Feeds:
Posts
Comments

Selecting the evidence

There’s a strange presumption in some quarters that “science” (as if there was a “thing” called “science”) is the only way to know the TRUTH about reality. Research is a fascinating phenomenon to consider, and the more you consider it, the less straight forward it appears! One of the issues in medical research is the issue of bias produced by the funds for a study being put up by the pharmaceutical company which makes the drug. This is an issue which has been, and will continue to be, discussed and debated extensively. I’m not going to go down that road in this post. What I would like to draw your attention to however is an article published in PloS Medicine. The authors argue that the sheer size of the output from labs and research groups so outweighs the number of outlets for publication that there is an intense publication bias through the necessary highly limited selection process of the journals, that what is published amounts to a serious distortion of the reality of scientific endeavour.

The scarcity of available outlets is artificial, based on the costs of printing in an electronic age and a belief that selectivity is equivalent to quality. Science is subject to great uncertainty: we cannot be confident now which efforts will ultimately yield worthwhile achievements. However, the current system abdicates to a small number of intermediates an authoritative prescience to anticipate a highly unpredictable future. In considering society’s expectations and our own goals as scientists, we believe that there is a moral imperative to reconsider how scientific data are judged and disseminated.

An example of the kind of distortion of reality this selection process produces was highlighted in the New England Journal of Medicine which found this –

Results Among 74 FDA-registered studies, 31%, accounting for 3449 study participants, were not published. Whether and how the studies were published were associated with the study outcome. A total of 37 studies viewed by the FDA as having positive results were published; 1 study viewed as positive was not published. Studies viewed by the FDA as having negative or questionable results were, with 3 exceptions, either not published (22 studies) or published in a way that, in our opinion, conveyed a positive outcome (11 studies). According to the published literature, it appeared that 94% of the trials conducted were positive. By contrast, the FDA analysis showed that 51% were positive. Separate meta-analyses of the FDA and journal data sets showed that the increase in effect size ranged from 11 to 69% for individual drugs and was 32% overall.

The PloS article makes some suggestions for improving the system, not least recommending the digital publication of any research without significant errors rather than selection on the basis of what someone considers “important”. That would be a start! But the most important point here is that published research is not equivalent to Truth. We should consider it, but remain wary of claims to certainty.

When I recently made myself a visual diary, I explored the origins of the names of the days of the week. In fact, a while ago, when I went to Japanese language evening class, I was struck by how the days of the week in Japanese were named after certain planets, and knowing a bit of French I was struck by the fact that the French too named the days of the week after the same planets. It’s not so clear in English because we’ve swapped the Greek and Roman Gods for Norse ones – like Woden and Thor, but in fact, these Gods are associated with exactly the same planets for each of the days as we find in the Japanese and French traditions.

One of the things which makes human beings unique is our ability to handle and play with metaphors and symbols. We are great at both applying and discovering meanings. Absolutely everything can be considered to be a representation of something else. This allows us to experience life in a rich variety of ways. So I got to wondering about the Classical myths associated with each of the planets and their associated gods. How would a Monday feel if I was more aware of its association with the Moon? Any different? How about a Friday and its association with Venus? Would the week develop a different rhythm if I reflected on each day and the different qualities related to the myths and stories we’ve associated with each of the planets? Let me be clear, I’m not talking about astrology, I’m talking about myth, narrative and symbolism……the way we use these ways of colouring and even creating our experiences.

I’m still working on this but before I say more about it, there’s another factor affecting my thoughts about it. I’ve just finished reading “La sagesse des jours”, by Andre Guigot. The translation of the book’s title would be “The Wisdom of the Days”, and in it, this French philosopher considers how each day has its own unique qualities which can stimulate our thoughts about different aspects of life and living depending on which particular issues are predominant on specific days of the week. In fact, it wouldn’t be possible to write a book like this in English, certainly not for a UK audience (and probably not for a US audience either), because we’ve lost the kinds of rhythms to life which the French still enjoy. To give you a flavour of his book, he identifies Saturday as market day for example, (I don’t know any towns in France which don’t have a market on a Saturday!) and he identifies Tuesday as the first day of commerce in the week (many shops in France, in fact most shops in smaller towns, close on a Monday) It’s an inspiring little book but translating it into a UK context isn’t very easy.

