Gone is the time when people believed that medicine could cure all known illnesses and the doctor was the high priest of the arcane rites. The advent of the internet has meant that patients may be as informed about their diseases as their doctor and the medical consultation is more a dialogue between experts than a trip to the Oracle. It’s more about containment and management than cure. Popular acceptance of the healing arts practiced by alternative and complementary therapists has led to a greater understanding of the core relationship between mind and body in the achievement of well being. 

By far the greatest demand for gastroenterological services comes from patients with recurrent or chronic symptoms of dyspepsia, abdominal discomfort and bowel upset and long term conditions such as Irritable Bowel Syndrome, Chronic Liver Disease, Inflammatory Bowel Disease, Coeliac Disease and Barrett’s Oesophagitis. A modern GI service will not only need to respond rapidly to gastrointestinal emergencies, but also to monitor and facilitate  the self care of long term gastrointestinal conditions. 

In the future, more patients will be encouraged to care for themselves while their condition is monitored with simple blood and stool tests in their local health centre. There will be greater emphasis of self help groups, which could  be facilitated by specially trained health care professionals; practice nurses, dietitians and counsellors, and resourced by the third sector; the patient charities (e.g., Core, Coeliac UK, CC(UK) and The IBS Network). The IBS Network, for example, publishes its own self management plan, operates a telephone helpline and offers medical advice by email.

Patients with long term gastrointestinal conditions crave the confidence of a consistent, responsive and reliable service. This may well be better supplied within the patients’ locality, avoiding unnecessary referrals to hospital and allowing gastroenterologists to focus on the increasingly sophisticated and complex diagnostic and therapeutic procedures required for the more life threatening and complicated conditions. 

Freed up from day to day management of chronic conditions, it could be that specialists will adopt a more supervisory and educational role, monitoring the test results of patients with chronic life threatening GI illness through shared websites, responding to email enquiries from local health services, training local health care professionals, advising patient charities, and  preparing educational videos to be disseminated via local television services.

There will be less separation between primary and secondary care in future.  It seems likely that the bulk of gastroenterological services, including diagnostic endoscopy, will be conducted within local hospitals and health centres, which specialists will visit to advise and consult. For example, dyspepsia could be managed in the community with a test and treat approach to H. Pylori, while health teams will be set up to tackle major public health issues such as chronic alcoholic liver disease and obesity.

Population screening will be increasingly important.  It is already here for bowel cancer and it is likely that simple, sensitive and specific biomarkers will become available for other abdominal cancers; pancreas, ovary, liver, stomach and oesophagus as well as coeliac disease, IBD and viral hepatitis.

And as always, the focus of gastrointestinal research will continue to shift with fashion, establishing evidence for changes in health care, improving outcomes, eliciting patient experience, estimating the nature of well being, developing appropriate biomarkers for screening tests, and seeking insight into the relationship between the gut, the mind and the alien within, the all consuming intestinal microbiome. The future may well be not so much orange but beige or brown!

This was the piece I was asked to write to celebrate Core’s 40th anniversary.  Core, previously the Digestive Diseases Foundation, is the charitable limb of the British Society of Gstroenterology.  

Jules Henri Poincare (1854 – 1912) was in trouble.  The most famous mathematician of his generation,  he set himself the task of predicting accurately the orbits of the earth, moon and sun.  His solution was brilliant. It was nominated for a prestigious international prize, but just before he was due to present his theory and collect his award, he found he had made a mistake.  If he had used different assumptions at the outset, he would get very different results.  Mortified, he wrote a follow up paper explaining his mistake, but in so doing, made the first mathematical contribution to what became known as chaos theory,  though this aspect of his work was largely ignored until the 1970s when ‘chaos’ became the rule for many systems.    

Chaos is evident in all aspects of life.  Weather forecasting is an exercise in probabilities because we can never be sure of the starting conditions.  We can’t factor in  all the variables.  This is why it is said that a butterfly flapping its wings in West Africa will result in a typhoon is south- east Asia.  It’s not meant to be taken literally, just a mathematical possibility to illustrate how small unconsidered variations can cause enormous effects.   

And take sport.  They said England had a good chance of winning The World Cup this year, but what went wrong?  Could a glance across the table by a teammate’s wife have set in train a sequence of events that unsettled the captain, led to a players revolt against the coach and culminated in a catastrophic collapse of confidence?

And what about politics, computing, and the stock market?  Somebody can’t sell his house in Wisconsin and we end up with a global recession.   Or the rail network.  The wrong leaves on the line in the Home Counties and business in the City of London slithers to a halt. Small variations can have massive effects.  A tiny wobble in the orbit of an asteroid could destroy all life on earth. 

