The gift of accompaniment

I remember it from my medical practice; I remember it from dealing with friends with incurable illness: the feeling of helplessness in commiseration. The recognition that my often naïve suggestions, intended to help, were not what was required, nor even wanted, for that matter. Sometimes there are no solutions; sometimes presence –listening- in itself is enough… No, not enough, but at least comforting.

I suppose some people come to this realization naturally -instinctively understanding what is needed- while for others it is absorbed only gradually and after much trial and error. Some issues require solutions, guidance, and expertise, but some require the simpler yet more difficult task of companionship. Being there, often with wordless compassion. Silent empathy.

Not trying for control and directing things can be difficult, but usually there is a time for silence. Sometimes, there is an inevitability that simply has to be accepted. It’s a subject that many of us would rather not confront, and yet we have to -it is important. Perhaps that’s why I was drawn to the short essay in Aeon written by Nicholaos Jones, department chair and professor of philosophy at the University of Alabama in Huntsville. https://aeon.co/ideas/at-times-of-suffering-the-greatest-gift-is-accompaniment-by-another

Jones writes about the issues that often accompany suffering: ‘despair, dissonance and desolation: despair as hopes for the future confront the inevitability of fate; dissonance between an imagined future and present reality; and the desolation of being alienated and isolated when others withdraw.’ We want so badly to solve the problem, and console the suffering person that we find it hard simply to listen without interfering. Indeed, their despair can become our own.

A remedy he suggests -if that’s an appropriate word to use- is one of ‘accompaniment’, and his way of illustrating the process is, in itself, helpful and imaginative. ‘In music, the accompaniment is the musical part that supports the melody or main themes of a musical performance, as when an organist or guitarist accompanies a choir, or a drummer and bass player accompany a lead singer… accompanying another involves lending support to the other in ways that amplify or strengthen their efforts… accompaniment aims to acknowledge and engage with the efforts of another – not for the sake of helping the other achieve some goal that’s impossible to achieve on one’s own, but for the sake of enriching, and making manifest the value of, the other’s efforts.’

So, ‘To accompany another is to give companionship against despair… one who accompanies offers consolation, being with another in their solitude by creating opportunities for testimony, listening and hearing without judgment, and reinforcing the other’s dignity by acknowledging their experience and struggle.’

There’s something about that which strikes a chord, don’t you think? There are times when we need to recognize that not everything can be solved -an exceptionally difficult concept to accept. But, it’s important to embrace a truth the other knows all too well, and in so doing, embrace them. Indeed, ‘It succeeds not by resolving problems but by aligning with the other – experiencing the other’s suffering in common, allowing the other’s struggle to matter.’

I learned something about that in my early years of medical training when, as a third year medical student, I was assigned to the gerontology ward of a general hospital. In fact, it was a sort of bribe, I suspect: in turn for doing entrance physical exams and handling the nighttime preliminary calls by the nurses for the elderly patients, I was given free room and board.

There wasn’t really that much to it, so I spent a lot of time reading, and talking to the patients. One patient in particular, still stands out in my memory, however. Jane was a 94 year old, frail looking woman who always seemed to have her wheelchair placed near a window overlooking a little park in front of the hospital. Loosely strapped in the seat so she wouldn’t fall out when her head occasionally fell forward in a medication-enhanced somnolence, she never seemed to bother with any of the other patients who talked to each other while similarly positioned by the same window.

I was new to gerontology, and, apart from my recently retired parents, I had never before had much interaction with the elderly, so I wandered over to talk to her. I have to say I was a little unnerved by the thinness of her skin, the sparsity of the spiderweb hair remaining on her scalp, and the degree to which her cheekbones were so prominently on display. She kept grinding her gums together, almost as if her tongue was searching for some teeth and she barely looked at me as I pulled up a chair beside her.

“Hi,” I started, a little nervous about how to talk with someone so old. “My name is G -well anyway, that’s what everybody calls me- and I’m the medical student assigned to your ward…”

She turned enough to allow me into her head through two large rheumy eyes that rotated in their sockets as easily as well-greased ball bearings. A tentative smile appeared briefly on her thin lips, and then quickly disappeared. “How do you do?” she answered -rather formally, I thought. “My name is Jane… Did they send you over here to cheer me up?” she added, as if it was what the nurses did if they remembered.

I shrugged, rather embarrassed at the thought that I had been sent on an errand. “No… I’ve just seen you sitting here day after day, and thought I’d introduce myself.”

She studied my face for a moment and then blinked. “I thought perhaps they sent you to convince me to take some more of their pills.”

I wasn’t sure what to say to that -I was just learning to be a doctor. “Pills for what, Jane?”

Her face relaxed into another brief smile, and she looked away again. “Cancer, and pain, mostly…”

“So… Are you not taking them?”

“Sometimes -when the pain gets too bad, I relent a bit.”

“But…”

Her smile broadened and she finally turned her head to look right at me. “But you can’t convince me, G.”

I was confused. “But why don’t you take them?”

She sighed and her eyes softened as she tried to decipher my question. “I’m 94 years old,” she started, her voice soft and confident. “And I’ve had a good life. There’s no cure for Age, nor is there a cure for my cancer. The pills just make me miserable…”

“Are there no other pills they could try?” I was trying to make sense of her rebellion and she must have seen that.

Like two little birds, she sent her eyes to slowly circle my face before she allowed them to rest on my cheeks. I could tell she was trying to read my expression. I must have looked puzzled, because she reached over and grasped my hand to reassure me.

“I’m sure this is hard for a young doctor like you to understand, but I don’t fear Death…” she said, smiling at the notion. “…No more than I fear Life at any rate,” she added.

The idea of accepting death was new to me, and I suppose it showed on my face because she squeezed my hand more strongly this time.

“None of us can live forever, Dr. G. Life’s not a battle we have to keep on fighting… Eventually, we’re allowed to walk away if we want.”

I smiled and stroked her fingers with my hand. It was her eyes that smiled at me in response.

Thinking back to that time, I realized I had learned something they’d never covered in my lectures. Of course, Jones was right in his essay about the value of accompaniment, but I have to wonder if it was Jane who was actually accompanying me

I am undone

By now, you’d think we’d have a pretty good idea who we are. I mean, we’ve been assessing and predicting things about each other since… well, a long time. And because each of us feels a pretty unbroken identity from when they were a child, it probably makes sense to assume others do as well. ‘I am that I am,’ is the transliteration of what the voice in the burning bush told Moses. Identity is fixed; it’s only the attributes that change… Or are they actually co-dependent?

Is there another way of assigning identity other than by characteristics, or traits? One obvious way is by appearance, of course, although that changes over time. So, what is the form of identity for which we are searching in, say, a long lost friend? What are the interpersonal interactions all about? What is it that makes her that same person you knew, even if she now seems… different? Imponderables all.

I began to wonder if the whole question of what I’ve relied on to determine a friend’s identity may be couched in my expectations -as if they were buried, somehow, in what their peculiarities had meant to me, and therefore, perhaps, in what I hoped to get out of the  encounter. Who I, not they, in other words, had become.

