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Archive for the ‘life’ Category

Growth as in better not bigger

Posted in from the reading room, life, personal growth on January 6, 2008| Leave a Comment »

In Charles Handy’s Empty Raincoat he tells a story of speaking to a successful winemaker in California. He asked this man what he hoped for in the future and he said he wanted to grow his business. Handy could see that the valley was already full of vines and couldn’t see how the business (a vineyard) could grow bigger there, so he asked the man, sharing that thought. Oh no, said the winemaker, growth is not making it bigger, it’s making it better.

I like that story.

Growth is an essential principle of life. If we stop growing, we stop living. And I don’t mean just waist size! Growing for a human being should be about growing better – increasing your knowledge, your skills, your wisdom, your pleasure, and your sense of purpose.

Here’s my wish for you in 2008 (I’m writing this on January 1st) –

May you grow this year. May your life grow better in the ways that matter to you.

May you know that you are a hero, not a zombie!

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Now instead of some other time – not goal-setting but fractal planning

Posted in life, personal growth, writing on January 5, 2008| 3 Comments »

I don’t know about you, but I’m not a great fan of goals. I know, almost every book you read about personal improvement, “getting things done” or management methods harps on about goals. Have a look at 43 things, which is a website which is supposed to help you achieve your goals –

People have known for years that making a list of goals is the best way to achieve them. But most of us never get around to making a list. 43 Things is great for that! Make a list on 43 Things and see what changes happen in your life. Best of all it’s a way of connecting with other enthusiasts interested in everything from watching a space shuttle launch to grow my own vegetables. So the next time someone asks you, “what do you do?” you can answer with confidence, “I am doing 43 things!”.

One of the interesting things on this site is the list of the “all-time most popular goals“. It might not surprise you to see that number one is “lose weight”. And the fact that number two is “stop procrastinating” will give you some idea of the likely success rate of subscribers! (actually reading their comments on their progress is really a rather sad experience 😦 ) Some of the goals are quite well circumscribed, like “buy a house”, and “get a tattoo”. What bothers me about those kinds of goals is that the goal itself has little to do with daily life. Buying a house is an event. Getting a tattoo is an event. Quite a lot of goals are like that. Now there’s nothing wrong with planning to experience an event, and there’s nothing wrong with wanting a house (though why people want tattoos escapes me!!), but the process of getting there is unrelated to the end goal. I always found those suggestions about visualising your goal (like they do in the Secret) a bit naff.

Other goals aren’t like that. “Learn Spanish”, “Learn to play the guitar”, “Practice yoga”, for example are activities. Turning activities into goals though risks developing a tick box mentality. When do you reach a goal like that? When do you say “OK, that’s Spanish cracked, what now?” But there’s something about these goals that appeals more than the event type.

Before I finish this little rant about goals, I’m pretty sure the reason I got so fed up with goal-setting was the introduction of “targets” into the National Health Service. Not only would I dispute the prioritisation of the particular targets, but it annoys me how so much of the health service’s resources are then consumed hitting those targets. Targets distort health care and move the focus away from the individual patients to the declared outcomes either politicians or managers have decided are most important. And don’t get me started on “measurable” targets because what they do is give what can be measured greater priority over what can’t.

And yet……there’s a nagging doubt that goals aren’t all that bad, that they can be a way of bringing focus, and contributing towards motivation. But my lingering discomfort comes from the many people I’ve met who are not living the life they want to live but have some goal, some time in the future, (after retirement or winning the lottery are two common future scenarios), which they would like to achieve, get, experience, or whatever, but by the time that some time arrives it’s too late and in fact they never live the life they wanted to live.

Well, my brain works in a way that makes connections between ideas and I’ve long been fascinated by something called fractals. A fractal is a shape which looks pretty much the same at whichever level of magnification you view it. It’s based on a characteristic called “self-similarity” (others call this phenomenon “self-symmetry”). When you use a mathematical formula to create a pattern based on this type of symmetry you get beautiful images.

