Bends In The Timescale

Sempe

The World According To Sempé – Cover image

I have always taken more interest in cultural themes and steered away from science.  However, it strikes me that culture so easily separates people, while science can connect people, regardless of their personal or professional background.  For this reason, I have been making regular visits to the ROM’s Life Galleries, and have started to write about my experiences.  

The first concept I needed to come to terms with was the geological time scale (GTS).  Here is the Wikipedia definition:

The geological time scale is a system of chronological dating that relates geological strata (stratigraphy) to time, and is used by geologists, paleontologists, and other Earth scientists to describe the timing and relationships of events that have occurred during Earth’s history.

The length of the GTS is calculated with remarkable precision: 4.543 billion “years.” Scientists know that the GTS is a useful abstraction – not an absolute accounting.  (After all, the “earth-year” is a relative term, and even if it had an absolute value, we could never prove that this value was a constant over billions of years.)  Although this device is useful for scientists, it does not preclude the use of alternative devices. Consider, for instance, the poetry of William Blake:

To see a World in a Grain of Sand

And a Heaven in a Wild Flower,

Hold Infinity in the palm of your hand

And Eternity in an hour.

Imagine the effect of posting this poem alongside the GTS at the opening of an exhibit. Perhaps this would be seen as unscientific. In practice, however, I think it would stimulate a much higher level of engagement.  No longer a finished concept, the GTS becomes a structure for further inquiry and exploration.

The Dawn of Life Preview Gallery is a great place to practice.  It contains many stunning specimens, models and 3D animations of lifeforms from the Burgess Shale – truly inspiring!  And I can grasp conceptually how today’s lifeforms (including my own!) are directly related to these ancient creatures.  It becomes a more visceral experience when I contemplate the statement:  ontogeny recapitulates phylogeny.  I suddenly realize that my own organism went through the same embryonic phases as did these creatures:  the past is present!

The geological time scale is a very useful tool, but it does not tell the whole story.

Dementia and the User Interface

Open Lab at Toronto General Hospital

Open Lab at Toronto General Hospital

At some point in the 1980s, I heard a talk by Bill Buxton about “user interface design.”  Dr. Buxton was one of those unusual folks who actually seemed to understand this topic.  For him, user interfaces were all about designing human environments.  Computer system efficiency was only a secondary consideration.

As I recall, he spoke at some length about  artificial limbs and other prosthetic devices.  He stressed that their primary purpose is to support  a recovery process.  They should only be used to replace a body part or function when recovery is simply not possible.

By analogy, he said that computer systems can support us in finding ways to improve our natural human environments – our lives in other words.   However, it’s easy to get carried away, and lose touch with the joys and challenges of everyday life.

I would like to add that these questions become more urgent for people with dementia –  and for their friends and caregivers.  What can we do help these people connect with each other in meaningful ways?  Here are two contrasting examples:

Open Lab at Toronto General Hospital

Dotsa Bitove Wellness Academy


Empathy In Medical Training: Two Stories

atlantic-empathy-articleHow do you make a young doctor really understand what it’s like being 74?  Virtual reality.

This is the theme of We Are Alfred.  (See the full story and video here.)  Young doctors experience a simulation  of everyday events in the life of Alfred, a hypothetical older person with several sensory deficits. For instance, in the birthday party shown above, the participant experiences the effects of macular degeneration – and feels the disturbing emotional disconnections that come with it.

This project is a promising first step in developing empathy.   Doctors become more sensitive to what is actually happening, and are in a much better position to help.  Rather than jumping to conclusions about cognitive deficits or psychiatric disorders, they can begin to have real dialogue.

Still, much of medical education is designed to suppress empathy, so that doctors will be clinical and “objective.”  Leading medical schools are slowly changing this attitude and ensuring that young doctors understand the need to engage with people.  Our second story,  an article in The Atlantic , describes a project at the University of Oklahoma College of Medicine.  Before dissecting a cadaver, first-year med students  are invited to meet the surviving  family members.  The story concludes:

Lunch was served sometime during the story and empty plates were cleared before the family finished their biography. When the story caught up with the present—ending with the donor willing her body to OU College of Medicine—the students sat for a moment in silence. “It was humbling,” Thurman recalled, “to think she was our first teacher.”

Dr. Arno Kumagai and The Renewal Of The Humanities in Medicine

 

Medicine is the opportunity to bear witness to the mystery, tragedy, and wonder of being human. – Dr. Arno Kumagai

 

discussions-vs-dialoguesDr. Arno Kumagai was recently appointed Vice-Chair, Education, at the University of Toronto Faculty of medicine.  (Read the story here.)  As a champion for the humanities in medical education, his vision goes far beyond putting a friendly face on healthcare.  He is passionate and articulate about how dialogues in medicine are opportunities to deepen and transform the human experience for all concerned…doctors included!

