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Archive for the ‘life’ Category

I’m enjoying a series on BBC Scotland just now. It’s called Scotland’s Music with Phil Cunningham. Phil’s an amazing contemporary Scottish traditional musician and each part of this short series examines the relationship between some aspect of Scotland and Scottish music. This week’s episode (Part 4) was entitled ‘Heaven and Earth’ and explored what Phil called the soul of Scottish music. I loved this and understood with every fibre of my being. I liked the way he showed such diverse ‘spiritual’ inspirations for Scottish music, from superstitions and beliefs in magical creatures like selkies, to Christian traditions both Protestant and Catholic, to the ‘spiritual’ inspiration of the land itself. It’s this last that means most to Phil, and it’s this last that means most to me, but to range over such a diversity of sources for inspiration to produce music that connects the individual to something much greater, be it Life, or God, or the Natural World is quite unusual.

Take a look at the BBC site dedicated to this series. In particular take a look at episode 4, ‘Heaven and Earth’ and play the video entitled ‘Soraidh Leis An Ait’ which is played by all the musicians appearing in this part. If you’ve any Scottish blood in you, I swear this will touch your soul! And even if you’re not Scottish, Tommy Smith playing his sax in the Hamilton Mausoleum is enchantingly beautiful.

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Heads up

Heads up, originally uploaded by bobsee.

I took three of my grandchildren to the Kelvingrove Gallery last week.
I’d seen photos of these heads but I’d never actually been to see them in situ so to speak.
It’s a great experience. You can stand and look at them for ages and you keep seeing something new, something different. Some of the expressions make you laugh. In fact, I think the whole installation makes you laugh and that is SO Glasgow! Glasgow people have quite a reputation for their sense of humour. I think it’s one of their greatest qualities.
I like art that makes you think and/or makes you feel. It’s that old Deleuzean thing again – the three ways to think – science, art and philosophy. It’s not a competition between those perspectives – they work together to reveal more than any one approach can do by itself.
If you ever take a trip to Glasgow I’d recommend taking in the Kelvingrove while you’re there.

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According to Deleuze and Guattari (see a thousand plateaus, and other writings too), the dominant model of thought which we employ is what they term the arboreal model. By this, they mean, tree-like.

tree

You’ll be familiar with this. Think of how we categorise using this model. It creates a hierarchy with layer after layer of subdivisions, branches or roots. But everything is connected back to the trunk, or up to the top level of the hierarchy. They say

The tree imposes the verb “to be”

It attempts to nail down exact definitions, to fix things in their place, to pigeon-hole them.

They challenge us to think instead using the rhizome as a model.

the fabric of the rhizome is the conjunction, “and….and….and…”

In a rhizome every element is connected to every other. There is no central trunk and no hierarchy. Think of a web

web

This is a non-linear model. You can’t fix things into pigeon-holes this way. It’s dynamic and flowing, without clear beginnings or endings.

I love this simple analogy. It’s one of my favourite parts of Deleuzean thinking. I find it liberating, even to the point of being dizzying. It’s got life and movement and creativity and flow. It helps us understand by considering difference rather than by categorisation.

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I read this book some time ago but it came back to my mind when I stumbled across the dancer who claims to reveal whether your are dominantly left-brained or right-brained. The book in question is “A Whole New Mind”, by Daniel H. Pink (ISBN 1-904879-57-8). Let me say at the outset that I really liked this book. I found it stimulating, thought-provoking an useful. The basic thesis is that there has been a time of great progress in societies from left-brained dominance and, rather than argue that what we need is a time of right-brained dominance, Pink, I reckon, gets it right by arguing for a whole-brained approach. I like that. I find the left-right debate rather stale and unhelpful.

What he does is argue for the development of six, what he calls “senses”, which are, in effect attributes, or characteristics, which he says will give people who use their whole brains success over those who stick with old sided dominances. I really like all six of them. They are –

  1. DESIGN – products, services and experiences that aren’t just functional, but which are also “beautiful, whimsical, or emotionally engaging”
  2. STORY – it’s not enough to fashion effective arguments from information and data, “The essence of persuasion, communication, and self-understanding has become the ability also to fashion a compelling narrative”
  3. SYMPHONY – not analysis but synthesis “being able to combine disparate pieces into an arresting new whole”
  4. EMPATHY – “logic alone won’t do. What will distinguish those who thrive will be their ability to understand what makes their fellow woman or man tick, to forge relationships, and to care for others.”
  5. PLAY – there is a need for seriousness but there is also a need for play
  6. MEANING – many of us live in material abundance, and this has freed us up to “pursue more significant desires: purpose, transcendence, and spiritual fulfillment.”

