Archive for the ‘philosophy’ Category

The tendency to think that whatever we see is made up of small parts goes back a long, long way. You can trace it at least back to the Greek concept of the “atom” – that basic unit, or building block, from which everything else is made.

Well, maybe it took the 20th century splitting of the atom to discover that there are no basic units after all…..that when you look inside the “smallest” component part, there are even smaller ones inside, then when you look inside of those, there is……well, it all fades into invisibility somehow. Turns out there are no fixed, fundamental building blocks after all.

The Italian Physicist, Carlo Rovelli, who wrote “Seven Brief Lessons in Physics”, and “Reality is not what it Seems”, describes this well. Here are a few passages from him…..

The world of quantum mechanics is not a world of objects: it is a world of events.

The world is not a collection of things, it is a collection of events. The difference between things and events is that things persist in time, events have a limited duration. A stone is a prototypical “thing”: we can ask ourselves where it will be tomorrow. The world is made up of networks of kisses, not stones.

A handful of elementary particles, which vibrate and fluctuate constantly between existence and non-existence and swarm in space even when it seems that there is nothing there, combine together to infinity like the letters of a cosmic alphabet to tell the immense history of galaxies, of the innumerable stars, of sunlight, of mountains, woods and fields of grain, of the smiling faces of the young at parties, and of the night sky studded with stars.”

“Elementary particles which vibrate and fluctuate constantly between existence and non-existence” feels like a totally different universe from the one built from indivisible, fixed, discrete atoms.

The deluded idea that the universe is made of bits was compounded during the Industrial Revolution where the machine became the dominant model for interpreting the world. It still is.

Human beings are not like this.

But we still interpret experience using this lens of the machine. We want what was described by Arthur Frank as the “Restitution Model” in Medicine – just fix the broken bit and I’ll be on my way – Diagnosis is finding the wonky part and sorting it or removing it. A patient with multiple disorders is compartmentalised with each disease treated by a different team of specialists….some to deal with the heart, another one to deal with the stomach, yet another to deal with the bones and joints. We even turn symptoms into parts, treating “pain”, for example, with “pain specialists”, as if pain was an entity in its own right.

We take the same machine model and apply it to society as well, reducing human beings to mere cogs in the great machine.

The English philosopher, Mary Midgley, in her “Beast and Man”, said

I had better say once, that my project of taking animal comparisons seriously does not involve a slick mechanistic or deterministic view of freedom. Animals are not machines; one of my main concerns is to combat this notion. Actually only machines are machines.

Animals are not machines, human beings are not machines, and society is not a machine. Using machine models to understand and create institutions, policies, methods of health care, education…….I’d like to see all that disappear.

Life is not machine-like.

You think you can understand, and explain the existence of, a creature like this by seeing it as a machine?

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What’s this young woman doing? She looks relaxed, leaning both her forearms on the low wall as she gazes, or looks, (there is a difference) towards….who knows what? You can’t help but turn your head to see if you can see what she is seeing.

Deleuze and Guattari, in “What is Philosophy?” talk about three ways of thinking – concepts, functions and affects+percepts. Philosophy, they say, is our way of thinking concepts. Science describes functions. Art deals with sensations, affects and percepts.

In the city of Angouleme, about an hour from where I live, there are many, many examples of wall art. Angouleme is a major, maybe THE major centre, for graphic arts in France. Several of them are absolutely stunning. Many of them make you stop and think.

If art is a “bloc of sensations, that is to say, a compound of affects and percepts”, then what does that really mean in everyday life? I’m no philosopher and I wouldn’t be surprised if I misunderstand philosophical writings, but I am a “wonderer”. So, the two photos I’m sharing with you today, in this post, are just two examples of murals I’ve come across in Angouleme…….two murals which really stimulate my powers of perception and evoke emotions. They both make me wonder.

In this first one, everything in blue is the painting, but it’s been so cleverly painted that, at least at first, you have the impression you are looking at a real woman, leaning on a real wall, in front of a real hotel. Well, actually, it is painted on the gable end of real hotel, and the painted wall is an extension of one you can actually lean on. Maybe this graphic woman is looking into the window on the left? If so, she’s looking into a real window, not an imaginary one. Here’s the full picture…..

I love how the painted image blends with the physical world around it. It transforms reality. As I gaze at this in wonder, I slow down, feel calm and contemplative, and take my time to explore the whole painting. Isn’t it amazing that the woman, who is the artist’s creation, somehow induces in me, the viewer, these feelings of slow, calm contemplation?

