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Systems Biology?

The European Science Foundation (ESF) has published a Forward Look (FL) report System Biology: a grand challenge for Europe. They are seeking to raise awareness of this “novel” way of looking at biology. The quote really caught my eye

“There is a growing awareness in medical science that biological entities are ‘systems’ — collections of interacting parts.”

Well I never! Holism comes to mainstream science! Seriously, this is good news. I think one of the main reasons why medicine has hit its current ceiling on the relief of suffering in chronic disease is its predication on a reductionist model of biology. Complexity science and the study of chaotic systems AND the development of scientific research under the headings of psychoneuroimmunology and psychoneuroendocrinology are beginning to shift the ground away from the reductionists who think that the study of parts is sufficient to those who acknowledge that we in reality, we live in a messy, complex world, which can only be understood through a holistic approach which studies contexts and connections.

Seeded web

Seeded web, originally uploaded by bobsee.

I love the idea of webs. It reminds me of Deleuze’s metaphor of the rhizome – the sprawling root system of a plant with no centre and no core – defined by its connections. It’s the metaphor of the network, of communities, of collaboration and inter-independence.
This particular web is stunning because it is thickly coated in wind-blown seeds.
The image of seeds, and the image of the web, entwined like this is exciting. It suggests connections, beginnings and endings.
Look at it again – it’s like a fairy hammock – maybe that’s what it is! A place for fairies to relax and chill out – what do you think, Amy? A nice relaxing bed for your fairies (after they’ve done with all that coughing and scaring the tourists!!?)

Good post today on iwillchangeyourlife.com about how people go through life on “autopilot” with some points to make you ask yourself how much of your life is on “autopilot”.

This idea is right alongside my basic premise for this blog – living life unconsciously – whether you call that being on “autopilot” or living like a zombie – is just not a rich or healthy life.

The answer lies in recognising yourself as the hero of your own story – becoming more aware, engaging with life more consciously and actively creating your own path.

The Secret

Do you know about The Secret? This was originally produced as a TV series by an Australian TV producer called Rhonda Byrne. It wasn’t shown by the TV channel which commissioned it and was turned into a DVD, book and now a whole movement it seems. Wikipedia has a pretty thorough article on the background story plus a presentation of the views of people for and against The Secret. According to their article, the book which inspired Rhonda Byrne was the 1910 The Science of Getting Rich by William Wattles. They also say the principles espoused are pretty much the same as those of the New Thought movement.

What is The Secret?

Well, it’s the “Law of Attraction” – which is the belief that if you ask for something, then the Universe will deliver it. Of course this will strike a chord if you ever read “Ask and you will receive” in the New Testament of the Bible, or if you came across the New Age “Cosmic Ordering” idea. These ideas have been around a long, long time but “The Secret” has packaged it up in a DaVinci Code kind of way to sell it to a new market.

I watched the film recently and found I had an enormous mix of responses. You can find a whole range of views and opinions about this film on the net – everything from the view that “The Secret” is the answer to life, the universe and everything to the view that’s it’s psychobabble nonsense. Actually, I think it’s neither of these things.

When I watched the film, which is basically a talking heads documentary, I enjoyed the graphics, but didn’t enjoy the rather trite little “drama” scenes used to illustrate the points, and the speakers, for me, ranged from inspiring to PU-U-U- LLEEEEZE – Let me OUT of here!!! (I’ll leave you to make your own judgement on exactly who fell into which category!)

It is EASY to be critical of this film – you could easily say it is simply positive thinking embellished to the point of magical thinking. However, there are useful and inspiring messages in it –

  • Starting your day with thoughts of gratitude orientates you towards an awareness of the positive in your life.
  • Having a positive mental attitude is likely to help you to greater happiness.
  • What you focus is on is what you experience most in life.

But where it goes wrong for me is pushing it into the magical realm of a belief system that we entirely create our own reality and that our thoughts will be responded to by the universe which will give us exactly what we think. This lends itself to a blame-the-victim mentality where suffering is seen to be a result of the person’s own thinking – they brought cancer, or violence, or abuse, or whatever, down on themselves. This is distasteful and naive. It also lends itself to the no-effort-required view that you don’t have to strive for anything you can just lust after it hard enough and the universe will deliver it!