The book has two sections. The first makes the case for a whole brain approach and the second devotes a chapter to each of these six “senses”. In fact, one of the things that takes this book out of the theoretical and into the practical is that he treats every “sense” to two chapters – the first clarifies what that sense is and the second is entitled “portfolio” which is a collection of exercises you can do to develop that “sense” in your own life.

You know what? I’m going to read it again!

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It’s Amy‘s birthday today. Happy Birthday Amy

I’m gonna watch you shine
Gonna watch you grow
Gonna paint a sign
So you’ll always know
As long as one and one is two
There could never be a father
Who loved his daughter more than I love you

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Being There, by Andy Clark (ISBN 0-262-53156-9) is one of the most interestingly challenging books I’ve read for a long time. Let me say first that it’s taken me longer to read than I’d have expected it to. There are whole swathes of it which just didn’t engage me easily. In fact, a few times I thought I’d pack it in, then I’d come across a few sentences or a paragraph that not only would grab me and turn my thinking upside down, but it’d be exciting, visionary and, yes, down right thrilling.

I really enjoyed Robert Solomon’s, The Joy of Philosophy, not least because I feel he gave me a new vocabulary. His one word/concept of “thin” really expanded my thought. You can read more about it here, but what really excited me about this word was the way it captured the inadequacy of logical/analytical/reductionist thought.

I then read Barabasi’s Linked, which homed in on the key concepts of connections and nodes. I especially liked the way he demonstrated that the world, though a complex and at times chaotic system, is not random. Randomness turns out not to be the explanation for the phenomena we experience daily. That changed the way I thought about the world – there are patterns to be discovered, and phenomena to be understood. Sure, there is such a thing as chance, and life is often extremely unpredictable, but we can begin to unravel the connections between things and events, and in the process we can improve our understanding of the world.

Now I’ve just read Andy Clark’s Being There and he puts forward concepts that similarly change the way I understand the world and uses language in some novel ways which open the doors to other ways to explore life.  His main thesis is that to understand the mind we have to step outside of the study of the brain – not that the brain is not important of course – but we need to understand the environments in which brains exist. He draws the connections between the brain and the physical, social and symbolic environments in which we live and shows that to fully understand how the mind works we need to explore the interactions between brains and the world. He calls this concept of the mind, the “extended mind” and in the process he nicely shows how we use our brains primarily for pattern recognition and for creating change in the world. In particular how we create the structures in the world that we can then use to extend the functions of our minds.

Let me highlight one simple example – doing a jigsaw. To do a jigsaw we don’t work it all out in our heads but we use our hands to literally manipulate the pieces, turning them around to view each piece from different angles, so stimulating our pattern-recognising brains, and moving the pieces towards and away from different sections of the puzzle. In other words we manipulate the physical environment to help our pattern-spotting brains do what they do best, and to do that more quickly. Andy Clark nicely shows how we do exactly the same thing with our social environment and, crucially, with our ability to handle symbols and signs, which has reached its highest point in our development of language.

What does public language do for us? There is a common, easy answer, which, though not incorrect, is subtly misleading. The easy answer is that language helps us to communicate ideas. It lets other human beings profit from what we know, and it enables us to profit from what they know. This is surely true, and it locates one major wellspring of our rather unique kind of cognitive success. However, the emphasis on language as a medium of communication tends to blind us to a subtler but equally potent role: the role of language as a tool that alters the nature of the computational tasks involved in various kinds of problem solving.

I’ve never read this idea anywhere else – it highlights language as not only being a tool of communication but also being a tool we use to reshape the world to enable our brains to more effectively use their capacities.

This whole thrust can feel a little vertiginous. Look at this for example –

Every thought is had by a brain. But the flow of thoughts and the adaptive successes of reason are now seen to depend on repeated and crucial interactions with external resources. The role of such interactions, in the cases I have highlighted, is clearly computational and informational: it is to transform inputs, to simplify search, to aid recognition, to prompt associative recall, to offload memory, and so on…

and this –

Our brains are the cogs in larger social and cultural machines – machines that bear the mark of vast bodies of previous search and effort, both individual and collective. This machinery is, quite literally, the persisting embodiment of the wealth of achieved knowledge. It is this leviathan of diffused reason that presses maximal benefits from our own simple efforts….

Well, I don’t know about you but this embedding of the brain in the web of relationships, stretching backwards, sideways and forwards in time, makes my head spin! It turns the mind into an even more dynamic phenomenon than I had previously realised and at the same time it turns it into a much less isolated phenomenon too.