What would this building look like unpainted? I’m not sure I’d even have noticed it. I certainly wouldn’t have stopped to gaze at it. And, here’s the other thing….I might not have followed the gaze of the woman beyond this low wall out over the valley below, towards the winding river, the boats, the houses and buildings at the edge of the city, and the farms and forests further out. I haven’t the slightest doubt that this work of art transformed my experience of Angouleme.

But, then, so did this one….

This is one of the most imaginative, evocative, narrative murals I’ve ever seen. It also stops you in your tracks. You can’t help but get drawn in, first to the woman and the man, who are kind of embracing, but there’s a mystery in this embrace. It doesn’t look entirely comfortable. What’s going on with these two? Then, above them, the glass in the window is broken. How did that happen? And above that, this enormous moon, which doesn’t really look like our Moon, but maybe some other planet? It always makes me think of the movie, “Another Earth“….But look at the biplane flying over the face of that planet? What era is this? Which makes us look at the couple again, and wonder what era they lived in as well…..they sure aren’t dressed the way we’d expect to see someone dressed in this day and age.

Then as I look again at this photo, I see the pink bike, parked against the railing, and I can’t help but think it’s her bike! So reality and fantasy blend and blur and lose their hard edges (do reality and fantasy really ever have hard edges?)

Finally, I look up and see what looks like the shadow of an angel with a trailing umbilical cord…..at least, that’s what it looks like to me, and I can’t help but turn around to see if I can see the actual angel behind me.

Oh, there’s the angel, over there, on the building opposite….

Isn’t that quite something? A drawing of a shadow which makes you turn around to see what’s casting the shadow? What a wonderful blending of perception and imagination!

Somewhere in the depths of my memory I seem to have a story of an ancient debate about whether or angels would have tummy buttons – because angels, allegedly, aren’t born, so don’t have umbilical cords. I remember thinking what an odd thing to have a debate about! But as I stand looking at this drawing, that old story comes rushing back to me, and in so doing, makes the artwork all the more interesting and engaging.

With both of these murals my experience of the day was transformed. They both challenged my perception of reality. They both stirred my feelings, stimulated my imagination and provoked memories. They both made me wonder.

As far as I know only human beings make art.

What kind of humanity would we be without it?

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This photo of water flowing over rocks in a Highland stream transfixed me the first time I saw it, and it’s lost none of it power.

When you watch water pouring down over, around, and between rocks in a stream or a river, you can see how the water itself is shaped by the rocks and the earth which create its edges (the banks of the river). If you look carefully you can often see that there is an ongoing lengthy relationship between the water and the rocks. It’s not just that the rocks make obstacles which the water has to flow around. You can see that as the water flows over the rocks, it shapes them.

However, what you see in this photograph is an additional dimension. You don’t just see that the rocks are making the follow a particular path. You can see that the surface of the water itself is shaped. Those bands, or ridges, look waves spreading over the surface of the water, except you wouldn’t expect to see waves in a stream or river as it pours down a rocky hillside. Where do they come? Maybe it’s something to do with the rocks on the river bed, or the rocks within the river itself, but it looks like something different. It looks like this pattern, this shape, emerges from within the water itself. As if it looks this way because of some influence within the water.

So, this photo always makes me think of that. It makes me think of how each of us is shaped by external structures, and the environments in which we live – by which I mean the physical, social, and cultural environments at least. But how we are also shaped by our constantly evolving inner structures and environments……our memories, imaginings, thoughts and ideas, as well as our physical bodies and all the cells, tissues and organs which lie hidden inside.

Who we are, what we are like, what we look like to others, what our characteristics are, are all shaped, are all constantly being shaped, by an alchemical mix of the external and the internal, of the visible and the invisible.

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This is one of my all time favourite photos. I took it while having breakfast at a little cabin at the top of the hill on the edge of Biarritz. I realise that the concrete fence is not bonny! But that doesn’t take anything away from the picture for me. The rich, deep hues of blue in the sea, sky and even distant mountain are just gorgeous and I like the fluffy summer style of clouds floating by.

Hey, you might be saying, you’re going on about the fence, the sea, the sky, the mountain, even the clouds, but isn’t this a photo of a coffee cup?

Well, yes. You could say that. But, then you know my tendency to explore the contexts, the connections and the environment….how I am drawn to the “whole”. But, yes, it is a photo of an expresso, and that’s what I want to talk about today.