Here are some excerpts from a talk he gave in the UK last year at the conference, Thinking with Metaphors in Medicine:

How we perceive and structure the world around us is dependent on the identities we carry with us… – P. Bourdieu

The “field:…a social space in which forces or influences interact (champ de pouvoir) as well as a space of struggle (champ de lutte) characterized by differences in power and privilege.                          P. Bourdieu

Group interactions may be seen as “fields” in which the habitus of each individual intersects and interacts with those of others within contexts of power and privilege.  P. Bourdieu

“Knowledge capital,” resources, opportunities, even ways of seeing, talking about and understanding, are under the control of those in power (the ‘Police’) – Jacques Rousseau

The goal of medical education is in large part, the professional development of the empathic self.  In essence, medical education is moral education.

Critical Consciousness – A recognition of individuals as conscious, reflective, social beings, an awareness of social contradictions and injustice, and a commitment to act to overcome injustice and oppression.  – P. Freire

[T]he essence of politics is to reveal what is possible through engagement with the ambiguous and uncertain.  – A. Bleakley

The foundation of Being is the relationship with the Other, and this relationship is ethical. – Emmanuel Levinas

The heart of dialogue is the recognition of the mystery of the Other and to act on this awareness.

Education as change: a process of transition or liminality.

Click the link to see the full presentation, which includes lots of pictures and some good humour!  Liminality – Dialogues at the threshold.  (If you don’t have Powerpoint on your computer, you can download the slides in Google Drive or similar apps.)

The Waiting List Trap – And How To Avoid It

from-waiting-to-livingThe main focus of many advocacy programs is a long waiting list: if we raise more money, we can reach more people and the list will get shorter.  Some organizations have found that this approach is not always effective, and have developed innovative alternatives.  For instance, Family Services Toronto (with the support of The Metcalf Foundation) has taken a very proactive approach.  They noticed that too many people on the waitlist feel like the seasons are passing without things changing.  And we focused on ‘Light Seekers’: people on the waitlist open to other types of non-therapeutic supports – from peers, groups, etc.  (Read about “From Waiting To Living”.)

Traditional waiting lists are stubborn and persistent – it seems that for every person served, two or three new folks join the list of waiters.  In the above story, people are motivated to take action themselves.  They learn to solve their problem in other ways, and are able to LEAVE the waiting list.  This in turn frees up resources for others.

The strategy behind projects like From Waiting To Living  does require a significant shift in the organization’s culture and training practices.  Staff are no longer simply administering a fixed program – each intervention requires creativity, a spirit of innovation, and  willingness to consider quite new perspectives.

I would be interested to hear about others who have had success with similar approaches!

Neuroscience and Cultural Conformity

brain2My mind has such wonderful qualities, and I am just beginning to feel its potential. Yet when I reflect on the images given to us by neuroscience, I am perplexed.  The language of neuroscience seems totally inadequate to describe what I actually experience.  I realize that the images are generated using actual data, and yet they do not co-relate in any obvious way with my own internal experiences.

The difficulty becomes even more pronounced when I experience poetry or art.  The gestures and forms of my mental activity in no way relate to the spidery motifs that propagate in neuroscience imagery.  Anyone who pays even cursory attention to to their own inner life will readily make the same observation.

Or will they?  Are people beginning to believe that the images generated by neuroscientists are actually pictures of the brain and its activity?  Will they lose interest in the unique qualities of their own thinking, and focus instead on the optimization of synapses and neural pathways?

The late Ursula Franklin, writing about cultural conformity, put it this way:

The technology of an activity defines the activity itself, and in so doing excludes the emergence of alternatives.

Silence and Healthcare

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Pico Iyer

Recently, I read the book, The Art of Stillness: Adventures in Going Nowhere by Pico Iyer.  Now, I am reading SIXTY – A Diary of my Sixty-First Year by Ian Brown.  Iyer and Brown are similar in many respects: they both are excellent writers, global citizens and keen observers.  Having said that, I would much prefer having Pico Iyer as a guest in my living room.

For Pico Iyer, physical and sensorial constraints actually provide  stimulus for deeper insight and – adventure!  Following the likes of Leonard Cohen, he turns simple, everyday moments into epiphanies. Ian Brown, on the other hand,  seems fixated on the symptoms of physical aging, and says little about the tender spiritual impressions that aging brings.  It seems there is nothing in sight but the end.

Much of modern healthcare and social services seems to be about caring for people – focusing on their needs, minimizing pain and waiting for the end.  But what we really want to do is care about people and create many magic moments together.  This is healing.

Note:  Thanks to my old friend Cynthia Dann-Beardsley for inspiring the last paragraph of this post.