So I’m wondering how to ascribe certain qualities to particular days of the week. And I’ve come up with a few ideas already. For example, the moon is usually associated with feelings and with reflection. Could Mondays be days to be more aware of what’s going on inside? To be more aware of my emotional reactions throughout the day? Then, Tuesday is Mars day. Themes associated with Mars are themes of physical strength and fitness, and themes of the urge to distinguish oneself as a unique individual. This contrasts a lot with Friday which is associated with Venus. Whilst Mars is associated with maleness, or with yang energy, Venus is associated with femaleness, or yin energy. Whilst Mars is associated with distinguishing ourselves as individuals, Venus is associated with togetherness, with love, relationships and belonging. Wednesday’s name comes from Mercury, the “winged messenger”, a day to play with words and symbols, to be linguistically creative….hey, maybe a day for writing poetry, or for communicating. Thursday is named after Thor, or Jupiter, associated with expansion, of reaching out, of empathy and the understanding of others which comes with travel. Whilst Saturday is associated with Saturn and themes of conservation, of strengthening and consolidating. Which leaves Sunday as a day to celebrate Life and being alive.

You get the idea? This is just a brief outline, but I hope you can see the germ of an idea here. I hope you can see a way of creating your own personal rhythm to the week. I’ll work on this and return to it, but meantime, I’d be really interested to hear your own take on this. How do you distinguish the days of the week from each other? What qualities or characteristics would you ascribe to particular days?

A Visual Diary

It’s come to that time of year when I’m needing to put some events, meetings, trips and so on into a 2009 diary. For the last couple of years I’ve been using a small moleskine week over two pages diary but I’ve grown disenchanted with the linearity of such diaries. They are all divided up into sections (either per day, or per week, or month) and all the sections are of the same size but because days are all different (well, they are in my life anyway!) I find that some days the entries are spilling over into surrounding days and other days are virtually blank. This all comes down to how you use a diary. I’m pretty minimalist. Key points only for me.

So, having looked around in the stationery stores I decided to MAKE a diary which was better suited to my purposes. I won’t lay out here all the steps involved in the creative process but I thought I’d share the result. Maybe you’ll be inspired by some element of this, make your own, or borrow some of the ideas I’ve used.

I decided to stick with Moleskine, but to use what they call a “Japanese fold” notebook – like this –
Japanese fold moleskine
This is a continuous single sheet of paper which is folded instead of cut to make the separate pages. I wanted to use a double page spread for each week. I mark the top right hand corner of the right hand page with the starting and ending dates of that week (my week starts on Monday and ends on the Sunday).
I want to use the whole spread to lay out my commitments and information in a kind of “mind map” style, so I thought I’d put the days of the week down the middle of the spread. That looked pretty ugly and I am a very visual person (which you’ll have realised from all the photography on this blog!), so I decided instead to use a symbol for each day of the week. Well, it turns out that in many languages of the world the names of the days are related to the names of the sun, the moon and five planets – the same ones in many, many languages.
Sunday = Sun
Monday (French; Lundi) = Moon
Tuesday (French; Mardi) = Mars
Wednesday (French; Mercredi) = Mercury
Thursday (French; Jeudi) = Jupiter
Friday (French; Vendredi) = Venus
Saturday = Saturn
I didn’t want to draw all the symbols every week so I made a jpeg of the symbols and uploaded it to moo.com to get stickers made. Here they are –
moo stickers days of the week
I place one sticker just to the left of the centrefold (I have more entries usually on Monday, Tuesday, Wednesday, than I do on Thursday, Friday and Saturday). You’ll see I’ve got the Sun in the middle (it’s not a day I usually enter any commitments). There are Monday, Tuesday and Wednesday on the right, and Thursday, Friday and Saturday on the left, and they follow the sequence like a clock face (time goes clockwise in my life! 🙂 )
one week spread

To enter a new piece of info I draw a pencil line out from the day of the week and enter the details. I can follow this item out with branching lines, mindmap style, if necessary. (I’ve found it useful to put the actual date (numerical day of the month) at the root of the line.)
That’s it really.
I’m enjoying it. It’s aesthetically pleasing and it suits the way I think and I organise.
I’ve added two additional features to make it more functional. In the pocket at the back of the moleskine I put 3 x 5 index cards, one for each month ahead (carrying only 3 or 4 at a time). This gives me a kind of planner overview.
monthly index cards

And I’ve attached two small post-it pads inside the back cover, to write details of any dates not covered by the existing spreads or cards.
post-its

I’ve been using this new diary for about a month now and I’m finding it’s sparking off a whole chain of thought I hadn’t predicted. But I’ll tell you about that in a separate post!

Finding hotspots

There are more and more wifi hotspots around the world. It’s getting easier and easier to connect wherever you are.

