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Archive for the ‘science’ Category

Here they come! The first little crocus flowers.

It’s the middle of January, and here in the Charente we have blue skies and a bitingly cold wind blowing from the North East (the literal opposite direction from the prevailing winds which come from the South West).

Every year in late autumn I poke some more holes in the grass around the mulberry tree and plant some crocus bulbs. Last time I planted about fifty of them. I’ve lost count of how many I’ve planted in the last five years. We have an image in mind of a carpet of yellow, purple and white crocus flowers covering the ground at the foot of the tree, but, so far, it’s never looked remotely like that, so I just keep adding a few more every year.

Did you know that there is no scientific way to tell if a seed is dead or alive? No way to know which have the potential to burst out of their shells and make their way through the soil towards the Sun. Any botanists out there can correct me, but I suspect the same applies to bulbs. There’s no way of knowing which will produce full-blown flowers, and there certainly is no way of knowing which of them will appear first.

That means that every single year the sight of the first crocus is a surprise and a delight. It’s like making a discovery. Even if I know it’s me who planted the bulbs there. That delight doesn’t go away with the appearance of the first flower either. Every single new plant brings an equal measure of delight. It’s the gift that goes on giving!

This is one of the occasions where I am struck by how we humans can welcome and embrace uncertainty. We’d like to think we can control things. We’d like to think we can predict things. And there are certainly cases where we can, but more often than not, we can’t. I worked as a General Practitioner for four decades of my life, and the core skill of a GP is to be able to handle uncertainty.

In the Primary Care setting, a GP (Family Doctor), tends to be one of the first to be consulted when a patient becomes unwell and can’t manage their illness by themselves. In my training I was taught this meant I’d see a lot of patients with “undifferentiated illness” – because in the earliest stages of illness things can be pretty vague. There might be a bit of a fever, or just a symptom or two….feeling tired, or achey, of slightly nauseous. In these early hours or days there might not be much to find amiss on a physical exam, or at least, not much to find which is distinctive of any specific disease. A few days, or even hours, later, it can be glaringly obvious! Which is why GPs learn to assess the severity of a patient’s symptoms, the over all level of their health, and the need for any urgency. We learn to review the situation as quickly and frequently as appropriate. We also learn that the future is not predictable at the level of the individual patient. We can have a good knowledge of the likely progress of certain pathologies, but we can’t predict the future path of an individual’s illness. Same thing goes for any treatment. Whether or not a certain treatment is so-called “evidence based”, only the unfolding story of this particular patient in the days and weeks ahead will reveal the course of the illness and the appropriateness of the treatment.

I can see that you might read that and despair, thinking, surely the doctor can do better than that? Surely they can predict the future with certainty. Well, nope, they can’t. What that means is that the uniqueness of the individual can never be set aside. The particularity of the person can never be replaced by the categorisation of their illness by diagnosis, or by the likely effectiveness of any treatment. At all the times, the GP has to make a judgement, based on knowledge and experience, use that judgement to decide what to do, then, crucially, follow up.

That’s why I don’t think it’s a good idea to chop the delivery of health care into little pieces. Dealing with the whole person has got a time dimension to it. We need to know how things are progressing, and make another judgement, another decision, in the light of the changes.

So, I might have started writing this thinking about a little yellow crocus popping up, by I find my train of thought exploring uncertainty, unpredictably and the Practice of Medicine, (who saw that coming?!)

Where that takes me to is – I think there are at least three crucial elements to good Medical Practice –

  1. Time – sufficient time for the patient and the doctor to get a good understanding of what’s going on
  2. Continuity of care – follow through of every event into an emerging story over hours, days or weeks
  3. Open minds – never closing down the thought processes by ticking a box, or issuing a prescription, knowing that the future, in all individual circumstances is uncertain.

I’ll leave you with one of the “new”, newly emergent, crocus flowers, by which I mean one of the new variety I planted last year which has just popped up to say hello!

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It’s almost the end of the year and a few days I go something caught my eye when I walked out into the garden here in the Charente – daisies!

