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Archive for the ‘health’ Category

red-veg

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

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

What do you think when you read this?

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

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

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

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

Life is the sum of the forces which resist death

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

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

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

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

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

cosmic_calendar

(the cosmic calendar)

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

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

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

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Twelve project Day Six.jpg

Day six of my twelve images, one for each month of 2016, (the twelve project) brings me to June. Look at this – gathered over a few minutes from the potager, our vegetable patch in our garden. I’ve lived in a second floor apartment for many years, but since moving to France I’m living in a house with a garden. The potager isn’t large but in this part of the world a wide range of plants thrive outside without.

Every vegetable is a revelation. Look at the colours! Sadly, what I can’t share with you are the tastes, but believe me the tastes are every bit as intense, varied and impressive as the colours. Have you ever tasted vegetables which were literally minutes ago still growing in the soil a few yards away? They are different. I didn’t realise radishes had a nippy, peppery taste until I ate the ones which were straight out of the ground. Fresh peas are a totally different flavour from frozen or tinned ones. And that rainbow chard you can see on the right hand side there? I’d never come across that before but isn’t it a fantastic colour? Cut into ribbons and added to a stir fry they are a revelation. The rocket leaves are as peppery as the radishes. I hate bland, tasteless rocket leaves. They seem such a pointless thing to eat, but fresh leaves are zingy. I could go on….you don’t see in this photo some of the other great tasting veggies which matured a bit later than June….the tomatoes which grow in abundance in several different varieties, red, yellow, striped…..the courgettes, oh, the yellow courgettes, totally delicious….and later yet, the squashes, pumpkins, butternut squash and so on…..

There’s something else which has happened from experiencing this food. I’ve become more aware of the seasons, looking forward to certain foods at particular times of the year, I mean in the local markets and supermarkets too, not just from the garden.

I’ve begun to strongly favour food which is as fresh, as little travelled and as little processed as possible. In the markets and shops I look at the origin of the food now and opt for the what’s been grown close over what’s come thousands of miles.

I’m enjoying salads and salad vegetables more than I’ve ever done before. When I was growing up in Scotland salads were dull, boring and tasteless. A couple of lettuce leaves, plus a tomato and some cucumber chopped up and maybe some cheddar cheese. Here in France people have a few salad leaves (mainly varieties of lettuce….yes there is more than one kind of lettuce! Who knew?) with a sprinkling of vinegar and oil dressing, almost with every main meal. Just on the side. It’s delicious. In fact, there’s a restaurant in Bordeaux, “L’Entrecôte”, which has no menu but serves everyone salad leaves with their own special dressing and walnuts sprinkled through them as a starter, and steak and chips as the main to everyone. You can’t reserve a table and there is a queue stretching along the pavement outside every lunchtime and dinnertime seven days a week.

I’m enjoying a simpler level of food preparation and a larger range of foods than I’ve ever done. When the food is fresh and locally produced it tastes so good it doesn’t need much preparation.

And, here’s the final thing. I’m eating most of my meals outside for about four or five months of the year. Both in the garden, and when out and about.

I moved to France from Scotland to savour a different lifestyle. Climate and food are two of the biggest influences on that lifestyle. I think this photo from June captures some of that.

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no-straight-lines

Look at the shape of this tree!

It heads up from the ground, reaching for the sky just as pretty much all trees do, then suddenly it’s taken and almost ninety degree swerve to the left, but not for long, because then it turns abruptly upwards again, only a little later to take another almost ninety degree turn to the right, after which is takes a much more relaxed ascent, bending slowly upwards.

It caught my eye.

It caught my eye because it was so unusual, so striking, and so unique. None of the other trees around it had shapes or trajectories even remotely like this one.

So what happened? What’s the explanation for the particular shape of this tree’s life?

I realise that’s a question which lay at the basis of my consultation with patients. An individual’s life story has a distinct and unique shape. Are there any explanations for that shape? Which life events made the biggest impact? What kind of impact did they make and, crucially, how did the person respond to those events?

But even without the context of illness, I think life is like this for all of us. We are gaily living in one particular way when, bam! someone happens, there’s a change, an event, and life continues afterwards but in a completely different direction.

What shape is your life story? What changes of direction has it taken and why?

