Archive for the ‘health’ Category

Social distancing, physical distancing, isolation, “confinement”, lockdown. We’ve been going through an enormous period of physical separation from each other, and from the Earth.

Sure, there’s Zoom and WhatsApp, and FaceTime and all the rest, but we’ve been reduced, I think, by connecting through screens. These virtual meetings, avatars and asynchronous communications have got two sides, haven’t they? They open up channels for us and allow us to speak, to send messages back and forth, and so to have some sense of connection. But they add an extra layer between us, almost as if there is a mist, or a fog that we can’t quite see through.

I think part of the problem is that reality is physical and even the apparently invisible, un-measurable, Self, is embodied. Our feelings and our thoughts are embodied. Our everyday experience exists within physical reality.

Yet we’re being told that touch is dangerous. That we must keep a metre or two away from everybody else. In France you’re not supposed to kiss anyone on the cheek anymore, and in many countries you’re not supposed to shake hands…..and I don’t know about you but this knocking elbows or kicking each others ankles just doesn’t do it for me! We’re told that surfaces are dangerous. They need to be wiped, and washed, and sprayed and cleaned again and again and again. We’re told to wash our hands for longer and more frequently than most of us have ever done before…to remove all trace of whatever we might have touched.

Don’t get me wrong. I understand what this is all about. I know this virus can only spread through physical and/or close contact. But, all the same, these new habits and new rules have turned the sensation of touch into a fear of touch. And that doesn’t strike me as a good thing.

So, today, I want to remind you of that particular one of your five senses – touch.

Look at this tiny white feather. Don’t you just long to reach out, pick it up, stroke it gently, or stroke your skin gently with it? It is beautiful to look at, that’s for sure, but to touch it, to feel its almost weightless physical presence, makes it more real.

At the other end of the scale, look at this burr. What an amazing creation! What a way to spread around the world! It looks a little bit like those images we’ve seen of the coronavirus, and if you’ve ever brushed up against a burr like this you’ll know it catches onto to you pretty damn effectively. And no wonder…look carefully….every single one of those spikes has a sharply hooked arrowhead at the end of it. If you wanted to design something to easily fix onto whatever creature comes close to it, you couldn’t do much better than this. At first glance, of course, this mass of needles looks like a protection mechanism. It looks like a huge STAY AWAY signal. And if you touch it with your fingers, it really isn’t a pleasant experience. But it’s not designed to keep creatures away. It’s designed to connect, to attach, to hook on and stick.

Here’s my box of curiosities. You know the idea of a “cabinet of curiosities“? That always appealed to me. Those cabinets were, in some way, the precursor to museums, but they were more personal. I kept this box right next to my chair in my consulting room. Children, almost always less inhibited than adults, were fascinated by it, but, actually lots of the adults were too. In fact, the majority of objects in my “box of curiosities” are gifts from patients, colleagues and friends over many, many years. People who saw my box, often brought me something to add to it.

You’ll see there is a quite a variety of textures in there. There’s feather, leaf, and stone. There’s metal, shell and chestnut. There’s cord and there’s wood. Every single one of these objects begs to be picked up and handled. Yes, to be looked at, but mainly to be touched.

So why not take a little time to explore the sense of touch today? I think it connects us to reality in a completely unique way.

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We like to be close to the edge, don’t we?

I think that the “call of the sea” is real. We are pulled towards the oceans. Are houses with seaviews the most expensive houses in any country? Why is that? Is it that the sea represents both freedom and adventure? When we look out across the water towards the horizon it is somehow incredibly appealing when all we can see is water and sky. We don’t need to glimpse any distant coastlines to feel drawn to the edges of our land.

It does seem as if the sea, itself, stirs our souls.

But I think there is another factor. The edge.

I am naturally drawn towards the edges. I love to walk along a beach, gazing at the far horizon, breathing in tune to the rhythm of the breaking waves. That constantly changing, dynamic, irregular, line which marks where the water meets the sand, and the sand meets the water.

