Silent as light

Posted on September 11, 2017 by Snow-Leavis

The Antiquary: “is preoccupied on every level by the relation between past and present.”

Mary Midgley: “These doctrines are often bizarrely over-confident and over-simple”

George Orwell in Why I Write: “… one can write nothing readable unless one constantly struggles to efface one’s own personality”

Raymond Tallis in Summers of Discontent “There are several things to be noted about emotions. The first is they fill the world with meaning”

Kenneth Calman in Makars and Mediciners: “It is perhaps here that the role of literature and the arts generally can have an advantage, by the author exposing poor health choices and behaviour patterns, in ways which are more powerful and effective than that of the medical teacher or professor. The writer’s imagination and expression can change things. The word can be powerful.”

Nathan Filer in The Shock of the Fall: “I think that’s what I am doing now. I am writing myself into my own story and I am telling it from within”

Andrew Greig: “He knows fankle from bourach.”

Raymond Tallis in Defence of Wonder “When we are in love we see the ordinary things about another person for what they are: not in the slightest bit ordinary.”

Gilbert K. Chesterton: “The world will never starve for want of wonders; but only for want of wonder”

“She makes sunlight dim” (Sian)

Thomas Tranströmer to his lifelong friend Robert Bly: “In this climate it`s all or nothing. Anybody not 100% for is “self-evidently” 100% against. Have I given you a little picture of the climate? All you can do is Follow your own crooked conscience, wait for the moment of truth and hope you won’t need to be ashamed one day of how you lived through these years.”

Raymond Tallis: “[Philosophy is a return] into that nearest, which we invariably rush past, which surprises us anew each time we get sight of it”

Tomas Tranströmer: “Balansnummer is ‘balancing act.’ The poem is partly a protest-poem against the prevailing mood in Swedish intellectual life. What I say is that finding the truth, being honest etc. is a difficult individualistic act of balance, you have to put off the rhetoric, all slogans and moustaches and prejudices and . . .”

Stephen Bann, MIDWAY: Letters from Ian Hamilton Finlay: “I recall saying once to Finlay that the special feature of the letter as a literary genre was that one never went back on the first draft to produce a fair copy.”

Nathan Filer in The shock of the Fall: “I have approximately 7.4 x 10²⁷ atoms in my body”

Ian Hamilton Finlay: “Sometimes my wee best seems just not good enough”

Richard Holloway in Leaving Alexandria: “The toughest lesson life teaches is the difference between who you wanted to be and who you actually are. And it can take a whole life to teach it”

Robert Louis Stevenson: “Letter to a young gentleman who proposes to embrace the career of Art”

A. S. Byatt in Possession: “He put little slips of paper in the entries that made up his fragile narrative or non-narrative”

Adam Nicolson in Sea Room: “I’m wedded to this plunging-off form of thought, and to the acceptance of muddle which it implies”

Mukul Kesavan in Looking Through Glass: “Like all chroniclers of the relatively recent past, history ran out against the present”

Julian Barnes in The Noise of Time: “He bought a large scrapbook and pasted ‘Muddle Instead of Music’ onto the first page.”

Ronald Ross: “Science is the differential calculus of the mind, Art is the integral calculus; they may be beautiful apart, but are great only when combined.”

Walter Scott in The Antiquary (in Oldbuck’s room) “Amid this medley, it was no easier to find one’s way”

Margaret McCartney in The Patient Paradox: “The conclusion that variability is bad is distant from the much simpler observation that patients are all different.”

Robert Crawford in Young Eliot: “Leafiness suited him”

Alexander McCall Smith in Chance Developments: “His one and only book, ‘The Future Lies in the Past’, eventually published”

Patrick Deeley in The Hurley Maker’s Son: “I sensed the sun, beaming from a place that was higher than the world”

Penelope Fitzgerald in The Bookshop: “The sky brightened from one horizon to the other”

Hanya Yanagihara in A Little Life: “You made art because it was the only thing you’d ever been good at, the only thing, really, you thought about between shorter bursts of thinking about the things everyone thought about.”

John Berger in Here is where we meet: “To find any sense in life it was pointless to search in the places where people were instructed to look.”

Edmund De Waal in The White Road: “He writes a letter about how things are made, but it is actually about compassion.”

Alice Hoffman in Faithful: “No one could count all the stars. There are far too many.”

Madeleine Thien in Do Not Say We Have Nothing: “So familiar to me, like an entire language, a world, I had forgotten”

John Steinbeck in Of Mice and Men: “Both men glanced up, for the rectangle of sunshine in the doorway was cut off”

Gardens of the Mind

Posted on May 8, 2017 by Snow-Leavis

I have put together this post in my appreciation for Geoffrey Jellicoe (1900 -1996).