I don’t know why, but I’ve always associated daisies with the summer, and I don’t remember ever seeing them flower around the time of the winter solstice, but, who knows? Maybe they do! Perhaps if you’ve more botanical knowledge than I have you’ll be able to enlighten me. However, what I’m saying is this is the first time in my life that I’ve been aware of daisies flowering in the winter time.

So what, you might ask?

Well, here’s why this interests me……

I find that when I notice something different, something new to me, that it slows me down, draws me into the here and now, makes me more present. I felt compelled to turn around, get my camera, then go back out and take some photos of these daisies. I enjoy getting down in the grass to take a close up of the small flowers which grow there, and for a few moments, as I frame and focus, I lose myself in this action. Lose myself in the sense of interrupting the almost chaotic nature of the endless flow of thoughts which seem to occupy my busy brain, and focus for a bit, on looking, on discovering, on photographing these little flowers.

So, there’s the first thing. They take me to another place, to another pace.

Second, as is often the case when I slow down, notice, savour and become absorbed by something, I find a sense of wellbeing, of joy, and of transcendence occurring. I feel nurtured by that.

Third, I start to think about what I know about this family of plants – the daisy family – what I know about them is that they have been used by humans, for hundreds of years, to treat injuries. They have a reputation for stimulating and encouraging repair and recovery. Bellis perennis (this common lawn daisy), Chamomilla, Calendula, Echinacea, Millefolium, Arnica, are all members of what we now call the Asteraceae (the daisy family). And they are all members of Nature’s Pharmacy of healing plants, used particularly in the treatment of injuries. There’s an interesting quality which many of the flowers share which relates to this repair-ability they seem to have – when you walk across the grass, standing on daisies as you go, if you stop and look back, it’s hard to see which ones you stepped on – they have great resilience, great ability to withstand and recover from trauma. Isn’t that interesting?

Fourth, and this is because of what I’ve learned over the years about these little plants, as I wander around the garden, crouching down to take the photos, I start to wonder about resilience. How resilience, which incorporates both an ability to withstand trauma, and an ability to recover from it, is much neglected in Medicine. Even in the treatment of injuries, I wasn’t taught much at Medical School about resilience or how to stimulate and nurture it. But isn’t this an essential part of all healing? This poorly understood phenomenon of self-defence, self-regulation and self-repair. I know now it’s a common feature of all “complex adaptive systems“. But that’s not something taught at Medical School either…..

Fifthly, and, if you are familiar with my thought from other posts on this site you’ll see this one coming, I feel humbled. I feel humbled by the astonishing phenomenon of the lives of these pretty flowers. I feel humbled by the realisation of the limits and partial nature of all human knowledge, and, certainly my own! I feel humbled to be in touch with the natural phenomenon of resilience, and ponder what I can do, what we can do together, to stimulate and support the resilience of ourselves, our loved ones, of other living creatures, of ecosystems, of Nature, of our planet Earth.

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What do you see here?

Autumn leaves? Some turned partially red, some now brown and dusky, others as white as bones…..

People talk about leaves falling at this time of year, but do they fall, or are they pushed? Or do they jump? I’m not a botanist and I don’t know the answer to that question but I do wonder about it….especially when I look at this wonderful “Boston Ivy”, or “Faux vigne”, which covers the huge wall along one side of the garden.

Isn’t it glorious when it’s at the peak of the transition?

Well, I’ve seen hundreds of photos of red, yellow, golden and brown leaves over the years but I never get tired of them. Like sunsets and rosy dawns they are magnets for me. They draw me outside to have a better look. But look what happens next with this particular plant…..

These are the stalks which connected each leaf to the rest of the plant. A few days on, and these stalks will be lying on the ground in heaps. How does that happen? How do the leaves leave the stalks, and then, the stalks leave the vine? I don’t know. It amazes me. I’ve lived here for five years now this month, and every year this unfolding sequence of leaves changing colour, leaves falling to reveal all the stalks, then stalks falling to reveal ……..