What’s this got to do with goals? Well, the issue of doing one completely different thing, to get to another, like, say, working 9 – 5 in a job you hate to put enough money in a retirement fund which you hope will enable you to do what you really want to do in 30 or 40 years time, just strikes me as crazy. It’s not a way to live. If I’ve got a goal, then the experience of working towards it should, ideally, be as good as the goal itself. That way, I experience what I’m hoping for today, and in a way that will, hopefully, grow and continue to deepen. Take learning a language for example. I decided I’d like to learn Japanese and enrolled in an evening class at Glasgow University. It’s fun. I really enjoy it and so far I’ve learned all the hiragana characters and am moving on to learn the katakana ones. It’s like learning to crack a secret code and the fact I can now read a menu in Tokyo is a great thrill! But there isn’t an “end point”, there’s no box to tick. There might be exams in my course but I’ve no desire to get a certificate. It’s the learning that’s the thrill. You could say the same about my photography. I could say I’d like to take better photographs but I do that by taking better photographs, carrying my camera with me everywhere and seeing what works and what doesn’t work. These “goals” have the quality of self-similarity. They look the same no matter what time scale you examine them under – today, next week, this next year, by the time I’m 65.

I have a notion that if we keep the idea of the fractal in our heads when thinking about goal setting we’ll have more chance of living a life NOW that we choose and enjoy AND which leads us to where we want to go.

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Charles Handy’s Doughnut

Posted in from the reading room, health, life, personal growth on January 4, 2008| 1 Comment »

Another of Charles Handy’s useful concepts from his Empty Raincoat is the ‘doughnut principle’. He says to imagine an American donut (see how I changed the spelling to the American one?) but to invert it so that instead of a hole in the middle, you have a core, and outside of the core you have an area bounded by the donut’s edge.

He says the core is what’s essential. It’s the agreed given of a job, or a project, or a person. And the outside of the core is the potential. The potential is variable and you can develop as much or as little of it as you want. But it does have a boundary, or a limit.

Without a boundary it is easy to be oppressed by guilt, for enough is never enough.

This is a good model in health care. The core might be the essential health outcomes you’d hope to achieve eg a normal blood pressure reading, but the outer ring of the doughnut represents the potential which might be achieved – how might this person’s health be improved, not just their blood pressure?

Societies which overemphasise the core can be too regulated.

This is his warning and it’s so true. It’s the danger inherent in a system of targets in health care. The ‘Quality Outcomes Framework’ at the heart of UK General Practice is the core, but if it consumes all of the doctors’ attention and energies, we’re going to lose an awful lot of good medical practice that sits out there in the potential.

There’s also something in this idea of a core which reminds me of the concept of virtues, where the focus is on developing character rather than on tasks and duties.

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The Third Age

Posted in from the reading room, life, personal growth on January 3, 2008| 4 Comments »

Did Charles Handy come up with the concept of the “third age”? I’ve done a bit of searching online but I can’t find the answer to that. Wikipedia reckons the Third Age, is the history of Middle Earth in Lord of the Rings! In The Empty Raincoat, Handy describes four ages –

  1. Formation – education, training, life experience
  2. Endeavour – work, parenting, house-keeping
  3. Second Life – extension of the Second Age, or something different
  4. Dependency – the final years

He attributes roughly 25 years of life to each of these stages (or ‘ages’).

Whoever coined the term originally, the concept is a useful one, and as Handy points out, with increased life expectancy and quality of life for most of us, the Third Age is becoming increasingly important. He points out that the Third Age used to be what we called retirement and was seen as a time to do nothing, live off your pension, then die! Nowadays, with the changing demographics producing many more older, healthier people, and correspondingly lower proportions of younger people in society, he says we can no longer think of the Third Age as a time for doing nothing and earning nothing. He describes four sources of income in the Third Age –

  1. State pension
  2. Occupational pension
  3. Savings/inheritance
  4. Paid work

and he says that as neither State nor occupational pensions will be enough to live on in the future, that we’ll increasingly have to rely on paid word beyond the age of 65. This needn’t be a bad thing of course. Many people feel tossed on a waste heap on retirement day. But certainly, it’d be good if it wasn’t about just more years of 9 till 5 and wages! Given that most people will have some pension income, and maybe also some savings or inheritances, then paid work needn’t take centre stage but might potentially be more meaningful work – something which adds value to life beyond a simple income. But, then, that’s a pretty good goal to have at any age, isn’t it?

