Heroes Not Zombies

It’s all down to your genes….oh, no it’s not!

December 6, 2010 by bobleckridge

Excuse the title – panto season is upon us!

Are you, like me, fed up with headlines suggesting that now “scientists” have found the gene for X then a cure for X is just around the corner? I think it’s such nonsense. This idea that we will be able to read someone’s DNA like a computer program and figure out exactly what diseases they are going to experience, and head those diseases off at the pass is mechanistic, reductionist nonsense.

A recent article in ScienceDaily is headed “The gene-environment Enigma”. What’s the enigma? Well, it turns out just having a gene doesn’t guarantee what effect that gene will have. What’s important is the “environmental” effect which is different for every individual so individuals experience different effects of the same genes.

The effects of a person’s genes — and, therefore, their risk of disease — are greatly influenced by their environment,” says senior author Barak Cohen, PhD, a geneticist at Washington University School of Medicine. “So, if personalized medicine is going to work, we need to find a way to measure a human’s environment.”

Hmm. Measure a human’s environment…..good luck with that one….ever encountered one of the characteristics of complex systems……that outcomes are not predictable in detail in individuals? It’s not possible to measure all the potential factors involved in producing the state of a unique organism which is embedded in multiple environments (physical, relational, social, cultural, semantic etc).

Still, scientists of faith find it hard to give up on their fundamental beliefs……

Cohen says he’s not hopeless when it comes to personalized medicine. As scientists conduct ever-larger studies to identify rare and common variants underlying diseases such as cancer, diabetes and schizophrenia, they will be more likely to uncover variants that have larger effects on disease. Even then, however, a person’s environment will be important, he adds.

Posted in from the reading room, health, science | 2 Comments »

Health and disease

December 5, 2010 by bobleckridge

Doctors are taught to use two basic concepts – health and disease. Disease figures very predominantly on the medical curriculum. In fact, Davidson’s Textbook of Medicine is all about disease. There isn’t even an entry in the index for “health”. We create our “health services” around disease, with specialists who specialise in understanding and managing diseases of certain parts of the body. That’s why we have oncology departments, gynaecology departments, dermatology, cardiology, otolaryngology (ENT) departments and so on. Out in the world of Primary Care in the UK there’s an attempt to do it differently. Most Primary Care doctors work in “health centres”. However, especially since the introduction of the “Quality Outcomes Framework”, there’s been a further push towards concentrating on diseases rather than health.

This enormous emphasis on disease has led many doctors to act as if disease isn’t a concept at all. They treat it as if each disease is an independent entity. This is a misunderstanding. It’s also led to the development of so-called “evidence based” protocols for managing disease.

Where’s the attention paid to health (without reference to disease at all)? Where are the health experts as opposed to the disease experts? Have you ever wondered what a true “health” service would be like? One which addressed “health” either in addition to “disease” or as a first point of engagement with patients instead of the first point of engagement being once pathology has emerged? (and I do mean health as a whole organism state of being, not drugged psuedo-health!)

As I see it, it all depends on the timescale you consider. In acute illness, disease-focus strikes me as highly appropriate. It’s where we show the greatest effectiveness of pharmaceutical and surgical interventions. But in chronic illness, the disease-focus gets less and less useful. Here the emphasis needs to shift to a health-focus – and as health is a lived experience, that requires understanding and engaging with the human at an individual and whole-person level.

Disease is a biological dysfunction.

Health is a life state.

Disease impacts on health, and health impacts on disease. Don’t we need to address the issue of illness from both angles, emphasising what’s most important according to the time scale we’re considering?

Posted in from the consulting room, health | Leave a Comment »

Ice nymph

December 4, 2010 by bobleckridge

……amazing what little creatures you can find in the average hedge……

Posted in from the dark room, photography | 1 Comment »

worlds within worlds

December 3, 2010 by bobleckridge

Do you remember finding a hollow in a tree when you were a child and imagining a whole world in there? Scotland’s folk culture is rich with stories of fairies, strange lights appearing at night, selkies and other such other-worldly creatures. I always enjoyed imagining the miniature world that I could conjure up in such dark and interesting natural places. So when I was looking at the snow on the hedge outside this week I suddenly noticed the sunlight shining through intricate passageways in the snow………worlds within worlds.

