nANIMOv

Isn’t it kinda strange that we mute ourselves over Zoom during group conversations? I’m not talking about lectures or presentations, I’m talking open-form, group conversation. Do people not trust themselves not to interrupt that much? But we typically have no problem with that in in-person settings. I feel like in Zoom culture the self-mute has become more of a way to indicate that you have nothing to say or that you have no intention of saying anything or to justify awkward silence, even though we tell ourselves that we do it out of “respect” for whoever is speaking at the time.

Sure I understand muting if you got a bunch of background noise or if you don’t want to broadcast your chewing or gulping or typing sounds, but personally if I am speaking its kinda nice to get “verbal” feedback (/affirmative sounds) from the people I’m talking to or at least see that the potential is there.

This is a common quip used to counter people trying to make a point of a seemingly insignificant moment or interaction. It’s a valid argument in some cases and trying to make gravity out of levity can definitely be off-putting or ruin “the vibes.” That said I think it’s also important to pay attention to when and how it’s being used. It ain’t that deep. It’s just a joke. Why so serious? All these phrases are defensive and are often used (often not intentionally) to invalidate the feelings of individuals with valid concerns and to deny the impact that their (or someone else’s) words had another person, regardless of the intent. In many cases phrases like these can be used to dismiss microaggressions which perpetuate cultures and attitudes that further suppress already marginalized populations.

At the same time I think its important to recognize the reverse perspective. People need to give each other the benefit of the doubt in conversation. If I hear something that I think is inappropriate or that is “triggering” especially from someone I know well, I would like to think that their intentions were not bad, and rather than lecture or attack them, I can ask for clarification or expresses my concerns in a non-judgmental way.

Though from there it is also on the “offender” to not feel offended themselves by a perceived attack on their character. And this can go back and forth forever. Human’s are fragile creatures, but I think the more we seek to understand each other as opposed to seeking to impose our worldview on each other, the closer we can get to making genuine progress on issues that really matter.

I just finished The Undying by Anne Boyer in which the author recounts her painful experience with breast cancer and its treatment and the culture associated with it in striking poetic prose. In it Boyer quotes Diane di Prima’s Revolutionary Letter #9,” 1. kill head of Dow Chemical / 2. destroy plant / 3. MAKE IT UNPROFITABLE FOR THEM to build again.” This was written in its own context, and Boyer applies it to her own, and reading it in Boyer’s context I can apply that version to my own context (such is art right?).

If we want to make lasting change in the world around us, old infrastructures, and the people and cultures that create and sustain them need to be destroyed. If I want to make lasting change within myself, it can be a bit trickier, but I can apply a similar framework:

“1. kill head Dow Chemical”
Dissociate myself with the person I am in the present.

“2. destroy plant”
Free myself from the environment that sustains the behaviors I want to change.

“3. MAKE IT UNPROFITABLE FOR THEM to build again”
Make it inconvenient or burdensome to return to the old ways, and find joy in the desired behaviors.

Of course all of this is easier said than done, and like many great revolutions throughout history a catalyst is likely needed.

There are so many sci-fi and superhero TV shows and movies that depict creatures from other planets. These beings developed lightyears away from Earth in their own unique environments and their own set of selective pressures, and yet they always seems to be humanoid in form, laterally symmetrical bipeds (at least the most advanced and “highly evolved” ones). Not only are they similar physically, but culturally and socially as well, or at least the dominant culture and social norms of the species are extremist or ideal versions of common ones on Earth. In many cases these beings come from highly advanced societies compared to Earth in terms of technology and chronological age suggesting that they are truly the epitome of evolution where they are from, Kryptonians, Viltrumites, Titans, to name a few.

Sure there’s an argument that humans are the dominant species on Earth, and therefore there must be some objective truth to the supremacy of our form, but honestly I think humans just got lucky. The right extinction events, the right mutations, the right pressures, the right environmental conditions, at the right time. As wonderfully organized as our bodies can seem on dissection I don’t think they are particularly advanced compared to other animals, its our brains that are highly developed, much more so than our bodies. I am convinced that if cephalopods, with their independently-moving tentacles and adaptive bodies, were the creatures to develop our current level of “intelligence,” instead of humans, that species would be interplanetary already.

All that said I also realize that its harder to make stories for humans with characters that we can’t relate to in some way or human form is needed in some way to drive the plot forward, so it makes sense to stay away from weird looking alien main characters when you are making a story about humans or a commentary on humans. I do think the movie Arrival does a really good job imagining beings whose understanding of the universe and the way they interact with it is beyond our immediate comprehension.

There are a lot of good words relating to the gastrointestinal system. Motility. Peristalsis. Tubular. Bladder. Duodenum. Jejunum. (Not you ileum). Pylorus. Omentum. Peritoneum. All these words have a very…soft and warm feeling to them, though maybe because they are by definition related to guts. But I think there’s also something about the rhythm and sound of these words that give them a kind of relaxed quality.

Yesterday morning, I went outside to meditate as I have been doing. Part of my meditation routine includes a body scan, so I was just going head to toe noticing how different parts of my body were feeling. When I got to my throat I noticed that I was feeling a little dehydrated and I had that classic lump in throat feeling. From there I decided to do the rest of the body scan tracking internally along the GI tract, which I thought could double as pseudo-studying for my upcoming exam. I began to imagine myself as a bolus traveling through my own GI tract. Something about the idea of being fully enveloped and slowly propelled through the soft tissue of the gastrointestinal system is honestly quite relaxing. First gently, but deliberately making my way down the esophagus, being undulated and massaged by the walls the stomach, and then molecularly deconstructed in the small intestine as tiny villi and microvilli brush across…or rather through my contents. Then, nearing the end of my journey being squeezed and compacted by the colon, and finally, release as I graduate into the world as a freshly born stool.

