Should Life be a walking shadow?

I have to admit that I had not heard of the ‘attention economy’ before -never even thought about it like that, in fact. And yet, when I think about attention, I suppose I’ve always heard it used as a currency, a thing that was paid to a specified ‘other’ -the thing attended to, in other words. Inattention, was no attention at all; it was an aimless, uncontrolled drift that gathered nothing of importance, and hence was to be discouraged; it was the kind of activity that, if noticed, would inevitably evoke a ‘pay attention’ rebuke from the teacher in a classroom, thus reinforcing the idea that there was only one flavour of the concept: the directed attention.

Indeed, capturing attention is the way business works, isn’t it? Getting you to think about a particular product when the need arises, and making you aware of its attributes and benefits, is the only way to interest you in buying it. We tend to segment reality into little fragments that we grasp, one at a time, to sew into the fabric we call our day; from the moment we awaken until we slip, often exhausted, into sleep, we wear a patchwork quilt of attendances as our realities. Only in retrospect, should we ever choose to examine them, are we able to recognize the qualitative dissonances we have accepted as seamless.

Perhaps the perceptually dissolute may decide to comb the day for information, but somehow that act seems as bad as stripping a sentence of all its adjectives to get at the nouns and thereby losing the colour and vibrancy each was intended to wear. Sometimes attention misses the beauty of the forest by examining the trees too closely. At any rate, I’ve often thought there must be more than one variety of ‘attending to’…

I can’t help but notice people on the street walking past me wearing earphones, or staring at their phones, oblivious of my presence unless we bump. Do they see the series of comic faces in the clouds, or the hawk circling high above the little park? Do they notice the missing brick in the wall of the hospital across the street, or the sad old man leaning on the post outside the Emergency department? Would they stop to smell the flowers in the little pot beside the barbershop; do they wonder if the owner takes it in each night so it doesn’t disappear? Do they even care?

Do they feel the wind on their cheeks, and hear the rustle of leaves as it fights its way into the meadow? Do they see the squirrel that stares at them from a branch above their heads and wonder which tree he calls home? Even more important, do they notice that there are less birds singing in the trees above the trail in the nearby woods, and more litter along the way?

I suppose they are entangled in another, more important, world -and yet it’s probably the same one as mine, but without the distracting detours that make the journey as important as the destination. Of course I realize that few of us are monolithic, or so wedded to each moment that we are not tempted by diversions from time to time; we all daydream, I imagine, although some of us are more open to it than others; some of us are not wracked by guilt at the imagined loss of time that should have been better employed.

We have all, no doubt, travelled to someplace new to us, and been completely absorbed in the novelty of discovery: the unusual smells, the strangely loud buzz of traffic, or maybe the unanticipated imaginative architecture, or the flash of unfamiliar clothes hurrying by on unexpectedly familiar bodies. In those moments, we are immersed in the experience and only when the shock wears off do we re-emerge to attend to particulars and grasp at purpose.

Yes, I know I am not alone in seeking different ways of defining what it is to pay attention, but I have to say that I was delighted to find that someone had actually written an essay about it:

Dan Nixon, a freelance writer and senior researcher at the Mindfulness Initiative in England writes that, ‘Talk of the attention economy relies on the notion of attention-as-resource: our attention is to be applied in the service of some goal.’ So ‘Our attention, when we fail to put it to use for our own objectives, becomes a tool to be used and exploited by others… However, conceiving of attention as a resource misses the fact that attention is not just useful. It’s more fundamental than that: attention is what joins us with the outside world. ‘Instrumentally’ attending is important, sure. But we also have the capacity to attend in a more ‘exploratory’ way: to be truly open to whatever we find before us, without any particular agenda.’

‘An instrumental mode of attention… tends to divide up whatever it’s presented with into component parts: to analyse and categorise things so that it can utilise them towards some ends.’ There is also, however, an exploratory way of attending: ‘a more embodied awareness, one that is open to whatever makes itself present before us, in all its fullness. This mode of attending comes into play, for instance, when we pay attention to other people, to the natural world and to works of art.’ And it’s this exploratory mode that likely offers us a broader and more inclusive way to experience reality: an attention-as-experience. In fact, it is probably ‘what the American philosopher William James had in mind in 1890 when he wrote that ‘what we attend to is reality’: the simple but profound idea that what we pay attention to, and how we pay attention, shapes our reality, moment to moment, day to day.’ And ‘It is also the exploratory mode of attention that can connect us to our deepest sense of purpose… the American Zen teacher David Loy characterises an unenlightened existence (samsara) as simply the state in which one’s attention becomes ‘trapped’ as it grasps from one thing to another, always looking for the next thing to latch on to. Nirvana, for Loy, is simply a free and open attention that is completely liberated from such fixations.’