Not certain if this was a helpful insight, I decided to keep an eye peeled for writings touching on the subject. An article, written by the journalist Carlin Flora, a former features editor at Psychology Today, but writing this time in the online publication, Aeon, seemed close: https://aeon.co/essays/are-novelists-or-psychologists-better-at-describing-people

Entitled ‘Indescribable You’ she asks ‘Can novelists or psychologists better capture the strange multitude of realities in every human self?’ She starts by quoting a paragraph of an author describing some of the attributes of a character in his novel which ‘touches upon [her] looks, social class, psychology and behaviours. It’s hard to imagine a better description, and it’s certainly superior to what people provide to each other conversationally or on dating websites. And yet, any particular reader will project his or her own stored images, memories and worldview upon [her]… we’re constantly describing ourselves and others.’

But, ‘Writers search for emotional granularity, consequential details and apt metaphors, while sociologists and personality psychologists have come up with sorting tools such as the ‘Big Five’ personality traits – extraversion, neuroticism, agreeableness, openness to experience, and conscientiousness… But across time and contexts, any of these characteristics can change… A million tiny human factors – tone of voice, brand of shoes, frequency of smiles – form a gestalt as difficult to pick apart as it is to pin down. If a person contains multitudes and is perhaps even infinite, how can we compare infinities? … This fluid state of affairs is often captured best by writers, who tend to have an agenda when delineating characters.’

Indeed, ‘Novelists know that behaviour is always more revelatory than a grocery list of traits… writers often expose not the ‘truth’ about someone, but rather the gaping distance between how they see themselves and how others view them.’

We seldom have omniscience, however: what we experience, is what we get, and any analysis is, by necessity, only temporary. Even if we have used the ‘Big Five’ personality traits in an attempt to categorize their tendencies, as Flora writes, ‘Tendencies, while real, are not as revealing as countertrends: a friend is an extravert, except when she’s with her colleagues. A daughter is agreeable at school, but pretty cranky at home.’ We are all contextually fluid in other words, and our -and their- personalities, quirks, and preferences are all bundled together.

This was on my mind when I saw her: the short thin woman apparently holding court with a friend in the middle of the Food Area of a large shopping mall. With her shock of fluffy red hair, and gesticulating arms it was typical Jane. If there were people around, she’d find a table somewhere amongst them, hoping for inquisitive glances that she could return with interest.

She had always been like that -all through university, at any rate. But I hadn’t seen her since graduation. We were frequent lab-partners in our biology classes because our last names both started with the same letter. Even when we first met, it was as if I’d known her for years -and since I hadn’t, there was a lot of ground for her to cover. Her curiosity was insatiable, both about me, and about whatever classes we shared.

I remember the time of our first assignment, when I found it difficult to risk dissecting the long-dead-and-pickled Taenia solium (pig tapeworm). I tried, unsuccessfully, to hide behind my eyes I think, but she just laughed, picked it up with her bare hands, and pointed out its frightening scolex through a magnifying glass she’d brought for the occasion. Jane was like that.

She was always a pleasure to be with, even if I didn’t want to talk. And if I didn’t ask her a question about something, she’d answer as if I’d meant to ask -always with a warm smile that threatened to break into a laugh if she caught me staring at her.

We both enjoyed each other’s company, so I’m not sure why we lost track of each other, but I imagine my being shy didn’t help. And then, of course, our career paths diverged and, well, new memories greeted us both.

And yet I never forgot her, so when I saw her unmistakable hairdo even from across the Food Court, I knew I had to say hello. I waited until her friend left to pick up their orders, and decided to walk over and say hello.

“Hi,” I managed to rasp, feeling dizzy because my heart was pounding so fast.

She looked up from her coffee with a start, and managed an embryonic smile for me. “Hi,” she answered, warily, and stared at me for a moment.

There was an awkward silence.

“I… I’m G,” I stammered, using the nickname she’d always called me. “Biology at McMaster…?”

The smile never left her lips, but her eyes scanned my face as if it contained a barcode somewhere that might help.

There was no question in my mind that it was Jane. She had the same olive-green eyes, the same slightly lob-sided grin she had always unleashed whenever she was puzzled in Biology class. “We were lab partners, in Biology… maybe nine or ten years ago…” I explained to the still baffled face

But, except for the little grin, her face remained a blank slate, and her eyes continued to sample my expression, hoping for a clue. Suddenly, they stopped, mid-scan and seemed to fixate on my hair. It was always bursting with unruly curls that I’d never been able to tame.

“Oh, yes… Now I remember you,” she said slowly, and a little uncertainly for my liking. “Didn’t you have trouble with a tapeworm or something…?”

I nodded hopefully.

“It’s nice seeing you again,” she added, obviously pleased with herself for remembering, even though her voice didn’t seem that happy I’d suddenly re-appeared in her life.

The painful silence returned and obviously neither of us could think of anything more to say. The thousand questions that had been bubbling through my mind seemed suddenly inappropriate. Things had changed.

I suppose time does that, though…

The robbed that smiles, steals something from the thief

I don’t know what to think of laughter anymore. I used to be happy with it solving so many issues, soothing so many cuts, but now I wonder whether it was only me all along just applying patches to the wounds. It would seem that humour is no laughing matter -or, rather, it’s the laughter itself that confuses the issue. And it’s not always fun and games that provoke it. There is a serious side to it as well. A guilt-ridden side.

Like most people, I suspect I have always taken the wonder of laughter for granted; it feels almost as delightful to witness as to perform. But it has not always enjoyed this role. I recently read Laughing Gods, weeping virgins, laughter in the history of religion, a 1997 book by Ingvild Selid Gilhus, a professor of History of Religion at the University of Bergen, Norway. I learned that laughter has evolved. She writes about a time when it was looked upon as sinful, or at least a tool used to maintain control by whatever gods a society honoured – it mocked or shamed disobedience.

Then in the medieval period, laughter was shunned as the secular body’s attempt to escape from spiritual control, escape from holding God foremost in one’s mind and it was suppressed with guilt. Of course, the occasional escape valve was necessary, so the church in France allowed laughter for the Feast of Fools and roles were briefly reversed, the lowly becoming powerful, the carnal spiritually acceptable.

A more interesting question, though, is why humour exists at all. Why do people laugh? Gilhus’ book only touched on its encounters with religions, and yet it seemed so much broader than that. We laugh a lot, it would seem -some studies suggest every 20 seconds in an average conversation. But studying laughter is fraught. As the authors, E.B. and  Katharine S. White observed, ‘Humour can be dissected, as a frog can, but the thing dies in the process and the innards are discouraging to any but the purely scientific mind.’

And yet, even bearing that in mind, there have been several theories that have attempted to explain laughter. One of them is superiority -we laugh when we think we’re superior to something. The purpose of the joke is to mock from a more exalted position. Freud had a say as well, feeling that we find something funny if had been repressed and then suddenly leaked out… I’m not sure how tenable that idea is, but Freud will be Freud, after all.