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I’m a Lord of the Rings fan – both the book and the movies. One of my favourite scenes is this one –

I find this inspiring. I think this is what we can do. If you have passion for life, you light a beacon. That beacon spreads light that changes lives. If I had to write down one tip for a better life it would be this – be passionate. Passion is flow. The Chinese have a concept of Chi – a kind of energy. Csikszentmihalyi espoused the concept of “flow“. In modern, Western terms, we are able to be very aware of energy. I often ask medical students to take a score from 1 to 10 where 1 is the worst possible energy they can imagine and 10 is the best possible and to tell me what figure they’d apply right now to describe their own energy state. They can all easily state a number. Then I ask them to do the same thing for their mental energy and they find that equally easy. Then I ask them how they came up with the numbers they picked. What did they assess, and how did they do that? What criteria did they use? Which parameters did they pick? They don’t know. We assess our own energy levels holistically and intuitively. We don’t have to break it down into components, and the strange thing is that the energy we are measuring is not measurable by either instruments or others. Only we are capable of assessing and experiencing our own energy levels.

I think this “energy” idea is related to flow. Flow can be thought of as the Western equivalent of Chi. When the flow is strong, and we are “in the flow” then we feel well, our energy feels good and we alive and healthy. When our flow is weak, we’re unwell. Passion is both a product and a cause of this flow. When we are passionate about life, our energies flow, our creative abilities surge, our resilience is strong and we touch, and are touched by, others. Passion is contagious.

Pass it on.

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Research by Danny Dorling at Sheffield University has shown clear links between inequality and death rates.

Sure, there’s a kind of intuitive logic to the fact that poorer people suffer poorer health, but a slightly less intuitive finding is that the amount of social inequality (as indicated by the differences in income between the poorest and the richest) impacts on death rates in all countries, rich or poor. So, within any one country, when social inequality gets greater, mortality rates rise. Danny Dorling’s research has shown that this is an age dependent factor – he’s shown that the larger the inequalities in a society, the greater the mortality in people from 15 – 65 ie. people of working age.

there is an age related mechanism that results in higher mortality being experienced in societies where there is greater social competition, all else being equal. Higher rates of income inequality tend to reflect more competitive rather than more cooperative societies. Whatever the mechanism that results in harm from competition (or protection from cooperation), it has its strongest effects in early to middle adulthood.

One of his conclusions particularly struck me –

social inequalities as reflected through unequal incomes are damaging to health for those living in both rich and poor nations, and the direct mechanisms for such damage are likely to vary by area. Psychosocial stress is unlikely to be the only route by which income inequality damages health. However, the underlying mechanism may be similar—that, because humans are social animals, human health is best protected when people cooperate.

It’s that last phrase that really interests me. “…..because humans are social animals, human health is best protected when people cooperate”

It’s always been the case that the big impacts on the health of populations doesn’t come from the skills of doctors, or the power of drugs, but from the changes in the contexts of peoples’ lives. Education, housing, sanitation, food and water, and income are still the most powerful levers of power in the creation of health.

Yes, of course, there’s lots we can do as individuals. We can make choices about our own lives. And when we are sick individual treatments can make a difference, but if we want more people to have more health, if we want to reduce suffering from cancer, heart disease, mental illness and a host of other diseases, the big gains come from changes in these areas. How we behave towards others, whether or not we value competition or cooperation more highly, impacts on the prevalence of disease and on death rates in people under the age of 65.

One of the things I love about the net, is how it gives us a chance to build our links, to share ideas and thoughts, to encourage and inform each other. In short, to cooperate. And, well, who would have thought it, turns out that’s good for you!

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I’ve a lot of respect for a London GP, Iona Heath, who frequently writes in the BMJ, . Last week she wrote an opinion piece about what she sees as the corrupting influence of money on healthcare. I know that healthcare is a big debate in the US, what with Rudy Giuliani throwing around mis-information about cancer treatment to bash what he calls “socialised medicine”. Well, I guess if he reads Iona Heath’s views he’ll confirm his current view that the UK has it all wrong. The system of payment for GPs in the UK has changed with the government paying them for carrying out certain procedures (actually mainly paying them for recording certain pieces of information, like whether or not a patient smokes, BP readings and so on). This has resulted in massive income rises for GPs and the advocates of the system say this shows that money motivates doctors to work according to best practice. Here’s what Dr Heath says –

But if money is thought to be the only motivation, hugely important human aspirations are systematically marginalised and our conception of what it is to be human and a member of society is diminished.

And, this –

In The Burial at Thebes, his translation of the story of Sophocles’ Antigone, Seamus Heaney gives King Creon these words: “Money has a long and sinister reach. It slips into the system, changes hands and starts to eat away at the foundations of everything we stand for. Money brings down leaders, warps minds, and generally corrupts people and institutions.” It seems an extraordinarily accurate description of the state of the NHS. Money is everywhere the driver of change but it is warping minds and corrupting both individuals and institutions. There seems no place left for the altruism of public service to flourish and this is taking a huge toll of the morale of those working in the frontline of health care, whose motivation has always gone beyond the simple question of money. The neglect of altruism seems likely to prove both destructive of social solidarity and ultimately extremely costly for individual citizens.