It’s the same with rocky outcrops. Just like the fisherman in the second photo there, we love to get to the edge (of course, he’s hoping to catch fish so if he doesn’t go to the edge, he’s not going to have much success!). But it’s not only the fishermen who like to stand, or sit, at the edge of a rock.

I wonder how much this instinctive attraction is due to a basic law of Nature – that all complex adaptive systems move towards “far from equilibrium” points? All living systems do. All ecosystems do. In fact, I think the concept of “steady state”, or “balance” misleads us. When I was taught about “homeostasis”, the idea that our “internal environment” has multiple checks and balances to maintain a constant inner state, I thought it made a lot of sense. I learned about all the feedback loops which kick in to ramp up or damp down activity in the body, to keep things ticking along in the “normal range”. But gradually I realised that was a bit simplistic.

The missing pieces included growth and adaptation, both of which are linked to creativity. That creativity manifests itself in “emergence” – the appearance of new behaviours and conditions which couldn’t have been predicted from the pre-existent ones. It manifests itself in novelty and difference. It manifests in growth, development, and maturity.

Once we start to understand that Life is based on a dynamic equilibrium – the kind of balance which never settles down – then we notice that everything tends to be drawn towards the edges.

It’s the same when we look at the activity of organs like the heart and the brain. The rhythm of the heart is constantly changing. You can measure the “heart rate variability”, and find that when there is next to none, the heart has become rigid, non-adaptive, and is about to fail. On the other hand, when you find that it’s chaotic, the heart is also about to fail. The sweet spot is the zone at the edge of both of those extremes. Same with the brain. When a seizure occurs the somewhat chaotic activity of the brain waves suddenly develop zones of constancy. It’s the imposition of rigid, regular wave patterns which seems to obliterate the underlying, normal, variable rhythms. The sweet spot, again, is in that zone at the edges of these two extremes – the zone between rigidity and chaos.

If we are going to learn from this pandemic we’re going to need new thinking, new ideas, different ways of living and organising ourselves. We aren’t going to learn if we try to “return to normal”.

The future is still to be invented, and we’re going to find it at the edge.

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I have a shelf in my bookcase where I collect some of the books which have made the biggest impact on my thinking and understanding. On that shelf sits a first edition of Iain McGilchrist’s “The Master and His Emissary”. If you’ve been reading these posts for a while you’re bound to have come across my references to his description of how our two cerebral hemispheres engage with the world in different ways.

When I came across this old photo from Marseilles the other day I immediately thought of the “left brain” view of the world. The left cerebral hemisphere is utterly brilliant at focusing in on whatever we are considering. It helps us to see the trees in the wood. It picks out elements, features, characteristics or parts. Then it helps us to analyse, label and categorise whatever it is that can be recognised.

It needs to have a narrow focus to be able to do that. It zooms in. It hones our attention. It separates and abstracts by blanking out the connections, the contexts and the environment.

This long corridor of arches looks very much like that kind of focused attention to me.

But there’s more. At the end of this passageway what do we see? It’s kind of hard to make out, isn’t it? What you are looking at here is an installation of irregular, angled mirrors. So you aren’t seeing a complete picture. Rather you are seeing a number of disconnected views or parts.

Our left brain is pretty good at doing that too. Its preference is for the parts, not their connections.

How the brain is supposed to work is that the after the left side does this focusing, separating, labelling and categorising, it’s supposed to pass this information back to the right side to have it contextualised. In other words, after seeing and recognising the pieces, the left passes over to the right to recreate the whole picture, to help us to understand whatever it is we’ve “grasped” by seeing how it connects to everything else.

Iain McGilchrist’s thesis is that this natural flow has become rather disrupted. The left brain has a tendency to hang on to what it grasps, and to convince us that whatever it has analysed is “correct”. Over the centuries we’ve evolved a complex society and civilisation which has encouraged us to prioritise the left brain over the right.

