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illuminate

One day, I stepped out through the back door of the cathedral in Segovia and onto a large paved terrace surrounded by stone lions. When I turned to look back towards the tall arched doorway I noticed that the plain glass doors which hung in the doorway perfectly reflected the buildings across the street. I took a photo.

When I loaded up the photo later I noticed that there were some strange lights above and on the roofs and when I zoomed in I saw more clearly that behind the reflection of the tiles and the satellite dishes some of the cathedral’s stained glass windows shone through the glass door.

That got me thinking……

For centuries the church has created images and told stories to convince people what the world is like, what life is like, and how we should live. With captivating art and gripping stories it presented a particular view of the world. More than that, really, because in presenting that view and spreading it so widely, it created a reality for the people who lived in it.

But look at those satellite dishes.

Who is creating the images and the stories now? Who is telling people what the world is like? What life is like? And how they should live?

Who is presenting a view of the world and spreading it so widely, that it’s creating the reality for us who live in it?

With the rapid development in communications technology, with powerful mobile phones, connected computers, the internet, social media, memes, images and videos which “go viral”, some writers say we have created a whole new layer of the environment in which we live – the “noosphere” (the sphere of human thought).

The truth is we’ve always had a noosphere. We’ve always lived, we humans, within this environment of human thought.

There are image creators and story tellers who fashion the patterns of thought in this noosphere, and in so doing, they influence many others. They create the reality we experience.

But we have a choice. We can be the image creators and the story tellers, or we can be passive consumers. If we choose to be passive consumers, whose world, whose idea of the world, are we choosing to live in?

If we choose to be the image creators and the story tellers, what images shall we share? What stories shall we tell?

Are we going to live as zombies or heroes? Let’s co-create the world we want to live in. Let’s “be the change [we] want to be”.

I think it’s time to resist, to refuse to accept the world view which is responsible for massive inequality, injustice and suffering through the promotion of selfishness, division and greed.

We can make a better world than that. Can’t we? Let’s share our images of beauty, truth and goodness. Let’s share our daily delights and our experiences of awe and wonder. Let’s tell each other our stories of kindness, love and generosity. And let’s promote the world view that we are all connected and interdependent in this one, small planet we call Earth. Let’s share our attempts to adapt and live sustainability so we can co-create a better future for our children and grandchildren.

Shall we?

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I read Barrie Condon’s, “Science for Heretics” a few years back and returned to it recently. 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 for whom 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 of 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 be 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.

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Common sense would tell you the world is made of things. We are objects surrounded by other objects. The left hemisphere of the brain is great at narrowing our focus so we can separate some of what we are looking at from its environment, and its connections. So I can stumble across this beautiful dandelion seed-head and focus the lens of my camera right onto “it”. Isn’t “it” gorgeous?

But then and object, or a thing, needs to have some kind of consistency for us to see it. I mean, look what happens a second or two later, when the wind blows –

It’s changed already! And why did it change? Because something happened. Some of the seeds blew away when the wind blew. So if I want to understand this “thing”, this “dandelion” that I’m looking at, I need to see more than what the first image can show me. I need to know that these plants we call dandelions have evolved a method of multiplying and thriving – they have created these astonishing little means of dispersal of their offspring, of their seeds. So when the wind blows, as it always does, these children of the parent plant will fly away to land somewhere else, maybe far away, maybe close by –

and then the cycle starts again with each seed germinating, pushing its roots down into the dark earth, and it’s leaves and flower up to reach the sun, and the bees and the butterflies and who knows how many other kinds of insects will come along and spread the pollen in the yellow flowers to fertilise them and produce these magnificent seed-heads again.

So this is what this object, this thing, called the dandelion does. And it’s hard to know to where to begin its story, but maybe we begin by following one single seed, blown on the wind. We don’t know which way the wind will blow, how far the seed will travel, whether or not the ground it lands on will enable it to germinate and whether or not it will be able to successfully grow into a green leafed, deep rooted, yellow flower and whether or not the insects will cross pollinate it with its neighbours, whether near or far, and produce seeds of its own.

So many unknowns.

But also, and here’s the point, so many happenings.

So many events.

So many occurrences.

This object, this thing, which we call a dandelion. Is it really reasonable to think of it as a thing? Or is it more useful to consider it as so many happenings.