And yet, and yet……….

Here’s the most interesting thing for me about it so far. It’s not the positive thinking bit. I reckon that idea is difficult to challenge. There’s ample evidence from psychologists and philosophers that taking a deliberate focus on the positive can be beneficial not just in terms of mental health, but in terms of physical health, and recovery from serious disease. It’s also quite evident in life terms – from personal to business success.

Now it is quite clear to me that just thinking you can be whatever you want to be will bring that about is nonsense – as a 53 year old, 5 foot 5 inch man I will never get to play for the Harlem Globetrotters and I won’t run in the British 400 metre Relay Team at any Olympic games! You can NOT just “be whatever you want to be” – there ARE limits!

No, the interesting bit to explore is the idea that you create your own reality. I think this cosmic ordering kind of idea has got it the wrong way round. It doesn’t seem credible to me that there is some mysterious magical force in the universe which delivers your every wish if only you visualise it clearly enough and apply a type of faith to believing that whatever you visualise will come to pass. I do believe, however, that if you focus clearly on something, you raise your awareness to daily phenomena, events and circumstances which are relevant to that focus. I also think if you apply a highly motivated creativity to your focus then you are way more likely to actually achieve your goals. But I think this direction of flow is the opposite to that espoused in The Secret.

Stuff happens. Good stuff and bad stuff. We live in a chaotic universe. The development of scientific understandings of chaos and complexity shows us that chaos has both features of cause-and-effect and of randomness. Some things happen as a consquence of the actions of ourselves or those of others. But some things happen that are literally random. Nothing to do with anyone’s thought processes. How we cope with that stuff, how we adapt to that stuff……..that’s what radically alters our experience.

So our reality is created both by our experiences and by our reactions to our experiences. It’s not created by an intelligent or magical universe and it’s not created just by our thinking.

I’m glad I watched The Secret. Yes, its tacky focus on materialistic consumerism feels small-minded and is uncomfortable. But, it’s also thought-provoking and inspiring.

Honeysuckle

Honeysuckle, originally uploaded by bobsee.

Can’t you almost smell this?
What’s your favourite scent?
I love the scent of honeysuckle. In fact, I love the scents of most flowers but lilies I can’t be near. The smell is overpowering for me. Makes me instantly nauseous. A strange thing but I’ve met several other people who share exactly the same experience.
I wonder what it is that makes some scents attractive and others disturbing?

The richness of stories

When patients consult me I begin the first consultation (after having made my introductions) with some variation along the lines of “Your doctor has sent me a referral letter which gives me some of the background information about your illness but it’s best you tell me your story yourself”. This allows the patient to set the agenda and to tell me whatever they want to tell me in their own preferred order. When they come back to see me for a follow-up appointment I tend to begin with a question like “How’s things?” – deliberately vague and open, again to let the patient tell their story their own way.

I try to write down their exact first words. How they are doing is often captured richly in those opening sentences. For example, something along the lines of “Doing well. Got back to work and really enjoying it now” or “Managed to have our first family holiday in years”, tells me that there has been a significant shift. The details follow but the essence and magnitude of the change is often right there in the first few words.

We use an “outcome scale” with our patients in Glasgow Homeopathic Hospital. “0” means no change; “1” means some improvement, but not enough to be of value in daily living; “2” means improvement of value in daily living; “3” is significant change which has brought a significant improvement in daily living; and “4” is hallelujah, I’m cured!

Whilst it’s satisfying to see that two-thirds of our patients score a 2 or more, these bare numbers really lack the richness of the actual words the patients use. What is more important really is to capture the “story” of the change. The story needn’t be a long one; the first few minutes are usually time enough the hear it because the essence of the story is conveyed literally in the first three of four sentences the patient utters.

Interesting that this issue was on my mind today as I was musing about to capture these changes more systematically, when I came across a post on Lifehack about stories. (This post, by the way is Part 6 in a series about Chip Heath and Dan Heath’s book Made to Stick: Why Some Ideas Survive and Others Die)

This phrase really struck me –

Stories, then, allow us to impart not just our conclusion, but the actual experiences by which we came to that conclusion.