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The ‘S’ curve

Posted in from the reading room, life, personal growth on January 2, 2008| 5 Comments »

One of the concepts which Charles Handy writes about in The Empty Raincoat is the ‘s’ curve. Here’s an example of one –

S curve

We start something new, it develops and grows, then the problems and limitations start to appear so the growth flattens out, and in the final stage, decline sets in.

Handy says

It’s one of the paradoxes of success that the things and the ways which got you where you are, are seldom the things that keep you there.

In other words, when things are going well, we shouldn’t become complacent thinking that we’ve got it all sussed. If we want to keep growing (and if we don’t we’ll start to shrink or decline) then we have to change what we’re doing now. The future will be different from both the past and the present.

An example of this from medical practice would be the treatment of an individual with a chronic illness. The doctor might find some therapies which are helpful eg some particular drugs which work for this patient, but, as time passes, those therapies won’t be so helpful any more.

I find the idea of “proven” or “unproven” treatments to be very unhelpful. Not only because no treatment will work for every patient, so a treatment is only “proven” for that person when we see how things turn out for them, but that because everyone is always changing, what works now, what is “proven” now, will stop working, or at least stop working so well, as time passes.

If we are to continue to improve and to grow we need to understand the reality of this ‘s-curve’ and as

it’s easy to explain things looking backwards, we think we can then predict them forwards

we soon find that the next phase, the new medicine, the new way of doing things, will be quite unlike the present – related to the present and emerging from the present – but different.

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What’s an Empty Raincoat?

Posted in from the reading room, life on January 1, 2008| Leave a Comment »

Charles Handy wrote ‘The Empty Raincoat‘ in 1994. Strange title, huh? It refers to a sculpture he saw – ‘Without Words‘ by Judith Shea.

I canot forget a sculpture I saw….’Without Words’ by Judith Shea……a bronze raincoat, standing upright, but empty, with no-one inside it. We were not destined to be empty raincoats, nameless numbers on a payroll, role occupants, the raw material of economics or sociology, statistics in some government report. If that is to be its price, then economic progress is an empty promise. There must be more to life than to be a cog in someone else’s machine.

We shouldn’t be zombies, we should be heroes.

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The Empty Raincoat

Posted in from the reading room, life on January 1, 2008| 7 Comments »

Here’s the trail…….a colleague emailed me about MacNamara’s Fallacy, which was mentioned in an article, by David Haslam, in the Journal of the Royal College of Practictioners. I really liked the quote and set about hunting it down. Turns out it was first quoted in a book by Charles Handy, ‘The Empty Raincoat’ (ISBN 0-09-178022-5). I found a hardback copy on sale for a penny on Amazon Marketplace. It was written in 1994 and a lot’s happened in the world since then but this book is still a refreshing and insightful read. I guess I’m going to be hunting down some more Charles Handy books in the future because I really enjoyed this one. It is full of creative ways of thinking about life, and, in particular, work and business.

I’ll do individual posts on some of his main ideas because I liked them so much but one of thing that really struck me was the advice he gave to his children as they came of age and began to look for work. He told them not to look for a boss, but to look for customers. Wise advice and, it turns out, very relevant to how work was already changing, but especially how work has changed since the book was written. And it struck me that this advice fits beautifully with the heroes not zombies theme.

To find satisfaction in life, it’s best not to try and sign up for, as Charles Handy puts it “100,000 hours of your life” sold to someone else, but, instead to think what do I have to offer people? Or how can I gain the experience, knowledge or skills that will allow me to offer something to people? Once you know what you have to offer, you can begin to set out to find the ways to provide it.

Being a hero, is writing your own story of your own life. It’s about having the personal confidence in what you have to offer the world and setting out to share it.

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Bricks

Posted in from the dark room, life, photography on December 24, 2007| 2 Comments »

Bricks, originally uploaded by bobsee.

For those of you who like spotting patterns and wondering what exactly you’re looking at, you might find this photo interesting.
I took it a couple of mornings ago. It’s the car park outside my building. Looking at it now, it’s like some great board game or something……

The shiny bricks are covered in ice and are very, very slippy. The other bricks were dry. Gave a whole new reason not to stand on the lines!