…purple berries on bright red stalks……well, I just love it.

If you go back to the first photo in this post you’ll see a couple of purple berries lying there in amongst the leaves…and, remember, each of those berries contains the seed/s of new plants, so in that one image I see something like the alchemical image of the snake which swallows it’s own tail (the Ouroborus)

Nature, seen, this way, isn’t linear…..the past, the present and the future all there in the one moment, the one image…I feel the rhythms, see the cycles, experience the connectedness of everything.

As T S Eliot wrote, in The Four Quartets –

 

Time past and time future
What might have been and what has been
Point to one end, which is always present.

 

(read the poem here)

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I came across a discussion about identity recently, and as identity politics and populism seems to be to the fore in many countries these days, it got me thinking – who am I, really?

A few years ago I was in Marseille and these incredible sculptures were installed around the “Vieux Port”. They really grabbed my attention. Here’s just one of them (see the photo at the start of this post) showing what I immediately perceived as a person. He’s not all there, of course, but we fill in the gaps to make him whole, don’t we? Well, it struck me that that’s what we do all the time.

At least once a week in my consulting room a patient on their first visit, after telling me their story over the course of an hour, would say “I’ve never told anyone what I’ve just told you. Never.” And they’d often add “I feel you know me so well”. It was good feedback, and it reassured me I was on the right track and had established a good therapeutic relationship. But I often thought, “Actually, I only met you an hour ago, and I think it takes a lifetime to get to know someone. I think we can spend most of our lives with a partner but we never really completely know them. I’m still getting to know myself, for heaven’s sake,¬†and I suspect I’ll be doing that for the rest of my life”. Sometimes, I’d say that out loud, but other times, I’d just think it. I think it still.

Here’s me at Primary school –

And here’s me about sixty years later –

Is this the same person?

From my perspective it certainly is! I have the experience of a continuity of Self. I know these are both photos of me, but, boy, have I changed!?

So, who am I, really?

Am I this body?

It’s pretty obvious, even from just those two photos, that this body has changed a lot over the decades. Our bodies are made up of over 30 trillion cells (a number too big for us to imagine, and that’s just an estimate because nobody has been able to count them). Almost all of these cells live much shorter lives than I have done. Some cells live only a few days, other weeks or months, and only a minority last a full lifetime. So, it’s pretty certain that only a minority of the cells in this body I have now are the same ones I had in that earlier photo.

Interesting choice of verb there…..”had” – do I have a body? If so, who is this “I” who has this body? I’m tempted to say, no, I don’t “have” this body, I “am” this body. But there’s the trap, huh? Because if the body is always changing, am “I” always changing too? Where does my sense of continuity of being come from? And I am more than my body aren’t I?

What more am I?

Scientists have discovered and put forward at least three other elements of identity by studying genetics, the “the human microbiome” and epigenetics.

For a while the “Selfish gene” idea gained a lot of traction. “The Human Genome Project” was completed in 2013 and there were great claims for it at the time – a bright new future of “personalised medicine” based on your gene sequences was heralded. Some claimed it would lead to the elimination of a host of diseases. Richard Dawkins, whose book entitled “The Selfish Gene”, popularised the idea that our essence, our core, the “real” “I” wasn’t the body, it wasn’t the mind, it was the double helix spirals of gene sequences….our DNA.

Things haven’t turned out the way the great gene believers imagined however. It seems we can’t be reduced to the level of chains of little molecules. We are more than that. What more?

Well, next up was an exploration of the cells which are part of us but aren’t us – all the bacteria, viruses and other micro-organisms which live on and in our bodies but don’t have the same DNA as we do. It turns out there are at least as many of them as there are “our own” cells. “The Human Microbiome Project” was launched four years after the end of “The Human Genome Project” and by 2016 a lot had been discovered, but it’s still not enough to pin down who we are.

