Feeds:
Posts
Comments

Living in the present – it’s what we do

June 5, 2008 by bobleckridge

It’s a strange thing, the present. We consider three time zones, don’t we? The past, the present and the future. A lot of patients I see are suffering because they are trapped in one of these time zones (and it’s not the present!). We experience the past through our use of memory. The past doesn’t exist. Not any more. We can only bring it back to life by remembering. Remembering is something we do. The future doesn’t exist. Not yet. We can only bring it to life by imagining. Imagining is something we do. So if we do remembering to experience the past, and imagining to experience the future, then what do we do to experience the present?

Usually when I think about experiencing the present, I concentrate on my senses, and becoming aware of what I’m hearing, seeing, tasting, smelling or touching. Amy, at livelessordinary, has written beautifully about just that way of living in the present.

I was reading “Donner un sens a l’existence“, by Jean-Philippe Ravoux, recently. Jean-Philippe is a French philosopher who has written about the philosophical basis of “Le Petit Prince”. He makes a strong point about the present which, when I read it, made me suddenly stop and think. Some of the greatest truths are the simplest ones. He says that living in the present is about acting. He says that we can ONLY act in the present. The present is the ONLY time we can DO anything. When I read that point, it was as if a penny dropped. Until then I had considered living in the present as a fairly passive affair – a time of sitting still, being quiet, savouring, sensing consciously and mindfully. Well, I still think all that is true, but look at all the verbs in that sentence! The present isn’t something that just happens to us, or passes us by. It’s what we do.

The way to live in the present is to be conscious of what you are choosing to do.

What are you doing right now? Reading? Thinking? Drinking tea or coffee? Remembering? Imagining? All these actions are your actions. These actions, these choices, are how you create your experience of living. William Glasser understood that when he developed Reality Therapy. Living in the present – it’s what we do!

Posted in from the living room, life, psychology | 6 Comments »

Becoming more child-like

June 4, 2008 by bobleckridge

I came across a great post entitled “Why it may be worth becoming more like a child” on the slow leadership blog. The main reasons to become more child-like laid out in this post were – being more imaginative, being encouraged to learn, forgiven for mistakes and becoming more creative. Carmine Coyote, the post’s author, asks what would work be like if people started to be a bit less adult? She argues it could be more exploratory, experimental, exciting and passionate. I like this post, and agree with it too. But let me tell you a little story, because this post fits in with one of those strange, synchronicity moments for me.

I regularly spend time in France. My French language skill isn’t great. I get by, understanding most of what I hear, but I’m not good at expressing myself in French. I love to read French however and I’m not too bad at that. I take my time and consult a dictionary when I need to. I never let a visit to France pass without a good browse in the bookshop. French language books are SO different from the English language ones I find in the UK. It’s really like a whole other world for me. Last month, as I browsed in one of my favourite bookshops, “Vents du Sud“, up past the market in Aix-en-Provence, I picked up an interesting-looking book, entitled “Donner un sens a l’existence” by Jean-Philippe Ravoux. I guess you could translate that as “Making sense of existence”, but “donner” means to give, so it’s more “Giving sense to existence”. I am convinced that one of the essential characteristics of human beings is that we are meaning-seeking/meaning-creating animals. A closer look revealed that this book is by an Aix-based philosophe and is an exposition of the work of Antoine Saint-Exupery – in particular, “Le Petit Prince” (The Little Prince) and “Citadelle” (Wisdom of the Sands). “Le Petit Prince” is THE top selling book in the world, second only to the Bible. I bought it, and I’ve been reading, underlining and annotating it since. I SO enjoyed it! I also decided it was time to refresh my memory of “Le Petit Prince” so re-read that too (first in French, then I bought myself a new English language copy and read that too, in case I didn’t understand anything in the French version). Well, I finished it during a train journey yesterday, and I’ve already gone back to the beginning to re-read the parts I’ve marked up for myself. I’m intending to write a few posts about the main themes over the coming days. But here’s the connection and the strange part –

The main theme of Le Petit Prince is how child-like innocence and wonder can challenge the adult view of reality. The little prince questions everything. He doesn’t just take things for granted. Ravoux claims that Saint-Exupery based this attitude on Descartes‘ “Discours de la Methode” (but more of that in another post!) Through his wonder and questioning, the little prince challenges our rather unthinking ways of living, our attitudes to power, money, belief and so on, and this questioning makes us “wake up” (become heroes not zombies?)

My head is full of these thoughts just now, so what a surprise to stumble this very day upon a post about becoming child-like!