That’s a big mistake. That’s only using half a brain. To rectify this we have to learn how to use the whole brain again, and to practice doing that as often as we can. That’s going to involve deliberately returning again and again to the right brain functions – seeing the connections, discovering the particular, appreciating the whole, and weaving together the multiple threads to enjoy the entire tapestry of the world.

I don’t know about you, but that excites me!

I love that this idea is not about abandoning our left brain functions but re-integrating them into the right brain ones. How satisfying!

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At the port in Marseilles there is a hug mirrored roof over an open area. It provides people with some shade, but also attracts people to gather underneath it and look up – to see the world upside down.

Looking at the world upside down can be very revealing.

Think about this current pandemic. We are told there is this COVID-19 virus sweeping across the surface of the Earth, seeking out victims to slaughter. Several governments have used war metaphors accusing the virus of being an invisible, cunning and evil enemy. The answer, if this is your perspective, is to “beat” the virus, to “crush” it, “flatten” it, or “eliminate” it.

In the absence of treatments which kill the virus, the authorities pin their hopes on better defence – by which they mean immunisation – a mass vaccination programme to increase each individual’s ability to “resist” infection by this particular virus.

But, what if we turn our view upside down? What if we look at ourselves instead of the virus? Who gets sick when they catch this virus? Mainly the elderly, those with ongoing chronic health problems, the poor, and ethnic minorities. Why can’t either Public Health or the hospital services prevent the deaths of tens of thousands? (I mean reduce the number of actual deaths, not save the lives of an imaginary number who haven’t got sick)

What if we addressed these problems by making them the central target of our efforts? That would need our societies to deal with inequality, poor and overcrowded housing, poverty, low waged precarious contract work, racism and discrimination, under-resourced health and social care. We would need to invest in the creation of resilient well-resourced Public Health services including laboratory testing, contact tracing and the supply of safe place, supported isolation of the infected. We would need to invest in the resources of the clinical health services to have enough beds, nurses, doctors, equipment and personal protection for staff. We would need to address under-staffing in the health and care sectors so that too few workers didn’t have to look after too many people in too many different locations, so spreading the virus.

In other words, if we look at this pandemic from an upside down view, we might avoid future pandemics by creating healthier, more resilient, stronger societies…..no matter what the next virus is.

OK, I’m sure you’ll be thinking “but we need to treat all the sick, kill the virus which is overwhelming them, and reduce the current spread through hygiene and distancing measures”. All probably true. But none of those measures are enough. Remember my favourite phrase?

“And not or”.

We need to do both. Treat the sick, try to reduce the spread of the virus through the community, AND deal with the problems in society and the economy which have made us this vulnerable in the first place.

Sometimes it helps to add the upside down view.

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There is always another way.

I don’t believe people who say there is only way to do something. There are always other options, other choices to make, all dependent on our preferences, values, beliefs and particular circumstances.

Margaret Thatcher famously said “There is no alternative” – which was shortened to “TINA”. It wasn’t true then, and it’s never been true since.

I’m suspicious of algorithms and protocols because they tend to marshall everyone down the same pathway in order to produce the exact same outcome. But we are all different, and we are all living our every day lives, moment by unique moment, in each of our individual and particular circumstances. The more generally “TINA” is applied, the more inappropriate it is.

It’s been frustrating to hear politicians say they have been “following the science” all the time during this pandemic and that they have “taken the right steps at the right time”.

There is no “the science”.

Science is a methodology. It’s a way of considering the world, of exploring and attempting to understand it. The scientific method doesn’t produce end points. “IT’ is never finished. There is always more to discover, more to learn. Science is about doubt, not certainty. The findings and analyses of scientists can increase our understanding but they will never be set in stone, fixed for all time.

There are no “right” steps to take at “the right time”. There are just the steps we choose to take, in good faith, or carelessly. There are just the steps we choose to take now. They say hindsight has “twenty twenty vision” (or will we say in the future “2020 vision”?) but that’s not true either. Things just look different when we look back. Looking back is just a change of perspective. Not a perspective we had at the time.

