I think of each of them as a representation of a path, or a journey.

When I trained in Medicine, we were taught “how to take a history”. While I developed a bit of discomfort around the use of the verb “to take” there, I kept the concept of the history. In fact I’d tell people a large part of my work was about enabling people to tell their own personal history…..or their story. I used the idea of “story” a lot in my work. I’d ask people to tell me about their present experience in the light of past events and within the scope of their fears and hopes for the future. The traditional life story has a clear timeline, starting at birth and ending with the person’s death. Except, I quickly discovered, that in order to understand a person well I had to explore the family stories too….in other words to hear what happened before the patient was even born……as well as exploring the stories of many of the others (brothers, sisters, other relatives, friends and colleagues) whose stories intersected with the patient’s story.

So, I was quite surprised when I read a small article in “Philosophie” magazine about maps – they described how the French philosopher, Giles Deleuze said that our “subjectivity” was created from our movements, from our meetings, and from the relationships we had with other beings, other things, and other places. He said the map was an imprinting of all these movements, encounters and relationships which was laid down in our psyche, and so, when analysing ourselves we had to explore more as a geographer than as a historian.

Now, as you know, I’m a great “and not or” person, so I wouldn’t replace the work I did, or the way I make sense of my life with a geographical approach instead of an historical one, but I find that notion incredibly appealing.

What if, next time you are exploring your life, your experience, and your “self”, you make a map – a map of the journeys you’ve taken, the places you’ve gone, the experiences and encounters you had there, and the relationships with people, other living creatures, things and places which you’ve woven into your soul as you have lived?

What might that map look like?

It strikes me that adding this geographical approach to my life opens up new insights because it reveals and highlights the interactions, relationships, encounters and experiences of my life. The historical approach, of course, can reveal the characters, the events and the chronology of a life, but this shift of focus from my “story” to my “map” has, I think, loads of potential.

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I reckon we pretty much expect trees to grow straight up, then branch a bit, then grow further, still straight up. But, actually, of course, this is seldom the case. Trees, even their main trunks often veer off this way and that, or bend in one direction, only to turn in a totally different one a few metres further on. I confess I don’t know what makes a tree take the twists and turns that it does.

Look at this one for example, not only has it swerved around an almost 90 degree angle but it seems to have entwined itself on the neighbouring tree. What do you think? These trees are lovers? They’ve entangled themselves in each other’s lives forever?

It looks that way to me.

So maybe some of the shape of this tree can be understood in relationship to the other tree. Now how often is that the case with we humans? Do we ever reveal our character in any other way than by responding to what we encounter and by acting in response to the others in our social world? Can you really understand anyone without understanding their place in a family, in a community, a society? Can you really understand anyone without seeing how they respond to others, without exploring the nature of their relationships? I don’t think so.

A belief in the uniqueness of every single human is at the core of my world view and my practice as a doctor. But I never attempt to understand a person solely in isolation. I can only get an idea of who they are by hearing the stories of their experiences and relationships, and by observing how they respond to others….including myself.

I’ve no doubt that all our interactions with others change us. I would not be who I am today without having been changed by all the doctor-patient relationships I experienced in my life. You could say patients made me who I am. Not only patients of course, you also have to take into account the others in my life, family, friends, colleagues, even those who challenged me, or disliked me.

Our lives are entangled.

That’s just how it is.

But we can make choices, and we choose both who and how. We can choose to pay attention to certain people, to care for them, to engage with them, to collaborate with them, or to compete with them. All of those choices weave our unique, personal web of inter-relationships. And that constantly evolving cloth forms the very tissue of our being…..or should I say of our “becoming”.

When I look at this photo today it leads me to contemplate the people in my life, those who are no longer present, those who I’m actively relating to, and those who played significant roles in fashioning my experiences and creating the memories I have. You could say, it leads me to consider the characters in my life story. Who they are, who they were, what experiences we had together and how we become entwined and entangled.

