I was driving up the road from Comillas to the sequoia forest early in the morning and as I turned a corner the patches of mist lying in the valleys caught my eye, so I pulled in to a lay-by and took this photo. In fact, I took several photos, and also took a few moments to gaze from side to side and into the distance, just taking in the whole landscape stretching out before me.
As I look at this photo now I see even more than I saw when I stood at the side of the road. Yes, of course, I still see how several valleys are holding the morning mists, giving the impression of white river, and maybe a soft white lake. And as the range after range of mountains recedes into the background I notice, as I have done many times before, how the distance is, so often, a shade of blue….although at this moment, the early morning autumnal light brings a green tinge to it all.
But now I notice the electricity pylons, the ones in the foreground with their insulators catching the sunlight, and the more distant, much larger ones in the top left of the scene. I see a fence, where someone has claimed this little patch of planet Earth for themselves….something we humans have done for centuries, producing borders, privatising the commons, creating a distinct “mine” and “yours” (or, at least, “mine” and “not yours”!). I see a handful of houses, and a van. I see a road sign telling drivers to keep to less than 50 km per hour….a rule somebody has decided to impose, no doubt with the intention of keeping pedestrians safer. There’s a sign with the name “Valoria”, a tiny village of a handful of houses.
I love taking photographs, particularly of anything which catches my attention. I find that when I upload them to my computer and take my time with them, I invariably notice much more than I did when I was actually there. It’s not that the photographs are better than being there (in fact, if I hadn’t been there, I couldn’t have taken the photo anyway), but they enrich and enhance the experiences I had at the time.
I think it’s good to slow down. It’s good to take your time before you press the shutter and take a photo. And it’s good to return to the image you’ve created, time and again, to explore, to savour, to enrich.
One of the things which frustrates me most about Medicine is this question – “Is it physical?”, which may be asked in a slightly other form – “Is it organic?”, (or, the apparent opposite – “Is it functional?”), “Is it a problem of the body or the mind?”. This way of thinking which divides illnesses into two categories, separating out the mind from the body, is still way too common. It’s common in patients who refuse to accept their illness could have anything to do with their mind – “it’s a virus”, “it’s a hormone problem”, “it’s my genes” – usually because they have been led to believe that a problem involving the mind is a “mental problem”, which strangely continues to carry a stigma that an infection, or a broken leg don’t carry. Separating out the mind from the body is a common misunderstanding not least because it is promoted by doctors who should really know better by now.
The human being is a living, multicellular organism. Starting from a single, fertilised egg cell, the foetus doubles and doubles and doubles the number of cells, until the fully formed human being is born with trillions of cells on board. Trillions. It’s too big a number to visualise. In fact, the number of cells in a human body are estimated, not accurately counted, partly because cells die and are replaced constantly. None of these cells exist in isolation. They are all in constant communication with, and respond to, other cells within the organism, so that although we each have a heart, two lungs, a stomach, a liver, a brain etc, none of these organs exist by themselves. Every single one of them is “integrated” with all the others – that means each is in an active two-way relationship with other organs, tissues and cells. The cells of your body don’t compete with each other. They collaborate. They work together to make the whole organism healthy, so that it can adapt and to grow.
The mind, as best we understand it so far, is more than a function of the brain. It’s embodied. There are extensive neural and endocrine networks throughout the body which work together to produce what we call the mind. This understanding of mind is sometimes referred to as “embodied mind”. Search for that term online to learn more if you like. It’s a useful concept which allows us to see that the mind is not confined to the skull.
It turns out that terms like “heart felt”, and “gut feeling”, are not mere metaphors, but reflect biochemical activities and phenomena which involve, not only the heart and the digestive system, but the whole organism.
I used to say to patients and medical students, I only ever saw a body without a mind in the mortuary, and I never met a mind without a body.
It makes no sense to me to separate out the mind from the body, because when illness occurs, it might arise in a specific tissue, or organ (or it might not), but the response to the disorder is a whole being response – we use the powers of every system within the body, and our abilities to think and to feel (I mean emotional feeling), to defend and repair.
The big problem with separating off the mind from the body and looking for “physical” or “organic” problems is that if all the lab tests and imaging comes back within normal limits, an illness ends up being classed as “mental” – and treatments for mental disorders are then offered. Or worse, it is dismissed as “not real”.