The theory that seems the most credible to me, however, is incongruity. This was championed by the French philosopher Henri Bergson and his popular essay published in 1900,  Laughter: An Essay on the Meaning of the Comic. He realized that it was difficult to subject such a pleasurable and universal experience to any meaningful analysis -much as having to explain why something was funny, means that it probably wasn’t. But the incongruous is difficult, or impossible, to reconcile and the very attempt, in Bergson’s phrase, is something ‘mechanical encrusted on the living’. In other words, artificial when it shouldn’t  be, and the realization of this juxtaposition is ludicrous and therefore humorous. We’re trying to recognize ourselves in something that isn’t…

I’m not totally convinced by that argument either, and yet it may be that he is simply referring to what happens when we attempt to solve the incongruity. And I suppose it’s the very attempt to reduce the process to reasonableness that bothers me. So it’s more in the inept exercise rather than the success of the explanation that leads to the humour in the situation -the incongruity made manifest.

But Bergson dissected things even further, and felt that if too many emotional states were involved -sadness, fear, melancholy, and so on- they would interfere with seeing something as humorous -interfere with our ability at laugh at it. How then, to explain the comedy in Voltaire’s alleged deathbed response to a priest who was encouraging him to renounce Satan? “This is no time for making new enemies” was his reply.

And yet, laughter also ‘appears to stand in need of an echo’ according to Bergson. I came across a readable article in Aeon that summarized it more broadly. The essay was written by Emily Herring, at the time, a postdoctoral researcher at the University of Ghent in Belgium: https://aeon.co/essays/for-henri-bergson-laughter-is-what-keeps-us-elastic-and-free  Evolutionary theorists have hypothesised about the adaptive value of laughter, in particular in the context of social bonding… Most friends share ‘in-jokes’ that are meant to be understood only within the context of their particular social group, as do certain communities brought together by a football team, political opinions, or shared specialist knowledge… Our laughter ‘is always the laughter of a group’, as Bergson put it.’

Again, though, is he still dissecting a frog only to have it die? This is remains much too reductionist for me. Somehow humour lies in its spontaneity, its unexpectedness. When it is contrived, it may result in laughter, but is it the same animal…?

For some reason, the question takes me back to those days of innocence when my children were young and everything was new and fresh to them. They helped me see the world differently.

I remember one time when my son was fascinated by the reports on TV of continuing protest marches in some country or other. Although he was only about four years old and not at all clear about the reasons for the demonstrations, he was obviously fascinated by what he kept referring to as the ‘parades’.

“But actually, parades are different, daddy,” he eventually volunteered as he watched with fascination.

Thinking he had perhaps grasped the angst of the people protesting against their government, I asked him what he meant.

He looked at me as if to say that fathers could be so unobservant sometimes. “There’s nobody standing on the sidewalks watching them… Everybody’s walking in the street,” he added.

“They’re all protesting,” I explained, realizing he might not understand the concept.

“Is that why they keep bumping into each other with their elbows?” he said, and smiled knowingly.

I had to laugh, but was it humour I was reacting to, or his awareness of the seeming incongruity of their actions? And did the distinction actually matter? Maybe innocent detachment – and unexpectedly naïve observation- is really how it all starts…

Neither here nor there

I don’t think I’m very good at handling conflicts -I hate confrontation; I prefer the view from the top of the Bell Curve where I can safely watch the goings-on of the extremophiles in their respective antipodes. I suppose that’s why I gravitate to boundaries where, if I’m careful, I’m neither here nor there.

This is probably not a recipe for success, let alone conquest, but nevertheless it is a position well suited to observe the vagaries of both sides. After all, the victors should not always be the arbiters of history -not even history lasts forever…

But what, exactly, constitutes an ‘us’ and ‘them’? I realize we all seem to fit into categories -much like we all belong to families- and yet, exclusion from one list doesn’t necessitate exclusion from another. The allotment often seems quite arbitrary in fact. Random. If a member of another sports team is injured, say, should I rejoice? Their loss might confer an undeserved advantage to our ‘side’, but surely it means less than if we’d won with both sides playing their best.

I know this sounds naïve, especially when applied to teams and competitions -it’s what games are all about isn’t it? You’re supposed to pick a side… But does the choice imply that you are therefore expected to dislike the other team? Hate them, even? I think not. And what about victory? Is it for all times, or given that it is a competition, does the other side have a chance at the next encounter? After all, if the results were always a foregone conclusion, it wouldn’t be much of a contest, would it?

With this consideration in mind, I thought it might be valuable to canvass various opinions as to the origin and value of the ‘us’ and ‘them’ thing. It turns out that there seem to be as many opinions as there are conflicting groups, so in a bid for compromise, I settled on a rather lengthy essay by the journalist Marek Kohn entitled, appropriately enough, Us and Them: https://aeon.co/essays/if-we-love-our-friends-does-that-make-us-hate-our-enemies

‘We come into the world with open minds, ready to tune in to whatever language or culture surrounds us. But as we lock on to the strongest signals, the others become less distinct. As our sense of ‘us’ develops, our sense of ‘them’ degrades… New-born babies gaze with equal attention at faces regardless of ethnic appearance, but by three months they prefer looking at faces from their own ethnic group… These findings are unsettling. They suggest that a sense of ‘us and them’, with its accompanying biases, can emerge from vital processes that are not directly concerned with sorting people into in-groups and out-groups… During its first nine months, an infant seems to refine its models by narrowing its focus. In the process, it loses its ability to recognise less familiar-looking people as individuals.’ Unless, that is, they possess some feature that appeals to it.

Kohn sites innumerable examples of studies that suggest, much like William Golding’s The Lord of the Flies, that we search for features with which we can identify -shirt colours, fashions, opinions, talents, and so on- and join the groups that serve our purposes. ‘Humans are not simply social beings but political ones. From playgrounds to corridors of power, they are constantly forming, modifying, ending and generally complicating alliances. Stable cues that signal alliance, such as speech traits or styles of dress, offer regularities that help people orient themselves.’

But, what should we do with them? Is it ever a justification for discrimination? Mistreatment? Kohn is disappointingly coy in his ultimate conclusions: ‘Perhaps we simply have to accept that the relationship between us and them is always a work in progress.’

I was thinking about this when I met some friends for our still physically-distanced meetings outside the local coffee shop. The four of us were an elderly eclectic bunch: Harjit with his turban, Arthur with his accustomed woolen sports jacket and tie, and Jeremy with his long, snow-white Santa Claus beard. I, alone amongst them, was appropriately attired in my grey long-sleeved sweat shirt and contrasting black sweat pants -you don’t overdress for coffee. All of us, according to the custom of the day, had our face masks hanging from an ear, or tucked into a handy pocket however -each of us was ready for a nearby sneeze or cough.

But Arthur was already complaining by the time we’d found a sufficiently large patio table that overlooked the grassy meadow of the adjacent park. “Look at them,” he hissed, pointing at a group of twenty-somethings walking through the grass towards some trees close to us. We all turned our heads to see who he was pointing at. “No masks,” he continued when he was sure he had our attention. “Not one of them…” he added with disgust evident on his face.

“But they’re outside, Art,” Harjit said. “Not everybody wears a mask outside. And besides, they’ve obviously just come from a baseball game -look at their uniforms. We were like that when we were their age… Immortal,” he added with a wistful smile.

“More like vectors,” Arthur grumbled and had a sip of his coffee.

“Except for age, they’re not so very different from us,” Jeremy said, brushing some doughnut crumbs out of his beard as he spoke.