 

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Randomised Controlled Trial of Parachute Use

Posted in from the consulting room, from the reading room, health, humour, life on December 20, 2007| 5 Comments »

Every Christmas issue of the British Medical Journal, now known simply as the BMJ, has some really fun articles. I haven’t opened this year’s issue yet but when I picked it up from behind my door just now a study from old BMJ Christmas issue came to mind. It was a systematic review of the evidence base for the use of parachutes. In the introduction they say –

The perception that parachutes are a successful intervention is based largely on anecdotal evidence. Observational data have shown that their use is associated with morbidity and mortality, due to both failure of the intervention1 2 and iatrogenic complications.3 In addition, “natural history” studies of free fall indicate that failure to take or deploy a parachute does not inevitably result in an adverse outcome.4 We therefore undertook a systematic review of randomised controlled trials of parachutes.

The authors completely failed to find a single randomised controlled trial of parachute use! This article is typical of the BMJ Christmas editions. It’s funny, tongue in cheek, but thought-provoking and makes serious points through the use of humour. I love their conclusion –

Only two options exist. The first is that we accept that, under exceptional circumstances, common sense might be applied when considering the potential risks and benefits of interventions. The second is that we continue our quest for the holy grail of exclusively evidence based interventions and preclude parachute use outside the context of a properly conducted trial. The dependency we have created in our population may make recruitment of the unenlightened masses to such a trial difficult. If so, we feel assured that those who advocate evidence based medicine and criticise use of interventions that lack an evidence base will not hesitate to demonstrate their commitment by volunteering for a double blind, randomised, placebo controlled, crossover trial.

Any volunteers? (and, no, you’re not allowed to volunteer anybody else!)

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Tracing the threads that connect us

Posted in life, music, narrative on December 16, 2007| 2 Comments »

I have so enjoyed the series on Scotland’s Music with Phil Cunningham on BBC. The final part in the series is called Home and Away and traces some of Scottish music’s origins and its influences around the world.

Well, Tommy Bibey, imagine my surprise when Phil’s journey from Scotland took him to Cape Breton then down through Appalachia to the home of bluegrass music! Bluegrass has just been a name to me really but when Dr Bibey connected to me through this blog I got more interested – really because I enjoyed his writing so, and he’s impressed me as the kind of doctor, doctors should aspire to be – caring, passionate and humble. He told me his favourite bluegrass had its origins in Scotland and Ireland. It made more of a connection between us. The Scotland’s Music series (by the way, it looks like the BBC has now removed all the video clips from the earlier parts of this series – boo!) was something I recorded on my hard drive and I just got round to watching the last episode yesterday. I watched in anticipation and sure enough he made the link with bluegrass and with Alison Brown in particular (whose album ‘Stolen Moments’ is on my pod – the track ‘I’m naked and I’m going to Glasgow’ always brings a smile to my face on the Stirling/Glasgow Scotrail train!). So, it turns out I had some bluegrass in my collection after all!

I have a very diverse musical collection, and that shouldn’t surprise anyone who reads this blog – I am a great fan of diversity. Neither uniformity nor conformity appeal to me. Why is that? What is it about diversity that I find so appealing?

Two things spring to mind –

first of all, Deleuze has a great concept which he terms “lines of flight” – it’s the idea of not thinking of anything as having fixed co-ordinates, not seeing anything as existing as a point, but instead seeing all points as lines, so that a point is just a cross-section through a line or a thread or even a vapour trail

vapour trails

I love that idea of seeing whatever it is you’re considering in its origins and its becoming (see that subtitle at the top of the blog? “Becoming not being…….”) It makes everything dynamic, changing, moving, developing and it connects what is both to what was and what is to come.

Secondly, I love the idea of connections, seeing patterns and resonances. I think that’s why ‘Linked‘ appealed to me so much.

Amy, has a lovely post about ripples of connection and what a good metaphor that is for blogging…..and there we go…..a whole other set of paths to follow…..the threads that connect us…….and the stories that weave us together.

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