But there is another way to look at all of this – a holistic way – where we don’t separate out the mind from the body and whatever the disease, we seek to address the person, not simply some of their cells or organs. Yes, maybe there are cellular pathologies which can be, and should be addressed, but healing and repair always involves a whole person.
Wouldn’t it be better if we never limited ourselves to addressing “pathologies” in cells and systems, but, rather, in addition (and not or, remember), we engaged with the whole person through their story, their actions, their thoughts and feelings? Shouldn’t we address the circumstances of their lives, because nobody lives in isolation from environmental influences?
It makes no sense to me to address only a pathology found in a particular tissue or organ. Medicine isn’t a kind of mechanics. It’s an art, and science, of understanding and relating.
By the way, do you think you can see the suggestion of a heart on the bark of that sequoia in the photo I’ve posted above?
We made a visit to a sequoia forest in Catalonia recently and this is one of the many photographs I took. When I look at it now a passage from C S Lewis comes to mind. It’s many, many years since I read his little essay, “Meditation in a Toolshed”, but I’ve never forgotten it. It’s pretty easy to find online if you search for it. It starts like this –
I was standing today in the dark toolshed. The sun was shining outside and through the crack at the top of the door there came a sunbeam. From where I stood that beam of light, with the specks of dust floating in it, was the most striking thing in the place. Everything else was almost pitch-black. I was seeing the beam, not seeing things by it. Then I moved, so that the beam fell on my eyes. Instantly the whole previous picture vanished. I saw no toolshed, and (above all) no beam. Instead I saw, framed in the irregular cranny at the top of the door, green leaves moving on the branches of a tree outside and beyond that, 90 odd million miles away, the sun. Looking along the beam, and looking at the beam are very different experiences.
He goes on to describe several examples of the difference between “looking at” and “looking along”, where he juxtaposes the “objective” vs the “subjective” (although he doesn’t use those terms), the “quantitative” vs the “qualitative”….and issue which has been at the heart of my career and my life. He summarises his idea with this –
We must, on pain of idiocy, deny from the very outset the idea that looking at is, by its own nature, intrinsically truer or better than looking along. One must look both along and at everything. In particular cases we shall find reason for regarding the one or the other vision as inferior.
Most of the essay is about how we seem to have developed a habit of favouring the objective over the subjective to the point where the latter is dismissed as irrelevant, or even, unreal. I’ve heard a junior doctor say that his mentor told him “You can never believe patients. They lie all the time. You can only believe the results (the laboratory findings)”, and time and again, in neuroscience, our inner thoughts, sensations and feelings are reduced to biochemical reactions and neural pathways….as if the MRI scans and biochemistry reveals “the truth”, whereas the patient’s reported experience is dismissed as “anecdote”, or, worse, “illusion”.
As I look at this photo I see my wife, Hilary, standing in a sunbeam in the middle of the forest. I am “looking at” her in the forest. She is “looking along” the sunbeam and photographing the illuminated trees. And I know in that moment that these are two different representations of reality. Both are true. But there’s more – because as I am “looking at” this scene in the forest, I recall, and re-create, the experience I had of standing in the forest surrounded by the massive trees. I feel again the awe which I felt as the sunbeams shone through to the forest floor. I feel again the wonder I had standing amidst this community of trees (which, by the way, were planted only about seven years before I was born!)
We can understand a lot by measuring, by being objective. But we fail to grasp reality if we dismiss both the inner experience of others, and our own subjective one.
That means we need to value personal stories. We need to be curious about them, to respect them and to listen with non-judgemental empathy. Otherwise, we are only scratching a surface. Worse than that, we are in danger of replacing an understanding of what it is to be human, with a distorted and demeaned mechanistic one.
Spring and autumn are the two seasons where I notice change happening right before my eyes. Right now, in October, here in France, we are beginning to see leaves change colour. I love to gaze for a few moments at a plant like this, where some of the leaves are still bright green, some have patches of red or brown appearing, and some have gone fully deep red or even purple.
This reminds me of two things – the first is that change never stops. Everything in the world is constantly undergoing change. We are not the same today as we were a few weeks ago, and we are very different from what we were a few years ago (just browse through your photo albums to see how you’ve changed since you were a baby). The reality is that we change moment by moment. That’s why the advice to “be present”, or to “be here now”, is so relevant. Every single moment is unique, and if we breeze past it without noticing, it will be gone forever (except, of course, in the background of our subconscious the changes never cease to play their part).