And in medicine, a small change in environmental conditions, a particular event, can so easily bring about illness.   Perhaps a tune on the radio could revoke a memory that could upset the gut and result in an argument that ends a marriage.  With no chance at resolution the gut upset persists as unresolved IBS.   When scientists do trials of treatment, they try to hold all the conditions constant.  This is what is called a controlled study.   It relies on certain  assumptions about which factors are important.  Age and gender may be controlled,  diet might be in a few studies, emotional factors almost never and yet these may be crucial.  So they can never really control the outcome.  If they make the same measurements 100 times in the same patient and they will come up with a hundred different results.  So what do they do?  Employ a statistician to tell them an answer they might (or might not) be able to rely on!  But  they still might be ignoring certain crucial factors because they don’t think they count or they are impossible to control.  As Albert Einstein declared, ‘Not everything that counts can be counted.  And not everything that can be counted, counts.’  

Irritable Bowel Syndrome is an idiosyncratic disease.  It is more an expression of the personality, life experience and life style than those variables that can be easily measured.  Moreover it can’t be easily defined because there is no identifiable change in body structure or chemistry.  It is whatever doctors say it is.  No wonder treatment is so variable and so personal.  It’s an exercise in chaos; a bit of a lottery.  What works for one person may not necessarily work for another.  But you can cut down the variability by reading the self management programme and getting to know about your illness, yourself and with some guidance managing your own symptoms.

There is so much we do not know.  There is so much we take for granted.  There is so much that we think we know but we cannot prove.   How did stars form out of gases?  Where did the gases come from?  Was there really a big bang?   If so why?  Did life really start because of chemical coincidence,  a freak combination of nitrogen, hydrogen and carbon in a cooling world?  Did these chemicals arrange themselves to create molecules that could replicate themselves and encode for every other protein in the body?  How was the first unicellular organism created?  How did these develop into more complex organisms; plants, animals, fish, amphibians, reptiles, mammals and finally man? Why is man able to reflect on things and create meaning? How can such phenomena as thought transference, dreams, synchronicity and distance healing be explained?    

Cosmology and evolution seem so far- fetched; a series of lucky accidents.  Left to itself, matter tends to disintegrate by processes of inertia and decay. So why doesn’t it?  For most of the world’s population, the answer is simple. God created the world and everything in it.  And he created man in his own image. 

Yoga, while believing in a super-intelligent design, is not against evolution or science or psychology.  All are  part of the divine plan. Everything that we perceive to exist contains the essence of the divine, the vibration in stones, the way a plant bends towards the light, the way a beautiful lotus flower will blossom in the mire. Divinity, it asserts, pervades the whole universe from the stars to the smallest cell in our body.  God creates life out of Himself, like a divine spider weaving a world wide web.  Scientists may claim to have created life,  but they had to rely on the forces and raw materials that God provided in order to do it.     

Just as a tiny seed has the potential of a tree inside it, just as a grain of sand can be made into a silicon chip, so the potential for humanity was there from the beginning in the DNA of the smallest organism.  Ontogeny recapitulates phylogeny.  The human embryo starts as a simple unicellular organism and from there develops through fish stages with gill arches, amphibians, mammals and man.  The philosophy of yoga acknowledges evolution as one aspect of a divine plan that conceived humanity from the start. ‘Karma’ embraces past and future lives and the ultimate purpose of our multiple lives is to merge with this divine being.   Thus yogis believe that man’s destiny is to evolve into a state of superbeings  at one with the divine.   

But hang on a minute, belief is one thing, but when faiths apply science to support their convictions, it doesn’t quite work.  Take the inertia argument. Things only disintegrate when you don’t apply energy to them.  If you apply the enormous energies generated by the birth of stars and locked up within the universe, then synthesis is not only possible but obligatory and there are an infinite number of chemical combinations to choose from, many of which may ‘work’.  But, we might ask, where does all that energy come from?   What caused the big bang?  Or is that just another act of faith?     

And is evolution evidence of divine plan or a wonderful genetic system through which life adapts to environmental change?   Did God really look at a chimpanzee, scratch his beard and say,  ‘Hmmm, there are capabilities there’.  Would an intelligent designer have built in so much junk DNA?  And why should a race of superbeings develop?  We might equally argue that we are in danger of generating a race of sickly degenerate beings only able to exist in our artificial environment. 

Karl Popper’s dictat that we can only accept hypotheses that are capable of being disproved  indicates that the creationist’s position is, by the rules we adopt to establish our universe, antiscientific.