What an amazing and curious world we live in! I love how it continually surprises me!

Posted in books, from the reading room, life, philosophy | 4 Comments »

The end of May moment

June 3, 2008 by bobleckridge

the moment of the setting sun

This is the moment, the present moment, that time we call sunset, and as the sun sinks behind the mountains, it throws up a final farewell flare. I’ve never seen it do that before. Not behind these particular hills. The unexpected, the unpredicted, how it jumps up and grabs our attention, demands we pull ourselves right out of the dreams and worries about the future, right out of the memories and reveries of the past, and just for this brief moment, we are reminded that the present is sliding past our eyes, so maybe, just maybe, it would be good to open them.

Posted in from the dark room, life, photography | 4 Comments »

Figuring out how your brain handles the meanings of words

June 2, 2008 by bobleckridge

fMRI is definitely the “in” tool in neuroscience. It allows a scientist to see what areas of the brain light up while a person is doing something. A study I recently came across is using this technique to work out how the brain deals with words. More specifically they are mapping the areas of the brain that light up when someone here’s a word associated with a “concrete noun” – a noun related to something experienced with one of the five senses.

Hmm, not quite sure how interesting that is, but then I read this –

“We are fundamentally perceivers and actors,” he said. “So the brain represents the meaning of a concrete noun in areas of the brain associated with how people sense it or manipulate it. The meaning of an apple, for instance, is represented in brain areas responsible for tasting, for smelling, for chewing. An apple is what you do with it. Our work is a small but important step in breaking the brain’s code.”

This is SUCH an important point in understanding how human beings function. Our nervous systems involve a whole network involved in sensing stimuli from the environment and a whole network involved in carrying out actions. These two networks are intensely and complexly (is there such a word?) linked up to each other. At a simple level, that implies we sense things then we act in response. In fact, it’s more complicated. Some neuroscientists and philosophers have suggested that sensing and acting are actually two aspects of the exact same thing – that sensing is a kind of an act. That seems right at some level, but it’s also quite challenging. This particular insight from these researchers makes that idea a little clearer I think. We can see that the brain actually represents what it perceives by using the areas that are involved in carrying out the actions normally associated with the object being perceived. In other words, perception and understanding are fundamentally entangled with acting.

Posted in neuroscience, perception, psychology | 8 Comments »

It’s good to talk……except sometimes it’s not!

June 2, 2008 by bobleckridge

I find that people are all very different. One of my core values as a doctor is that there are no one-size-fits-all medicines or approaches. Because people are different, the ways in which they get better differ, and the treatments which work best for them are different. That’s why I have concerns about the more extreme “evidence based medicine” fanatics, who see only two classes of treatment – “proven” and “unproven” (as if you can be sure what’s going to work for an individual before you’ve even met them)

One of the significant differences I see between people is that some really need to talk. They want to talk, and encouraging them to talk about their traumatic experiences is a way of enabling them to cope and to improve. Others, however, are quite unlike that. Some, even if encouraged, really do not want to talk about past traumas. I think it’s important to understand these differences between people and to offer them the kind of help which is best for them.

Psychologists have studied the particular issue of talking about trauma post 9/11. Their work was reported today on the BBC news site. What I found very interesting was their discovery that contrary to popular opinion that it’s always better to talk about such things, they found a significant number of the people who did well after that event, had chosen not to talk about their feelings at that time.

So, it appears, it’s good talk……..sometimes, and for some people, but don’t apply that advice indiscriminately.

Posted in from the consulting room, health, psychology | 12 Comments »

Medical immortality?

June 2, 2008 by bobleckridge

I had a letter published in the BMJ today. Here’s the text –

What exactly does it mean to say that a treatment produces a decline in “all cause mortality by 21%” in a group of patients aged 80 and over? How long did the treatment postpone deaths from “all causes?” A month? A year? Forever? Use of all cause mortality without a time frame stops researchers and readers asking what the treated group end up dying from. By focusing too narrowly we fail to clarify the true consequences of taking a particular treatment.

I wrote this in response to an Editorial about the treatment of elderly patients with high blood pressure. Somewhat astonishingly the article claimed a study had shown that treating over 80 year olds with antihypertensives not only reduced their chances of having a heart attack or a stroke but produced a reduction in mortality “from all causes” by 21%.