I am grateful to them all. We made each other who we are…..together.

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One of the most beautiful things to see in any garden is the unfurling of the petals of a flower. That phase where the bud opens up and the gorgeous coloured petals unfurl themselves captures an essence of Life for me.

I see this and I think “becoming not being” – you’ll have noticed that phrase at the top of my blog? I wrote that as a subtitle because it is the most fundamental lens through which I see and understand the world.

The difference between those two words is movement…a particular kind of movement…..movement of change from one state to another.

Everything is in the process of becoming. It’s easy to see that in living organisms. The trillions of cells which make up the human body are in constant process of birth, growth, maturing and dying. They are replaced at different rates according to their type (blood cells living much shorter lives than bone cells for example), but none of them stay the same for the whole lifetime of the person.

When we look at an old school photo we might recognise ourselves, but when we compare that to one taken a decade later, then another and another, we see very, very images of the same person. All might be photographs of me, but all look utterly different.

This process of growth and development is a key characteristic of health for me. When I was working as a doctor, it was important for me to have a positive definition of health. I wanted to to help people to become healthy, and healthy, I think, is a positive state in its own right, not just an absence of symptoms or disease.

When I used to look out of my window in Central Scotland I could see the mountains, and the distinct shape of Ben Led always caught my eye. It amazed me that every day it looked different. Of course, I wasn’t close enough, or around for long enough, to see the physical structure or the surface of the mountain change (though change it did, over millennia). But my daily experience of the mountain was created more than rocks and earth. It was created by the light, the clouds, the sun, and the seasons. And all that changed all the time.

Nothing is fixed.

That’s my point.

Nothing can be understood in isolation from its environment, from its network of connections and relationships, or from its unique history and potential.

Stories….narratives….are always in the process of becoming….because stories weave together the past, the present and some possible futures, into one beautiful cloth. A dynamic cloth, which is always unfurling, always becoming, not being.

This image stirs all of this for me. I love how the “becoming not being” lens makes every day so much more alive!

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Sometimes I think I don’t say it clearly enough, so I’m focusing on it today.

Here’s my core belief – I believe love is the strongest force in the universe. I believe that love, in all its manifestations, underpins the creation of Life, the existence of human beings, and the constant movement towards ever greater complexity through the creation of an infinite network of connections.

I believe that it is love manifests as attraction. From the blending together of energies and universal forces, to the binding together of subatomic elements to create atoms, the building up of atoms into molecules, and molecules into complex materials which combine to create living cells, to the desire of cells to live together and form mutually beneficial bonds so creating multi-cellular creatures, right up to the way we humans are fundamentally social creatures where none of us could exist in utter isolation.

That deep intense love a parent feels for their new baby from the moment they set eyes on each other. Without that love, no bond would form, and without the bonds of selfless care, that baby would die. With an abundance of love and care that baby can more than survive, they can develop, grow and excel in becoming the unique individual that only they can be.

I believe it is love for other creatures, other forms of life, for this little planet, Earth, in which we all live, which stokes our curiosity, opens our hearts, moves us towards each other and to towards new discoveries. It’s our love of knowledge and understanding which underpins everything from science to philosophy. It’s our love of beauty which underpins so much creativity and art.

I believe it is our love for justice which drives us to demand it.

As I look around the world in these pandemic times, of course I see lots of evidence of cruelty, unfairness and neglect. But I also see an outpouring of love, of people reaching out to each other, of people caring for each other, of people risking their very lives for each other.

I am attracted to those who have loving hearts and minds. I am repelled by those who are driven by hate and cruelty. But here’s the strange thing, from my experience of a lifetime of work as a doctor working with patients one to one I believe that love has the potential to heal even the most hardened, most hurt, most closed off hearts and minds.

So, let me say it clearly once more.

I believe love is the strongest force in the universe.