Here’s the same passageway, viewed from the other side – looking back to the way we came, where the first one was looking forward to the way we were going.

Change the perspective, change the understanding, change the options.

There is always another way.

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We’ve reached a stage in this pandemic where more and more people are beginning to think about the “after life” – no, I’m not thinking about a life after death this time, I’m thinking about the life after the pandemic. Will there be a “reset” or a “bounce back” and everything will return to how it was before? Or will there be sufficient public and political will to learn the lessons and create a different, more robust, more resilient society in the future?

I’m more drawn to the latter idea because it seems pretty clear that we got into this mess by doing what we were doing. If we want to avoid the next catastrophe we have to stop doing that and do something different.

This photo stimulates some of these thoughts for me. You can see how this building has changed radically over the years. There is half an arch….what happened to the other half? It was removed to create that doorway on the right? There is half a lintel, and it’s pretty likely that the other half went the way of the missing half of the arch. The window that was there has been blocked up with stones, then either some of them have fallen out, or someone has knocked a hole in them to let some light in again. All in all, you can see that the present has emerged from the past. You can see the traces of how things were which determined how things would become.

There’s an orthodoxy around which seems to claim that the only way this pandemic will be “brought under control” is with a mass vaccination programme. Well, good luck with that. Hasn’t worked so well with the other emergent epidemic viruses in recent years, has it? Or a new “treatment” will be discovered which will reduce the severity of the impact of the virus on people who catch it. Maybe. But then what about the next one? Will the new “treatment” work for that too?

What do we know about the severity of this new disease? It hits the elderly, the poor, and the disadvantaged far, far harder than the young, fit and relatively wealthy. Is it any surprise that it hits those with “underlying conditions” harder than the fit and well? Is it any surprise that it’s exactly the same groups, the elderly, the poor and the disadvantaged who are most likely to have “underlying conditions”?

There’s a common theme there, isn’t there? Can we start with that one? If we are going to construct a new society in the “after life”, can we address our attitudes towards these sections of the population and ask how we are caring for them? Could we do better? Could we create better, healthier, more resilient lives for the elderly (maybe by valuing them more, perhaps?) Could we do the same for the poor (maybe by making them less poor, perhaps?) Could we address inequality and prejudice to improve the lives of those who are disadvantaged (maybe by making them less disadvantaged, perhaps?)

Then there are our values. Is it time to shift from consumerism to humanism? To recreate our economies around people and relationships rather than things and money? Is it time to move towards sustainability instead of single-use throwaways? To renewable energy instead of resource depleting forms? Is it time to nurture the local and the particular, rather than the global and the general?

What about our relationship to the rest of Nature? Can we decide to treat animals differently? To change the way we farm and produce food? To change the way we live on the land?

What about work? Is it right that the masses of people who we now think of as “essential workers” are amongst the least rewarded in society?

What about health and social care? Don’t these two sectors need to be integrated and better resourced? I read an interview with some French Hospital Consultants today, and they said that during this crisis, the relationship between the frontline doctors and nurses and the management had changed. Now the doctors and nurses said what needed to be done and got on with doing it, while the managers listened and then acted to do their best to enable the doctors and nurses to do what they had to do. Prior to this, somewhat amazingly, the system had evolved into one where managers set goals and targets, and told the doctors and nurses what they could and couldn’t do. Well, there’s one change, at least, that I’d like to see remain!

My point is that I believe we have to start where we are, learn how we got here, and create a different way forward. Don’t you?

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At first glance, this is a beautiful old building with its creamy, yellow stone all cleaned up and looking pretty glorious. But it doesn’t take long before you realise there’s something not right here. Something not whole. There’s no glass in any of the windows, which is the first clue, but when you look through the window frames you see…..the sky. When you walk around the building to the other side you see that there is nothing there. This isn’t a building any more. It’s a facade.

It’s not uncommon for towns to do this. The local authorities demand that the front of the old, beautiful building is preserved whilst the developers are free to demolish every other trace of it and replace it with a concrete, steel and glass box to put little offices or shops in.