Even though these short coffees in Europe are called “expressos” they don’t necessarily imply a brief, speedy period of time. I noticed that when I first stopped for a coffee in Italy that the cafe had tall tables and no chairs. That was a surprise. Maybe that’s when I thought that an “expresso” wasn’t just fast to make, it was fast to drink. But that was a misunderstanding. When I went for breakfast with a group of Italian friends, they stood around the tables chatting, drinking their coffees, eating pastries or biscuits, and there was absolutely no sense of urgency or hurry.

Coffee time is a pause.

It’s often an in-between time….between waking up and engaging with the tasks of the day, for example. When I worked in Glasgow, I lived in Stirling, and traveled in the train for about an hour each way each day. I’d stop and enjoy a coffee once I arrived in Glasgow and before I caught my second train to the hospital, and, often, I’d stop and enjoy another one on the return journey. Those were times of pausing. Of stepping off the busy flow and slowing down to reflect, to read, to ponder. Coffee times were also times of sharing, of enjoying the company and chat. Not all coffee times are social times, but many of them are, and that’s important.

There’s a term in buddhism – “bardo” – it means a space. For example, there is a bardo between each in breath and each out breath, and another between each out breath and each in breath. There is even a bardo between each thought, but good luck catching any of those! I think a pause is a kind of bardo. A life bardo, breaking up a busy day, and helping us to re-centre, to re-focus, to re-connect and to re-store.

I was reading in an article in “Philosophie” magazine this morning. It was about rituals and one philosopher described his coffee ritual. He said he wakes up, drags his heavy feet and thick head through to the kitchen, pops a “dosette” into the coffee machine, presses the on button, and listens to the familiar sounds of the machine. That first coffee begins to re-connect his disconnected brain cells, but it also makes him cough. He has a second coffee, which settles his cough, then, the third coffee, he says, is “for pleasure”. Then he is ready to get on with the rest of the day. Wow! I think if I started every day with THREE expressos I’d FLY through the day!!

We all have our own rituals, our own habits, our own routines. This little coffee cup resting on the fence reminds me of that. It’s good to pause now and again, and in that bardo to take stock, to reflect, and to become aware of rituals, habits and routines. What are they, and what part do they play in my life?

How about you?

What comes to mind when you think of a pause, a bardo or a ritual?

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When I noticed this stone on the beach I was entranced. It looks like a whole small world. Look at the layers of minerals, their colours, their extent and shape. Look at the top of the stone with several species of lichen and/or seaweeds living there.

It makes me think of illustrations I saw when I was a child. Colour drawings of the Earth with a segment removed to show you the multiple layers all the way down to the core.

It also makes me think of the concept of the ecosystem, or even a biosphere….a complex of elements, some living, some non-living (which reminds me….I came across a quotation yesterday which said the opposite of “life” is not “death”, it’s “non-living”……must look that up!)

The idea of networks of connections and relationships between minerals, uni-cellular and multi-cellular organisms, air, water and sunlight co-creating the reality we live in…..I just love that.

It makes me think of the idea of viewing whatever we are looking at from different scales, because everything which exists, exists in nested layers of everything else……remember the old funny story about the teaching that the world floats on the back of a turtle? How the enquirer asked “And what does the turtle sit on?” The answer “Another turtle”. To which the enquirer asks “What does THAT turtle sit on?” The answer “Another turtle”. After a few minutes of this exchange continuing along the exact same question and response, the teacher finally responds to one of the “What does THAT turtle sit on?” with “It’s turtles all the way down, son. It’s turtles all the way down.”

On a more serious note, I found Lynn Margulis’s theory of “endo-symbiosis” hugely convincing. Briefly, she claimed that all multi-cellular organisms (that includes you and me) are made up an incredibly complex co-operating network of single cells, and that inside each of our cells are individual elements, like mitochondria, for example, which, way back in history were single celled creatures in their own right. She hypothesised that the evolutionary path of development was driven by collaboration and co-operation, with single celled organisms combining to live together at new levels. In other words all the different elements of a single cell came from smaller single “celled” creatures merging. Maybe that idea was a bit too challenging for some people, but it’s pretty undeniable that multi-cellular organisms like humans can actually be understood as whole worlds of vastly networked individual cells. It’s reckoned that only a tenth of the cells of your body are genetically “you”, the other ninety percent being bacteria and other unicellular organisms. Pretty mind boggling isn’t it? But it seems to be true all the same.

