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Sunbeams

I looked out of my window yesterday evening and this caught my eye –

sunbeams

I’ve seen the sun and the clouds work together to do this regularly at this time of year and I knew I was in for a treat.

sunbeam

sunbeams

sunbeams

It brought back to my mind a C S Lewis story about a blind man who starts to be able to see, and having heard so much about light he asks people to show him light, but everyone points to light sources not to light itself.
When the clouds part slightly to let these great shafts of sunlight emerge it really does feel like we are looking at light itself. It’s great ART isn’t it?

Then once the show is over, and the sun has disappeared down behind the mountains, it does this little encore, throwing red flares up into the sky to bring a rosy glow to the clouds. Phew!

sunset flare

I’m a great Bob Harris fan. I love his Radio 2 show on a Saturday night. Last night he played three tracks from an album entitled Songs Around the World, from a project known as Playing for Change.

Here’s one of the three he played (I could have posted ANY of them!) This music is JOYOUS. Is there any better way to show how the paradox of difference and similarity is so characteristically human?

Human history, as best we know, dates back around 200,000 years. For 190,ooo of those years we were hunter-gatherers and for the last 10,000 we’ve had agriculture.

I suppose I’d read about the hunter-gatherer phase long since but the significance of it never really struck me, and certainly the fact that so much of human history was in that phase was something that really didn’t register. For some reason, I’ve stumbled upon a number of different references to this in recent reading. I was musing about what characteristics have been to the fore in the two phases, and I wondered if the hunter-gatherer phase demanded a greater focus on co-operation, whilst the agriculture phase led to ownership and competition. But maybe that’s too simplistic. These thoughts have been around for me during these crises of recent times – the economic, environmental and political ones. There’s a feeling just now that we could be witnessing the crumbling of whole global system, and it leaves us wondering what might emerge to take its place. Which characteristics are we going to need to deal with these current, and future challenges?

I don’t have the answers in place, but here’s a couple of interesting articles to throw into the mix. First off, I read a post on Deric Bownd’s blog. He titled the post “Civilisation has caused the decline of human health“. Well, that caught my eye! He was referring to a presentation by Ann Gibbons at an Americal Assoc. of Physical Anthropologists meeting. 72 researchers studied the data on the remains of 11,000 individuals who lived from 3,000 to 200 years ago in Europe. Here’s the conclusion –

…the health of many Europeans began to worsen markedly about 3000 years ago, after agriculture became widely adopted in Europe and during the rise of the Greek and Roman civilizations. They document shrinking stature and growing numbers of skeletal lesions from leprosy and tuberculosis, caused by living close to livestock and other humans in settlements where waste accumulated. The numbers of dental hypoplasias and cavities also increased as people switched to a grain-based diet with fewer nutrients and more sugars…After a long, slow decline through the Middle Ages, health began to improve in the mid-19th century. Stature increased, probably because of several factors: The little Ice Age ended and food production rose, and better trade networks, sanitation, and medicine developed… But take heed: Overall health and stature in the United States has been declining slightly since the 1950s, possibly because obese Americans eat a poor-quality diet, not unlike early farmers whose diet was less diverse and nutritious than that of hunter-gatherers.

So a bit of a mixed picture but an interesting analysis of the impact of agriculture on our species.

Then I read an article in the Independent on Friday. The article was subtitled “Scientists explain how altruism evolved over 200,000 years of conflict”. This piece described the work of Samuel Bowles, of the Santa Fe Institute in New Mexico who is challenging the common “Darwinian” theory that altruism is not a characteristic which would be selected for (the “selfish gene” theory) Bowles argues that during the time of hunter-gatherer tribes –

Warfare was sufficiently common and lethal among our ancestors to favour the evolution of what I call parochial altruism, a predisposition to be co-operative towards group members and hostile towards outsiders.