Look at these two students I spotted one night on my way through Aix en Provence. I’m guessing someone inside that building has got a wireless router on! Look at the way the light of their laptop screens lights not only their faces, but casts both a shadow and a shine onto the wall behind them.

night time hot spot aix

I read a short article in the Glasgow Herald yesterday about a London based financier, Kirk Stephenson, Chief Operating Officer of a private equity company called Olivant. Originally a New Zealander, he had a senior position in his company. He was a wealthy man who had a £3.6M Chelsea home, a home in the West Country and who loved to travel, acquiring a formidable knowledge of boutique hotels and loved going to opera. He was married and had an 8 year old son. Here’s how his family described him –

a life-enhancer – not with a showy, life and soul of the party sort of charisma, but as a planner and coordinator who quietly and with no fuss ensured everyone around him had a marvellous time. A dedicated father and a devoted husband, he valued his family above all else. At the same time he had a gift for friendship and was a generous and exceptional host, gathering his wide circle around him in summer villas all over Europe, as well as for parties, dinners and opera. Any occasion with Kirk was a wonderful experience. He spent many a fine – and less than fine – summer evening listening to opera at Garsington, Glyndebourne and the Grange with friends. (He) also loved board games and tennis, passions he shared with his treasured eight-year old son Lucas.

Aged 47, he killed himself by throwing himself in front of a train last week.

How do you make sense of that? You’ll find so much in self-help books, books about happiness, websites which advise you how to have a good life……..but just what constitutes a GOOD life? By good life, I mean one worth living, one you want to hold onto, one you don’t want to give up.

Obviously I only know what the papers published about this man, but the details are desperately perturbing. Those little details paint a picture of a successful professional, a materially wealthy man, a loved man with many friends, a young son…….a man who committed suicide at 47.

I don’t have any answers here. It’s just the story really disturbed me, and it’s continued to niggle away at me since I read it.

I am because you are

One of greatest joys of blogging is how it facilitates the discovery, and creation, of connections. My daughter, Amy, who writes the wonderful lessordinary, has developed a whole online network of friends through her blog. She’s a great networker and deliberately creates her blog to make and develop connections with others. Let me tell you a little story which will illustrate how this is such a core quality of hers. When she left school, she was accepted for an English Literature course at Stirling University. We drove her to the halls of residence in the grounds of the university at the start of the first semester and helped her unpack her small collection of belongings from the boot of the car and pile them in bags and cardboard boxes into her small room. If you’ve ever been to a student hall of residence you’ll have an idea of what they are like. This one was typical in my experience – a series of corridors full of identical box like rooms each with the same furniture (most of it custom built to fit the room exactly and screwed to the floor or the walls). At first sight its a bit bleak and very impersonal. It wasn’t easy to leave her there. I shouldn’t have worried though because the very next day she phoned and said when the door closed behind her and she sat in that bleak room alone she cried. Then she thought, well, everyone else in this corridor is in the same boat as me, I’ll go and say hello. So she set off down the corridor, knocking on all the doors, introducing herself and inviting the “freshers” down to the pub for a drink and a chat. She never looked back.

It strikes me that blogging can be a bit like that. Each of these posts is like a little room, something to be discovered, a door to knock on. I’ve been blogging for about 18 months now and there have been over 55,000 visitors in that time. Almost 2000 comments have been left and every one of those comments is like a little knock on the door.

I hope that some of the posts you read here will be like little discoveries for you, that you’ll hear that knock on the door, and that you’ll find new connections and new possibilities in your life. But let me tell you of a recent experience where it’s happened the other way around for me.

A couple of weeks ago a new commenter, Ian, came along and left comments on a few different posts. At the same time he emailed me and introduced himself. In his introduction he described the trail which led to our connection. Ian said he’d been in Ullapool recently and had picked up a copy of “Why do people get ill?”, completely resonated with it and decided to read some reviews online. One of those reviews was the one I wrote on this blog. He browsed my blog and discovered a like mind. He also recognised my name and remembered a poet friend of his mentioning me to him some time back – Larry Butler. Well, not only has Ian left some really interesting links other sites in his comments, but last week he emailed me and asked if I’d like to go to a traditional music concert at the Tolbooth in Stirling. It was an eye-opener for me. Or maybe, more accurately, and ear-opener. Too much to say about it here in this post but here’s the bit which is most relevant to this story. The three musicians, for some of their tunes, all played mandolins. I can’t say I’ve ever been attracted to the mandolin, but one of the people I’ve met through blogging is the wonderful Dr Tom Bibey. He plays mandolin in a bluegrass band and as I listened to the music I not only heard the mandolin differently from how I’ve heard it ever before but – and here’s my point – I heard it differently BECAUSE of the connection with Tom Bibey – and enjoyed it as never before, but the whole evening, and the people I met there, showed me another possibility – that of playing music. I listen to music all the time. But I haven’t played music since I was a teenager. I think it’s probably time to change that. That thought, the possibility of picking up a musical instrument again, is like a rediscovery of part of me. But several decades on, its a rediscovery of a different me, as I’m obviously much changed by my experiences and my connections of the last thirty years or so.