That just cannot be true……..not without qualification. And the qualification is the time period under study. The author of the editorial made no mention of the time period. Mortality remains 100%. Everybody, but everybody, dies. If we effectively reduce the chances of dying from one particular kind of disease, then before we make an informed choice to do what will achieve that, don’t we need to know what we’re MORE likely to die from instead? In fact, it’s not just a matter of death, it’s a matter of life. With an increasing emphasis from biomedical medicine to take drugs for life for a healthier life we desperately need some good whole of life research to show what the impact these interventions have on not just the kinds of deaths such people experience, but the kinds of lives they experience too.

There is a terrible tendency still in Medicine to think in too small pieces. We need the bigger picture.

Posted in from the consulting room, health | 3 Comments »

Man-made and natural patterns

May 30, 2008 by bobleckridge

As I flew over the coast recently shortly after taking off from Edinburgh airport, I snapped this shot.

Lothian coast

What strikes me here is the almost symmetry between the man-made shapes of the golf course, and the natural shapes in the sand created by the tides.

Posted in from the dark room, photography | 2 Comments »

The intimate connectedness of life

May 29, 2008 by bobleckridge

the spider and the flower

I was photographing this lovely yellow flower when suddenly I noticed a bit of it was moving…….then I saw the little spider!

Look at it! See how the yellow of its body so PERFECTLY matches the yellow of the flower! Goodness! How does that happen? Isn’t it astonishing!

One of my favourite philosophers is Deleuze. He emphasises not thinking of discrete objects. He rejects the typical “arboreal” system of thought where we set every organism into a specific branch in a taxonomic tree. Instead he suggests we think in terms of the connections and borders and interactions. He emphasises a “rhizome” model (like grass, which has no single centre, but is, instead more like a vast web). I’ve always found that idea appealing because it rejects labelling and putting things into boxes. Instead it emphasises dynamic change. That’s why I have the byline at the top of my blog – “becoming not being…..”

When you think in terms of becoming, not being, you focus on the interactions, the connections and the development of organisms. After all, can we really understand either this flower or that spider without considering how, together, they make a little functioning unit, a little ecosystem?

Posted in from the dark room, from the reading room, philosophy, photography, science | 4 Comments »

Seed

May 28, 2008 by bobleckridge

I was sitting sipping a coffee at an outside table in the cafe at the market the other day and I saw this seed lying on the table.

seed

I thought I’d capture it and share it with you.

Isn’t it amazing? If you look closely, there are two capture devices built into it! At the left end, there’s a tiny, wee hook-shaped hair for grabbing onto something and, at the other end is this delicate and exquisite brush of fine, fair hairs for carrying it far in the wind.

Seeds have always been a source of wonder to me. How can such a tiny object turn into a flower, or a bush, or a tree? I guess if you are knowledgeable about such things you’ll know what this seed might become – I’m afraid I don’t! One of the subjects which enthralled me at university was embryology. How on earth can a single, fertilised cell turn into all the diverse types of cell in the human body and grow in the right places?! Awesome!

Do you think this seed might become a great tree somewhere? Like these ones?

forest sky

I also went to a garden festival and one of the stalls sold seed pods. Look at their diversity!

seedpods
seedpods
seedpods

So, there’s two things that amaze me about Nature – creativity and diversity. These are such important features of human beings too, aren’t they? How little we guess about the potential of a baby! How little we know about his or her uniqueness! Amazes me every time I think about it!

Posted in creativity, from the dark room, life, photography, science | 3 Comments »

The essence of medicine

May 27, 2008 by bobleckridge

If you were asked to say what is the essence of medicine, I wonder what you’d say?

Something about “evidence based” or “scientific” or “effective treatment”?

Well, David Sokol, a lecturer in Ethics and Law took this as his subject for an article in this week’s BMJ. He reports attending a clinical neurology class at his local medical school and witnessing a patient with Motor Neurone Disease becoming upset when asked what she had been told about her disease. He sees the neurologist comfort her by taking her hand, and he says this –

As I watched him comfort the patient, my thoughts returned to Selzer’s essay and his concluding words: “Out of the resonance between the sick man and the one who tends him there may spring that profound courtesy that the religious call Love.” As I read this, it occurred to me that Paracelsus in the 16th century and the late French haematologist Jean Bernard also claimed that medicine was grounded on love.

and this –

The words of Paracelsus, Bernard, and Selzer, which hours earlier sounded fuzzy, now rang out with a newfound clarity. I saw, for the first time, the very essence of medicine.

Impressive. Very impressive.

I’ve often said that if I am ever ill and need a doctor I want one who, frankly, gives a damn! I want him or her to care whether or not I am suffering and for that to be the basis of their choices.

Posted in from the consulting room, from the reading room, health | 4 Comments »

« Newer Posts - Older Posts »