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Archive for the ‘science’ Category

Look at the sand. Look at these lines. They look like waves, don’t they? Except sand doesn’t really do waves, does it? We know, when we look at this, that the sand has been shaped by some other force. We know that that force was water. Well, not really water, although water was involved. It’s been shaped by the forces which shaped the water.

Water often looks like this. Whether it’s the surface of a pond, a lake, or an ocean, the surface of the water breaks into long peaks and troughs which we call waves.

Nothing remarkable there?

Well, actually, it is. Because those waves in the water are movements of energy. You can’t capture a wave and examine it under a microscope.

A wave is more a verb, than a noun.

A wave is more a process, than an object.

The forces which create the wave are invisible to us. The shapes they make in the water are not.

So, when we look at the sand and see a pattern like this, we are seeing a kind of symmetry. We are looking at sand, fashioned into similar shapes to the water. But underlying both the sand and the water are these invisible forces which are doing the shaping.

Or, rather, the invisible forces are doing the shaping by interacting with the water and the sand. It’s a sort of collaboration.

I often wonder about the invisible forces which interact with the material world to produce the patterns, shapes and forms which we see around us.

I wonder about the invisible forces which interact with each of us to shape our experiences and our lives.

There is one particular quality in this kind of pattern which really captures my attention and imagination – transmission. When we see a wave move across the surface of a body of water, or we see how the sand has been shaped, then we realise we are witnessing something moving, something dynamic, something which is carrying particles, energy and information from one place to another.

That’s how I see the world now. A myriad of transient forms produced by continuous flows of materials, energies and information. Nothing exists in isolation. Nothing is fixed. Everything exerts influences which spread far and beyond the here and the now.

Everything, and everyone.

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The river Charente which flows through this region has a reputation for being calm and steady. At least, here in Cognac, and in this photo I took in nearby Jarnac, it pretty much always seems to be flowing with no fuss. It’s a total contrast to the tumbling, rushing, foaming waters falling down the rocky hillsides in Scotland, although, I must confess, the River Forth which meandered around Stirling where I was born, was also pretty smooth….it’s just that it seemed to swell and overflow frequently, which I haven’t seen happen in the Charente.

Local people claim the easy, relaxed attitude of the river influences their state of mind, and their behaviours. I’ve lived here for coming up on six years now and it isn’t stress free, but the values of ease and taking your time are really prominent here. Hey, it’s no surprise that the symbol of the Charente is a snail! And that’s not because they are a local delicacy – they aren’t!

On the particular day when I took this photo the water was astonishingly green. That was pretty unusual. I was walking along a riverside path shaded by trees and I came across this box which someone had placed here as a seat. I was struck by just how attractive this spot was for taking a pause, slowing down, and savouring the day.

As I look at this photo again now I am yet again astonished by the green-ness of it! Isn’t it lush? The overhanging tree, the river itself, and the far wooded riverbank are all completely different shades of green. Wonderful!

I don’t know about you but I definitely associate green with Life. This image seems full of Life to me. I’d be hard put to decide what colour is my favourite colour because I adore the blues in the sky and the sea, and I love the reds, yellows and goldens of autumn, but green, in particular seems to be the colour of Life for me.

I suppose when I stop to think about it, its the chlorophyll in the plants which gives us most of the green around us, and without that chlorophyll, there would be no life….at least, not as we know it.

I believe there is a power in Nature. A power of healing. A power of presence. A power of Life. And this green image exudes those powers. Surely we humans need to live amongst green spaces?

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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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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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I am very attracted to liminal spaces…..the zones of change, the places where the boundaries dissolve, the areas where the elements mingle at their far edges creating new, different and unique phenomena.

One of my most favourite such space is the shore line. That magical rhythm of the sea dissolving on the sand as the big waves turn to foam and flatten themselves out as they land on the beach, followed by a rush of water, sand and pebbles as the closest waves to dry land retreat speedily back into the sea again.

On this one particular evening an extra layer of “liminal” came into play, as the light turned pink and tinted both the sea and the sand with the colours of a setting sun.

So, simultaneously, in both the dimensions of space and time, that liminal zone emerged….that place of wet sand, not quite beach any more, but not yet wholly ocean yet. And that time of the day, not quite daytime any more, but not wholly night yet.

It makes me tingle just to remember it.

These phenomena of borders, of liminal spaces, of junctions and transitions….they all appear in the “between-ness”. That means they all share that characteristic of revealing connections, influences, bonds and relationships. Whilst the left hemisphere of the brain is so brilliant at selectively focusing on parts, analysing them, classifying them and categorising them, it’s the right hemisphere which sees the “between-ness” and in so doing reveals the singular, the unique, relationships and connections, and, so, the “whole”.

I think it’s good to stimulate your right hemisphere with these experiences. If we are to re-balance the influences of the two hemispheres and move towards more human, more humane, more holistic values, the more we can develop our right hemisphere powers the better!

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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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Not all days are the same.

Not all changes are significant.