The other argument for the divine is collectivism. All cultures on earth; Indian Yogis, Christians, Moslems, Buddhists, the ancient Greeks as well as primitive peoples such as the aborigines, American Indians and African bushmen, have at one stage or another believed in an all powerful divine presence, who created the world, watches over it and requires appeasement.  Certain truths seem to exist in all religions;  so many people seem to have independently experienced a similar concept of divinity.  In his book, The Perennial Philosophy,  Aldous Huxley describes how leaders of religions throughout the world  claim remarkably similar expressions of the divine.  But that does not constitute evidence of the divine existence, just a collective culture of meaning.   Millions of people believed the earth was flat.  That didn’t mean it was!  We are all of us driven to find meaning in our existence and God is the simplest and mast lazy answer.  We have a template.  Weren’t our parents originally our Gods?   So is it surprising that our Gods exist in their idealised image.  Life can be so lonely without anybody powerful to look up to.         

Many would see intimations of the divine in thought transference, synchronicity, dreams, premonitions, faith healing, fate, love, but can we always be sure that there is not a more grounded explanation?   Very sensitive people can ‘read’ subliminal signals in much the same way as aboriginal trackers can read the landscape.  They are very suggestible.  People, who know each other well tune into those signals and each other and think the same thought, do the same thing.   Hope and faith alter the function of the immune system and are the essence of healing.  Dreams, as Freud commented are often wish fulfilment or the enactment of dread and we can all have an unerring tendency to bring about what we most want or fear or to re-enact the conditions of trauma.  This is not fate; it’s more about the way experience wires our nervous system.  .    

Some people even claim to have had encounters with the divine being, but there is a rational explanation for this too.   Just as traumatic events can make us ill, they can also make us cleave to the idea of redemption by divine grace, the perfect love by an all caring deity.  This desire can be so powerful, it can create delusions, even generate hallucinations.  And because there is a collective impression of God,  then these hallucinations will appear similar.

We cannot know everything, but  is that justification to invent a divinity?      

And then there’s fate.  A person’s life can tend to run according to a script.  People do tend to make the same choices, make the same mistakes.  It’s what is called character or personality.  But that  isn’t evidence for the divine, merely that our personality is forged by the influences on us early in life and given the same set of circumstances, we will make the same decisions.  Change often requires a crisis.   Yogis also do not believe that fate is ineluctable.  Man does have choice.  He can change fate, but the pull to the divine is inexorable and the path is rarely direct and may take many lifetimes. 

If there really is a God, why did he create such an imperfect world?   Yogis would say that the divine plan does not exist to give comfort to human beings.  Sometimes it is necessary to create tragedies, disasters because these manifestations of the divine will are opportunities for spiritual growth.  How many people have come to terms with the reversals in their lives by being more reflective, more spiritual?   Don’t we all need grief to appreciate joy?  Don’t we need darkness to appreciate the light.  This argument has always seemed to me somewhat contrived.

And what about emotions?  Are not love, fear, shame, remorse and guilt, manifestations of the divine?  Or can they be simply explained by neurochemistry?  I define emotion as ‘feeling put into context’.  Many feelings have a chemical signature.  Hormones, a class of chemicals named after the Greek word ‘eremonos’, literally, messengers from the Gods, are quite heavily implicated;  adrenalin – fear and anger, cortisol – depression,  thyroxine – agitation, oxytocin – love.   They help to define the subjective self and underline such phenomena as awareness, experience, memory, meaning, metaphor and attitudes.

The other area in which people perceive the existence of the divine is morals and ethics.  It is the influence of the divine grace, the religious argue, that encourages us to live a good and honourable life.  I cannot agree.  It’s not God that encourages us to be good but the mores of the community.  God, I believe, is a human projection; the embodiment of an inner authority.  If God didn’t exist, then we would have to invent him. Instead of God creating man in his own image, it seems more likely that we created God in our image? The social argument of a man made God seems very powerful to me.  Gods are necessary to provide a moral and ethical framework for communities, to provide structure and security and belief, hope and meaning.  Without the belief in God, the world could descent into chaos. To my mind, whether God exists does not exist in reality does not matter.  It’s the fact that most people believe in a divinity and that that divinity represents a moral code that is important.   

To my mind, concepts such as soul and spirit represent the meaning we ascribe to life’s deeper issues .  And  thoughts and  meanings the generated by the activation of neural networks, established by experience.   Believers state that faith is the starting point of knowledge.  No.  Imagination is.  Imagination is a predictive construct based on previous experiential associations.  Discovery favours the prepared mind.  As King Christian X of Denmark said many years ago, we console ourselves with our imaginings and delusions.  A meaningful life can be so beautiful; it doesn’t have to be divine. 