Arthur rolled his eyes theatrically, and put his coffee down carefully on the rickety table. “Come on, Jer,” he said, shaking his head slowly. “The youth nowadays are all the same. Look at them. They’re crowded together, and patting each other on the back… very irresponsible if you ask me.” Nobody did, however -Arthur was very sure about things. Too sure, sometimes.

The crowd must have won their game, because they seemed in a jovial mood, and gathered at a bench under the trees. Soon, a couple of members of the losing team appeared from trees on the other side of the grassy meadow. In contrast to the winners’ red, both were attired in grey uniforms, but one of them was coughing badly.

“What’s wrong with him?” I could hear one of the reds yelling at the two greys.

“Don’t know,” the healthier grey answered back. “He suddenly got worse after the game. I’m trying to get him home,” he explained.

“Was he okay before…?” the red asked.

The healthy grey that was helping his friend shrugged. “He said he was a bit tired, but he’d been out partying last night, so…”

“I told you,” Arthur said in a low voice to the rest of us. “They don’t think of anybody but themselves -no thought for the rest of us in the community…”

Suddenly the grey collapsed, gasping onto the grass, and everybody on the red team stood around in a wide circle as one red ran to help the coughing man. “We’ve got to get him to the hospital,” he shouted, obviously searching for a phone in his pocket.

Nobody had one, of course, so the red yelled at our table. “Can one of you phone 911 for us?”

“He’s probably got Covid,” Arthur whispered to the rest of us.

But Harjit already had his phone out, and signalled to them he was phoning. “Can we help?” he yelled at the crowd, and started across the field towards them. Two of the players ran to stop him from coming closer.

“He might have the virus,” one of them yelled at him.

“I’m a doctor,” Harjit replied. “Or at least was until I retired…”

But the two reds blocked his way as one of them looked over his shoulder at the young man lying on the grass. “Thanks, but he seems to be settling now,” he added. “We can manage till the paramedics get here.” And he gently took Harjit by his shoulder and guided him back to our table. “Thanks again,” the red said to him again, and turned to leave.

“I think the youth of today are just fine,” Harjit said when he sat down with us again.

Fortunately Arthur decided to sip quietly at his cooling cup of coffee.

“We are all ‘us’ nowadays, I think,” Jeremy said as he added a few more crumbs to his beard.

You Don’t Say?

It’s hard to be upset by something you don’t know about. It’s hard to be offended if you don’t know you’ve been insulted. And, if somebody has to point out that you really have, then have you? For insults, snubs, or even rudeness to be effective, they need to be understood as such.

I think that explains some of those comments that seem to slip under the radar -comments that we could term ‘micro aggression’. Things like: “I’d really like to hire a woman for the job, but they take so much time off for family matters.” Or even worse, perhaps: “Women are beautiful, but they’re fragile.” Are they compliments or insults? Of course these examples are also forms of sexism, and nowadays more easily spotted.

Suppose, though, you had the distinct feeling that what was said was something that crossed a boundary, but you don’t know why? You couldn’t quite pin it down? Then, what if I had pointed out to you that they are really forms of something called ‘benevolent sexism’ and asked you for other examples you might have encountered? Would categorizing them help with subsequent recognition? I suspect it would -now that you were aware of a term that describes the action more fully, it becomes more apparent.

This hypocognition is far more common than I might have thought. The concept was nicely summarized in an essay in Aeon by Kaidi Wu, who was a doctoral candidate in Social Psychology at the University of Michigan at the time: https://aeon.co/ideas/hypocognition-is-a-censorship-tool-that-mutes-what-we-can-feel

‘It is a strange feeling, stumbling upon an experience that we wish we had the apt words to describe, a precise language to capture. When we don’t, we are in a state of hypocognition, which means we lack the linguistic or cognitive representation of a concept to describe ideas or interpret experiences.’ So, ‘Lacking the concept of benevolent sexism blinds you to its occurrence. Knowing the concept of benevolent sexism renders visible its manifestation.’

Then, Wu gives a more humorous example of hypocognition: shoeburyness -something that I, at least, had never heard of, and so wasn’t aware whether I had ever experienced it until it was explained: ‘shoeburyness: the vague uncomfortable feeling of sitting on a seat that is still radiating warmth from someone else’s bottom.’ See what I mean? Mind you, I have no idea where the word came from, nor does knowing it cure the sensation of which I was only vaguely aware before. But still…

As Wu explains, ‘As cognitive psychology affirms, having a verbal label – even a nonsensical terminology, an apparent portmanteau – can distil a nebulous phenomenon into an experience that’s more immediate and concrete… In the absence of an expanding lexicon, we default to denotations bounded by the traditional descriptors.’ So, an example she gives is ‘Single parents are routinely asked what it is like to be “both mother and father”’. Embarrassing, perhaps, and yet often the lack of an appropriate understanding is just that: a default assumption.

But what would happen if, instead of attempting to use other words, the awkward subject was ignored altogether? Swept under the carpet? Would that solve anything, or help to promote further understanding of the situation? Would refusing to discuss gender issues really help those who struggle with it? ‘Regulating what is said is more difficult than ensuring nothing is said. The peril of silence is not a suffocation of ideas. It is to engender a state of blithe apathy in which no idea is formed.’

Still, as Wu suggests, ‘the attempt at hypocognising a concept can often propel a more urgent need for its expression. The emergence of a unifying language of #MeToo gives voice to those who were compelled into silence…  Ideas and categories that are yet to be conceptualised leave open aspirational possibilities for future progress.’

Her essay was very compelling, I have to say, and yet I fear I still have a lot to learn.

I had just ensconced myself in my favourite table by the window of a little coffee shop I usually go to for breakfast when I saw Agnes in the line at the counter. She’d been a good friend of my ex-wife Sally, and I hadn’t seen her for several years now. We’d never been particularly close, and strangers since my wife left, so I was surprised when she brought her coffee over to an adjacent table.

“G,” she said, smiling and using my nickname. “I haven’t seen you since…” She hesitated for a moment, obviously wondering if it was polite to mention the divorce.

“Since Sally,” I filled in for her, trying to diffuse the awkwardness.

I could see her face relax, and her smile broadened, transforming her into the person I remembered from the dinner parties of yore. “So, how are you?” she continued, staring rather curiously at the pancakes and sausages on my plate. “Breakfast?” she asked, rather unnecessarily, I thought.

I nodded and had a sip of my coffee, following her example. “I like the selection here,” I answered.

She was quiet for a moment and then glanced at my plate again. “I’m surprised you go out for breakfast, G…”

I chuckled quietly to myself. “I eat out a lot, Agnes,” I said, although I’m not sure why I felt I had to explain my habits.

Her expression turned from curious to what I can only think was concern… Or maybe it was disappointment -she had always been difficult to read. “Sally said you often used to have dinner ready if she told you she was going to get home late.”

I shrugged – a little embarrassed, I suppose. “Well, nothing special, though -nothing like she could do, that’s for sure…”

I could see her eyes narrow almost imperceptibly, and then quickly revert to neutral. “So you don’t cook much anymore?”

I shook my head, and attempted a little self-conscious laugh. “Well, sometimes, I guess, but Sally was so good at it, I haven’t been able to duplicate it…” It was a bit weak, I realized. “She was such a great cook!” I added, almost hearing the exclamation mark. “In comparison, I’m afraid I just play in the minor league.”