But when you look at a tree like this you realise something has happened, not once, not twice, but several times. This tree seems to have started growing pretty normally but then, for unknown reasons, has take a right angled turn to grow horizontally for a bit. Was that a storm? A strong gust of wind? An animal or a human who bent the young tree over like that? Then a little later, the tree keeps on the horizontal but takes another right angle turn. How do you explain that one? I can’t. But surely we’d agree both turns were significant. On both occasions the future path of the tree was changed enormously. Not long after this second swerve, it starts on an upward path again, as you might expect any tree to do. But we can’t explain why it happened then.

You know, I think life is often like this.

Here’s one of the most useful questions I’d ask a patient – “When did you last feel completely well?” I liked that question because over the course of weeks, months and years an illness changes. It can change so much that at the point of presentation it looks quite different from how it began. So, I didn’t ask “When did this [insert diagnosis here] start?” Or, “When did you get sick?” Those questions often missed the origins of the illness. Also, many times, people would present with more than one diagnosis. Human beings can’t be compartmentalised into neat separate diagnostic boxes without losing sight of them as human beings. Sometimes a story, or narrative if you prefer that word, would begin with a certain illness, but then others would emerge on top….either replacing the original one, or blending in somehow. It was, therefore, more revealing to ask “When did you last feel completely well?”

You’d be surprised how often that was a difficult question to answer. Often I needed to prompt and coax, sometimes going right back to early school days, before someone would say, yes, that’s when I last felt completely well.

Once they’d told me when they had been well, we’d then start to discuss two things. Firstly, what was happening in life around the time you began not feeling well, and, secondly, tell me about what you experienced when you first started to feel unwell. I don’t claim that the revelation of significant traumatic events, be they accidents, infections, emotional traumas or abuse, then enabled me to say it was this or that event which caused your illness. But pulling together these pieces of a person’s story frequently opened up a new level of understanding. And, actually, somewhat surprisingly for the patient, it often revealed just how amazingly they’d coped with significant traumas.

So when I look at an image like this tree, I’m immediately wondering what the story is……how did the tree develop in this particular way? What was going on when these dramatic twists and turns took place?

I’m not finished yet…….because the other thing this tree tells me is to consider the wider, fuller picture. It’s hard enough to unpick key events, but you need a longer view, a more holistic view, to make sense of the fuller life story.

Here’s what seems to have happened next…..

That upward movement we looked at a few moments ago continued until the tree managed to contact its neighbour. Then they bonded. They made a connection. And they grew upwards together for the rest of their lives (OK, I don’t actually know how much longer these trees lived so maybe it wasn’t for the rest of their lives, but we say that when we tell stories, don’t we?)

We still don’t know what happened in those early phases of life, but with this longer, fuller view, we can at least make sense of the final turn upwards. We can see what appears to be a seeking for a connection, a movement towards an-other. Or at least, our story-telling brains make it easy to make sense of what we are seeing by interpreting it this way.

I don’t think you ever fully know another person. I don’t think anyone can ever make complete sense of another person’s life. In fact, I’m not sure we can even do that for ourselves. But we can spot patterns. We can see shapes, and movements, and directions, and rhythms. And when we weave those together into a lifetime narrative they really can help us to make sense of our experiences.

At least, that’s what I found.

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Have you ever noticed how we like to complete what we see?

This photo which I took turns a semi-circular bridge into a complete circle by including its reflection in the water. I like it better that way!

That makes me think of two things – how our vision works, and what kind of symmetry pleases us.

The simple way to think of the eye is that it is a kind of prism….that the light enters through the pupil and then casts an upside down image onto a screen – except where is the screen? At the back of the eye ie the retina? Or at the back of the skill ie in the brain? Whoa! Not so fast! Because that’s already NOT what happens.

Light enters the eye through the pupil and stimulates specialised cells embedded in the retina – rods and cones. When they are stimulated they send electrical signals along the “optic nerve” directly into the brain where different parts of the signal are processed in several different regions scattered across the back of the brain. The brain then merges all the processed information and, somehow, (we’re not quite sure how) turns it into a complete image. So we have the experience of seeing the world as if its a photo or a video.

Now, quite honestly, I think that is mind boggling. I think it is utterly incredible. But it’s even more weird than light being turned into electricity then split up, processed and merged, apparently instantly, to create whole images. Because for all the signals to travel from the retina to the brain they have to pass along the “optic nerve” and this “optic nerve” obviously doesn’t have the rods and cones which the rest of the retina has. It’s literally a blind spot. In other words, at no point does our eye, or our brain, “see” a whole image the way a prism, or a mirror would. We literally create what we see. Moment by moment, second by second. Astonishing huh?

Symmetry. In Western civilisations it’s common for people to prefer symmetry. By that I mean the typical “classical” symmetry of whole circles, balanced pillars and so on. But in Japan, for instance, such symmetry seems too static for most folk. They prefer things to be left a little “incomplete” or “asymmetrical” believing that such a view is more dynamic, and more TRUE because reality is never static or complete. You can read more about that if you explore “wabi sabi“.

I can find both pleasing. Lucky me, huh?!

But when I stop to think about it, the Japanese idea of leaving the mind (including the imagination) to “complete” an image is actually a more true representation of our vision functions.

How about you? What do you find most pleasing? The symmetry which looks balanced and “complete”, or the symmetry which encourages you to “complete” the vision with your own creative mind?

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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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