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This cut crystal really hits the spot for me – firstly, I see it and I think it is really beautiful. The beauty of it delights me. Secondly, I’m amazed by it. The craftsmanship involved in imaging then fashioning a piece like this utterly astonishes me. Thirdly, it fascinates me. I gaze at it and look at the way the light travels through it. I see how each facet acts like a lens through which I can see the other facets, and how all the facets act as lenses on the window and the rest of the room.

I can have that blend of responses to many of the photos I have and I think that’s got a lot to do with my decisions about which to gather together into my “best photos” folder. Beauty, amazement, wonder and fascination. Altogether they bring me joy. And, without falling into the habit of ranking and creating hierarchies, I think joy is one of the most emotions we can have in our daily lives. Joy activates a whole set of physical and psychological changes in us. And, it just feels GOOD.

But this image does one more thing for me, the thing I really look for in my special collection of best of the best images – it inspires, stimulates thought, curiosity, wonder, and a potentially infinite web of threads of thought.

This idea of a multi-faceted interface gets me thinking about how we humans are like this. Whenever a patient told me their story, as we explored different themes, events and experiences, I’d see them shining like this – each aspect, each theme, each way of behaving, of experiencing, of engaging with the world glimmering like one of these facets. There are many selves within each of us. In 1977 the Scottish psychiatrist, Miller Mair, described a model of the “self” coining the term “community of self” – his idea was that none of us can be reduced to one simple set of characteristics, behaviours and qualities. Each of us exhibits a different self in different contexts – for example, there would be differences in how I was with patients, from how I was with my family, with colleagues and with friends. But that each of these selves were not separate, at least, if we were mentally healthy. Instead, they would all be integrated into one – into one community where they all interacted to give us the sensation of a unitary, or single, self. I liked that model. It opened up the possibilities of exploration of different aspects of a person, often contradictory or opposing aspects, while allowing every one them a place where they could be accepted.

This idea also makes me think of Indra’s Web – that beautiful idea of the universe consisting of an infinite be-jewelled web, where everything is connected, and every gleaming jewel reflects all the other jewels. I think that’s a great model for understanding the world in which we live.

It also makes me think of how we use multiple lenses through which to see, and understand, the world. In fact, if we reduce ourselves to seeing everything through just one small lens or window we find that we tumble into division and conflict with others who don’t share that single lens. But when we embrace the multiplicity of lenses through which we can see the world we can find points of connection with others.

That’s my final thought for today – not only are we all like this multifaceted cut crystal, but when one of our facets lights up in connection with one of someone else’s facets, then we don’t just make a connection, we can brighten each others lives.

I hope this lens, this shining small facet, here today, brightens your life today, and that you, too, feel the stirrings of joy, of wonder, of delight and of connection.

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A human being is a part of the whole, called by us, “Universe,” a part limited in time and space. He experiences himself, his thoughts and feelings as something separated from the rest — a kind of optical delusion of his consciousness.”

Albert Einstein

This is foam on a beach. As the waves break, turn white, and crash onto the sand, sometimes they make bubbles…..lots of them. If you look closely you’ll see all different sizes of bubbles and as they catch the sunlight they show us all the colours of the rainbow. They are like delicate, precious gems. However, like all bubbles, they don’t last very long. As you watch, they pop and disappear before your eyes, disappearing back into the rest of the surf, back into the great ocean which they never actually left.

Einstein says our sense of being separate is an optical illusion. We have these functions we call consciousness, ego and self…..what are they? Where can we find them? Where do they come from and where do they go to?

I am convinced that each of us is unique. I spent my working life meeting, getting to know and to understand, thousands of people, one person at a time. I never found any two people who were identical. I find it’s easy to judge people when you don’t know them. It’s easy to make loose assumptions about individuals when you only “know” them as members of a group or a category. But when you take time to listen without judging, when you actively build a relationship of care, I find that everybody has something amazing to tell. Everyone has the ability to astonish you. The hearts, the desires, the longings, the hurts and the struggles of others create utterly unique life stories, and remarkable people.