But my feeble attempt of humour only caused her to look concerned again, and she, too, began to shake her head -but slowly. Sympathetically. And then she sighed, and fixed me with a curious stare. “Don’t you think that’s a bit of benevolent sexism, G?”

I was surprised at hearing the expression again. “Why do you say that, Agnes?” I asked, genuinely puzzled.

She smiled sweetly, finished off her coffee, and stood up to leave. “Because you’re boasting about her reputation at the expense of your own, G,” she explained and left without the slightest trace of irony. Only a wave and a wink.

Sometimes it’s good to hear another opinion…

Is Lateral a Direction?

Damn! There they go again, pulling the masks off the faces of those of us who grew up hoping we were uniquely creative; those of us who eschewed the logical pathway of thoughts and instead stepped off the trail to see if anything was hiding in the bushes. That’s what we lateral thinkers like to think we do -I say ‘we’ laterally, of course. Although I certainly wasn’t a child in the 1960ies, it was a time when my hormones had settled sufficiently to allow me to think of things further afield -more laterally than chromosomally. In fact, I suspect it still wandered more than I would have liked, but the era was wrapped in sunlight and the resulting chiaroscuro made it hard to look in one direction only.

The stage was set, it seems, for someone like  Edward de Bono, a Maltese doctor and researcher, to write The Use of Lateral Thinking which espoused just what I had found myself doing: relaxing the need for vertical (logical?) thinking. Actually, he decided that several things needed to change if we wanted to be creative: things like recognizing that some ideas were especially persuasive, so we needed to find different ways of looking at them -and this meant pursuing a different way of approaching and solving problems, even if it involved incorporating serendipity.

It struck me as a relaxing way to approach life and although I never really went in for piercings or drugs, I could see how it might be seductive to some people. But it’s hard to maintain a belief when people keep poking holes in it. And it’s especially hard to feel safe within a dogma when the innards of the pillars you thought were supporting the roof are showing signs of decay. Still, I imagine stuff evolves as time moves on.

I suppose I did, anyway, although I couldn’t quite surrender the suspicion that there was value in approaching questions as if they were actually answers in disguise -well, at least that was the message I took from the lateral thinking craze. And then, I happened upon an essay in Aeon by Antonio Melechi, an honorary research fellow in the department of sociology at the University of York, which seemed to suggest that lateral thinking was, of all things, a pseudoscience: https://aeon.co/essays/lateral-thinking-is-classic-pseudoscience-derivative-and-untested

Imagine my disappointment when I read that ‘Historians of science questioned why de Bono invested so much in the genius ‘eureka’ moment, when invention and paradigm shifts were more commonly the work of communal endeavour and disputation.’ Not that I’ve ever experienced a genius moment, or anything, but I’ve always revelled in sudden surges in understanding that seemed to spring from a good night’s sleep. ‘Psychologists had more questions than most. Lateral thinking clearly overplayed the importance of the creative breakthrough at the expense of trial and error, feedback and reflection, not to mention unconscious incubation.’

I suppose I’ve always been an incubator, though -much as the process may cast the strength of my underlying gender into shadowy regions. But nonetheless incubation, however unconscious, is still eurekoid, don’t you think? It’s still sort of lateral -something that conscious processes await until ideas can be suddenly and perhaps even mysteriously hatched from wherever.

De Bono and his lateral thinking has been criticized as being more derivative than seminal; but, does it matter who first named it? Melechi points out that, there has been ‘a long history of research into creativity, a rich treasury of thought and experiment that had almost certainly provided lateral thinking with most of its magpie principles and pre-owned methods.’ For example, in a lecture in 1880, the famous American philosopher and psychologist, William James ‘observed that the ‘highest order of minds’ had a knack for straying from the ‘beaten track of habitual suggestion… we seem suddenly introduced into a seething caldron of ideas, where everything is fizzing and bobbing about in a state of bewildering activity, where partnerships can be joined or loosened in an instant, treadmill routine is unknown, and the unexpected seems the only law.’

Actually, ‘Known to some Enlightenment philosophes as ‘negative imagination’, this mercurially creative sensibility remained in the shadow of pathology and degeneration for much of the 19th century, and it fell to a new wave of French psychologists to push for its study and rehabilitation.’ So, ‘the mathematician and polymath Henri Poincaré dug deep into the ‘sudden illuminations’ that punctuated his research. The unbidden insights that had propelled him to make discoveries across various fields were, Poincaré insisted, evidence of complex work being undertaken subliminally, over days and weeks, as he busied himself with unrelated issues.’

Gestalt psychology also identified the very notion of lateral thinking in all but name. ‘Wertheimer [psychologist Max Wertheimer] noted that logical-analytical thinking, or reproductive thinking, was hostage to repetition, habit and intellectual precedent. Insight and breakthrough, in science and everyday life, needed the irruption of ‘productive thinking’, the ability to look at a situation or problem from a new perspective.’

On and on goes the evidence to suggest that only the name ‘Lateral Thinking’ was new, and there I was thinking that I was finally surfing on a wave I could handle. That somehow it had unlocked the door to a personal heuristic (to use a lateral-thinkingly-derived change of idiom).

Perhaps there are no shortcuts to wisdom, though. There’s no sense in simply wandering through the woods only to stumble into an unsuspected field of flowers rather than the missing answer for which you were searching.

Is it a sign of Age, though, that searching always needs to be teleologically driven? Planned, in other words? That there needs to be a reason for the search, other than bald, ungarnished curiosity? That you need an already prepared question to get an answer…?

Answers lie all around us, scattered like those wildflowers in the meadow; surely what we really need to do is find the right questions. The right keys that fit the locks. I don’t know about you, but I have always travelled with questions stuffed in my pockets. And so, if I happen to stumble upon an answer I hadn’t expected to be sleeping just off the trail somewhere, I merely fumble around in my jacket for the suitable question that I didn’t even know I was carrying.

Is that Lateral Thinking?

Marginal Thoughts

Now that my salad days are merely photos staring forlornly at me from a tattered album, I sometimes wonder what they would think of the one squinting back. Would it be as difficult looking forward in time, as it is in looking back? Not only do features change, but so do goals. Thoughts. I am no more the bright-eyed child petting the dog in the picture than he is the wizened old man desperately trying to remember him. So what, except for the chromosomes that are slowly losing their telomeres, is permanent enough to link us together?

I think about that a lot, nowadays; perhaps I am drafting my own eulogy, although I’d prefer not to put it in those terms. There are always clues we leave for those who follow, but can we leave a trail for those who are in front? A diary might help, I suppose, but in my case I was sure my mother would find it along with the magazines I had to hide; it simply wasn’t worth the risk.

So my childhood followed obediently behind me like a silent shadow, detected only if I turned around. I regret that now, of course, but not when I was young.  I would never have thought that my past would seem as loosely attached as the buttons on my shirt are nowadays; sometimes I think there are more memories sewn to the books I’ve read than to the experiences I’ve no doubt had but haven’t specially saved and organized on shelves…

I was thinking of that recently, as I cast my eyes over some familiar book-covers. If only life was as revisitable as the covered books seem to be… I doubt if I’m still as easily recognizable as the stories. The titles I read were varied -perhaps even precocious- and I suppose they should have cast some light on the younger me, but they could as easily have been the futile attempts of a short, bespectacled boy’s attempts at braggadocio.