I like the idea of liberation; I cherish the notion that by simply opening myself to what is going on around me, I am, in a sense experiencing what the French mystic Simone Weil called ‘the infinite in an instant’.  It sure beats grasping at Samsara straws.

Tis in ourselves that we are thus or thus

I must have learned a bit about phenomenology in Philosophy courses at university, but except for the fact that it has something to do with lived experience and consciousness, I have pretty well forgotten almost everything about it in the intervening years, I’m afraid. The name alone was enough for it to merit a place of its own in a dark corner of a barely reachable shelf inside my brain somewhere. Strange names like Husserl and Heidegger stand guard, but in all that time, they were relatively undisturbed by any neuronal probes -any interest whatsoever, in fact.

And now, in my yellow leaf, I’ve stumbled upon it once again, but this time in the context of health, ironically. Given that phenomenology purports to concern itself with experience, and nurses would like -and in fact, need– to understand the subjective experience of those under their care, it seems like a good, if somewhat awkward fit I suppose.

After more than 40 years in Medicine myself (as a specialist in Ob/Gyn) I recognize that it would be an advantage for all of us who deal with people with health needs, to understand how those individuals experience their worlds. But an essay written by Dan Zahavi, a professor of philosophy at both Oxford and the University of Copenhagen helped me to realize how nurses, especially, might benefit by looking at it from a more phenomenological perspective:

‘By being interested in patient experience and striving to understand people’s experiences of health, illness and care, the discipline of nursing might have more affinities with the social sciences and its qualitative methods than with medicine and its reliance on the quantitative methods of the natural sciences. Indeed, if the aim is to provide proper care for, say, stroke patients, or patients with diabetes or Alzheimer’s disease, it is important to have some understanding of what it is like, subjectively, to live with such conditions, just as it is important to understand the meaning that patients attach to the events that disrupt their lives.’

This is not to diminish the role of Medicine in any way, but merely to suggest that Nursing and Medicine each have complementary roles in the provision of care. After all, ‘This focus on patient experience isn’t simply about monitoring (and increasing) patient satisfaction. It is about obtaining information that will allow for more adequate healthcare… one reason why nursing science became interested in phenomenology was precisely because the latter was seen as a resource that could bridge the gap between research and practice… It might, in short, help to ensure that the academic field of nursing research actually led to an improvement of nursing practice.’ Medical practice as well, but for now, let’s stick with Nursing.

The issue, however, is not to become too entangled with the competing nuances of the various philosophical movements that call Phenomenology home. Does it really matter, for example, that the philosopher Heidegger stressed ‘the ontological difference, inauthenticity, solicitude, average everydayness, thrownness and fallenness’ -whatever in the world that means? Or that  Jonathan Smith (a psychologist) ‘has argued that his own approach, which is called Interpretative Phenomenological Analysis (IPA), is phenomenological because it seeks to ‘explore the participant’s view of the world and to adopt, as far as is possible, an “insider’s perspective” of the phenomenon under study’?

How about Max Van Manen distinguishing ‘what he calls the heuristic, hermeneutic, experiential, methodological, eidetic, ontological, ethical, radical and originary reduction as important elements of the phenomenological method’? I mean, come on, eh?

As Zahavi sees it, ‘nursing research’s current use of phenomenology faces three challenges: it risks being too superficial by mistakenly thinking that phenomenology is simply about paying attention to experience; it risks being too philosophical by employing too many theoretical concepts with little clinical relevance; and it risks being misled by misguided methodological requirements.’

But, shouldn’t it be enough to extract what value you find in viewing the world from the point of view of the person under your care -call it what you will? A balance, please: a just-right-baby-bear, Goldilockean approach would do just fine, thank you.

As a now-retired doctor, I have worked with nurses all my career; we have always worked as a team, each with subtly overlapping roles, and yet I blush to admit that it wasn’t until I required a minor surgical procedure that I truly appreciated the difference.

One cold night, as I lay in bed with the covers pulled up to my chin for warmth, I noticed some lumps in my neck. Subsequent specialist medical consultation did little to reassure me -despite the delicacy and empathy with which the differential diagnosis was outlined for me. To further clarify whether the lumps were indeed malignant, as the consultant expected -and if so, their origin- a surgical biopsy would be required.

A speedy diagnosis was deemed essential so that treatment, if necessary, could be started as soon as possible. But there was apparently no expeditiously suitable time available in the operating theatre, so the consultant surgeon agreed to do it under local anaesthetic in the outpatient department of the hospital within the next day or so. That was fine with me -I just wanted a diagnosis.