Jellicoe was an architect, landscape architect, historian, traveller, lecturer and author. He has been a lasting inspiration for me.

When I studied landscape Architecture at the University of Edinburgh it was Jellicoe who was the guide for my mind’s eye. Without Jellicoe, I feel certain that I would not have gained distinction in all subjects along with the award of the Scottish Chapter prize. I was not a good draughtsman but I had ideas; uncultivated ideas. Six years of training in Medicine (at the University of Aberdeen) had rather stifled my creative and imaginative self and I was altogether rather too tight and rigid. In good part, I feel this a consequence of the unhelpful, and really too strict division between the so-called ‘two cultures’.

In what follows I have “borrowed words” of my betters, taking three quotes from a number of my favourite authors: marginalia and fragments that for me somehow seem to say something about Jellicoe and the ‘two cultures’. Interspersed are a few short clips of Geoffrey Jellicoe talking about draughtsmanship and gardens of the Mind.

‘It was odd being dead’

Posted on April 21, 2017 by Snow-Leavis

This is a fictional film. It is about a teddy bear, Dr Hale Bopp and a day of two halves. In the morning Dr Hale Bopp goes exploring in the Scottish Borders and he comes across the ruin of the Monteath mausoleum on Gersit Law. The oak door of the mausoleum has been breached and one can get inside and be with Monteath and the two angels that guard this forgotten statesman. Above him the dome has beautiful window stars to the universe beyond.

Dr Hale Bopp is a well-travelled bear and is constantly exploring, enjoying and reflecting upon the world in which he lives. The guid doctor has come to the view that life is complex, diverse and sometimes “messy”. He leaves the Monteath mausoleum with paws that were muddy and heads for a different afternoon. An afternoon of Appraisal to ensure that as a fictional bear and doctor that he is providing Good Medical Practice.

So that was the day of two halves. This film is about that.

Dr Hale Bopp is getting on a bit now and is at the end of his fictional medical career. One day soon he will retire from being a doctor but meantime he is of the view that his wanderings, philosophical and creative between the arts and sciences, has been nothing but to the benefit of the patients that he cares for.

Important note:
None of the words used in this film are those of the filmmaker. They are “borrowed” from C.P. Snow’s “Corridors of Power”; Evelyn Waugh’s “Decline and Fall”; and Jessie Burton’s novel “The Muse”.

‘It was odd being dead’ from omphalos on Vimeo.

Source material:
(1) Physicians of the future: Renaissance of Polymaths? By B F Piko and W E Stempsey. Published in The Journal of the Royal Society for the Promotion of Health. December 2002, 122(4), pp. 233-237
(2) Time to rethink on appraisal and revalidation for older doctors. By Dr Jonathan D Sleath. Letter published in the BMJ, 30 December 2016, BMJ2016;355:i6749
(3) Career Focus: Appraising Appraisal. Published in the BMJ 21st November 1988, BMJ1988;317:S2-7170
(4) Revalidation: What you need to know. Summary advice for Regulators. General medical Council.
(5) The Good Medical Practice Framework for Appraisal and Revalidation. General medical Council.
(6) Taking Revalidation Forward: Sir Keith Pearson’s Review of Medical Revalidation. January 2017.
(7) GMC response to Sir Keith Pearson’s report on Taking Revalidation Forward.

Music credits (under common license, thank you Dexter Britain):

(1) Perfect I am not – by Dexter Britain
(2) Telling stories – by Dexter Britain

The poem that time forgot

Posted on March 19, 2017 by Snow-Leavis

In 1826 Robert Pollok began an epic poem. Ten volumes later, and not even 28 years of age, Robert was dead.

His poem was called “The course of time”

I came across this poem through St Ann’s, Bridge of Allan, where my mother Margaret was born and where my daughter Rachel went to Nursery School.

Credits: Dexter Britain, Dylan Thomas, Raymond Tallis, Michael Mara, the BBC, old newspapers and a magpie.

Time passes. Listen. Time passes.

The funeral took place in radiant sunshine

Posted on March 14, 2017 by Snow-Leavis

Auchengray House has been a ruined shell since a catastrophic fire in 1937. At the time all was going horribly wrong for the multi-millionaire owner, J M Colville. Not only did he lose in the fire his collection of fine antiques and paintings, but not long before the fire his mother had died and then his sister jumped in front to a train.