Posted in creativity, from the dark room, photography | 1 Comment »

Rainbow icicles

December 2, 2010 by bobleckridge

I swear I look out my window every day and never see exactly the same scene twice. If you browse through this blog, you’ll find lots of examples of that – the ever changing scene of Ben Ledi, the cloud patterns, the rich variety of sunsets and of dawns.
This morning I looked outside and saw something I’ve never seen before – from the roof of an adjacent building the long icicles catching the sunlight just like a rainbow maker, sparkling with colour.

Posted in from the dark room, photography | Leave a Comment »

Are all forms of meditation the same?

December 1, 2010 by bobleckridge

My answer to this question would be you’d only think all forms of meditation were the same if you think differences are irrelevant. My entire working life is based on understanding difference. I think it’s true of all holistic and integrative practices that understanding the uniqueness of a personal story, told by an individual within their distinct context, is the core focus. But I’ve wondered, just what is different between TM and Mindfulness practice? They seem very different to me. They involve different methods. So it wouldn’t surprise me if it turned out they had different effects on the brain, and hence on the body too. Well, here’s some fascinating research which is beginning to clarify just what the differences are. It starts with a description of three “types” of meditation practice – Controlled focus; Open monitoring; Automatic self-transcending, then goes on to explore different brain wave patterns associated with each, different mind-body changes and the published research on the effects of different practices. The summary is as follows –

Controlled focus: Classic examples of concentration or controlled focus are found in the revered traditions of Zen, Tibetan Buddhism, Qiqong, Yoga and Vedanta, though many methods involve attempts to control or direct the mind. Attention is focused on an object of meditation–such as one’s breath, an idea or image, or an emotion. Brain waves recorded during these practices are typically in the gamma frequency (20-50 Hz), seen whenever you concentrate or during “active” cognitive processing.²

Open monitoring: These mindfulness type practices, common in Vipassana and Zazen, involve watching or actively paying attention to experiences–without judging, reacting or holding on. Open monitoring gives rise to frontal theta (4-8 Hz), an EEG pattern commonly seen during memory tasks or reflection on mental concepts.³

Automatic self-transcending: This category describes practices designed to go beyond their own mental activity–enabling the mind to spontaneously transcend the process of meditation itself. Whereas concentration and open monitoring require degrees of effort or directed focus to sustain the activity of meditation, this approach is effortless because there is no attempt to direct attention–no controlled cognitive processing. An example is the Transcendental Meditation technique. The EEG pattern of this category is frontal alpha coherence, associated with a distinct state of relaxed inner wakefulness.⁴

My personal experience is greatest with the third category. I practice TM for 20 minutes twice every day. I’ve explored some Mindfulness meditation with colleagues at work over recent months (Mindfulness Based Cognitive Therapy is one of the services we offer at the Centre for Integrative Care in Glasgow Homeopathic Hospital) But I’ve no experience of the first type – controlled focus. My first take on this research is that I’m encouraged to know that it’s good to engage in more than one kind of meditation practice. If loving kindness and compassion meditation increases the amount of love, kindness and compassion in the world I’m all for it. If Mindfulness also reduces negative rumination as it suggests in this research, then that strikes me as also a very good thing. And if TM can lower blood pressure, reduce chronic anxiety and lower stress hormones like cortisol, then that’s good too.

I do enjoy a scientific exploration of how something might work, but I also think that we are all different and it’s likely that we will all experience different meditation practices differently. It is a subjective human experience as well after all! I know Dan Siegel, of Interpersonal Neurobiology fame, claims that there is plenty of evidence to show that Mindfulness meditation increases the size and function of the integrative fibres of the mid prefrontal cortex. He also says that just 10 minutes a day of breath awareness will produce measurable change in integrative neurons.