That’s the point I heard the physicist, Carlo Rovelli, make in his interview with Krista Tippett, in an OnBeing podcast. Have a listen. He puts it more beautifully than I do. He says the universe isn’t made of stones, its made of kisses. (Not things, but happenings)

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It strikes me that the practice of Medicine (I’m specifically referring to the world of Medicine for humans here), begins and ends with a relationship between human beings.

I’ll just focus on the doctor-patient relationship here, because that’s how I spent my working life. But I suspect that much of what is relevant to this relationship is also true for other health care workers, and perhaps even in other areas of human life.

When I say the practice of Medicine begins and ends with a relationship between human beings, I mean that the whole, unique person who is the patient has to be understood, cared about and attended to, by the whole unique person who is the doctor. Both individuals are important. I think this is partly why there are no doctors who are the best doctors for everyone, and I think it explains how in a group General Practice, each of the doctors in the partnership will have a specific loyal cohort of patients who always seek a consultation with that one particular doctor.

I also think this means that the whole person must always be considered. Anything less is reduced, and anything reduced is less than human.

In this context, I recently read “A General Theory of Love”, by Drs Thomas Lewis, Fari Amini and Richard Lannon. [ISBN 978-0-375-70922-7]. This book describes the model of the triune brain, which you might have come across elsewhere. (My introduction to that model was Dan Seigel, and later, Rick Hanson). It’s the observation that we have three brain regions – the brain stem, which is responsible for survival, and is found even in reptiles (henceforth to be known as the “reptilian brain”), the limbic system, which is responsible for memory processing and emotions (called the “mammalian brain”, because all mammals have this part), and the neocortex, which is massively developed in humans and seems to give us the capacities for abstract thought, conscious decision making and rational analysis.

In “A General Theory of Love”, Thomas Lewis and his colleagues focus on the limbic system – they describe in detail how this part of the brain helps us to “feel” other people’s feelings. It’s the kind of phenomenon that others call “heart feelings”. Without this part we’d have the reptilian survival strategies or the cold, analytic distancing of the neocortex. Let me be really clear here – this is a simplification and human beings are a lot more complicated than that. But this is a useful simplification which clarifies certain truths about what it is to be a human being.

In this post, I want to just bring to your attention some of the points the authors make when taking this perspective on the practice of Medicine, because I think health care is in a dire and degenerating situation in the world.

The last century saw a two-part transformation in the practice of medicine. First, an illness beset the relationship between doctor and patient, then radical restructuring attached the residual integrity of that attenuated tie.

I think the illness and the radical restructuring they refer to developed from a general reductive de-humanising of health care. Iain McGilchrist has shown how a “left hemisphere approach” has come to dominate society and I find that explanation helpful. Lewis says

American medicine has come to rely on intellect as the agency of cure. The neocortical brain has enjoyed a meteoric ascendancy within medicine even as the limbic star has fallen into disfavour.

Whilst this focus is a little different, the basic point is actually the same. By coming to rely on data, figures, statistics and techniques, we have reduced the human-ness of medicine. We’ve increasingly denigrated the patient’s narrative, the individual’s subjective experience, and the place of heart felt caring.

The limbic brain has a crucial role to play in attachment, and Lewis describes attachment theory along with the physical and social consequences of disordered attachment incredibly clearly. And here’s one of the most important points in this book – the physical reality and hence importance of relationships, emotions and attachment –

Medicine has lost sight of this truth: attachment is physiology

The radical restructuring they refer to is seen throughout Western Medicine – its the rise of bureaucracy. We see it in the proliferation of protocols and guidelines, of the prioritisation of measurement – what others have referred to as “Taylorism 2.0” (the modern equivalent of Taylor’s “scientific management”) – at the expense of what cannot be measured – the lived experiences of the patients and the health care workers.

Good physicians have always known that the relationship heals. Indeed good doctors existed before any modern therapeutic instruments did…

For many years, the medical community hasn’t believed that anything substantive travels between doctor and patient unless it goes down a tube or through a syringe.

They neatly sum up their thesis with

medicine was once mammalian and is now reptilian

Corporations and organisations have taken the high ground imposing their limits, their rules and regulations on those who try to care.

A corporation has customers, not patients; it has fiscal relationships not limbic ones.

The use of terms “customers”, “clients” and “consumers” in the area of health care has always disturbed me. Now I think I understand more clearly why!

I concur with this conclusion –

Before it is safe to go back to the doctor, a mammal will have to be in charge. And before that can happen, our physicians will have to recapture their belief in the substantive nature of emotional life and the determination to fight for it.