He argues that selection worked on groups, not just individuals and the groups which developed this “parochial altruism” did best. He does admit this is not the only possible explanation for altruism –

[The] willingness to take mortal risks as a fighter is not the only form of altruism… more altruistic and hence more co-operative groups may be more productive and sustain healthier, stronger, or more numerous members, for example, or make more effective use of information

Other scientists are supporting this challenge to the selfish gene theory, arguing that selection effects on groups may be more apparent in a species like humans because our species is a “cultural” one.

It’s interesting to take this longer view of human history. Such a change of perspective can help you see the wood for the trees I think. In particular I find this stimulates my thought about the relative merits of co-operation vs competition (as well as stimulating my thought about how we feed ourselves!)

purple

purple

purple iris

You don’t often see this shade of blue in the garden. Isn’t this poppy stunning?

blue poppy

In Scotland we have a lot of “bluebell woods” – here’s one near where I live…….

bluebell wood

bluebell wood

Eye-catching red

Red is such an eye-catching colour in nature.

red growth

one red tree

happy red

background red

red wings

fallen red leaves

If someone has an infection caused by a particular bug, and the doctor prescribes the best, most appropriate drug to kill that bug, what does the drug do?

The correct answer is “it kills the bug”.

The incorrect answer is “it cures the infection”.

You see, bugs and infections are not the same thing. Certainly a bug may “cause” an infection. You don’t get TB without the TB “bacillus” being involved. The TB bacillus can be isolated and grown in a laboratory, but it isn’t an infection until a person has it growing inside them. That might sound totally obvious but you’d be surprised how little doctors and patients think about this. There is no doubt that discovering the role of microbes in causing infection was a breakthrough in understanding and the availability of drugs to kill bugs is a real boon but the problem is thought often stops there. How do we help an individual to recover after the bug has been killed? Exactly how does a person repair their damaged body after an infection, and how can they increase their chances of defending themselves more effectively against future infections? How do we reduce the burden of infection on populations? Antimicrobials are only part of the solution, not the whole solution.

This is not a new thought. I’ve recently become a fan of Cabinet magazine (a magazine based on the idea of wonder rooms) and in the current issue there’s an article about Professor Max Joseph von Pettenkofer, a Bavarian chemist-apothecary who lived from 1818 until 1901 (when he shot himself in the head). He was a very colourful character who disputed the theory that germs cause infections. Koch and Pasteur’s discoveries were convincing the world that the cause of infections were microbes but Pettenkofer thought their theories were simplistic. He maintained that infection involved the interaction of three factors – factor x – germs, factor y – some condition of the region where the infection occurred, and factor z – susceptibility on the part of the patient. To prove his point, he conducted a very public, very dramatic experiment where he had a fresh culture of the germ which caused cholera (called at that time the “comma bacillus”) prepared in a laboratory. He then drank enough of this culture to kill a village and survived. (He claimed he did not suffer from the cholera at all but he did have stomach pains and some diarrhoea for a few days.) Despite this performance nobody was convinced. Pettenkofer ended up committing suicide. However, his conclusion that the way to prevent cholera was through sanitation to deal with factor y – the condition in the region, was actually spot on.

There’s a lesson here about the limits of reductionism. The simplest explanations are attractive, but in the real world, are often just too, well, simplistic. And there’s also a lesson about “this or that” or “black or white” ways of thinking. Often “and” is a better explanation than “or”. Narratives need not cancel each other out. They can complement each other and produce a greater, instead of a lesser, understanding.

Can we have confidence in bankers? Can we have confidence in politicians? We have a wee phrase in Scots “A hae ma doots” (“I have my doubts”). Well in the middle of this breakdown of trust and confidence in our economic and political institutions, along comes a piece of research from Edinburgh University which has performed a meta-analysis of surveys and studies into fraud and malpractice by scientific researchers. Here’s the conclusion –

On average, across the surveys, around 2% of scientists admitted they had “fabricated” (made up), “falsified” or “altered” data to “improve the outcome” at least once, and up to 34% admitted to other questionable research practices including “failing to present data that contradict one’s own previous research” and “dropping observations or data points from analyses based on a gut feeling that they were inaccurate.” In surveys that asked about the behaviour of colleagues, 14% knew someone who had fabricated, falsified or altered data, and up to 72% knew someone who had committed other questionable research practices.