This idea of scale…..a long time ago I created a “human spectrometer” to help me discuss a patient’s issues with them at different levels of scale. Here it is

I’d start in the middle with the “person” because that’s where we met, person to person. Then I could move left zooming in on smaller and smaller parts of the person to consider the problems and their effects….perhaps in the “nervous system”, or the “digestive system”, then further “in” to disturbances in particular organs, “the heart”, or the “liver”, then further in yet to consider the role of cells, like white blood cells, or the cells of a specific organ, or, at an even smaller level the circulating levels of individual molecules, like hormones, antibodies, chemical messengers and so on.

I’d then return to the “person” and start moving right to consider the person within their significant relationships, within their family, within society, considering cultural, economic and work issues, or, finally within the “world”, by which I meant the environment.

I didn’t usually work through this whole thing methodically, step by step, but used it as an illustration to consider everything from pathology, to pathogenesis, to the impacts from and on the vast networks of life in which an individual lived.

I created a post about it back in 2007, so patients could explore the idea a bit more in their own homes.

It’s only now, many years later, after reading Iain McGilchrist’s “The Master and His Emissary“, that the left hemisphere zooms in to consider the parts, while the right zooms out to consider the connections, the relationships, the whole! Funny, how the universe works!

This notion of nested scales was also explored by Arthur Koestler who coined the term “holon” to describe the idea of multi-level hierarchies. You can read a bit more about that here.

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Life is tangled.

Every one of us is a multitude. Check out Bob Dylan’s new release “I contain multitudes” for a very recent expression of this idea. In fact, as he sings it, maybe we are multitudes, plural.

The Scottish psychologist, Miller Mair, coined the term “community of selves” back in the 1970s. It remains a powerful metaphor for the complexity of an individual personality. That idea made a lot of sense to me, and helped me to understand not only my patients but also myself. We all have that experience of at very least tapping into different strands of our lives when we act within our different roles – parent, child, friend, neighbour, employee, professional, artist, consumer etc etc. We know all those roles are just a part of who we are but it can be very hard to untangle them, to see how they inter-connect.

The French philosopher, Deleuze, wrote about “multiplicities” as a way of understanding the complex universe, and described any particular instance as a “singularity of multiplicities”. I liked that idea the moment I read it. I happened upon his writings at the same time that I was exploring the new “complexity science”, and in particular the concept of the “complex adaptive system“, which fundamentally changed how I saw our lives and our world.

I once spoke to a “Chef de Service” at a Parisian Homeopathic Hospital and he described to me that he saw each patient as like a diamond, with multiple facets shining, each one different, but together all part of the same individual. He saw his therapeutic strategy as being based on addressing several of the most prominent of a patient’s “facets”. A rather poetic way to think of the same underlying issue.

What is the underlying issue?

Life is messy.

On the “inside” and the “outside”. I put those words in quote marks because I’m pretty sure that frequently there is no clear boundary between the two. I think wherever we look we can find multiple threads to follow. We can identify particular paths, storylines, themes, chains of cause and effect, which run through a lifetime.

And, here’s the important point, brought back to the front of my mind by this photo today, all those paths, storylines, threads or whatever, are entangled. They are connected. They are inextricably interconnected, astonishingly woven together to create a unique, beautiful tapestry of a single life.

I’m not a fan of labelling a patient with several different concurrent diagnoses then sending them off to separate specialists to have each disease treated as if it exists in isolation. In Medicine this is referred to as “silo-ing“, a strange word which means separating out someone’s problems into separate baskets, boxes, or “silos”, then treating each one separately. Most of the evidence used in “Evidence Based Medicine” comes from trials where patients have been selected on the basis that they have only the single disease which is under study, and that they are receiving only the single drug which is being trialled. But the real world isn’t much like that. Much more common is the finding that an individual patient will have several different diagnoses active at the same time and that they will already be on a cocktail of drugs. Medicine is more messy than some people would have you believe.

So what? Is this a counsel of despair? Am I saying life is too complex and entangled to make any sense of it? No. Absolutely not.

What I find is that this complex entangled life is beautiful. That it manifests in the most unique, most varied, most astonishing individual narratives you could imagine.

What I find is that when you look for the connections between the parts, you get insights and understanding which you’d miss if you kept your attention only on single parts.