I’m not sure I’ve heard any politician, manager or profession leader say this so clearly – the problems facing health care are not ones of efficiency, targets and “better” guidelines. The problem is we need to make health care more human.

We need Medicine based on love, care and attention….where the heart is the keystone.

 

 

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Points. When I look at this photo of a bifurcation of a railway track into one to the left and one to the right the first thing which comes to mind is playing with an electric railway set as a child. A single oval track which just went round and round was no fun. Once you added a set of points the whole thing became far more interesting. There was more than one route your train could now take, and you were the one who decided which way it would go, just by flicking a little lever.

The second thing which comes to my mind is a flood of memories of many, many delayed train journeys to and from work due to “points failure”, almost always in exactly the same place. Over the years I often wondered why they couldn’t fix those particular points for good. I wonder if they’ve done it now.

But then my mind goes off down some different tracks altogether…..the tracks of decisions, FOMA, and singularities.

Decisions – we are faced with many decisions to take every single day. The first time I visited a coffee shop in America many, many years ago, the wall behind the counter was covered with descriptions of all the options. At that time, all I had known in Scotland when it came to coffee choices was “black or white”! I heard customers in front of me ask for their favourite coffees choosing size of cup, type of coffee, type of milk, amount of foam, various toppings or additions…..my mind was boggled! Since those early days, this kind of coffee choosing has become routine. I don’t even think about it any more. That’s one thing about decisions…..we make the repeat ones easier by turning them into habits, and then we don’t even realise we are choosing any more. Think of the number of automatic decisions you are taking every day in this way. Choosing when to get up out of bed, choosing the various elements of your morning routine, choosing your commute to work…..and on it goes. I’m not saying that we shouldn’t make our lives easier by turning repeat choices into habits. I’m just saying it’s interesting to pause sometimes and become aware of some of our automatic choices. It’s only when we do that, that we discover there are other ways to do things, other decisions which can be taken.

FOMA – first time I saw this acronym I had to look it up! Fear Of Missing Out. It’s apparently a big thing! Sometimes we decide to do, or to have, what everyone else is doing or having, because we are afraid that, if we don’t, then they’ll all be benefiting from something and we won’t. I guess this is a variation on the age old “keeping up with the Joneses”. This is a manifestation of the power of social connectedness which has evolved in the human species. We really are intensely connected into our webs of social relationships and they influence our decisions enormously. Advertisers play on these fears to manipulate us and influence us to choose their products or services. Instagram, Tik tok, Facebook……they all ramp this one up to the max!

Singularities – I’m no expert on quantum physics but as I understand it scientists current understanding of how the universe works involves something like this – there is an infinite number of possibilities in front of us – as best I understand it, this is like the philosopher, Giles Deleuze’s idea of “the virtual” – all these possibilities, collectively can be described as a “multiplicity of singularities”. In quantum physics, at the moment of observation, this infinite multiplicity collapses into “the actual”. At that moment, all the other options disappear. They’re gone. Some suggest they play out in the “multiverse” which is the idea of an infinity of parallel universes, each one following a different path. Not sure what I think about that, and, hey, its kind of hard to prove, isn’t it? Well, I find, that whether I’m coming at this from the quantum physics angle, or from a philosophical one, reality seems to be that the moment we decide, the moment we choose, all the other options or possibles are gone – at least for me in my one, unique, single life. I like this idea of a “singularity” – of the one unique actual which emerges from the vast web of possibles or “the virtual” every moment of every day. It reinforces my feeling that the present is special.

My goodness…..wasn’t expecting to go wandering down those tracks when I saw this photo!

How about you? What comes up for you when you see a bifurcation of the ways ahead like this?

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What do you see first when you look at this photo?

For me, it’s the mountains. I immediately see their jagged shape, their almost purple colour, and notice the beautiful blue sky above, with only a few white, fluffy clouds. The fluffy clouds and the sharp mountain ridges make an interesting contrast.

But then I see the path, and am pretty amazed by how straight it is. My eye is drawn quickly from the foreground right up the line of the pale, sandy path as it narrows like an arrow and heads straight for the mountains.

Then I see that on each side of the path are rows and rows of trees. It’s clearly not a path through a forest, but more an orchard, or a cultivated garden. So, again, there is an appealing contrast between the wild, ragged mountains, and the trimmed and tended garden through which the path has been laid.