As the author points out, everything we know about scientific fraud tells us that it is grossly under-reported. These figures are pretty certain to be underestimates. To what extent, we don’t know. But even as they are, they are worrying. Scientists make great claims for themselves as the discoverers of “The Truth”. I’m always wary of people who claim only what they know or believe is true. However, let’s accept the hypothesis that the scientific method is THE best method for uncovering the truth about reality. The trouble is, there’s no such thing as “the scientific method”, there’s only what “scientists” do, and scientists, surprise, surprise, turn out to be as human as the rest of us. This study is of deliberate, conscious, admitted knowledge of fraudulent or questionable practice. The rates found, even if accepted as accurate (which would be foolish), are worrying. Add to that all the actions which are unintentional, unconscious and/or kept secret and what does that make you think? Can we trust scientists to be the beacons who show us the Truth, the whole Truth and nothing but the Truth?

One particular phrase certain struck me – “In both kinds of surveys, misconduct was reported most frequently by medical and pharmacological researchers.” – is that because these particular researchers are more honest than others, admitting their behaviour more? Or is it because such practice is more frequently found in medical and pharmacological research than it is in other areas?

“Evidence Based Medicine” (EBM), is undermined by the “evidence” produced by these researchers.

Yesterday the BBC site posted an item about a patient’s experience of having MS. It was entitled “Living with a hidden illness”

This patient, Alison Potts, says this –

The boldest outward evidence of the disease appears in my MRI scans, but no one sees those. Together they tell the story of the last 15 years, each one showing an increasing forest of lesions in my nervous system – tiny white pin pricks running up and down my spine, like the mangled sheath of a damaged electric cable interrupting the flow of nerve signals around the body. They are the roadblocks on the map of my life. The kind of MS I have does not cause paralysis or hinder my mobility. On bad days I do have problems with balance and dizziness and numbness in my hands and feet. I have difficulty doing up the buttons on my five year olds clothes and everything falls through my hands. Crockery and glassware never last long in our house. My main symptoms are hidden. The most prevalent one is fatigue. I rarely wake in the morning feeling rested – but more like I have run a marathon with a bout of heavy flu, particularly if my sleep has been disturbed. Fatigue is not another word for tiredness. It is a total shutting down of the mind and body – a barrier comes down past which you cannot move on. It puts everything I plan to do under threat.

I think this is a great piece of writing. She makes it very clear that for her (as it also is for many patients with MS) it’s invisible symptoms which cause the greatest problem – dizziness, numbness, clumsiness and fatigue, in her case. As she says, the “boldest” evidence for her disease is in the MRI scans and nobody can see them (apart from the radiologist of course!). I’ve posted before about the dubious and non-linear relationship between scans and symptoms.

How do we address a patient who has these problems? A patient whose problems are “invisible“? At least in Alison’s case there are lesions which can be revealed by technology – the “tiny white pin pricks running up and down my spine” – and this will be her ticket to being taken seriously. Sadly, countless patients present to their doctors with equally disturbing and problematic symptoms, but in the absence of “lesions” they are dismissed as “the worried well”, or the problem somehow being a psychological one. I believe this is naive. Don’t we often see a disorder of the system? of the person? (of the “complex adaptive system“?) Such problems maybe only can be known through the patients’ narratives.

If Alison didn’t tell her story nobody would have any idea what she is experiencing. Don’t we need to acknowledge that in health care, and accept that health cannot be reduced to a simple materialistic “objective” phenomenon?

I think this little example is a great one and makes a clear case for the importance of addressing the phenomena of illness rather than the lesions of disease.

I caught this tiny snippet of an interview with Brian Eno on BBC Radio 4 this morning.

eno (click his name!)

The subject of the piece was his curating of the Luminous festival at Sydney Opera House.

Here is Eno arguing that not only do we need imagination more than ever now that we have hit these crises in the world, but the faculty of imagination is the faculty which separates us from all the other animals.

I agree. We need to use our imaginations if we are to come up with new, different ways to make the world a better place.