What I find is that it’s best to use your whole brain, not just half of it, as Iain McGilchrist, author of “The Master and His Emissary“, would say. It’s not enough to separate out the threads and elements and study them. You have to weave them back together to see the contexts, the contingencies and the connections. In other words, you need both your left hemisphere ability to see the threads, and your right hemisphere ability to weave them together into a whole.

What I find is that when you look at life this way, then you encounter the “émerveillement du quotidien” – that you find yourself wondering and marvelling every single day. You find diversity and uniqueness. You find infinite trails of connections. You find that curiosity is constantly stimulated and never ends. You find that you are humbled by how little you actually know. You find that you doubt predictions and develop a distaste for judging people.

You find that Life is astonishingly, endlessly, fascinating.

What a delight!

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One of my most favourite phrases in French is “L’Emerveillement du quotidien” – which translates as something like “the wonder of the everyday”, but actually there are other layers of meaning which I find hard to capture in English.

I suppose the thing I love about the word “wonder” is that has several connotations. It suggests a certain curiosity, a “wondering” what something is, or how it came about. But it also suggests a kind of awe, something amazing, astonishing, or, at very least attention-catching. The sense of “everyday” also has a couple of nuances. It means something common, as in something you might encounter any day, and it means something ordinary. So you immediately find yourself dealing with a paradox – how can the “ordinary” seem “extraordinary”? How does something “common” become both “particular” and “special”?

I’ve come to believe that there is always something extra-ordinary in the ordinary, and, after working with thousands of patients over four decades of clinical work, I’m convinced that every human being is “special”. Special not in the sense of above or superior, but in the sense of particular and unique. In fact, I think it a dehumanising act to reduce any person to “ordinary” or “common”. It’s a failure to really meet and get to know the individual.

So, although these terms seem somewhat paradoxical I find no conflict in them. I find that every single day I can have my attention captured and feel a sense of wonder and amazement develop inside me, just by living my “ordinary”, “normal”, “everyday” life.

I think there are two important principles to bring to this idea and practice – attention and imagination.

We humans have remarkable powers of unconscious and subconscious functioning. We can easily slip into auto-pilot. Have you ever had that experience of driving somewhere with you head full of thoughts to such an extent that on your arrival you have virtually no memory of the actual journey? This happens especially if your trip is one you have taken many times before. You navigate, without much conscious thought, from one familiar landmark to the next, through one well known intersection to another, but you might be hard pushed to describe any of the details of the journey. We are equally great at acquiring habits, and once we set those routines off, unless anything interrupts the expected flow, then we cruise through those activities, “without a second thought”, or, maybe more accurately, without a first one!

These are great powers and they enable us to get on with living without having to stop and make sense of life in every lived moment. But it comes at a price. We miss a lot. In fact, it comes at another, perhaps even greater price. We open ourselves up to being controlled. There are vast industries of advertising, propaganda, and persuasion designed to hustle us along towards somebody else’s desired goals without stopping to consider them.

So, how do challenge that? By slowing down and paying attention. OK, maybe not all the time, but more than we are in the habit of doing. The more often we slow down and pay attention to what is here and now, the more we notice. And, my contention is, the more we notice, the more we wonder.

Repeated experiences of wondering undermine the belief that there is nothing interesting or different about any individual, that all flowers are the same, that nothing changes, or that generalisations are more true than specificities. In fact, repeated experiences of wondering create the exact opposite. They affirm, every single day, that every person is unique, that every plant is unique, that no experience is ever really repeated, and that the truth is always found deeper than in a surface generalisation.

When I walked along the banks of this stream, which you can see in the photo at the start of this post, I noticed rocks and water. Everywhere I looked the rocks looked different, and I spent a long time mesmerised by the flow of the ever changing water.

Have another look at this particular shot. Don’t you find yourself starting to wonder? Starting to wonder about the shapes of the rocks? How smoothly they have been carved by the water. Don’t you start to wonder how each rock becomes this particular shape, and how the rock got to this position in the stream in the first place? It’s pretty easy to let a whole river of questions pour through your mind, and even without answers, those very questions start to stir a sense of amazement, of awe, of wonder.

The second element is imagination. We humans don’t just “see” the way a camera “sees”. We select, represent and interpret. We pick certain elements out of the immense flow of materials, energy and information which constantly course through our minds and bodies. We re-present those original flows and turn them into mental images, thoughts and ideas. And we interpret those representations, colouring and shading them with meanings which we draw from our memory banks and conjure up with our imagination.