But I’ve never thought that we are separate. As you start to follow the threads in a person’s life story, it’s hard to find a starting point. In fact, we doctors are taught to explore a patient’s family, their social, work and personal relationships, as well as their particular body and mind. Holistic practice demands that we follow the threads in as many directions as we can. Frequently, patients would tell me they had never told anyone else what they had told me and that I must know them better now than anyone else does. Yet, I knew I spent only a few short hours over a number of months with them, so how could I really know them? I knew how I’ve never got to the point where I think I know and understand everything about myself, let alone about anyone else.

Well reality is like that. We encounter individuals on particular occasions. Like these bubbles in the foam we can see them, recognise their uniqueness, but they are never separate. We are all connected. We all emerge from the same ocean, from the same atmosphere, from the same ecosystems. We have all evolved from the same beginnings. As we live our lives, our short, transient lives, we build an infinite number of connections and relationships. Everything and everyone is always changing.

I think that’s the most amazing and thrilling aspect of life – that we have the ability to separate out, to see each bubble as it is, to know each person as they are, whilst at the very same time knowing that whatever it is, whoever they are, this appearance of separateness is a delusion.

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I love spirals. I find them quite captivating. My attention is caught by them and I’m drawn close to contemplate them. I’m not sure what it is that makes them just so beautiful, but, to me, they are amongst the most beautiful shapes in the universe. You can see them around you in many places of course….in plants, especially climbers which use this method of finding places to hook onto, then pulling tight to hoist themselves upwards. But also in ferns, and in plants which throw out creepers and tendrils which stress across the ground. We humans often create spirals in our art. Maybe it’s because I’m Scot, because like most Scots I’ve been steeped in the traditional Celtic and Pictish complex knots, three armed spiral shapes which we call the triskele, and intertwined ribbons which swirl around each other. However, I suspect it’s not just those of us with Celtic backgrounds who like spirals.

One of the things I like best about the spiral is that it seems to me that a person’s life story often has that sort of trajectory. There are issues, problems, difficulties which we meet, attempt to address, or run away from, which just keep spiralling back again and again. In fact, human development too seems to have a spiral path.

I don’t think time flows in a straight line. It loops, and it spins, slows down, pauses, runs forward. The past and the future both have their part to play in my ability to make sense of the present. They don’t exist in three separate, sequential boxes, but rather, they loop, cycle and spiral together to create the intricate patterns of the tapestry of a life.

There’s a special thing about this photo. You have to look a bit more closely to see it. Right in the middle of the main spiral in this photo you can see the world clearly – it’s as if you are looking through a lens.

Isn’t that magical?

It reminds me that if I really do want to see the world clearly, then the lens of the spiral can be a pretty good way to do that. What do you see more clearly about your life, when you consider it through the lens of a spiral?

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“Emerveillement” is one of my most favourite French words. It means wonder, amazement, marvel…..words like that. You get the idea? I am a “wonderer” – Curiosity may be one of my core features. I’m sure that helped me to be a good doctor. I found every single patient fascinating. Monday mornings for me were an opportunity to begin a new week of meeting new patients, hearing their stories, working with them to make sense of their illness and to understand both who they were and what they were experiencing.

But my sense of curiosity, of wonder, of “emerveillement” was never focused solely on human beings. Every day my mind fills with questions, I find myself astonished by something I see, hear, or read. New discoveries delight me. New knowledge thrills me. And perhaps nothing pleases me more than achieving a better understanding of something.

This photo is one I took during several visits I’ve made to Segovia over the last few years. Surely it’s Segovia’s most impressive feature! It’s an enormous aqueduct built by the Romans (yes, the Romans!) to bring water from the countryside into the heart of the town.

I mean, just look at it! Isn’t it astonishing? What a conception! What a feat of engineering! What a vast labour, heaving those stones, cutting them to the right size, putting them into the correct positions! The aqueduct didn’t have a pump. As far as I know, Romans didn’t have pumps…..well not machine ones anyway. No, instead they built this impressive structure so that water would flow continuously downhill along the length of the high channel. Seriously impressive! Human genius!