I have vague and ill-defined memories of reading the Compact Edition of the Oxford English Dictionary on weekends hunting for obscure words I could use in class: words such as ‘tarn’, ‘lugubrious’, ‘threnody’ and even ‘sesquipedalian’ briefly materialized in the linguistic mist when I thought more about those days. Still, maybe that was just a phase; surely I wasn’t that embarrassingly desperate the whole time. But who was I then?

Without ancient bones, or cave art to map the changes though, how can I now chart the evolution of my thought through what seems, from this end, to have been a rewarding, if idiosyncratic, life? Only the occasional photograph remains of those days. I’ve moved a lot, I suppose, and books seem to maintain their integrity in the dust of relocation that the loose scraps of unorganized photos do not. Well, at least that’s how I’ve rationalized it over the years.

So, here I am, approaching the terminus wondering about who it was who travelled along the largely solo route. I have to hope it’s not dementia kicking in, nor the result of expunging undesirable aspects of my personality. No,  it’s more of a philosophical conundrum: how do I know if I am the same person over the years? There is a chromosomal continuity perhaps, no doubt traceable despite the random copying errors, but how about the I? What knits all the I’s together -or must I just accept that they are the same ?

I was reminded of the almost apocryphal destruction of ancient knowledge that was stored in the great library in Alexandria when it was destroyed by fire around 48 BCE by Caesar. How could I ever really know who I was if there are no records of it? My books -or at least the ones I have managed to keep- are all I have of those days.

And then it occurred to me that I might have written comments in them: marginalia. Not in my medical textbooks, of course. Those I underlined, I remember -underlined and then wrote précis on foolscap pads to prepare for exams. Nothing personal in those – at least nothing sentimental; nothing of lasting value.

I decided to search for some of my favourite authors from high school and university. I started with Alan Watts -a writer I devoured in my late high school days, but the only book I could still find on my shelves of his was The Wisdom of Insecurity, and it was bare of comments. Then I turned to Hermann Hesse –Steppenwolf– but apart from a ‘Thank you for supporting the Girl Guides’ card hidden as a bookmark on page 134, it too, was bereft of clues about who I used to be -except that I have maintained my love of Girl Guide cookies through the years.

I moved on to my years in Medical School with my collection of the books of the famous Dr. Lewis Thomas (who I initially learned about through his column in the New England Journal of Medicine), but although I loved his style and ideas, there were, alas, no personal marks -indeed, nothing but the crinkled and sometimes smudged pages that bore witness to my passage.

I almost gave up at that point -there were just too many books- but in a final grab, I liberated Loren Eiseley’s The Unexpected Universe from a collection I found on an Ikea bookcase along with some old LPs. Unfortunately, there were no comments in the margins, no little snippets of my thoughts about the prose or images of the author -nothing quaint and revealing- but there were a few tick marks in the margins beside sentences or metaphors I’d evidently found appealing. Then, in a chapter titled The Hidden Teacher, looking more closely at the little marks I’d made to draw my attention should I ever pass that way again, I was suddenly captured as of old. It was Eiseley describing how he’d been taught a profound lesson by a spider and its web. He suddenly understood, after touching its web, that ‘spider was circumscribed by spider ideas; its universe was spider universe. All outside was irrational, extraneous, at best, raw material for spider.’ And as he proceeded on his way along the gully he had been exploring, he realized that in the world of the spider, he did not exist. And similarly, for the white blood cells of his blood, the conscious ‘I’ of which he was aware, had no significance to them either. He was, instead, ‘a kind of chemical web that brought meaningful messages to them…that among the many universes in which the world of living creatures existed… we were creatures of many different dimensions passing through each other’s lives like ghosts through doors.’ Something surfaced in my mind -something that had once stirred me to reverence was performing its magic once more.

I started to read the book again and began to remember what I was -what I am: I am the ghost passing through the dimensions of a different time, following the same thread, and caught in the identical web I wove so many years ago.

There is far more to me -or any of us- than the changing face in the mirror…

Yet Death will seize the doctor too

Death seems a lot closer now than in my youth; but it was always just around a corner, peeking out from traffic lights, hiding in the limb of a tree I might have climbed. And it’s not as if it suddenly surfaced when I retired either -death is a fact of life; we come from the void; we return to the void. But there are as many questions about death as about life, aren’t there?

What, except as polar opposites, are we to make of either? Is one the absence of what was once a presence –or is that too simple? Too much of a question from those who live? What might we ask in the void from which we sprang? Would we not now be considered equally absent from there?

It’s hard enough to winnow through the ageless questions without having also to wade through the countless theologies with their parochial answers. As if they themselves had arisen in the vacuity from which we are currently the temporary precipitates.

No, Death needs to be handled gently. Sensitively. I happened upon an empathetic essay with an intuitive feel to it a while ago by Stephen Cave from the University of Cambridge. A philosopher by training, he has also served as a British diplomat. https://aeon.co/essays/if-death-comes-for-everything-does-it-matter-what-we-kill

He was reminded of mortality when he accidentally squished a little fly that had been buzzing around his desk as he worked. It wasn’t so much guilt from his act, as the sudden transition from life to not-life that intrigued him. The parts that he once could identify were ‘in turn made of cells, each one of which is hugely complex. And in those cells, among many other things, are – or were – the fly’s genes, which in turn embody an astonishing intricacy and an ancient, multi-million-year history, while in the fly’s gut would have been countless bacteria with their own genes, their own goals. Worlds within worlds, now squidged together into a single dark smudge that I am already finding it hard to pinpoint among the scratches and coffee rings.’

All things die, and if not here and now, then there and whenever. It wasn’t that he’d changed anything significantly, but more that he’d ‘destroyed complexity and beauty many orders of magnitude greater than any [he would] ever create.’ Thus it seemed to him ‘quite reasonable to think that the death of the fly is entirely insignificant and that it is at the same time a kind of catastrophe… highlighting the inconsistencies in our philosophies, our attempts to make sense of our place in the world and our relations to our co‑inhabitants on Earth. The reality is that we do not know what to think about death: not that of a fly, or of a dog or a pig, or of ourselves.’

The death of one, sustains the life of another -that’s how it works, isn’t it? So what should we make of that? ‘In the language of ecology, life and death are obligate symbionts, each wholly dependent on the other. We too are built on a bedrock of old men’s bones. Our evolution to Homo sapiens is a product of the endless winnowing out of the unfit and the unfortunate.’

And yet, when the author squished the fly, he writes that he summoned the Reaper to his desk. ‘If only briefly, I caught his eye. If I had turned away fast enough, the fly’s death would have remained as insignificant as those of its invisible brothers and sisters caught by the swifts. But I was drawn instead inside its tiny head, drawn to imagine the great finger coming to squish me, my little life flashing before my bulging, compound eyes. Through a lapse in my indifference, I was drawn into the catastrophe, drawn to make its death my death.’