What I hadn’t anticipated, however, was just how very anxious I would feel as I lay in one of the same rooms -and maybe on the same table- where I had performed many of the gynaecological procedures so common in my own practice. I knew the surgeon, and we talked pleasantly enough about our lives, and how often our specialties intersected. I knew he was trying to be empathetic and set me at ease, but we both realized there was an unbridgeable gap that separated us now, no matter the care we both took to disguise it: I was the patient -and not just a colleague. It’s difficult enough to be a patient, but perhaps even more so when the roles are suddenly reversed.

I knew the nurse in the room, of course -she had helped me on many occasions with the procedures I had booked in the department. But that day, her eyes were seldom far from mine, even though she was helping the surgeon set up some of his equipment. I could sense her concern whenever our eyes met -she’d always been attentive when she’d helped me before, and yet it was subtly different this time: she was dividing her attention between helping the surgeon and making sure I was okay.

But I wasn’t; I was terrified, although I tried my best to disguise it. Even though the local anaesthetic was working, I could still imagine what the surgeon was doing because of the subtle pressure changes I could feel on the skin distant from the lumps -you can’t freeze an entire neck. I tried not to tense any muscles in the area, but I suppose panic was starting to set in…

Suddenly, there it was: a hand gently grasping mine. The warmth of it, skin to skin, was soothing, reassuring, and although I couldn’t turn my head to look, I knew it was the nurse. I also realized she was aware of what I was going through –she had been all along, I sensed. She was living it herself in a way.

Until that moment, I don’t think I really understood the true value of rapport in caring for people. Of course I often used touch to reach out and connect with others in my own practice: on morning hospital visits to my patients after surgery or with new mothers and the babies I had helped deliver, and frequently in the office just to show anxious and fearful patients that I was listening and would try to help… That I wasn’t just a voice from the door, or on the other side of the desk.

And yet, that reassuring hand during the biopsy taught me something else: that there is more to compassion than a reassuring smile, more than just an offer of help. Care involves trying to understand what the other person is going through, and guiding them thoughtfully and kindly along the way. We can probably never really know the pain of another, but we can let them know we are trying.

If that is what Phenomenology offers, then by any other name, it would smell as sweet…

Let shame say what it will

Call me overly sensitive, but I don’t like to be shamed. There, I’ve said it. I suspect it is because shaming causes me to think less of myself: to feel humiliated, demeaned. And yet, there is another side to humiliation that seems to hide in the shadows: the feeling of humility – ‘This amounts not to thinking less of yourself but to thinking of yourself less. The person so ‘humiliated’ becomes less self-centred: her ethical concerns bear witness to a kind of revolution through which her own private and peculiar desires lose credence and authority, a diminution that finally allows her to take notice of what is positively owed to others.’- so writes Louise Chapman, a PhD candidate at the time in Philosophy at Pembroke College at the University of Cambridge in an essay on shaming in Aeon.

‘Has the behaviour of another person ever made you feel ashamed? Not because they set out to shame you but because they acted so virtuously that it made you feel inadequate by comparison.  If so, then it is likely that, at least for a brief moment in time, you felt motivated to improve as a person.’

Perhaps, in the embarrassing circumstances of the moment of humiliation, I never stopped to think about it very deeply, but operating behind the scenes was a type of hydraulic system whereby ‘the elevation of one desire in a closed system causes a proportional diminution in another… the 18th-century German philosopher Immanuel Kant presents it as a useful metaphor for capturing the seesawing nature of real psychological forces. In his view, the subordination of self-interest removes, or at least diminishes, hindrances to willing the good. For Kant, the denigration of one’s pathological interests is thus tantamount to removing barriers to acting well. This pivotal mechanism of moral education could be classed as a form of sublimation or diversion, whereby inappropriate desires are channelled into higher pursuits.’

In more recent times, it was Sigmund Freud ‘who claimed that psychic energy can be redirected from lower aims to higher ones, at least when the patient herself recognises that the desiderative drive imperils her.’

This is where exemplary individuals come into the picture. ‘These are people who have the ability to cause profound shifts in the motivational landscapes of their spectators.’ But the exemplars should not serve as a model but only as proof that it really is possible to act in a better way.

Social Media nowadays provides an instructive example. It is tempting to rid ourselves –unfollow– those who continually post their successes, and yet ‘while they can stir up the pains of comparative humiliation, in so doing they strike down our tendency towards intellectual and physical torpor, thereby inspiring us to action.’ This could be termed a form of ‘appraisal respect’. We don’t have to engage with them, only to bear witness -and appreciate that we are not being manipulated if we see some merit in their success as an example for ourselves. In theory, at least, ‘Once the spectator has been shamed by the exemplar’s behaviour, external examples of morality are no longer necessary for continuing moral progress.’ Moral hydraulics.