It’s kind of sad. And yet, the front remains, and, when well preserved, it retains a lot of its initial beauty.

Have you ever visited a movie set? I don’t mean a movie theme park with rides and parades, but a set. I visited one once and it was the strangest experience to walk through a New York street, only to discover that every single building was a facade propped up from behind with great beams of wood and scaffolding. The building in this photo reminds me of that.

This sets my mind off down two quite different paths. The first is how we all present a certain face to the world. A certain look, style, a certain conformity really. Even when trying to be non-conformist, the “look” recreates conformity. I used to walk from Glasgow Central Station to Glasgow Queen Street Station on the way home from work. I’d pass the Gallery of Modern Art. On the steps of that gallery, goths would gather. Some evenings there would be a few dozen of them. Now, one goth in an office, or a shop, might stand out as really different, but several dozen of them together looked pretty much the same. (By the way, the pigeons used to hang about those same steps in large numbers too and I often wondered if there was some natural association between goths and pigeons!)

Our uniqueness is at its greatest on the inside. It’s not in our clothes, our “lifestyles”, our diets or our habits. We share all of those with many other people. (“Other customers who like X also like Y” – as the algorithms tell us)

So that’s the first thing I wonder about when I look at this photo. It’s uncomfortable because it isn’t “whole”, which, in my book, means it isn’t “healthy”. But, more than that it has no inside. So it’s lost its uniqueness.

The second line of thought is about imagination, because this image reminds me of the movie sets, and I know that whether it’s on TV, cinema or even in a theatre, “appearances” are manufactured to stimulate our imagination. So, I look again at this building and I wonder who built it and why. I wonder about the people who used to work there and how they related to the building they were working in. I wonder about the place this building had on this particular street, in this particular town. I wonder what stories these stones could tell, if only they could speak.

Here’s another photo which picks up that second thread.

Josette Navarro’s Dance School. Isn’t that beautiful? Doesn’t it capture your attention and set your imagination running? What a name! Once I got home I looked up Josette Navarro and her “Ecole de Danse” and she was still giving lessons, but I couldn’t really find much detail about either her or her dance school.

However, I still find this an incredibly evocative image. I love the wind-vane style of the sign with the dancer in full flight. I love the name. “Josette Navarro”. And the fact she has a dance school. I love the blue of the sign and how it echoes the blue paint on the shutters opposite. I love the light hanging directly opposite, and wonder if it casts a spotlight on the dancer at night.

Even when we can’t see what’s inside, what we do see can really stimulate the imagination, and/or bring back memories, such that it’s easy to imagine stories, scenes from movies, drama, romance, or whatever your favourite genre, and just spend a while enjoying that. Following where it leads you.

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It might be Spring time in the Northern Hemisphere but this pandemic has the feel of autumn to me.

One way I think of the cycle of seasons is – Spring is the time of life emerging anew, Summer is the time of flourishing and growth, Autumn is the time of harvesting and paring down, and Winter is the time of conservation and hibernation.

Oh, sure, there is SO much more I could say about the seasons and that wee synopsis is only one particular perspective, but it’s the one which comes to my mind when I look at this photo.

This is clearly an autumn photo. You can tell that from the browned and fallen leaves. It’s late autumn, I’d say, because some of the leaves are pared right back to their skeletons.

This skeleton leaf intrigues me. You’ll have read my thoughts on the two basic structures which Deleuze and Guattari describe – the “arboreal”, or “tree-like” branching kind, and the “rhizomal”, or networking, web like kind. Well, this little skeleton leaf reveals both. The larger fibres are clearly arboreal, branching into ever thinner, smaller strands. But between them, the smaller fibres make webs. If you look carefully you can see that. The smallest fibres create networks with multiple connections and nodes.

“And not or” – my favourite moto.

The underlying structures of Nature are both.