I look at these particular rocks and I see a giant wide open mouth. I can imagine that some great monster fell, or was thrown or chased, into the water some time in the distant past. I can imagine that “once upon a time” something happened here, and there’s a story to be told to “explain” what we can see now. In Celtic traditions there is an abundance of such stories about the landscape. The mountains, rivers, forests, lochs, boulders, trees and ponds have stories attached to them, names given to them. Those stories and myths enrich the landscape, and add an extra, invisible layer to Life on Earth. Some people refer to this phenomenon as “enchantment” and I rather like that.

Here’s to a life of wonder and enchantment bursting up into our consciousness every single day.

Here’s to finding our inner heroes and discarding our inner zombies!

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At the beginning of the year I received an invite to speak at a conference in Canada. The invitation was to talk about my experience of four decades of work as a doctor who used homeopathy. I was surprised, but it was a very kind invitation and I accepted.

The way I prepare for talks is to let some ideas and questions rattle around my brain for a bit, then start making notes. The kinds of notes I make are sort of mind maps. They aren’t as formal as those you’d find in books about the mind mapping. I just put down key words and phrases on a page, then draw circles, squares or diamond shapes around them and link them up. I’ll do a few versions of that, then I open up “Keynote” and I make a slide for each element in the mind map, pull in images from my photo library, write a few words (not many) on some of the slides, then arrange them to create a sequence which enables me to tell the story I want to tell. Well, I ended up with a set of three presentations, each of which would take about an hour to tell. I’d been told I’d be allocated two 90 minute slots in the schedule.

Then before the time arrived for the conference, along came COVID-19 and the event was cancelled. Maybe it will happen some other time, but maybe not. I’d enjoyed putting the presentations together so that gave me an idea. Why not write a book covering the same ground? I’d had an idea for a long time that I should tell my own story. I didn’t want to write a textbook, or a polemic, an argument for a way to live, a way to practice Medicine, or even make the case for the use of Homeopathy. I just wanted to make a record of my own life, my own experience.

I’m sure if any of us sat down to write our own story we’d immediately come up against the question, “But which story?”, because there are many stories of our lives. I didn’t want to write an autobiography which told the story of my family, my relationships, and my personal development. I wanted to tell the story of why I became a doctor, what kind of doctor I became, and how that came about. Not least because I thought it would help me to understand my own life better. I suppose it’s my “professional story”, but really, it’s the story of my “calling”.

I wanted to publish the book too, because I wanted others to be able to read it. Not to earn money from sales, nor to try to convince anyone of anything, but more to add to my over all project of sharing my personal experience of curiosity, wonder and joy – that’s what this blog is all about – and that’s what I committed to do daily from the day of lockdown. I’ve been writing a post based on one of my photos every day since the middle of March and I don’t feel like stopping any time soon. I already know, from feedback from some of you, how much you appreciate these posts and that completely delights me. Writing them adds to my life, so I’m very, very happy if reading them adds to yours!

Now, more than ever, I want to set off some positive, loving, inspiring waves. I’ve no idea where they will go, or what effect they will have, but it feels like a way to make a positive contribution to our times.

With lockdown, with the presentations already mapping out a story, and with the daily practice of writing for the blog, it all came together and I wrote this book – “And not or” – “A calling and a listening”.

This is how I did it, the tools I used, and what I had to learn.

I wrote the text using an A4 sized notebook and a pen. I wrote and wrote and wrote, till I thought I’d written all I wanted to write. Then I used that handwritten text to write the digital version using a program called “Ulysses“. Listen, before I go any further, I’m just laying out what I did, not saying you should do exactly what I did if you want to write your own book! But, on the other hand, I’ve always found it helpful to read what other writers have done. So, you could use any software you want. I started with Ulysses. I use this program on my desktop Mac, as well as on my iPad (for which I have a proper Bluetooth connected keyboard).