Have these projects helped me to answer the question “Who am I, really?” Not really, but it does make me deeply aware of the fact that I’m not so much an object as some scientific models have suggested. I’m certainly not a fixed entity. Instead, it seems I’m a constant, lively, energetic flow of cells.

It makes me think I’m more like a river than a stone! I’m certainly not like a machine.

But wait, it gets more complicated yet – following on from the discovery of the “genetic codes” researchers discovered that not all the genes are active all the time. In fact they switch on or off all the time. They’re more like music than they are computer code. What presses the keys to play the tunes? What determines which genes are expressed, and when? It seems a whole host of “environmental factors” are involved. You aren’t determined by your genes. They only represent some kind of potential. Whether they become active or not depends on the life your live – the environment you live in and the events and experiences of your life.

We don’t know what all the factors are, or how they work….. “The Human Epigenetic Project” anyone? Well, what do you know? There IS “The Human Epigenome Project“! A consortium exploring at least one of the links between genes and the environment.

So, if my body isn’t all there is to me, if my genes aren’t all there is to me, if my microbiome isn’t all there is to me, then what else is there?

My thoughts? My feelings? My memories, dreams and imaginings? The stories of my life?

Tick “all of the above”. (There are volumes of books which have been, and are still to be, written on each of these)

But there’s a vivid red thread running through all these observations – connections.

Who I am, really, will never be answered by considering myself in isolation. It seems I am a flow. Constantly changing, constantly receiving materials, cells, energies and information from the world in which I exist, constantly sending out materials, cells, energies and information, and constantly changing myself and the world in the process.

My story is not just my story. It’s our story. You and me. Every relationship, every encounter, every exchange, shapes, changes and moulds me, and, you, and the planet we live on.

That excites me.

It’s a new story. It’s the story of evolution, of emergence, of connections, contexts and change.

The answer to “Who am I, really?” won’t be found by looking at smaller and smaller parts. It’ll be found in experiences, in performances, in events, in relationships and interactions. It’ll be found in the unique stories that only I, and only you, can tell. It’ll be found in what we share and how we relate.

Identity is fluid, relative and dynamic.

Maybe we should think of it more as what we share, than what divides us.

 

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One of the things I love about living here in Cognac is the availability of different, fresh, locally produced food. I popped into one of the market-style shops here this week and discovered it was “Fete du Pommes” week – a celebration of apples. Because, of course it’s autumn now here and apples are available in abundance. I know I can go into one of the big name supermarkets and select a plastic bag of shiny “perfect” same-size, same-shape apples of a big name variety (“Pink Lady” anyone?) which have been shipped here all the way from the Southern Hemisphere but look what I can get when I go local instead?

I selected four different varieties, none of which I’ve heard of before, and placed them in the cardboard box from the stack at the entrance. Even within each of the many varieties available I could choose big apples, small apples, round apples, wonky apples! What a delight!

Diversity is a core feature of Nature.

There are no two of us the same. The Universe celebrates diversity by bringing to life millions and millions of unique plants, creatures and forms.

Nature abhors mono-cultures. They die out, taking the richness of the soil with them.

I delight in the diversity of human beings. During my four decades of work as a clinical doctor I looked forward to the start of each week when the next patient in the door would tell me an utterly unique story, one I’d never heard in my life before.

I wonder if it’s possible to respect uniqueness and diversity if Clinical Practice is determined by guidelines and protocols for patients who are even more diverse than the locally grown apples in the market.

There’s a beauty in diversity, as you can see from my photo, but it’s a fundamental tenet of reality too….

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When I opened the shutters this morning I saw mist. OK, so I saw more than mist, but the mist was pretty dense. It was hiding all the surrounding vineyards, and, normally, I see vineyards straight ahead, to my left and to my right. I knew, of course, that the vineyards were still there. John O’Donohue came to mind, talking about the imagination and how we can’t see the mountains when they are hidden by the fog, but that we still feel their presence, still know they are there……

“You know it’s there, but you cannot see it with the eye. This is a wonderful living metaphor for the imagination. Around every life are these adjacencies–these huge, invisible presences that you can’t pick up with the human eye, but that you can connect to viscerally and affectively through the power of imagination. This is the threshold where polarities can enter into conversation with each other, and take us to new levels of complexity, differentiation, and integration.”