This is one of those images which makes me reflect on those two elements of motivation and/or focus in our lives. There is the goal, or the destination – whatever we are working towards, whatever we hope for, visualise, or desire. And there is the path – the way we walk towards that destination, or work towards that goal.

Put them together, in other words, don’t choose “or”, but instead choose “and”, and you have the journey – the entire, irreducible experience of living – the subjective, unique, personal experience of you, on your way, along your chosen paths, along the paths you are busy laying, as you move towards your dreams, your desires and your destinations.

Life isn’t just about destinations, is it? And it isn’t really about only the paths either. But it is about the journey, which only you will make. Only you can tell your unique travel story if you choose to share your experience with an other.

One last point – these destinations, these far mountains, in our lives – well, some of them are there already, some have been created by others, and some of them are ones that only we can imagine. Same thing with the paths – some are there already, some have been laid by others, and some are our own creation.

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I was walking in a forest just outside of Kyoto and I noticed the reflections of these strange stumps of wood in this pond. I raised my camera to capture the scene, expecting to have a photo of a slightly unsettling landscape of chaotic, jagged sticks and stumps standing at all kinds of angles in the pond, their reflections doubling the feeling of their brokenness. I clicked. As I did so I noticed a blur of white flashing past. It was only when I checked the image in the screen at the back of my camera that I saw this white bird. A heron, I think. A moment of its flight captured in the instant of the camera’s action. Its great white wings elegantly beating downwards to propel the creature over the surface of the water.

It’s pretty difficult to get photos of birds in flight. Well, at least, I find it quite hard to do so deliberately. I have lots of photographs of birds standing on the ground, or perched on rooftops, or in branches of trees. But capturing a bird in flight takes a certain amount of luck. It’s almost a zen archery thing where you don’t try to hard but relax into capturing the scene.

Actually I have several photos of flamingos in flight, and swans too, but in both those circumstances I was somewhere where there were dozens, if not hundreds of them, and they were so busy flying here and there it was hard not to get a photo of at least one of them in flight. But this was different. Here I hadn’t even noticed there were birds around before I took this photo.

So what is this? A lucky photo? Serendipity? Or simply an example of the unplanned moment produced an experience of delight, an opportunity to wonder and feel awe?

I once read that a General Practitioner is a “specialist in managing uncertainty”. I know why that was said. As a GP you never knew what the next patient was going to tell you about. You never knew exactly what you’d have to deal with today. More than that, many, many people present to their GP at a stage in their illness where nothing is yet clear. You know the kind of thing. Someone feels “off”, “achey”, or “has a pain”, or some other of a host of possible symptoms, but it’s the early stage of an illness, and the “signs” – changes in the body which can be felt, heard, or measured – are not very clear. Within hours, or maybe over many days or weeks, the disease makes itself more obvious. It always struck me that this was one of the big differences between GP work and hospital work. In the latter case, the vast majority of patients present with something pretty obvious – either because of the severity, or the acuteness of the problem, of because by the time the problem is this troublesome the “signs” have all become clear. Absolutely, that’s not always the case, but having worked in both settings, my experience was that GP work was filled with much more uncertainty. There was another aspect which intensified that – time. In hospital practice the time spent with the patient is pretty limited. There’s an event or an episode, a diagnosis to be made, a treatment to be administered, then the patient, hopefully, is “discharged”. They go away. In General Practice the relationship is, potentially, for life. For those who spend a whole career in Primary Care they will have patients who they met as newborns, accompanied through their school years, their relationships, setting up their own homes, their work pressures, and the creation of their own little families. They will have known some middle aged men and women become elderly and frail. Patients in General Practice, at least traditionally, didn’t exist only in events or episodes, they existed in these long term relationships. So, of course, when someone developed a serious, potentially chronic illness, as a GP you had no way of knowing how the illness would progress. For some, it would become trivial, or even non-existent, for others there would be an unsteady but unrelenting path of decline, for yet others, this disease would be fatal. The uncertainty came in not knowing what might lie ahead……a fact of life, you might say, but, still, a key issue in the daily life of a GP.

Since the beginning of this pandemic, it’s felt that uncertainty has become a more difficult, daily presence for most of us. The twists and turns of the infection rates, the government responses, the attempts to find ways to treat and prevent it…….

How many times have you heard the word “unprecedented” in the last couple of year? I bet it’s an unprecedented number of times!