I love how no two life shapes are the same, because no two lives are the same.

And there’s something else to consider when gazing at this tree…..you couldn’t predict it. If you were taken to the forest and shown a seedling, you couldn’t draw the exact shape it will manifest as it grows. DNA analysis isn’t going to give you your answer. Generalising to say most trees of this type will grow this particular way isn’t going to give you an accurate answer.

Every single life is unique, and the shape of every life emerges in the living it.

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dscn7600

Barrie Condon, a retired Professor of Physics, generously shared his new book, “Science for Heretics” with me. He thought I’d like it. He was right. The subtitle of the book is “Why so much of science is wrong” and his aim is to provoke the reader into questioning both the claims of science and its methods. He uses the device of three characters, The Believer, The Sceptic and The Heretic, throughout the book as he considers several fields of science including mathematics, physics, and medicine.

The Believer is one who science reveals the Truth and will one day enable us to understand everything in the universe. The Sceptic accepts the basic tenets of science but retains some doubts about whether of not we will ever be able to understand everything. The Heretic doesn’t buy the whole project. He thinks the universe is not completely knowable and that our scientific theories which shape our views what we see are simply the projections of our human brains.

He particularly attacks the use of theory in science which tends to be translated into “laws”. He clarifies that no such “laws” exist and sets out the case for a return to observation and experimentation instead. I really enjoy his writing style and some passages particularly stood out for me.

For centuries we have been measuring all sorts of things but generally only recording the results we expected and ignoring the rest.

This captures two of my main objections to so much of medical practice – the reduction of human beings to measurements and the belief that the particular measurements which are made allow us to completely understand a patient and their illness. Although I have heard of a medical teacher say “Don’t listen to patients. They lie all the time. You can only trust the results.”, my own experience of doctoring couldn’t more diametrically opposed from that view. ONLY the patient’s experience can be trusted. Measurements, sadly, frequently mislead, and ALWAYS need to be set in the context of this individual patient.

Life saving claims for medicines need careful examination. Drugs do certain things which are beneficial to the human body in disease, but they inevitably have other effects which can be deleterious or even fatal.

I wish more doctors made that more clear every time they write out a prescription.

He’s even better on physics and cosmology.

For me, the two most important things he has to say are, firstly –

Science gives us theories that purport to explain how the universe works. This breeds confidence in scientists who then go on to do things that carry certain risks. These risks are rationalised away on the basis of existing theory. Even if our Heretic is wrong in saying that all theory is actually erroneous, history shows us that most or perhaps all theories ultimately prove incorrect. Our perceptions and calculations of risk are therefore also likely to be erroneous. Science generally also assumes a high degree of control over experimental conditions and again this faith seems misplaced. While we may routinely underestimate risk, we also routinely overestimate our ability to control it.

This is SUCH an important point. He’s arguing for a greater use of the “precautionary principle”. Instead of assuming that everything we produce, all our chemicals, all our technologies are safe until proven otherwise, we should be more wary. What we need is a whole lot more humility and the ability to confess that we really don’t know very much at all. And we certainly way overestimate our ability to control things. It’s the arrogance of believers which frightens me most – people who are so sure that they, and only they are right – I’m on the side of the Heretics in Barrie’s terms. It’s likely that what we think we know at any point will be proven not to be quite right in a few years time (or, indeed, to be completely wrong).

The second important conclusion he reaches is that there are no fundamental laws of the universe…..apart from, maybe, two –

As well as a possible law for uniqueness, the Heretic is open to the possibility of a second law governing complexity, namely that it increases with time.

Well, there he puts his finger on what I’ve written about many times on this blog – that the most important characteristics of the universe are its tendency to create uniqueness and its trend of ever increasing complexity.

Take those two undeniable features on board and try and practice science or medicine by measuring, generalising and trying to control the future! Good luck with that.

Thank you, Barrie Condon, for your delightful, humorous, thought-provoking, paradigm-challenging book. If it was an integral part of science education we might be able to look forward to a better world.

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two

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

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

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

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

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

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

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

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

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

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alone

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

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

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

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

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

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

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

How can it be?

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

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

Being heard isn’t enough.

We need to be cared about too.

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

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

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

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really

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

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

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

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

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

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

Really?

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

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

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

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

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