But does this polarity impose meaning on it? Should it? Cave talks about Tennyson’s concern on seeing animal fossils, and on Nature’s seeming indifference: ‘how she is so careless of whole species. She cries: ‘I care for nothing, all shall go’, and Tennyson concludes: ‘O life as futile, then, as frail!’

And yet we all create meaning -especially, perhaps, Tennyson: ‘death’s relentless reaping should lead us to question the existence of some higher meaning – one above, beyond or external to us. But whoever thought there was such a thing anyway? Not the frogs and tadpoles… Because life is so teeming with intentions and meanings, the death of each creature really is a catastrophe. But we must live with it anyway… the alternative is the most desperate and convoluted of denials.’

You can see the picture the author is painting: the tension of simultaneously holding two opposites in one’s heart. ‘To take both sides seriously and to seek some way to live with them is part of what it is to be human.’ The canvas is at the same time mysterious, yet affirming.

It takes me back to what could have been a destructive moment in my early childhood. One morning, after getting out of bed, I found my dog, Boots, lying on the rug by the door, but when I called him he didn’t move. He was quite old at the time, and had been slowing down on his walks with me, so my father had warned me that he might not live much longer. But Boots was so entangled with my own life, I couldn’t even imagine a life without him.

When my father heard me crying on the steps outside, he sat down beside me, put his arm around me, and waited for me to speak.

“Boots is dead, daddy,” I managed to splutter. He tightened his embrace. “He’s gone… forever…”

I remember my father taking a slow, deep breath and then sending his eyes to rest on my cheeks. “But he hasn’t gone, G -not really…”

I remember staring at him through my tears. “But…”

“He’s going to return to the earth again, but he’ll live in a different form.”

I thought about it for a moment. “You mean, as dirt, or whatever…?” He nodded. “But…”

He smiled sadly at my tears, and wiped one away that had made it down to my mouth. “Suppose we plant a baby tree over his grave?” He watched my face for a reaction. “Then you’ll remember him whenever you see the tree.” He smiled softly. “And when the tree grows, he’ll still be with us.” He winked. “Maybe even longer than us…”

In the moment, they were just words to me, I suppose -a dog is more than that- but in time, I came to realize just how healing it was. And although I have long since moved from Winnipeg, and even though my own leaves are now falling off, the Boots tree is still there whenever I return to check. Nature has a way of re-creating us as something else. We are, after all, the world.

Breathing health into a stone?

Are my emotions mine? That is, do they live inside me, or are they things that are shared -exist between me and others, in other words? Are they more the combination of genetic predisposition and situational features which are dependent on societal norms that we were taught from our early years at home and in the community?

It seems to me that it is an important point: where should we direct our efforts if we feel  emotions are getting out of hand? Is simply treating me sufficient, or am I the fabled canary in the coal mine? I’ve been retired from specialist medical practice for some years now, and I can feel my loyalties shifting. It’s not that I have joined the dark side, or anything -more that I can see both sides better from the border.

If we are to confront medical skepticism, it is a good idea to examine it from a historical perspective. I found a helpful essay by Bernice L. Hausman, professor and chair of the Department of Humanities at the Penn State College of Medicine in Hershey, Pennsylvania: https://aeon.co/essays/what-explains-the-enduring-grip-of-medical-skepticism

Early in her explanation, she writes that ‘while medical therapeutics have advanced considerably, many current treatments are also aggressive… Consider the expansion of disease categories to include personality quirks and body types, side-effects that demand further medications, drug interactions that are deadly, and medical supervision of things left well enough alone. If 18th-century medicine lacked a scientific basis, our problem might be too many therapies for our own good. The expansion of treatment has led to a critical response – ‘medicalisation’, which describes a skeptical approach to mainstream medicine’s social role in defining health.’

Indeed, what is ‘health’? Is it merely a state of being free of injury or illness, or is there something else involved as well? Something that medicine often fails to address: who has the social authority to decide what constitutes health -not so much for society as a whole, but for the individual? And how it should best be treated, for that matter?

Take an old example: TB. The proximate cause, of course, is the tuberculum bacillus, Mycobacterium tuberculosis, but in some sense the bacterium is merely opportunistic. The ultimate, or distal cause may well be something like impaired immunity from malnutrition or poverty. So, which cause should be addressed -the proximate one, of course, but should we leave it at that? Is it enough to rub our hands and say ‘done’? For that matter, to whom should we look for a remedy?

But, the problem is still with us -for example, the current pandemic of Covid 19 with its massive social and economic upheavals. From time to time, there has been promulgated the exculpatory mantra that the virus knows no boundaries; the virus does not discriminate, unlike our political borders. But of course it does. The communities of colour -African American and Latino, in America at least- seem to be disproportionately affected. Why? Well, there are a few obvious factors at play. ‘African-Americans have higher rates of underlying conditions, including diabetes, heart disease, and lung disease, that are linked to more severe cases of COVID-19′. And, ‘They also often have less access to quality health care, and are disproportionately represented in essential frontline jobs that can’t be done from home, increasing their exposure to the virus,’ according to a report (May30/2020) from NPR.

And, from the same report, ‘Latinos are [also] over-represented in essential jobs that increase their exposure to the virus… Regardless of their occupation, high rates of poverty and low wages mean that many Latinos feel compelled to leave home to seek work. Dense, multi-generational housing conditions make it easier for the virus to spread.’ Of course, by now that is old hat… isn’t it?

I suspect I saw it differently when I was in practice, but perspective is often beguiling -the old aphorism about the hammer and the nail, perhaps? ‘In Medical Nemesis (1975), Illich [the intellectual iconoclast, Ivan Illich, a Croatian-Austrian Catholic priest] made a starkly prescient argument against medicine as a dangerous example of what some call ‘the managed life’, where every aspect of normal living requires input from an institutionalised medical system. It was Illich who introduced the term ‘iatrogenesis’, from the Greek, meaning doctor-caused illness. There were three levels of physician-caused illness, as far as he was concerned: clinical, social and cultural. Clinical iatrogenesis comprises treatment side-effects that sicken people. Social iatrogenesis describes patients as individual consumers of treatment who are self-interested agents rather than actively political individuals who could work for broader social transformations to improve the health of all.

But, cultural iatrogenesis is the one that interests me the most, I must admit: that ‘people’s innate capacities to confront and experience suffering, illness, disappointment, pain, vulnerability and death are [being] displaced by medicine.’

Illich thinks that ‘medicine takes a technical approach to ordinary life events, hollowing out the rich interpersonal relations of caring that defined being human for millennia.’ But to be fair, Illich still felt that ‘Sanitation, vector control, inoculation, and general access to dental and primary medical care were hallmarks of a truly modern culture that fostered self-care and autonomy.’ He was more concerned with the impersonal bureaucracy that surrounded medicine. An interesting criticism, and one that I also share -albeit one that seems to stem from the medical system as he saw it from south of our Canadian border.

And yet I think the thrust of Hausman’s essay was more a reaction to the disillusionment that followed the initial promise of modern medicine. Things like delegating the definition of health to professionals who have a vested interest in defining it in a way that seems to mandate the continued need for them. I think this view is unfair, but, given Illich’s iatrogenesis concerns, I can see how that attitude might seem plausible.