That’s what caught my attention when I looked at this photo, but that led on to thinking about this time in our world when it seems to me everything has been pared back. This paring back has revealed something – the underlying structures and frameworks of our societies.

I wonder if you see the same thing? What has this closing down, this minimising, this paring back, revealed to you?

Here are two of the things it has revealed to me.

  1. The importance of the Feminine. Now, when I’ve talked about this before I’ve been at pains to be clear I’m not talking about gender. I’m talking about the two great flows of reality to which we attach our myths of the Masculine and the Feminine. What do I mean by that? Simply, and concisely, for now, I mean the “Provide/Protect” energies and the “Nourish/Nurture” ones. I’m going to push this simplistic thought a step further – we have seen a shift in focus from Production to Care. I know this is too simplistic and that there is also a huge emphasis on “protection” too just now. I also know that a lot of what we call “production” isn’t really very productive (I’m looking at you, you people who drive the financialisation of everything, producing wealth from wealth in computers and papers, rather than from the soil, and the physical reality of the world). But bear with me for a moment……this crisis is revealing what every society needs to function, and who the people are who do that work….and I want to focus on the feminine here, because it’s mainly women who are carers, nurses, teachers, cashiers and cleaners – most of whom are vastly under-recognised, and poorly paid. (Yes, I know there are lots of important, even “essential” jobs which men do – including all the ones above, but also ones where men seem more prevalent than women – delivery drivers, power workers, waste and water workers etc). But none of that takes away from the main point I want to make which is I hope what has been revealed will lead to real change – change which values people and relationships more than consumption, change which values women more, change which values caring more, change which values “essential workers” more. “And not or”, for me, means we need both of these flows – the Masculine and the Feminine, the Provide/Protect AND the Nourish/Nurture, but we need to shift the balance.
  2. The failure of neo-liberalism. The idea that we are all selfish individuals ready to fight everyone else to grab the biggest share of everything for ourselves and “the market” is “self-regulating” which will, if left unregulated, deliver the best of all societies, has, I believe, been found wanting. None of our countries have entered this pandemic prepared. Hospitals have been closed, Public services have been cut massively, and the poor and vulnerable have been forced into ever more precarious lives. So, there’s my second hope – that a new economics and new politics will emerge – a more sustainable, healthy one. I hope we’ll see a shift away from mindless growth for growth’s sake, to choosing to grow better ways of living together in our one, small, shared planet.
  3. Thirdly, I’d like to see a shift in emphasis away from hierarchies and “arboreal” centralised systems to more networked, “rhizomal” communities of relationships. It seems the centralised, command and control, “just in time” structures have been found wanting – despite claims they are the “most efficient”, and that ordinary people and communities adopting personal hygiene and physical distancing behaviours have shown their strengths. My third hope, then is for a resurgence of community, local, devolved, and diverse structures of society. “And not or”, remember, I think we need both. We just need to shift our balance.

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This is a photo I shared with many patients and students over the course of my career. I saw this rock, a long, long time ago, just down from a waterfall in woods in the Scottish Highlands.

How did this rock come to have such a shape? It’s as if it had been struck by a Viking axe! What’s even more interesting is that it will never “heal”. That cleft, that wedge in the body of the rock, will never disappear.

It’s pretty common to think of healing as the complete resolution of something. We think of a cut, or a broken bone, and imagine that once it has healed, the skin or bone will return to how it had been before, forgetting somehow that all injuries leave scars. We think of infections as “self-limiting” – that is, once they have gone, they are gone. The body returns to some prior condition. We talk of “defeating disease” and use a lot of war imagery to suggest we can remove it (whatever “it” is) from our bodies, “defeat it”, and then it will be gone…for good. Job done.

But Life isn’t like that.

And neither is healing.

We don’t go backwards. Injuries, infections, traumas and diseases of all kinds change us. Even when we make a “complete recovery”, our lives have now changed. Something is altered….in the body and in the psyche. Whatever we encounter, whatever we have to “deal with”, becomes part of our story. Every event, every experience, changes our lives forever.