The second is that change is so variable. It is heterogenous, not homogenous. You and I are unique. Our daily lives are unique. Our moment to moment experiences are unique and become even more unique over time, as nobody shares with us an exact personal history, an identical string of experiences. Just looking at this one plant and seeing the huge variation in colour as the leaves begin to change makes me even more aware of this uniqueness, of diversity.
So awareness of change slows me down, inspiring me to savour this moment, to live today as fully as I can. It inspires me to pay attention to the flow of Nature, to be aware of the fact that there are no fixed objects in this world, only different rates of change.
And awareness of change does something else for me – heightens my appreciation of uniqueness, of difference, and of diversity. Reducing life to abstractions, selecting single characteristics and bundling everyone who shares them into a single category is such a deluded way of living. We need to stop putting people into little boxes, labelling them and judging them, because when we do that, we just stop seeing them as they really are.
Just a few more beautiful words from the book, “Orbital” (and photo I didn’t take!) –
“Before they came here there used to be a sense of the other side of the world, a far-away-and-out-of-reach. Now they see how the continents run onto each other like overgrown gardens – that Asia and Australia are not separate at all but are made continuous by the islands that trail between….. Continents and countries come one after the other and the earth feels – not small but endlessly connected, an epic poem of flowing verses.”
This isn’t a small world. It’s huge. But there really is just a constant ever changing flow of Life on this planet, manifesting through diversity, relationships and an infinity of connections. We belong here. Together. We become here. Together.
In “Orbital”, by Samantha Harvey, she describes how the astronauts aboard the International Space Station are first entranced by the Earth at night. It’s when night falls over the surface of the planet that the presence of human beings becomes most obvious….the networks of streets, buildings, roads sparkling and shining so brightly you can easily see them from Space. Then as daylight comes they see the Earth as a planet where humans beings are invisible, see it as a living, whole organism with its oceans, clouds, weather systems, forests and deserts. But then they come to realise just how much of the Earth is the way it is exactly because of human choices and actions.
We change the planet just by living here. How it changes comes down to our collective choices and those of the corporations and individuals with the greatest power and wealth.
Normally I use my own photos to illustrate my posts but, having never been to the International Space Station, this time, I’m borrowing a couple of photos from the French astronaut and photographer, Thomas Pesquet. Look him up. Check out his photos. They are simply astonishing.
“They come to see the politics of want. The politics of growing and getting, a billion extrapolations of the urge for more……The planet is shaped by the sheer amazing force of human want, which has changed everything, the forests, the poles, the reservoirs, the glaciers, the rivers, the seas, the mountains, the coastlines, the skies, a planet contoured and landscaped by want.” – from “Orbital” by Samantha Harvey.
This is the modern version of a very old philosophical exercise – taking the view from on high – to stand apart, above, and look out over the greater whole.
“The earth, from here, is like heaven. It flows with colour. A burst of hopeful colour. When we’re on that planet we look up and think heaven is elsewhere, but here is what the astronauts and cosmonauts sometimes think: maybe all of us born to it have already died and are in an afterlife. If we must go to an improbable, hard-to-believe-in place when we die, that glassy, distant orb with its beautiful lonely light shows could well be it.” – from “Orbital” by Samantha Harvey.
The mental capacities we humans have developed allow us to do incredible things, not least the ability to create a distance, and the ability to change our perspective. The ability to put a space, or a pause, between all the signals and stimuli entering our bodies, and carrying out an action, is the difference between reacting and responding. You know about the famous “knee jerk”, where a doctor hits a tendon in your knee and your legs jumps forward….this is an instant reaction carried out at the level of the spinal cord. It doesn’t require any thought, and it’s not possible to suppress or enhance it consciously. But when we act in life, we have the chance to put a gap into the stimulus-response loops which pass through our brains. We don’t need to act only on auto-pilot. We can “stand back”, consider, or reflect, and then choose what actions we want to take. This is responding instead of reacting…..an important skill in managing anxiety and learned loops of behaviour.
It’s this same “necessary distance” which enables us to have a sense of self, separate from the world in which we are living. Of course, that separation is a sort of delusion because we never step outwith the flow of all that exists. But it’s a useful skill.
The other skill, to change perspective, is a different way of creating a distance, of stepping off the treadmill, switching off the autopilot. We can do it by altering, or disrupting a habit. Walking a different route, shopping in a different store, visiting a different town or country. It’s a big part of why I decided to emigrate from Scotland to France when I retired….to force myself to experience a whole gamut of different perspectives….physical, cultural, social…..to learn to communicate and think in a different language.