That’s it! I thought. That’s it in a nutshell. Figures are so uninteresting because they present a conclusion. They are thin information. How much richer is the information conveyed in a story!

I can tell you that in all my years of practice I’ve never heard the exact same story twice. It’s by telling their stories, with their own preferred vocabulary, in their own preferred way, that patients convey the experiences of their illnesses to me. And healing is in no small measure a matter of enabling somebody to tell a different story, to start a new chapter with new vocabulary and to develop new themes – positive themes, health themes as opposed to illness ones. It’s such a treat!

Surely we must resist the current trend to do medicine by numbers where individual stories don’t matter, where individual people don’t matter!

Here’s to the richness of stories!

It is impossible to understand anything in isolation. If you really want to understand something you have to consider it in its contexts or environments. I think that plants make that point beautifully. Think how a plant cannot exist all by itself. Think how it connects to other parts of nature in order to live, to grow and to reproduce.This time of year you can see an amazing diversity of strategies that plants use to spread their seeds.

Wind dispersal

Wind dispersal can carry the seeds to some pretty unusual places –

Plant gutter from afar

Some of those places are more useful to the plant than others –

Seeded web

A quite different strategy is to hook onto passing animals. I’m not sure if this is a Scottish term or not but we call these “burrs” –

Burrs

These are such vivid ways of showing us the interconnectedness and interdependences of nature.

Humans are the same. We spread ideas, thoughts and even feelings. We can spread them deliberately, or randomly, but in neither case can we control where they’ll end up!

Day Moon

Day Moon, originally uploaded by bobsee.

The moon at night is often beautiful but when it comes up in the daytime I think most people don’t even see that it’s there.
Here it is!
Look!

Ben Ledi Grey and Pink

Ben Ledi Grey and Pink, originally uploaded by bobsee.

The view from my window…….I find this very soothing.
I can’t see and a grey and pink scene like this without having one particular song play through my mind…..

 

Wesley Fryer’s excellent Moving at the speed of creativity blog has an interesting post today on “Measuring Engagement“. Engagement is, I think, a key quality of a healthy life. But what does it mean exactly?

I think of it as being in active exchange with your environment – both consciously and unconsciously; physically, emotionally and spiritually. There are three elements to this –

  1. the environment
    We are embedded in multiple environments. By that I mean you can’t see who you are in isolation. Nobody exists out of all context. Our environments are multiple – the physical environment of air, light, heat, noise and so on; the relationship environment of our place in our own personal networks of people (family, friends, colleagues, society etc); the semantic environment of meaning – the sense we make of the signals and symbols around us; and so on…multiple life contexts.
  2. being in exchange
    Within our environments we are continually receiving and responding to signals – detecting changes and adapting to them.
  3. active
    By active I especially mean conscious – the greater our awareness, the greater our ability to choose between possible responses to the changes in our environments. In addition, by active, I mean creatively active, because when well we don’t just respond to changes in our environments, we initiate changes too.

Wesley Fryer’s area of interest is education. I’m primarily a physician but a significant part of my job is education so that perspective interests me too. I share his interest in web technologies and it’s a Facebook development that seems to have stimulated this particular post. Facebook has measured applications on the basis of numbers of users but is now changing that to measure “engagement” instead – by this they really mean they are measuring a number of ways users interact with an application. Jeremiah Owyang argues that this is not really “engagement” but just “interaction”. Whatever you think about the Facebook model, Wesley goes on to consider how teachers measure engagement in the classroom (as opposed to just participation).

So, all this got me thinking. If I believe that engagement is a key quality in health, how do I know how well that is functioning in a particular patient’s life? Let me explain a little further…….

When someone has chronic suffering, be it pain, breathlessness, depression, whatever, their lives can become much smaller. They can retreat from work, from social interaction, and even from the basics of life – not noticing the world around them, collapsing further and further into a deep, black, hole. As they start to become well again they begin to notice more and respond to more around them, become more active socially and their lives gradually expand. This expansion is one of greater engagement (in illness, the contraction of life is a loss of engagement).

So, here’s my query – how do you know you are more or less engaged in life? Are you aware, when your world is either shrinking or expanding, of what it is that’s changing? What does “engagement” mean to you?