It was this darkness that led to the building of Gribloch, the new hoose, one of light, designed by Basil Spence.

Epitome of current medical literature

Posted on February 14, 2017 by Snow-Leavis

This film takes as its title the opening section of the British Medical Journal of the last century.

The idea behind this film is to question what may be considered as “medical literature”?

I have deliberately placed myself at the centre of this film. What may appear as “monomania” is quite deliberate! I don’t know about you, but I read for pleasure and also because it gives me access to the lives of others. Literature opens up new worlds for me.

In this film I surround myself with some of those authors I have enjoyed reading and who have helped me to grow as a person and as a doctor.

We must remember that we are all subjective. We cannot put ourselves into the minds of others and truly share their lived experience.

This film also suggests, by including reference to the “modern ruin” St Peter’s Seminary in Cardross, (built in 1967, the year I was born) that we pass through time and that we age. I have included consideration of passing time as literature reminds us that medical science cannot ignore this.

In short this film is an artistic expression of the so-called “two cultures”.

Music credit: Spem in alium – Thomas Tallis

Locations:
(1) The Pineapple, Dunmore
(2) Mossgrove, Bridge of Allan
(3) Old Stirling Bridge

Backdrop:
Authors whose words have featured in my films.

Reductionism – truly, madly, deeply

Posted on November 24, 2016 by Snow-Leavis

On Friday the 25th of November 2016 I gave a talk for the Scottish Philosophy and Psychiatry Special Interest Group.

My subject was “Improvement Science”.

The following is based on the slides and the four short films that I presented.

My talk was entitled:
001-improvement-science The meeting was held at the Golden Lion Hotel, Stirling:I started the day off:
I gave these declarations:

I explained to the audience that like Dr Rev I M Jolly I can be overly pessimistic:

The dictionary definition of ‘Improvement’:

The dictionary definition of ‘Science’:

My concern is any pre-determinism to science:

The Health Foundation have considered Improvement Science: this is from 2011:

Many different terms are used including “QI” for “Quality Improvement”:

This is where improvement science began, in Boston, Massachusetts:

The Founder of the Institute for Healthcare Improvement (IHI) was Don Berwick:

The first description of this movement in Britain goes back to 1992 by Dr Godlee:

Fifteen years later, Dr Godlee, Editor of the BMJ, said this:
015-improvement-science

Only last month the BMJ briefly interviewed Don Berwick:

IHI describes improvement science as being based on a “simple, effective tool”:

This tool was developed from the work of an American engineer, W. A. Deming:

The “Model for Improvement” Tool [TM] is described by IHI as a “simple, yet powerful tool”:

The current President and CEO of IHI is Derek Feeley:

Up until 2013, Derek Feeley was Chief Executive [Director General] for NHS Scotland:

In April 2013 Derek Feeley resigned from NHS Scotland:

22nd February 2015 it was reported: “The astonishing and largely hidden influence of an American private healthcare giant at the heart of Scotland’s NHS”:

Dr Brian Robson, Executive Clinical Director for Healthcare Improvement Scotland [HIS] is an “IHI Fellow”:

Professor Jason Leitch, National Clinical Director for the Scottish Government is an “IHI Fellow”:
026-improvement-science

Might we be facing the biggest change to healthcare in Scotland since the NHS began?

Improvement science is moving quickly and widely across Scotland:

This “Masterclass 1” for Board members cost £146,837:
028-improvement-science

An NHS Board member commented after the Masterclass:

Healthcare Improvement Scotland is one organisation with a very wide remit over NHS Scotland and it works closely with the Scottish Government:

Nine cohorts of Safety Fellows and National Improvers have so far been trained following IHI methodology:
032-improvement-science

I was reminded of the current enthusiasm for improvement science when the Convener of a recent Scottish Parliament Committee meeting said of targets (another approach enthusiastically taken by NHS Scotland):

What is the place of ethics in Improvement Science?

In 2007 the Hastings Centre, USA, looked into this in some depth:

The Hastings Centre argue that Improvement science cannot ignore ethics:
036-improvement-science

In 2011 the Health Foundation, UK, produced this “Evidence Scan”:

The Health Foundation commented that “improvement science is just emerging”:

The Evidence Scan found a “real paucity of evidence about the field of improvement science”:

I would also suggest that there is a real paucity of philosophy about the field of improvement science:

The Health Foundation did find papers on the conceptual nature of Improvement Science but concluded that:

Mary Midgley is a philosopher now aged 95 years who is widely respected for her ethical considerations:

Chapter 7 of her book “Heart and Mind: The Varieties of Moral Experience” begins:

Mary Midgley is concerned about the overuse of reductionist tests in medicine stating that:

This film is about the potential consequences of inappropriate reductionism:

Leon Eisenberg has written many papers about this subject. He argues that reductionism should not be “abandoned” but that we must keep sight of where such an approach is scientifically useful and also where it is inappropriate:

In the Hastings Report, Margaret O’Kane asks:

In my view the answer to this question is YES. I am hopeful that the National Improvers recruited to NHS Scotland would agree:

As an NHS doctor I have seen unintentional harm brought about by National improvement work in Scotland. This related to a “Screening Tool” that was introduced across Scotland as part of this work. I found that the unintended consequences of the use of the following tool included implications for patients’ autonomy and the risk of over treatment:
048-improvement-science

Both the Hasting Group and the Health Foundation are of the view that improvement science cannot separate itself from the ethical requirements of research:

This article published in February 2016 argues that individual “rights transcend all aspects of Improvement science”

The following is a verbatim representation of a conversation held by National Improvers working in NHS Scotland:

In November 2016 Professor Joshi, also a psychiatrist outlined his concerns about reductionism in a published letter to the BMJ:

In this short film the mechanical language of healthcare improvers is considered:

Professor John Bruce was a Moral Philosopher in Edinburgh University in the 18th century. He built this temple, the “Temple of Decision”, in the grounds of his home by Falkland Palace so that he could consider his thesis:

Professor John Bruce did not succeed in his endeavour. His Temple however stood for many years:

But it eventually collapsed and his endeavour to “reduce the science of morals to the same certainty that attends other sciences” collapsed with it.

Any search of Healthcare Improvement Scotland for “ethics” finds this result:

This film is about more up-to-date buildings – the enthusiasm for which was based on improvement science: The Red Road flats in Glasgow:

                         Post-script:

The following is an edited clip of the evidence given to the Scottish Parliament by Healthcare Improvement Scotland (HIS) on the 31st January 2017:

The full session can be watched here

The Official Report can be accessed here

I am a severed head

Posted on September 19, 2016 by Snow-Leavis

I recently read an article about Iris Murdoch in the London Review of Books by Colin Burrow. I found it most thoughtful.

Today, many in the profession of medicine associate Iris Murdoch not for her writings but for her development of dementia. I have to be honest this troubles me. I am not alone to be troubled. This is what the Edinburgh author Candia McWilliams said in her memoir, ‘What to look for in Winter’:

When reading the London Book review of Iris Murdoch my thoughts returned to a work by Raymond Tallis, ‘The Kingdom of Infinite Space: A Fantastical voyage around your Head”. In this book Tallis describes a paradox: that consciousness manages to be both embodied and disembodied. This is a book that fills the head with wonder and demonstrates silliness in Cartesian divides.

Dr Felix Post was a psychiatrist who was interested in an area of study known as ‘Pathography’. This is the search for psychiatric disorders in individuals after their death.

I share the same career as Dr Post once practised. A career where Dr Post was a pioneer. However I do not share the determinism that he had to define people, or re-define people, after their death through a singular vantage.

I have worried enough about this approach –pathography– to make a short film about it:

All this is necessary backdrop to Colin Burrow’s balanced article on Iris Murdoch. What follows are some of the passages that struck me [dare I say it] as both an embodied and disembodied head:

Footnote: There is absolutely no doubt that Iris Murdoch developed
a severe dementia syndrome and that this was based upon biological 
changes in her ageing brain.

The questions that this Hole Ousia post asks are several:

(1) Would you want to be remembered for an illness first, 
or first as the brilliant person that you were?

(2) Can we define ourselves entirely through brain functions alone?

(3) What are your views on "Pathography"?

Sometimes history takes things into its own hands

Posted on March 22, 2016 by Snow-Leavis

This is a film about historic Bannockburn House.

I dedicate this film to Mick Collinson and feel fortunate that I was one of the last people to hold his hands in mine.

Sometimes history takes things into its own hands from omphalos on Vimeo.

Thanks must go to Terri Collinson, devoted wife of Mick. Terri somehow sensed I was an oddball lad of pairts and was so kind to me.

The city is yours

Posted on January 16, 2016 by Snow-Leavis

I recently transferred old family slide images to digital format.

Of the 1000 or so images, I was particularly struck by the panoramic, yet intimate nature of the photographs of my parents honeymoon in Paris in April 1964.

The city is yours from omphalos on Vimeo.

Hole Ousia

The whole being: the cultures of science & arts together

Tag Archives: Raymond Tallis