So, what are we to do with these wounds?

It would be nice if we could just ignore them. And in many situations they are minor enough for that to be a reasonable strategy. But the bigger impacts can’t be ignored, they can only be denied. That’s never a great strategy.

Maybe we could fill in the gap. Fill that wedge with prozac-a-filla or something like that. Would that work? Unfortunately, suppressing, and hiding the wounds tends not to work for very long. All those “anti-” medicines that we use – antibiotics, antihypertensives, antacids, anti-inflammatories, antidepressants etc combined with opiates and other sense-numbing drugs, don’t actually directly promote healing at all. They just “take the edge off” things….for a bit. You think antibiotics cure infections? I’m afraid not. They can do a very important job. They might even save your life. But what they do is kill bugs. The inflamed, swollen, and damaged tissues in your body need to heal. The antibiotics don’t do that. It’s your ability to self-repair that does. And antibiotics don’t stimulate the self-repairing functions of the body.

So what do we have to do?

Take a look at the photo again. See the river rushing by the rock? I think of the life force when I see that. The wound has become part of our internal landscape now. The illness, the experience of it, the memory of it, the impact it had on our psyches and our lives, is part of who we are now. It’s an integral part of our story. But life continues. We adapt. We find new ways to live and to thrive with this changed landscape. We evolve our inner environment.

I’m not saying we shouldn’t use our modern medicines. They can reduce our suffering and even, sometimes, save our lives. But they don’t directly help us to heal. We still need to recover, repair and adapt. How much of “Medicine” or our “Health Service” is directed towards that life-long, important issue of healing?

I hope that, whatever the answer to that question, the answer will be “a lot more in the future”.

Our lives are not going to be the same once this coronavirus pandemic is over. How are we going to heal? How are we going to adapt? How are we going to live differently?

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I took this photo at noon one January 1st.

You might think its pretty much just a photo of some grass, so, hold on, let’s look more carefully, and consider the contexts. If it was simply a photo of a patch of grass it wouldn’t be particularly interesting but what caught my eye wasn’t the grass, it was the interplay of shadow and light.

Despite it being noon, the Sun is still pretty low in the sky. Well, it’s taken in the wintertime in Scotland, so that’s normal. But, normal or not, the effect of the low sunlight streaming through the trees is spectacular. The angle of the light makes the shadows SO long and the spaces between the trees show frosted grass sparkling brightly.

I love the forms and the patterns of the shadows, the light, the frost and the grass. It takes all of them together to create the scene.

Here’s another scene –

This is a huge puddle which is there more often than it’s not in this particular field. I once saw swans swimming on it! But today, what makes this image so beautiful is the trees and their reflection. Without the trees, the clarity of the light and the stillness of the water, this just wouldn’t be the same. It has echoes of the previous photo but it’s completely different. However, both photos were taken within minutes of each other, the flooded field lying just a short walk along the road from the shadowed park.

I’m struck by how important the contexts are in these photos. If I’d “abstracted” just one element in each – a grassy patch, a section of the puddle, a single tree – I’d lose all the context. It’s the interplay of all the elements which makes these images more than the sum of their parts.

Life is like that.

When we focus too narrowly, when we consider only a part in isolation, we achieve only a partial understanding. It’s the whole experience, in all it’s contexts and environments, with the story which holds them together, and the remembered subjective experience of being there which makes them so unique, so particular to me.

So, if I am to share any of that with you, I need to show you, and tell you, at least some of the contexts. That way, you’ll come closer to experiencing what I experienced.

That was my everyday working reality. Every single patient who came to see me had a unique story to tell. If I were to understand them I had to hear their story. I had to try to have some experience of their experience, to feel what they were feeling, to know what they knew, if I was to understand, diagnose and help them.

But it’s the same for all of us. If we are to understand anyone, friend, relative, colleague, stranger, we have to hear their story, and try to experience some of their experience.

It’s always partial. It’s never fixed. It’s never completely knowable. But there’s no substitute.

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