What have so many people done to try to cope with this? Because, let’s face it, to be filling your thoughts and imaginings with future possibilities, many of them, frankly, scary, doesn’t feel good! I think what many of us have done is to either deliberately, or serendipitously, focus on the present moment. There was a time in mass confinement when our world’s shrunk to the walls of our dwellings, or the fences of our gardens. In those times it felt better to be aware of daily little wonders, to focus on the real delights. That’s my “émerveillement du quotidien” thing that you can read about on this site. And even since the restrictions have eased somewhat, there’s been a sense of increased value and importance in relationships, with more communication…..perhaps not more in person, but certainly more in WhatsApp groups, video calls, phone calls and messages.

I think that’s how we cope best with the unexpected – delight in it when it offers us delight, feel the calmness which can accompany focusing on the present, and filling our days with what we value most.

Because, although it’s almost a cliche, life is best lived in this present moment. And sometimes, the unexpected can actually feel like a gift.

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If you look carefully at any flower, the chances are you’ll see at least one insect there. Often it’s a bee, our best known pollinators, sometimes a butterfly, but, on this occasion it’s a ……. (can anyone help me out here and tell me what this is??)

The first thing that struck me in this photo was the symmetry, or echo, between the shape of the head of the insect and the ends of the pistil and the stamen. That resonance of form seems to emphasise the type of relationship which flowers have with such insects.

There are, of course, some startling examples of really high degrees of resonance between shapes of flowers and pollinators, and we know that in many cases the relationships are highly specific – one particular species of flower existing really only because of the presence and actions of one particular species of insect…….and vice versa. The one could not exit without the other. At very least, not in this manner, but, in reality, not at all.

This, it strikes me, is the fundamental basis of reality and Nature.

Relationships.

It’s like that word “ubuntu”, which, if I understand it correctly, means “I am because you are”.

Not a single living creature in this world, not a single human being, exists in any way other than in constant relationship with a myriad of others – others of the same species and others of utterly different species. These relationships are active ones. They change both beings constantly.

I am changed in my interactions with you, and you are changed in your interactions with me.

We are better understood as a community of subjects, than as a collection of objects.

Life is an experience and every individual is constantly evolving, developing and growing. That’s why I have that byline at the top of my blog – “becoming not being”.

Becoming not being – all of us, are fully becoming who we are, moment by moment, experience by experience, in a vast, interconnected web of others beings, also in the process of becoming.

Is that a radical idea? Not really, but it sure shifts our consciousness and attention away from the reductive, materialistic, atomistic, quantifiable aspects of life towards the whole, the subjective, the experiential, the flow, the movement and the interactive nature of relatedness.

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There are certain numbers which are described as magic numbers in particular cultures. Whether they are magic or not, there are clearly some numbers which are powerfully significant and which appear widely a huge variety of forms.

I could probably make the case for most single numbers to be thought of as significant numbers. But the one I want to highlight today is “3” because I just stumbled across this little group of photos I took during a trip to Japan some years back.

This symbol, of three “comas”, or “tomoe”, is one I kept coming across everywhere. The first photo shows it at the end of a roof, and this is really, really common in traditional Japanese architecture. The second one shows it on the lid of a pump at a fountain. I really like that something everyday, something otherwise quite functional or mundane, is made more beautiful this way. The third one is at the other end of the scale – it’s gold and magnificent. But perhaps the one I like the best is the biggest image in this collection. It’s embedded into one of those wonderful, standing rocks you find at temples and shrines. The white background looks like a light source, but it isn’t. I love the “wabi sabi” appearance of the rusty, reddish metal which forms the shapes of the three commas, and I especially like how the sun casts the shadow of the same symbol onto the white background.

Maybe I find this symbol of three commas especially attractive because it reminds me of the dual, yin yang, symbol, a version of which I wear around my neck. But more because the Celtic form, known as a “triskele” is a symbol which was around me as I grew up and lived in Scotland.

But to come back to the number 3……why do I, and I suspect, so many others, find that such an attractive, even magical number?

Well, for me, I relate it to “body, mind and spirit”, which is one of the key ways to think about an holistic approach to human wellbeing and health. Throughout my entire career, both as a GP in the first couple of decades, and as a Specialist in Integrative Medicine, in the second couple up to retirement, taking a holistic approach was the keystone of my everyday work.