Let me put my cards on the table. I completely agree.

From the age of three I wanted to be a doctor. Don’t know where that idea came from because there were no family connections with doctors but I pursued that dream and became a doctor back in 1978. Graduation Day was one of the most thrilling days of my life. But it’s only after graduation that doctoring starts and my training jobs were tough, demanding and challenging. In 1982 I became a GP. From the start I’ve always loved working with patients and I always brought my constant curiosity and desire to improve and change things with me. I always made what others would consider stupid decisions about money, not least deciding to leave one practice and join another in 1986 resulting in a drop in income of 70% overnight. Money didn’t motivate my medical decisions. But the government always thinks otherwise and the trend to motivate doctors to carry out government-determined tasks by paying more for what the authorities wanted the doctors to do started to take off in the early 1990s. It drove me out of general practice. It just didn’t sit right with me that I might get paid more if I persuaded a patient to choose one particular course of action over another. I wanted to help every single patient to choose the action they preferred, not to choose the one that paid me more. And I realised that when patients became aware of the payment system they started to question whether I was recommending a treatment because it was good for them or good for me. That was it. I couldn’t do that.

So I stopped.

In fact that was my crisis point. I resigned as a GP and didn’t have another job to go to. For the next 8 months, I got by on one day of clinics at Glasgow Homeopathic Hospital, a weekly radio show (Phone Dr Bob!) and I wrote a textbook of homeopathy for GPs. Financially, it wasn’t clever! Then I got the job I still do – a full-time job at Glasgow Homeopathic Hospital with half the week seeing patients and half the week focussing on teaching. It’s a great job. I love every day of it. There is no greater thrill and sense of reward than I get from the privilege of meeting new patients, getting to know people over time and helping them to find relief from suffering and to experience better health. Financially, I’d be way, way, better off if I’d stayed as a GP (or if went back into general practice now) but in terms of satisfaction and fulfilling a life’s purpose? Well, this current job ticks those boxes for me.

That’s my personal story, but I don’t think my motivations are unusual. I don’t think most doctors become doctors for the money and I totally agree with Iona Heath that creating the health care system around money as a motivator is destroying the environment in which altruism and the desire to care can thrive.

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Don’t you hate it when people judge you? And don’t you hate it when people assume they know all about you because they’ve stuck you in some pigeon hole? You know the kind of thing. I mentioned in another post sitting on the train recently next to two men who spent the whole journey dismissing huge swathes of humanity – doctors they said were only interested in one thing – money; Iraq was always a hell-hole, now it was just a hell-hole with less buildings; everyone who lives below the Mason-Dixon line is an in-breeder……and on and on and on. These are not uncommon conversations.

One way we function as human beings is to focus on part of reality, classify it and judge it. We do that to try and get a sense that we understand the world and we also do it to try and control our experience of reality. The thing is this strategy brings loads of bad side-effects. For a start, generalised judgement stops thought. Once you judge a whole class of something, you stop thinking about it. By that I mean you stop seeing, stop hearing, stop experiencing the context-sensitive reality of the individual member of that “class”.

I find this way of thinking very, very disturbing. I understand why it’s there, and I know that human beings are incapable of experiencing the totality of experience as it is. We can only perceive and experience aspects of reality at any given moment. But when we are not aware of the enormous down-side of this human function then we are no longer living in the real world. Instead we limit our experience of reality to our pigeon-hole set. We see everything through the thick discoloured lenses we’ve made for ourselves.

This happens in all areas of life. In Medicine, it happens with diagnoses. How sad it is to see people classified as a “case of X” and how much more sad it is to meet a person who can only see themselves as a “case of X”. When we squeeze every patient into a tightly defined diagnostic box we stop seeing them as who they are. People with mental illnesses experiences this a lot. Once they’ve been given a “diagnosis” they often find that all of their experience is interpreted by the doctors as part of that diagnosis. This is what leads to bad and dangerous prescribing. I recently saw a patient who had suffered from a variety of symptoms for the last couple of years. He was investigated at the outset of the illness and given a particular diagnosis. The diagnosis was wrong. But despite the fact that every time he saw his doctors he told them that certain treatments weren’t working they wouldn’t listen. The doctors said they were prescribing the right medicine for his problem. But they weren’t! Luckily, he got sicker and ended up with other doctors and a different investigation which revealed the true diagnosis. Since getting the appropriate treatment for that condition he’s not in a wheelchair any more.

We also stop experiencing the reality of the rich uniqueness of every human being when we classify them according to race, religion, accent, or life-style. It’s sad and it’s such a stupid way to live. Next time you catch yourself, or somebody else, saying that “all X are Y”, challenge them. All X are never all Y! And if you think they are, you’ve lost touch with reality.

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