Comparisons with others merely remind us of what we ourselves are capable of, and with continuing practice, can find ourselves achieving. But we do need reminders from time to time.

Take the old man I saw leaning against a lamppost on a main street in downtown Vancouver. It was a typically cool, wet, and windy day in autumn and I was snuggling into my umbrella trying to make the best of it. I almost bumped into him, but when a gust of rain suddenly tore at the umbrella, I jumped to the side in time. Dressed in a dirty brown baseball cap, a torn cloth jacket, and -judging by the cuffs that were rolled up many times- jeans that were obviously too large for him, he still managed a smile at the near collision.

It’s sometimes hard to judge the age of people who frequent the streets, but he looked old, and frail -someone who would have been sitting in a warm room somewhere, had Life not been so harsh on him. He did not have the look of a dissipated life -just an unfortunate one that had dealt him all the wrong cards.

“Spare some change…?” he rasped with an old man’s voice, then coughed as if the effort involved in speaking was too much for him. He sent his eyes to inspect my face, and they hovered over my cheeks like hopeful sparrows looking for a roost, then flittered away when they saw my expression.

I suppose his words caught me off-guard -embarrassed me, perhaps- and I merely pretended to listen, shook my head, and fought another gust of wind as I walked away. My first impression was distrust of the neighbourhood, and yet when I turned, warily -and, in truth, with guilt- to check behind me a few moments later, he was still there, the smile clinging to his face: a default expression – hoping, like its owner, for a reason to survive.

He looked so delicate, and elderly that I stopped, uncertain what to do. I was ashamed I had brushed him off so quickly, to tell the truth. His smile, I think, was what had disarmed me -that and the fleeting hope I’d seen written on his face at our chance encounter: an unexpected gift on a cold and blustery day on the street.

Something -perhaps his eyes, still heavy on my shoulders- made me turn to face him. His smile grew and his face crinkled happily at my change of heart. And when I reached him, his hand did not extend as if he expected a reward- just his eyes: two souls searching for my own to touch; two minds joining, if only for a moment in greeting.

I struggled for words, and all I could manage was an apology for being so insensitive. “I’m so ashamed,” I mumbled, reaching into my pocket. “It can’t be easy on the street…” I felt myself blushing as I pulled out the only bill I had -a crumpled ten- and handing it to him. I didn’t want him to think I was just expiating my guilt.

“Don’t be ashamed,” he said, evidently also embarrassed. “You came back… Most people don’t.” And he reached out and shook my hand like a long lost friend.

Looking back, I think he was what we all fear we might become some day. He was my face, in another’s mirror.

Does everything have meaning?

What is the meaning of rain? No, really -what, if anything does it mean? If we ask the same question of Life, we understand immediately the type of answer required, so what is different about rain? Both are processes, of sorts, although rain has the added advantage of also being a thing -both palpable and visible- I suppose. But should that disqualify it from having meaning?

Meaning is something that stretches beyond the thing described, and expands it in ways perhaps not obvious at first glance: beyond just descriptive definition, beyond attempts at capturing it with a synonym -those are mere tautologies and add little clarity beyond finding other words to say the same thing.

It would be all too tempting to resort to simply describing rain’s cause -its meteorological significance; or suggesting its value in the sustenance of Life -but these would only describe its purpose -what it does- not its meaning. There is surely more to rain than water falling from the sky, just as there is more to Life than growth, reproduction, and change.

No, it seems to me that meaning points to something else, and a grammatical equivalent might be something like a metaphor.

I suspect it was an essay in Aeon by Jeremy Mynott, an emeritus fellow at Wolfson College in Cambridge, that rekindled my wonder about meaning in the world around us:

As he suggests, ‘Sometimes you need to look at things from outside to see them more clearly.’ And history can do that for many things -birds, for example. Before the days of over-population with its attendant pollution and habitat destruction, the much smaller aggregations of humanity were more intimately exposed to the perils -and beauty- that surrounded them.

‘The Mediterranean world of 2,500 years ago would have looked and sounded very different. Nightingales sang in the suburbs of Athens and Rome; wrynecks, hoopoes, cuckoos and orioles lived within city limits, along with a teeming host of warblers, buntings and finches; kites and ravens scavenged the city streets; owls, swifts and swallows nested on public buildings. In the countryside beyond, eagles and vultures soared overhead, while people could observe the migrations of cranes, storks and wildfowl. The cities themselves were in any case tiny by modern standards – ancient Athens, for example, had a population of about 120,000 at the height of its power in the 5th century BC.’