As a medical student back in the 1970s I was hugely impressed with a “Biopsychosocial” understanding of Medicine. There’s another “3” – the biology, the psyche, and the social – all of which, my teachers impressed into me, were important in health care. In fact, it’s been the dominance of the “materialist” approach which has been my main source of discomfort in our form of health care which reduces human beings to data sets and Medicine to pharmacology. That never impressed me, and it still doesn’t.

It’s always struck me that whether I come from a “body, mind, spirit” position, or a “biology, psyche, social” one, that only one of the elements of those triples, is visible. Only the body, or the “biology”, can be observed, palpated, measured. The other two, the mind/spirit or psyche/social, are invisible, and, frankly, I’d say irreducible to measurements. Materialism can’t capture them. Maybe that’s why I’ve always given such emphasis to the individual story, to emotions, thoughts, values and beliefs.

As I understand it, it’s not completely clear exactly what the triple commas represent in Japan, but it’s sometimes related to something like three kingdoms – of Earth, of Heaven, and the Mundane World, or to the Gods who rule each of those kingdoms. In Western thought, perhaps the triad would be Heaven, Earth and the Underworld.

It does strike me as interesting that Freud came up with Ego, Id, and Superego, as his tripartite model of the human psyche. And Lacan, I believe, wrote about the Imaginary, the Real, and the Symbolic in his model of the psyche. I’m also struck by the more modern psychoneurological triad based on the structure of the central nervous system – the “triune” model of the “reptilian”, “limbic” and “neocortex” structure, something which I used a lot with patients after I learned Dan Siegel’s “hand model of the brain“. By the way, he also describes the “map making” capacity of the frontal cortex as an ability to create maps of “me”, “you” and “we” (another interesting triad)

Hey, I could go on, but I’m sure you could add your own favourite triads and triples to this understanding.

Powerful as the number 3 is, I often think in terms of other numbers. I’m quite a visual thinker and as I explore ideas I’ll often find I’ve created little maps of 4 zones, or 5, 6, or 8 pointed stars. How about you? Are you aware of these numbers and their symbols in your thinking and your culture?

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I took this photo in Ueno Gardens in Tokyo. It’s the centrepiece of a peace memorial and I think it’s utterly beautiful. I love the design of the dove whose curves suggest the flowing shapes of the yin yang symbol and the little flame flickering in its heart, or soul, is very moving. Isn’t it wonderful?

When I look at it, it stirs feelings of peace in me, but there’s more than that, which I think comes down to the nature of the little flame. It looks vulnerable. It’s not a raging fire. It’s a flickering light. It looks as if it could be blown out by not too strong a gust of wind. That moves me too.

That small, flickering flame, contains two polar opposites for me…….the energy which is at the heart of all Life, in other words the power of Life, and, on the other hand, the vulnerability and transient nature of every individual life.

When my daughter was small and had an illness which seemed to flatten her I told her to imagine a small candle flame inside her which would grow in brightness and strength as she paid it attention. That helped her to recover and it’s a practice we’ve used at other times as we’ve needed it.

There used to be a belief in an entity called “the Vital Force” which was an invisible spirit-like force which kept us healthy and restored us when we were ill. “Vitalism” fell out of favour a long time ago, even if it is kept alive in certain healing traditions. As far as I know there is no such entity, but the concept remains a good one. As I understand it now, human beings are “complex adaptive systems” which have the capacity to be “autopoietic” – what all that means is that biologically our systems and responses enable us to protect ourselves on a daily basis…..our immune systems are a part of this natural defence. And we have systems which enable us to repair any damage which occurs….our inflammatory systems are part of that. We also have the abilities to learn, change and adapt. Putting all that together, we have something which isn’t a “thing”, something which we can’t see, can’t measure and can’t pin down which is like an inner flame – it’s the flow of Life energy which pulses through our whole being from conception to death.

In short, we have the capacity to self-heal, and all “treatments”, in every stream of healing tradition, work, only if they support and/or stimulate that capacity. There is no artificial healing. There is only the ability of the living organism to heal itself. We can learn to nurture that, to support that and to stimulate that. That, for me, is what Medicine should be about.

Some philosophers have described human beings as “symbolic beings” – because we are only the creatures which seem to create and handle symbols. Symbols are a powerful tool for us. They help us to connect with each other, to communicate and to learn. They can help us to thrive. In fact, I believe, they can help us to survive.

So this work of art, in Ueno Gardens, works for me as a powerful combination of symbols – ones which activate the forces of both Peace and Life.

I hope this works for you too.

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