Then I noticed, directly opposite the front door, a sparkling jewel of a spider web adorned with water droplets. I find those serendipitous gifts of Nature irresistible.

Look at it! Just look at it! As far as I know (and correct me if you know better) spider webs are made by single spiders. These little creatures don’t work in teams. So ONE spider must have created this astonishing, complex web. Just look at the number of filaments, look at the junctions, the nodes, the points where the threads meet. Maybe this web was there the day before but because there were no water droplets on it, I didn’t notice it. Or maybe it’s the result of a single night’s work. Either way, I would have completely missed it, had it not been for two more phenomena – water and light.

Let’s start with the water. Where did this water come from? It wasn’t rain. It wasn’t a hose-pipe. It appeared, right out of thin air. We call it dew. Don’t you think dew is gorgeous? Whether its on a patch of grass, delicately outlining some petals or leaves, or adorning the work a spider. How incredible that it exists, invisibly, in the air, and that when the temperature and wind conditions are right, it precipitates out onto the surfaces, revealing itself.

Water reveals itself as thick mist, draping over the landscape like a heavy, dense, grey curtain. But it isn’t heavy, and it isn’t dense. When it reveals itself on the surface of flowers, leaves and spider webs, it reveals itself as droplets. Look at that image again.

How many different sizes of droplets are there? How many droplets are there? I guess that, theoretically, you could measure them, count them, add them up and tabulate them, but, well, hey, life’s too short. I just stand there, transfixed, in awe of them. Each one a tiny lens, showing me the world around it upside down.

I look at this and I think about the Milky Way which arched over my house last night, forming a dense, white carpet of stars stretching from one horizon to the other. You know what it’s like when you look at the Milky Way on a clear night. The longer you gaze at it, the more stars you see. The closer you look, the more the carpet dissolves into individual stars…..a bit like these individual droplets on the web.

It’s easy to get lost in the Milky Way.

It’s easy to lose yourself in a water adorned spider’s web, shining, sparkling, with the light which begins to penetrate the fog.

A couple of hours later, and this phenomenon has gone. The fog has receded into the invisibly watery air. The droplets have evaporated, leaving the thin threads of the webs harder to see.

You’d think that the sunlight would make the world clearer. But somehow, this morning, it was the fog, and brief appearance of the air’s water, which made the world much clearer, by reminding me, as the fox reminded the Little Prince , that

“What is essential is invisible to the eye”

And, oh, how wonderful it is, when what is invisible is revealed.

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I’ve been away visiting family in Scotland. When I returned to the Charente today I noticed that the Boston Ivy in the garden is just beginning to change colour. I also read today that the clocks go back this coming weekend….the end of “summer time”. So, I’m very aware that we are on the cusp of a seasonal change.

Has anyone every asked you which season is your favourite one? And, maybe, why?

I don’t have a favourite, but I do have a particular affinity for both Spring and Autumn because those are the seasons where I am most aware of change. I have a notion that Life is about change. We change constantly throughout our entire lives. We move constantly throughout our entire lives. Every breath we take changes us, and changes the world around us. I love to see change occur right before my eyes. I delight in the appearance of blossom and of buds in the Spring, and the leaves which go from green to red, brown or gold in the Autumn.

I find that the model of reality described by complexity science helps me to understand why things are the way they are. In complex systems, like our planet, the entire system tends to move towards “far from equilibrium” points. It doesn’t sit quietly, static and unmoving. We live on a dynamic Earth speeding through a dramatically dynamic Universe.

As complex systems move towards those edges it experiences “phase changes” and “bifurcation points” – the times and places where change becomes more dramatic, and places where it can go one way or another.

Autumn feels like one of those zones to me – a time and a place where change becomes more obvious, more widespread, and more dramatic.

That excites me!

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