When I wrote the first digital version, I didn’t just copy out all the words I’d written in my notebook. Instead, I’d read a section, then start to transcribe the words into the wordprocessor, but I found I often decided to write it differently, to leave out whole sentences or passages, and to write brand new ones instead. By the time I’d done that I had what I called “draft 2” (the written text constituting “draft 1”). The way Ulysses works is that you write “sheets” – for me, each “sheet” was a chapter. I like the simple markdown language you can use with Ulysses. If you put a # sign at the start of a line it turns that line into a heading. If you put two ## signs it turns that line into a secondary heading. I only used those two levels of headings. The first level heading were the chapter titles, the second level to navigate sections within a chapter. The other main markdown tools I used were for inserting images (hey, you know how much I love my photos!), for marking a paragraph as a quotation, and for creating lists. That’s pretty much it. Ulysses presents you with a left hand column of your sheets, each one showing just the first line or two. I used that to get an overview of the whole book. That let me see what I thought was repetitive, and what I thought was missing.

Next step was “draft 3” – read through the whole digital text, correcting and editing as I went. Once I got to the end of that, I felt, well….dissatisfied! Something wasn’t right, and I couldn’t see what it was. So I put the whole project away for a week. Then when I came back to it I saw there were half a dozen chapters which seemed problematic. They were in two groups of three, and each group had overlap and repetition in it. I still couldn’t see the way ahead though. So, here’s the next neat thing about Ulysses, you can select whichever sheets you want to review and print them off. I printed off the six in question. Then I read through the printouts with pencil in hand, scoring out, adding in, and linking up different paragraphs. Once I’d done that I went back into the program and changed the text according to that latest “edit”. I also chopped out three other chapters that just didn’t seem to fit well at all. What do they call that? “killing your darlings” – dropping some of the sentences you love the most – because they just don’t fit. I guess I now I had gone through “draft 4”, to “draft 5”.

Time for another complete read through, correcting and editing as I went – “draft 6”. OK, this felt good now. Time to try and turn it into a published book. I decided I wanted a physical, paper version, and a digital version (and not or….get it?).

For the paper version I decided to use Blurb. This is a company I’ve used about once a year to make a photo album of my best, or most memorable photos of that year. I love their quality of print. And I’d already taught myself the basics of their software – “Bookwright“. Now, I’m sure with all the software I use that I’m no expert and there are probably easier ways to do things, but, hey, I only know what I know, so I don’t know any easy way to import all the text into “Bookwright”. Instead I created the pages, inserted either text or photo “layout boxes” onto each page, copied and pasted the text, chapter by chapter into Bookwright, imported all the photos I’d used, and dropped them into the right places, then ran the “preview” option, and the error checking, both of which identified things that needed fixed. Then I uploaded it to the Blurb site and ordered up my proof copy.

Meantime I had to think how to produce a digital version. Apple have something called “iBooks Author” which I’d used before, (I’ve since learned Apple are about to discontinue that software) and there were ebook creation tools I knew existed to produce “Kindle” or “ePub” versions.

Whoa! Too much to think about it! I then discovered that Amazon had produced new software called “Kindle Create“. I downloaded it, discovered you could import a “Word” file into it, make a cover, preview it, then upload it to Amazon. Ulysses makes it easy to export your sheets as a single “.docx” file so I did that, opened it up in “Pages”, then exported the document from there as a “Word” doc into Kindle Create. It was easy, and straightforward, just took time and care.

Now, I’m sure if you use Windows your workflow and the tools you can use will be different, and maybe some of you know a lot more about these programs and methods than I do – and if that’s true, please go ahead and share what you know in the comments here, or share links to your own articles if you’ve written them.

Well, this is where I’ve got to now – a paper version – you can get it from Blurb at https://www.blurb.co.uk/b/10155078-and-not-or

and a Kindle version – https://amzn.to/2UozjIw – if you are in the UK. If you are not in the UK, go to your local Amazon site and search for “Leckridge” – you’ll find it quickly that way (let me know if you don’t!)

Here’s my summary of the book –

Why become a doctor? This is one doctor’s response to that question. It begins with a calling, then continues through listening. Patient after patient, over four decades of Practice, tells their own unique story. Each one is an attempt to find healing. To find healing, the doctor and the patient embark on a relationship which allows them to uncover Nature’s pathways to health. 
Each pathway is a life of adaptive strategies revealed through the body, the emotions, and in patterns of behaviour, language and thought.
Two small words open different doors of understanding.
“Or” divides, separates and focuses attention on single parts.
“And” connects, integrates and focuses attention on the whole.
We need both approaches but if we are to heal, individually, together, and at the level of the planet, we need to shift the balance away from “or” to “and”. 
Through an exploration of narrative, psychoneuroimmunology, neuroscience, complexity and complementary medicine, this is one doctor’s experience of shifting the balance from “or” to “and”.