Things in nature impressed their physical presence on people’s daily lives to a degree now hard to imagine. ‘Not surprising either, therefore, that they also populated people’s minds and imaginations and re-emerged in their culture, language, myths and patterns of thought in some symbolic form.’ Some things -birds in his essay, at least- acquired a meaning beyond their mere physical presence.

Because Mynott is writing about the ‘meaning’ of birds, he goes on to describe how they became metaphors -there is ‘a simple progression from a descriptive fact about a bird (swallows migrate here the same time every spring), to a human comparison (that’s when we change what we wear, too) and then, in a natural and almost imperceptible segue, to making the bird represent something other than itself (a sign of spring, a reminder to start gardening, a valued guest). That is, a metaphor, something that ‘carries us across’ from one dimension of meaning to another.’

I think there is a very obvious parallel with other aspects of the natural world, too -rain, for example. And where he supplies examples of proverbs to bolster his contention of how the idea of birds has migrated into the realm of metaphor: ‘One swallow doesn’t make a summer’, there is certainly an equivalence in rain proverbs that do the same: ‘You need to save for a rainy day’, or ‘Rain does not fall on one roof alone’.

Metaphors work by having one thing stand symbolically for another, and by so doing, achieve a meaning far larger than the original.

When my children were young and beginning to learn the intricacies of language, they sounded very literal -so much so, that at times it was difficult to explain things to them without endlessly searching for another word to use for clarification: definition again. And yet, often they seemed to be searching for something more than description -and the perpetual ‘Why?’ questions that dog every parent are testament to that. No matter the skillfulness of the answer, it is seldom enough to satisfy their inner quest.

I’m not suggesting that this is necessarily indicative of children’s innate need for meaning so much as simple curiosity born of insufficient exposure to the world -or perhaps incipient mischievousness- but it is interesting that it seems to be a search for more than just a cursory explanation. Perhaps it is a developing awareness that there is more to reality than surface -an early, and tentative, exploration of Philosophy.

“Why does it rain, daddy?” my little daughter once asked. I remember the question because of her drive to understand more about rain.

“Well,” I started, unsure of the answer, to be honest, “… you know how sometimes the air around you feels wet in the summer?” I was on shaky ground already, but I pressed on when she nodded her head enthusiastically. “And sometimes if you look really hard you can see little water droplets on the window glass?”

I have to admit I was making it up as I went along, but her little face seemed so eager for more, I embellished it a bit. “Well, those drops appear when wet air touches something cool like the glass in the window. It’s called condensation,” I added, but more for my sake than hers, I think.

“So, is that where rain comes from, daddy?” She was obviously confused that windows didn’t usually rain.

“Uhmm, no but it was just a way of explaining that wet air sometimes condenses on cold things, and it’s really cold way up in the sky…”
“So…” I could almost see her processing the information behind her eyes. “So, are there windows up in the sky…?” That didn’t seem right to her, I could tell.

“No, but there are little particles of dust up there, and they’re really cold, so water droplets condense on them. And when there are a lot of them, you see them as clouds…” I was way beyond my depth, so I rather hoped she’d be satisfied with that. But I could see by her face that the machinery inside was still churning.

“So, clouds are rain before it falls…” There, I had told her all I knew about rain -more than I knew, in fact.

Suddenly, a large smile grew on her face, and her eyes twinkled mischievously. “You’re just kidding me, aren’t you daddy?”

My heart sank. We were walking along a trail in the woods at the time, and had stopped to rest in a little clearing; I hadn’t thought to bring an encyclopedia. I can still remember the flowers peeking through the grass like children thinking they could hide in plain sight and I shrugged to hide my embarrassment. “What do you mean, sweetheart?”

She grabbed my hand and looked up at my face. “There’s more to rain than clouds, daddy…”

I tried to look like the wise parent, but she was having none of it.

“Why do you say that, sweetie?” I said and held my breath.

She sighed and rolled her eyes like she’d seen me do so often. Then she pointed to an enormous fluffy cloud that was floating lazily just over our heads. “Miss Janzen at kindergarten says that rain happens when clouds cry…”

I didn’t know whether to nod in agreement -it was a kind of vindication of my explanation- or stay still, in case it was a trap.

She suddenly blinked and stared at the cloud. “You can tell that cloud doesn’t have any rain in it…” I smiled and waited for the explanation. “It looks happy, doesn’t it…?”

I’m not sure, but I suspect my daughter already knew about metaphors, even if she’d never heard the word… and perhaps she’d grasped the meaning of rain, as well…