Ah, to be a bolus.

We all have our own self narrative; the story we tell ourselves about ourselves. Who we are. What we stand for. Why we are here. Where we are going. Whether or not that story matches with reality is an important point for introspection. Am I really the person that I tell myself I am, or the person I want to be, or the person I want people to think that I am? If not, why not? How can I move closer to being protagonist of my story? How can I make my story more dynamic?

Currently the character of my story has some pitiful traits and habits despite the loftiness of his aspirations, but if the story started out with our protagonist already able to do everything they set out to do, that wouldn’t be much of story now would it. It’s up to me though to decide where that inflection point is going to be.

When people think of entropy, they typically think of it as a measure of “disorder” or “chaos”. But entropy is a bitt more elegant than that as Steve Mould may be able to convince you. I like to think of entropy as more of a statistical phenomenon. There are simply more possible states in which energy/ particles/ etc. are spread out in a given system. When you have a high concentration of energy or when you have an energy differential, then you have movement of energy and interesting things can happen (engines turn, phones light up and buzz, flowers bloom)…..until that differential eventually evens outs.

What if we thought of ideas like energy or gaseous particles? In a confined space those idea particles will merely bounce around aimlessly in their container (i.e. your brain) and only interact with other idea particles that exist within that space. However, as new ideas come into our head from the outside (where there is a relatively high concentration of ideas) they have an opportunity to interact/ react with the existing idea particles.

Most of those reactions will produce worthless products, while a select few will produce valuable ones. How can we increase the likelihood of getting a valuable product? Simple, introduce more numerous and more various idea particles. Alternatively (or additionally) you can change other conditions within the system. For example, you can increase the energy of the system, increasing the rate at which those particles interact; after all, some reactions require a lot of energy behind them before anything noticeable happens.

But ideas aren’t finite. Our body can produce ideas. Like the energy we produce, those ideas are just the metabolized form of something we consumed previously. However, unlike energy, laws of conservation don’t apply to ideas. Once we loose an idea upon the world we don’t lose it ourselves. In this way, ideas are an infinite resource and we all can contribute to a limitless creative entropy, but only if we choose to both open our minds to ideas from the outside and free our own ideas from the confines our own minds.

What’s cool about puzzles is that every time you find the spot where a specific piece uniquely goes, it becomes ever so slightly easier to find the next piece. If we think about it mathematically, for example for a 500 piece puzzle, each time you find a piece, that removes one piece from the pool of possible pieces. So if you took one piece at the start of the puzzle and were to try each piece at random for a specific side on that original piece you would have a 1/499 chance of finding it. Once you do, the chances of finding the next piece for a specific space adjacent to those would be 1/498, and the progress should look something like this graph:

This doesn’t factor in edge and corner pieces or the fact that only certain pieces can go in certain spots based on their shape (for example a piece with protrusions on all 4 sides can’t possibly go next to another piece with 4 protrusions).

To me there’s some comfort in knowing that every time you find the piece of the puzzle it’s only going to get easier from there. And easier, and easier, and easier. Yea it’s gonna be slow going for most of it and along the way you may hit some road bumps or miss some super obvious pieces, or you may rule out the right piece early on because it didn’t look quite like what you were looking for, but each piece, each bit of information brings you closer to the finished product, and the only way forward is to to keep plugging away.

I just finished reading Attending by Ronald Epstein. In this book Dr. Epstein talks a lot about having presence as a physician. Presence here being more than physical, but emotional, intellectual, and “spiritual” as well.

As I’ve mention in a previous post, I received this book from a mentor and friend of mine who I met through Doctors Without Walls. When I started volunteering with the organization, I really knew nothing about street medicine or people experiencing homelessness. As the story goes, after a few weeks I fell in love with the organization and the people I met through it, patients and volunteers a like. For a long time I wondered what it was about those first few clinic days that made such an impression on me and inspired me further to go into medicine. I feel like I always had an idea and this experience is something I have written and talked about numerous times in applications and interviews, but it was always kind of vague. I would talk about how I was inspired by the team of volunteers and was motivated by compassion towards the patients, but this book has given me new language to talk talk about this experience more specifically.

What impressed me most all those years ago was the presence of the volunteers. Working in street medicine, not only benefits from, but in fact requires you to see a patient as a whole person. If you plan to have any level of success in treating someone on the streets, you have to know their whole story; where their from, where they sleep, what they do during the day, who they hangout with, what they know, what they don’t know, how they get around, where they get money, what resources they utilize (or don’t utilize), etc.

One could argue these are all things that should be a requirement for working with any patient, but I think when working in clinics or in specific environments, a lot of these factors can be taken for granted or are deemed socially inappropriate to talk about. And why I think it was hard for me to articulate all of this before is because when my senior volunteers were present with patients, it felt so seamless and natural that it didn’t feel like anything special was happening, which is ultimately what made those interactions so special, it was just a conversation.

This is the exactly presence that I think Dr. Epstein is talking about and that which he proposes we bring into all settings as healthcare providers, as physicians (who are stereotypically lacking in this area, at least in recent history), and just as people.

I feel extremely fortunate to have had such amazing examples of this presence prior to starting medical school, one of whom passed away this past week. So this goes out to you Fr. Jon, a beacon of compassion and a truly unforgettable presence.