If you fancy reading it, go ahead, and if you’d like to give me feedback you can find me most places by searching for “bobleckridge” – I’m here on WordPress, but I’m also easily found on Facebook, Twitter, Flickr, and I use gmail.com (just put “bobleckridge” before the @ sign)

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This remains one of the strangest trees I ever saw in any forest. In fact, it seemed to me that there were two trees here. You could clearly see two trunks arising from the forest floor, then something odd happens, the one of the left sends out a substantial branch, so substantial I’m not even happy calling it a branch, which connects with the one on the right. They fuse. Then they continue upwards in parallel, each distinct but traveling in the same direction, until about a metre or so further up they fuse again, and from that point on, continue upwards as one.

I’m happy simply to contemplate them, to trace their separate and entwined paths as they reach up to the Sun…..but I seem unable to resist the thoughts they inspire in me.

This is such a beautiful representation of how all of Life seeks out more Life. We get close to certain others, connect with them, form relationships with them, bond with them, entwine and entangle our lives with them. We influence each other. Yeah, sure, we still know that we are individuals, that I am me and you are you, but our shared experiences change us. I am not the same since I met you.

Each of us emerges from, and lives in, a multiplicity of environments. We are embedded in certain times and places. We exist within certain cultures and societies. We become who we are becoming in vast interconnected webs of relationships which span across the face of the Earth and reach both back in history and forward into the futures we will create together.

Each of us lives, an embodied, unique, singular being, never completely separate, never completely alone, never completely independent. So let’s just embrace that shall we?

How might life be if we acknowledged our entwined, entangled, embedded, embodied nature? Could we begin to share our lives better, here and now, in this present time and place, as co-inhabitants, co-creators, and co-operators?

Wherever we are….in a particular street, town, city, region, country, hemisphere, planet…..we share our entangled, interconnected lives with everyone else who has ever lived, every other inhabitant of this time and place, and every other child we haven’t even dreamed of yet.

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In one of my most favourite villages in France, Saint-Guilhem-le-Desert, there are two natural objects hanging on doors, above doors, and on walls, throughout the whole village. This is one of them. It’s a “cardabelle”.

A cardabelle is a kind of thistle which grows abundantly in this area.

Mostly you see dried specimens pinned to doors, but in some places there are copies sculpted in stone.

The other natural object you find is…..

….the scallop shell.

Why these two objects?

Well, the cardabelle is thought to be a good luck token. I suppose in a similar way to the horseshoe you see in some other cultures. It’s also been used traditionally to make predictions……about the weather! That’s partly because it changes shape according to the humidity levels and atmospheric pressure, so it acts a bit like a natural barometer. I’m told it’s also eaten and tastes a bit like an artichoke (not my favourite vegetable!). But I think its utility is a lot less significant than its power to give meaning. It changes life through the power of symbol.

The scallop shell is the symbol of the pilgrim. Specifically, the pilgrim making his or her way along the “Camino de Santiago”, or, in French, “Chemin de Compostelle”. It is used along these paths to indicate some support for, or welcome to, any passing pilgrims. The photo above indicates drinking water (“eau potable” in French, which is worth remembering if you are thirsty while walking in France!). It is also hung outside certain inns and hostels for the pilgrims to find something to eat or somewhere to rest for the night. I hadn’t realised just what an extensive network of paths make up the “Camino de Santiago”.

What really interests me about the cardabelle and the scallop shell is that both are transformed from their original, natural purpose in the world by this distinctly human capacity to make one thing represent another.

They both become powerful symbols. Symbols of place, of belonging, of tradition, of belief, and of purpose. There are a million stories connected to them.

How are we to understand this? I think symbolic thought, metaphoric thought, represented by objects, artistic creations, words and stories, are a kind of invisible, global network connecting us all. They are part of Jung’s “collective unconscious” drawing from our archetypes and myths. They are part of Teilhard de Chardin’s “no-osphere”, that extra layer of atmosphere encompassing the Earth, composed of human reason and thought. They are a world wide web of deep, complex, living and growing sense-making and meaning-giving phenomena which we can draw on to make more sense of our individual lives.

I love this power we humans have – the power to create this vast uniquely “human layer” of existence which is embedded in, and emerges from, the natural world, deepening and widening our experiences and understanding. It’s a shared phenomenon, a collective effort stretching back over centuries and we are adding to it every day, drawing from it every day, living it every day.

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