In her book, Orbital, Samantha Harvey describes in detail these experiences of distance and perspective. In this passage I quoted above she prompts us to think about heaven and earth by flipping the normal perspective. Instead of standing on the surface of the earth gazing “towards the heavens”, she describes the astronauts on the International Space Station, gazing down towards the surface of the earth and finding it “heavenly”.
I often think this life, this planet, is heavenly. It is so improbable, so incredible, so amazing…..how did it come to be? How did Life come to exist, and the myriad of species evolve? How, despite all our seeking, and all our statistical beliefs, this planet we call Earth, we call Home, remains singular, unique, quite unlike any other in the entire universe.
When you stop to experience this planet, and take time to reflect, and to wonder, it’s not hard to experience it as heaven. There is so much beauty in this world. We should protect that, nourish that, care for that, value that, make it a goal to enable all human beings to experience this planet as heaven on earth.
“The Earth is a mother waiting for her children to return, full of stories and rapture and longing.”
“Orbital”, by Samantha Harvey, describes the experiences of six astronauts aboard the International Space Station. It’s a beautiful little book, which reads as a poetic meditation on The Earth, Nature, Life and Space exploration. One of the lines which struck me, early in the book, was the one above.
The idea of Earth as a mother is an ancient one, but one we’ve become distanced from. The truth is we are born on this planet, emerging from millions of years of flows and interactions between energies, molecules and information. We have evolved as a part of Nature, with the planet’s resources of air, water, and nutrients, supporting us, enabling us, and with the Earth’s atmosphere protecting us from harmful solar and cosmic rays. We couldn’t exist without her. Mother Earth. We only exist because of her. Mother Earth.
But our direction of travel over the last few hundred years has been to distance ourselves from her, to objectify her, to treat her as a resource to be plundered, a wildness to be tamed. We talk of Nature as if “it” is something not human, as if “it” is something “out there”, separate from us, apart from us. And I think we’ve lost a lot along the way.
In this sentence, Samantha Harvey describes the mother as “waiting for her children to return”. Shall we return? We should. We really should.
And we’ll find her waiting for us with our “stories and rapture and longing”. That’s what we humans excel at – stories – telling the stories which enable us to make sense of ourselves, of our lives, of others and of our universe.
What kinds of stories are we telling these days? I think we need more stories of “rapture and longing”. I love the French phrase, “l’emerveillement du quotidien”, the wonder of the everyday. That’s where rapture lies….if we slow down, pay attention and allow ourselves to be filled with the wonder and beauty of the everyday. If we pay a particular kind of attention….the attention of longing and loving. Not a longing to possess, to control, to hold onto. But a heart’s longing, a soul’s longing, of deep resonance with “the other”, a harmony, a connection, a loving, caring attention.
Shall we do that now? Shall we return to Mother Earth filled with our stories of rapture and longing? It would take a change of direction….and a healthy one, I believe. But let’s start today.
It seems like, however the government want to label it, the UK is about to enter into another phase of austerity…..because, apparently, they’ve “found a black hole” in the finances. This is such a common narrative. The one where governments say they need to “balance the budget”, match the government’s income to its expenditure, or vice versa. There’s talk everywhere about “deficits”, “the gap in the budget” and “cuts’. Yet all this comes at time of wage stagnation, deteriorating Public Services, schools, hospitals, hospices, care homes, GP Practices struggling to deliver the basics.
Well, I’m not an economist. I trained as a doctor, graduating in 1978, with no debt, because the State paid for my education. My generation experienced job security, were able to purchase their own houses or afford rented accommodation, had access to local libraries, sports facilities and so on, in ways which are no longer the case for my grandchildren. I can’t help but wonder why. Why could the country afford better services, a better NHS, free education and decent jobs back in the sixties and the seventies, but can’t afford them now? Has the country become so much poorer over the last fifty years? If not, where has the money gone?
But my first thought is “what is money anyway”? I understand that centuries ago the Knights Templar developed an early banking system, allowing someone to deposit gold in an abbey in one country, receive written confirmation of that deposit, then travel to an abbey in a completely different country, present that note and receive the same amount of gold. There was a link between the paper and the gold. As best I know that remained at the heart of finance for centuries. The paper notes in my wallet, and the coins in my purse, represented something physical stored somewhere else…..gold, or other “assets”. But that’s not the case any more. Now money, for me, is a number on a screen on my banking app. A transaction involves somebody’s account increasing by the same number as mine reduces. We don’t actually send each other anything. It’s a sort of balancing act. Money is no longer tied to gold, or to anything else.