We are who we are because of the people we connect with. Human beings are highly social creatures. It’s impossible to know what a person is like by putting them into a room all by themselves. We reveal ourselves through our relationships. We create ourselves through our relationships. The patients I meet every day change me because they tell me their own, unique stories. Their stories are told from their own, unique perspectives. They are the heroes of their own stories. And in the telling of their stories they show me different ways of seeing and experiencing the world. The world is different after a story. I am different after a story.

Remember that a story has several components – a teller, a tale, something told about, and a recipient of the tale. Through the sharing of our stories we change each other. We create each other.

One of Ian’s links was to Roman Krznaric who has written a fabulous downloadable booklet called “Empathy and the Art of Living”. Go get it and read it. I highly recommend it. Here’s a key extract –

Most books or courses on the art of living focus on how we can
discover ways of improving our own lives. The emphasis is,
unashamedly, on what can be done to help me. I find this kind
of self-help approach too narrow, individualistic and narcissistic.
In my experience, those people who have lived the most joyful
and fulfilling lives have dedicated much of their time to thinking
about and helping others. It has given them not only personal
satisfaction but also a sense of meaning. They have, in effect,
lived a philosophy of ‘You are, therefore I am’.
Einstein recognised the need to move beyond self-help when
he said: ‘Strange is our situation here upon earth. Each of us
comes for a short visit, not knowing why, yet sometimes
seeming to divine a purpose. From the standpoint of daily life,
however, there is one thing we do know: that man is here for
the sake of other men.’ We will always feel something missing if
we attempt to live alone, hermetically sealed in an isolation of
our own making, thinking only of our own pleasures and pains.
The mystery of existence is constituted by our relations with
each other.
The twentieth century was an age of introspection, when
psychoanalysis impelled us to search for who we are by looking
inside our own heads. But the art of living involves escaping
from the prison of our own feelings and desires, and embracing
the lives of others. The twenty-first century should be the age of
outrospection, where we discover ourselves by learning about
other people, and finding out how they live, think and look at
the world.
Empathy is at the heart of how to live and what to do, and is
the ultimate art form for the age of outrospection.

Now I don’t know if Roman has invented that word – outrospection. But if he has then it’s hats off to him! This SO hits the spot! I find myself completely agreeing with this viewpoint. There’s way too much in the world of self-help which turns people in on themselves but most of what I’ve read about happiness includes an emphasis on the human need to connect to others, to connect to a sense of whatever is greater and more than ourselves, to be engaged with the world.

Who I am evolves and changes every day as I live in the world. I’m changed by my daily experiences, not least because of the other people I meet and connect with each day. This very fact brings back to my mind one of the books I have most enjoyed in recent months – Linked by Albert-Laszlo Barabasi.

Barabasi makes it crystal clear that to understand anything in this world we need to examine the connections, the links – how very Deleuzean!

I am because you are

What we see

painting by numbers

I took this photo of a man standing painting the landscape. He had two or three completed canvases at his feet. All his paintings were watercolours and all were realistic representations of his surroundings as he saw them. This was on a sunday afternoon in the busy port area of Cassis but he was completely absorbed in his painting. I was taken by both his absorption in the middle of such busy-ness but also something which has struck me before about people who stand in busy public areas painting at their easels. It seems quite typical that the artist in question comes across as quiet and somewhat detached but surely it also takes a lot of self-confidence to stand in a crowd and exhibit your act of painting.

One more thing…..as is often the case with a photo, once you look at the photo you notice something you didn’t see at the time. Why’s that man got a number SEVEN on his back??

Birds and the bell tower

birds in the bell tower aix

Looked up and saw this as I walked down the Rue Esperiat in Aix en Provence.
It looks like a giant bird cage but all the birds are on the outside and only the bell is inside the cage.

The sunflower seller

sunflower seller

Fascination

fascination

When I was in Tokyo last week there were Autumn Festivals going on. I saw one in the Akihabara district. There were lots of tables set up in the street and up on the first floor of the UDX building, selling freshly cooked seasonal foods and there were many stalls of games for children – Aunt Sally stalls, Archery, flower arranging and so on. There were loads of people there, and everyone seemed to be having great fun. These three wee girls caught my eye. Look how closely they are huddled together, and the sheer concentration in their faces. They are totally absorbed and completely fascinated with something. What is it? Look carefully. It’s a box of crayons. Lovely!