Wednesday, February 20, 2008


Human Development Trends

Tuesday, February 12, 2008

Arthur Schopenhauer

All truth passes through three stages.
First, it is ridiculed.
Second, it is violently opposed.
Third, it is accepted as being self-evident.

Arthur Schopenhauer (1788–1860)

Saturday, February 09, 2008

All movement is information

All movement is information. In falls and road traffic accidents that is obvious because injuries tend to be musculoskeletal. It is less obvious in respiratory tract infections, heart failure and abdominal pain. Obvious or not, the information remains germane.

It is not possible to state explicitly the differences in the movements of patients with renal colic or cystitis or appendicitis, but the gestalt is distinguishable. A great deal of medicine is observation.

I often ask patients to move and those accompanying – friends, relatives and carers – frequently attempt to assist and I must ask that they do not. Always, I have to explain that I need to see them move themselves unless I wish to be misconstrued as callous. Sometimes, I expect, I am still so construed....

The drooping lid of myasthenia, the tremor of hypoglycaemia, the swallow-cough of stroke, the hunching of kidney stones and the pursing of emphysema all constitute relevant information.

Watch, observe and diagnose.

Monday, February 04, 2008


Wisdom leads to wiser choices in wicked domains. A choice is wiser if the benefits are greater for more people, but such a utilitarian argument is intrinsically oxymoronic. Wisdom is necessarily humane.

The uber-rational is not wise. There is a component to wisdom beyond defined scales of costs and benefits. The humane subsumes compassion and empathy.

To be wise, one must be engaged, caring, accepting and generous. This implies that wisdom is an orientation more than a skill in the same way that trust is an orientation. This means that building wisdom is entirely different to and separate from thinking better.

To be wise then, one must orientate differently.

The principles of medical ethics seem wise: to avoid harm, to act for the good and to respect the choices of those who consult us without neglecting the rights of the wider society.

These principles seem wise because they contextualise all our interactions in place, time and community seeking a balance. It is a dynamic balance that needs to be actively maintained.

Wisdom then must include an acceptance that understanding is developmental, that we were lesser and will be greater yet if we can be more inclusive whilst making finer distinctions.

Better thinking and widom are different: as you sow, so shall you reap....