I could understand that in the past, more gold could be mined, refined and stored, and that notes could be issued relative to how much gold there was, but maybe that was always a sort of fairy tale. However, nowadays, for any country which has its own sovereign currency, it’s the government who “issues”, or “makes” the money. I know they talk all the time about increasing the government bank balance by taxation – taking it from other peoples’ bank accounts – but how did it get into other peoples’ bank accounts in the first place? Actually, it was the government which issued orders to change the numbers in the Central bank upwards. Money doesn’t grow on trees. It’s created in spreadsheets.
During the pandemic governments suddenly “found” or “issued” billions more pounds, dollars, or whatever. They lent this “new money” to individuals and companies, and, apparently, billions have been “lost”, loans not paid back, and money “disappeared”. They spent “new money” on purchases of vaccines, protective clothing and testing materials. They didn’t have to say, “sorry, we haven’t got any money in our bank account”. As has been said before, in times of war, governments always find the money. It’s at other times that they choose to say there isn’t any.
Over the last decade or so, the number of millionaires and billionaires has increased, while average earnings have stagnated, or fallen. The profits of energy firms, pharmaceutical firms, and global corporations have soared. Money, what money there is, has moved….away from workers and families and Public services to private individuals and corporations.
It turns out the country isn’t poorer now than it was when I was at university. It’s just redistributed the money into the hands of fewer and fewer people, away from Public services to private companies.
So, when the government talks about black holes, and needing to balance budgets, it is choosing not to do at least two things….one, redistribute money away from those who have the most, and, two, create the money needed to fix what needs fixed.
It’s the system which is failing millions of ordinary people. It’s the system which needs to change, and the system won’t change until the values change. The covid pandemic showed us that we need each other, that our shared environments affect our chances of getting sick, that poverty, poor housing and chronic ill health are the biggest determinants of who gets sick and who dies.
It’s not a lack of money which is hindering our ability to create a better society.
Maybe it’s time to try kindness instead, to draw upon the wells of compassion we saw in the early days of the pandemic. Most human beings will act to try to help others when they can. We’ve seen that time and again, during the pandemic, during floods, earthquakes and forest fires. We need to nurture that basic quality, instead of promoting selfishness, greed, and hyper-individualism.
What do you think? Does this make sense to you? If it doesn’t, tell me why. I’m always keen to improve my knowledge and understanding. I just don’t think it’s necessary to make peoples’ lives harder.
I don’t understand xenophobia. Why fear, and/or hate, someone because of some way in which they are different from you?
The rise of political “populism” seems to be fed by, and feeds, xenophobia. Whether the targets are immigrants, asylum seekers, or those who adhere to a particular religion, those who promote “send them back home”, or “take back control”, or “secure our borders” always focus on a “them” who are not “us” and “shouldn’t be here”.
I don’t get it.
Every one of us is different. Every day of my working life patients told me stories I’d never heard before. No two of us share the same story. No two of us have the exact same history or experience. No two of us share the exact same face, the exact same voice, think in exactly the same way or respond to life’s challenges in exactly the same way.
It’s our differences which make us unique. I find that fascinating, and, an essential part of treating someone when they are ill.
And yet, despite our differences, we all share a lot. We have many, many points of connection. We share the same air, drink the same water, live on the same planet. People live in the same city together, they live in the same street together, they might buy their food and clothes in the same shops. Many of us enjoy the same music, participate in the same sports, work in the same offices, shops, factories, hospitals, or schools.
Our points of connection are infinite. How often have you had a conversation with someone and explored your shared tastes, experiences, similar memories, discovered shared contacts?
It’s our connections which make us unique.
Yes, it’s both our differences, and that unique set of relationships, experiences and connections which we have, which combine to show us, simultaneously, that we are different, and that we have much in common.
If we are to thrive together, we humans, we’re going to have to reject the poison of xenophobia, and replace it with kindness, curiosity, and compassion. Is that so hard?
I welcome constructive criticism and suggestions. I will not, however, tolerate abuse, rudeness or negativity, whether it is directed at me or other people. It has no place here. ANYONE making nasty comments will be banned.
Heroes Not Zombies 