But there’s more….because not only is it an incredible solution to the problem of how to get clean water to the population in the town, but just look at it…..it’s beautiful. It’s a work of art.
Nowadays we would be more likely to cut a trench, lay some pipes and then cover them up. Not the Romans. They created a thing of beauty which was also a solution.

I can’t help but think we’ve gone too far down the road of “utilitarianism”, “short term thinking” and “profit taking” these days. How many of the water supply mechanisms made in the last century will still be functioning and looking beautiful two thousand years later.

The human genius is not just in finding solutions. It’s in creating beauty, and in seeing far enough forwards to make things which can last. We need a bit more of that.

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I know that it is still too early for many of you to feel that we’ve reached a time of opening up. Here in France we are into yet another “confinement” and can only travel up to 10 km from home and there’s a curfew every night. But this is Spring here in the Charente and as I look around my garden I see “opening up” everywhere I look.
The trees and flowers have buds starting to unfurl. I see the green protective covers begin to peel back and show me hints of the glorious colours of the petals and blossoms which are about to emerge.


Life doesn’t progress along neat straight lines. It’s not “linear”, and it’s not exact. In fact, Life is so diverse that the changes around me occur at different rates all the time. The plants go through their various stages of seasonal cycles in their own time. The plum tree blossom has gone now, the cherry tree blossom is carpeting the grass every time there is a breeze, but the mulberry tree is only showing its first hints of the leaves to come. The Spring daffodils and tulips are all but past however the irises, the poppies and the tree paeonies are only about to reveal their beautiful flowers.


Wherever you live in the world there will be seasonal changes going on around you which are a bit different from the ones I see around me. Life is varied and diverse, and whilst all Life shares a tendency to “becoming” over “being”, the evidence is always contextual. It all depends on the circumstances and the local environment.
I think we humans are like this too. Yes, you can see broad, sweeping life stages in every individual, from birth to childhood, through adulthood and into mature, old age. But we don’t all develop at the same rate or in the same way. And we don’t progress mechanically as if we are working our way square by square around a board game.
We leap forward, retreat, hit setbacks, meet challenges, stumble across opportunities. We build support and networks of relationships. We connect, and we disconnect. There really are an infinity of paths and an infinite diversity of life stories. No two of us are identical.

But this “opening up” that I see in today’s image, is an essential part of being human. We don’t grow if we don’t open up.

For the second half of my career I worked in a specialist centre for people with chronic illnesses. When someone has suffered for a long time they are often in a state of closing down, of separating themselves out from the world, and of building more walls in the hope of some security and safety. They are often exhausted and lack the ability to take even small steps forward. For all those reasons, our hospital was built around a garden which was like a small, abundant, natural, cloister, where we could wander, sit, wonder and talk together……the patients and the staff. Time and time again we’d see how this enabled people to re-connect, to break out from the closed, separated, fearful places they had retreated into, and begin to notice the plants, the seasons, the birds, the fox and the squirrels, to begin to be heard, to begin to feel cared for.

This process of healing required a coming together of “opening up”. The opening of the hearts and minds of the carers, who paid attention, and listened without judgement. And the opening of the hearts and minds of the patients who could begin to feel safe, to feel hope, and begin to get in touch with Life’s flow of energy again.
Wherever we are in life, whatever stage we have reached, we all need to open up in order to grow. We need to find the right circumstances, the fertile ground, the caring, loving connections between ourselves and the rest of this world……other people, other creatures, “Gaia”, herself…..in order to flourish, in order to become fully what we can become.

Even in the midst of these difficult times if you look around you will see signs of opening up…..in hearts, minds, bodies…..in communities, relationships, in plants and other creatures.
I think it helps to look out for those signs of opening up. It gives us hope and courage, and without those, then what?

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