Are you convinced yet? If you haven’t done it yet, maybe a month from now as you think ahead to 2011, making meditation part of your daily life should be part of the changes you might want to make. (you know what I’m talking about – resolutions!)

Posted in from the living room, health, life, neuroscience | Tagged meditation | 8 Comments »

nanowrimo – or where I’ve been for the last month!

November 30, 2010 by bobleckridge

If you’re a more regular reader of this blog, you might be wondering why my posting rate has plummeted this month……well, the answer lies in that little winner’s badge here.

nanowrimo is National Novel Writing Month. It happens every November and the deal is you sign up to write a 50,000 word novel in 30 days….that works out at a steady 1,677 words a day. Of course, you’re not expected to produce a fully crafted novel by day 30, just to have the raw text of a novel to spend the next few weeks or months, editing, revising and developing.

I signed up on November 1st, and completed my 50,000 words on November 27th and it’s been one of the most amazing experiences I’ve ever had. I write a lot. This blog is part of my writing output, but I’ve written almost exclusively non-fiction so far (I have a collection of about 80 or so small fictional clinical cases entitled Dr Cannyman’s Casebook to accompany my course in Patient Centred Homeopathy). I’ve had a dream to write fiction as long as I’ve had a dream to be a doctor and I’ve been doctoring some 32 years now, but a novelist for none of them! After all this time, I’ve wondered, could I actually do it? Do I have it in me? I’ve read a few books about creative writing and the one thing they pretty much all say is you have to actually turn up and write. I know. Sounds obvious, huh? But it just isn’t easy. And one of the things that always stopped me from getting started was I might have the germ of an idea, but I sure as hell didn’t have characters or a plot. Surely, I reasoned, you need ALL of that AT LEAST before you start.

I was wrong.

The nanowrimo experience is an experience in motivationally supported daily writing. Yes, I’ve done daily writing for long periods, but never daily fiction writing. Nanowrimo is about daily fiction writing. You sign up online, get your own user page, a box to enter your daily word count and a graph to show you your progress along with stats encouraging you to write a little more by telling you how much more you need to write today to get the 1667 daily target, and what date you’ll finish if you keep on at the rate you’re going. In addition to that you get regular emails encouraging you and they are just brilliant. Liberating messages from other participants and writers saying things like “OK, you’re several days into this now and you’ve probably no plot and no idea where it’s going. Welcome to writing fiction! This is how it is. Keep going. You’ll find your characters and your plot emerging as the month progresses”. Well that was news to me. I had no idea that an approach like that could work.

So here’s what I learned. First of all I learned it really took a LOT of discipline to write those 1667 words a day, but I was more determined the more I progressed. Second I learned that although on the vast majority of days I would have no idea what I was going to write, an idea would emerge, I’d start with that, and before I knew it these characters appeared, this dialogue occurred, these events happened. I found things coming together in ways I hadn’t planned (because I hadn’t planned anything!) and I found little remnants of stories of my life and of people I’ve met turning into brand new elements of other stories under my fingers as I typed. It was a total revelation. Thirdly, this comment from one of the emails “It’s so strange how our mind knows more than we are aware of it knowing.” hit me right between the eyes. That is exactly what I’ve discovered in doing this writing exercise. It’s all in there. Even when you don’t consciously know it.

So here I am. The proud owner of a nanowrimo 2010 winner badge. A writer with a new habit. The owner of 50,000 words to work on, words I feel which have a good chance of turning into a proper novel. I’ve only shared with others some of what I’ve written so far, but the feedback has been so positive I am thoroughly encouraged.

I think that’s what nanowrimo is all about – enabling you to get to the place where you can say to yourself “I believe I can do this”.

It’s been quite a month!

Posted in creativity, writing | Tagged nanowrimo | 1 Comment »