Have we doctors been -are we still- sometimes too aggressive in our treatments, too arrogant in our knowledge, too certain of our advice, and too resistant to alternative approaches? I’m not suggesting that we cave to pseudoscience, or acquiesce to theories just because they are currently fashionable; Science is never perfect, and is open to change. But still, primum non nocere is a good aphorism to guide us: First of all, do no harm. I seem to remember promising something like that in my medical oath…

Gedankenexperimentophobia

It’s fun to play with thoughts, to riffle through ideas, don’t you agree? Take ‘thought experiments’ for example -think up a problem, set some parameters to confine it and see what your brain, unconstrained by external reality, comes up with. It’s almost akin to the Scientific Method some would argue: ask a question; form a hypothesis about it; make a prediction based on the theory; test the prediction; and finally, come to some conclusion. But is it? Can a mind sitting quietly by itself in an armchair, circumvent the need for external reality?

Ever since I first heard it, I have felt uncomfortable with ‘the Trolley Problem’. There have been several iterations of it over the years, but by and large it consists of a runaway coach on a track that is approaching a switch. Down one track is a single person, whereas down another are several people. The coach cannot be stopped, the person (or people) cannot get out of the way, but the switch can be thrown to direct which track is used. The question, of course, is which track to use -either track will result in death.

What does the choice of one track or the other say about the person who has to decide? About their morality? About ethics? About anything, really? It seems far too monochromal for my liking. And, unlike its real-life cousin, by definition a thought experiment cannot really be subjected to any rigorous objective analysis. It’s more like an experiment done in a lab where all parameters are carefully controlled, unlike what would happen in the real world.

But for years I’ve wondered whether my discomfort was misplaced. After all, Einstein used thought experiments. My concerns, like an unused city lot, lay fallow until I wandered into an essay by James Wilson, a professor of philosophy at University College London: https://aeon.co/essays/what-is-the-problem-with-ethical-trolley-problems

As he writes, thought experiments are ‘short hypothetical scenarios designed to probe or persuade on a point of ethical principle. Such scenarios are nearly always presented context-free, and are often wildly different from the everyday contexts in which ethical sensibilities are formed and exercised… Even when scenarios are highly unrealistic, judgments about them are thought to have wide-ranging implications for what should be done in the real world. The assumption is that, if you can show that a point of ethical principle holds in one artfully designed case, however bizarre, then this tells us something significant.’

Sometimes, however, when considered as things that might happen in the real world, we can envisage other conditions that would invalidate, or at least complicate, any conclusions drawn in the thought experiment. We know too much, as it were. ‘Thought-experiment designers often attempt to finesse the problem through an omniscient authorial voice that… is able to say clearly and concisely what each of the thought experiment’s actors is able to do, their psychological states and intentions. The authorial voice will often stipulate that choices must be made from a short predefined menu, with no ability to alter the terms of the problem. For example, the reader might be presented with only two choices, as in the classic trolley problem: pull a lever, or don’t pull it.’ Exactly.

So constraining the choices limits the possibility of novel approaches to the stated problem. ‘Imaginative ethical thinkers look beyond the small menu of obvious options to uncover novel approaches that better allow competing values to be reconciled. The more contextual knowledge and experience a thinker has, the more they have to draw on in coming to a wise decision.’

But there are at least two other difficult challenges with thought experiments: internal and external validity. ‘Internal validity relates to the extent to which an experiment succeeds in providing an unbiased test of the variable or hypothesis in question. External validity relates to the extent to which the results in the controlled environment translate to other contexts…[but] the very features that make an environment controlled and suitable to obtain internal validity often make it problematically different from the uncontrolled environments in which interventions need to be applied.’ In other words, the world just doesn’t work like that.

I remember trying out the Trolley Problem on the guys who meet for coffee some mornings in the food court. I wondered if they felt the same unease with it as I did.

“So, which track are you going to switch the trolley onto?” I asked, after giving them a brief summary of the thought experiment.

Burt put his doughnut back on the paper plate, and wiped some sugar off his cheek. “It’s so obvious, G -I’d ring the bell. All trollies have bells, eh?”

“But what if the workers on the track don’t hear it…?”

Burt rolled his eyes, as he brushed a lock of his paper-white hair off his forehead. “I’d keep ringing it. The workers would hear it when it got closer…”

“But suppose the workers are tied to the track.”

Burt glared at me for a moment. “You didn’t say that. And anyway, why would they be tied to the track? That’s a bit Little Orphan Annieish, don’t you think?”

I decided to relent a little to make it more -what?- real worldy. “Okay, let’s say they’re just deaf…”

Burt was clearly unmoved by my compromise. “Still…”

Jason, who had been quietly munching on a bagel put his hand up.

Burt sneered at the hand. “You’re not in school, Jas…”

Jason blinked and lowered his hand, and then glared at Burt. “Whatever. Anyway G, you said they were working on the track. They’d be able to feel the vibrations on the rails from a moving trolley, so that would warn them to get out of the way.”

I had to sigh; the guys were not really getting into the spirit of the ethical problem I’d offered. “I don’t know how much warning that would give, but let’s say they weren’t actually standing on the rails…” I had to think quickly here. “Let’s say they were on the ties between the rails then.”

Arthur, who had been teacher before he retired, sighed loudly and shook his head. “You folks are missing the point.”

Burt took a big bite from his doughnut. “The point being…?” It was hard to distinguish word from doughnut, but Arthur ignored the sounds.

“It seems to me the problem is bimodal.”

I smiled and nodded my head at him -finally somebody understood the ethics at stake. “Correct,” I interrupted, “There are two choices: the left track or the right track -several deaths, or one death. Which one would you choose, Art?”

He glanced at me quizzically. “I didn’t say there were two choices; I said bimodal: values occurring most frequently in the data set we were given…”

Jason, Burt and I stared at him, but it was Burt that summed it up. “You had too many cookies, Art…?”

It was Arthur’s turn to roll his eyes. “What I mean is that we have to consider two data streams that affect the choice of track…”

“Too much sugar in his coffee,” Jason whispered to Burt.

Arthur ignored them. “First of all, there’s the trolley driver. He would be ringing the bell, of course, but presumably to be allowed to drive the trolley, he’d have been expected to know about things like the switch signs that indicated which track was open.” He stared at me. “Would that not be the case?”

I shrugged, but I had to agree with him.

Then a wry smile appeared to hover tentatively along his lips. “And then there is the person whose responsibility it is to work the switches.” His smile softened briefly. “A very important job, as you can imagine.”

None of us disagreed. I was more interested in where this was leading, though.

“So,” he continued, “We can assume that the switch person knows that the driver has to have some expertise in reading the switch signs…” He looked at each of us for a second to see if we were following him. Nobody moved. “Therefore, the switchman flags the approaching trolley to let the driver know he understands the trolley is out of control, and then sets the switch only at the halfway position. The driver would see this as an uncompleted switch and realizes it will derail the trolley, so he jumps clear.”

Arthur sat back in his chair this time with a big sloppy grin on his face. “So, nobody dies. Problem solved…”

I suddenly remembered that scene in Shakespeare’s Hamlet: There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy.

I wonder if Hamlet could have resolved the Trolley Problem as quickly as Arthur, though.