Proponents of any a belief system, whether this be a religion, a cult, psychoanalysis or aspects of neurochemistry and cosmology,  insist that we suspend and ultimately surrender disbelief for the security of faith.  It is true that for a full life, we must liberate our slavish dependence on evidence and let our imagination free in much the same way as the artist, the poet, and the composer, but that shouldn’t mean adhering  to a particular faith because we have been told to.  We are all seekers, but our quest should be generated by our own observations and meanings and not by obligations to science or God.

‘A dog is a man’s best friend’, so they say.  They are our companions. They are, like us,  social carnivores that hunt in the daylight. We were made to collaborate. How much more effective we would have been as hunters with dogs to detect and chase our prey.  And dogs would have played a crucial role in the development of civilization by protecting our crops and home and herding our animals. 

But there’s more to it than that.  Dogs offer us their devotion.  To them we  are the pack leaders – to be appeased and served. Dogs are attuned to us, they obey our commands, respond appropriately when we point; they can be trained. Chimpanzees, although they have 99% of  our genetic code, tend to do their own thing, albeit intelligently. There is even a dog who has learnt 300 words and can fetch an object from another room, having only just seen a picture of it.  And think of how working dogs can be trained to herd sheep, to retrieve an animal that been shot, to sniff out drugs or explosives.   

Dogs make a deep emotional bond with us.  Studies have shown that when dogs look at images of humans, they are drawn to the left side of the face which expresses emotion more eloquently and has a direct connection with the emotional right side of the brain.  They tune into our emotions and can respond to our feelings.  They know when we are upset or angry. They feel it. And dogs are good for us.  We are more likely to survive a myocardial infarction if we have a dog and less likely to have another heart attack.  

Dogs have evolved an elaborate vocal repertoire to communicate with us.  Most dog owners can recognize at least six types of bark.  These are emotional signals; excitement, anger, aggression, hurt, fear, playfulness.  Brains scans have shown that the same area of orbito-frontal cortex lights up and we release the bonding hormone, oxytocin, when we look at pictures of dogs as when we look at images of children.  Our need to nurture runs deep. Dogs induce the nurturing behaviour in us they need for survival, and they also release oxytocin when they look at their owners and are fondled.  Dogs not only give but they induce unconditional love. 

DNA data has established that our domestic dog is descended from the grey wolf and came into existence about 100,000 years.  But wolves or wild dogs do not acclimatize to humans naturally. They cannot read our emotions and they don’t have the same vocal repertoire.  When wolf puppies are brought up with humans, they revert to wolves at about 8 weeks and become dangerous.  It takes many generations of selective breeding to get an animal that behaves like a dog.  Long term experiments conducted on Silver Foxes in Eastern Siberia has shown that domesticity can only be induced after 50 generations.  Only then do they behave like dogs. The strange thing is that in breeding out aggression, other characteristics change too, like the colour of their coats and the shape of their heads, their ears and their tails.  In fact, they become like puppies.  Selective breeding for domesticity favours juvenile characteristics.

This makes me wonder whether sexual selection in human societies over the many generations since civilization began has also succeeded in breeding out aggressive characteristics?   Are we just all big babies?   Have we bred domesticity in ourselves and with this passivity, laziness, neediness and a predisposition to obesity, heart attacks and diseases related to anxiety, such as Fibromyalgia and Irritable Bowel Syndrome?    

Contrast our open faced, needy population with the hard bitten images of tribal chieftains, warlords who seize and impregnate their women by force.  Such brutal sexual acquisition might perpetuate a much more ruthless typology until such time as civilization suppresses the behaviour that has induced it?  The aggressive no longer rule the earth,  at least outside the strongholds of Afghanistan, but have we become too tame, like the dogs?

This article was inspired by this month’s BBC Horizon programme.

Time flies, the old man cried, as the alarm clock struck him on the back of the head.  For the elderly, time does indeed fly; not just the clock but the days, the weeks, the years.  Time seems to shorten, to press in on itself, as we get older.

But for the young, a week can last forever.  Remember how we measured our age in fractions of years.  ‘I’m seven and a quarter’, I’d reply if asked.  And that 13 weeks I boarded at school felt like 13 years.  Mathematicians have suggested that our perception of time is relative to the duration of life.  A year is 10% of our life when we are 10, but only 1% when we are 100. 

Personal time is perceived according to what new happens.  For children, the milestones are much closer. Their days are so packed with novelty, life is a constant stream of stimulation; their attention span so short that expectation seems endless.  As we get older, and accumulate responsibilities, the thrill of anticipation is replaced by the burden of obligation. There is little novelty, just more associations to work through, organise and file away. Too much to do; too little time!  With the end on the horizon, there is neither time nor inclination to look forward, so we tend to look back, reminisce, regret a bit and try to put it right. Events and thoughts collapse in on each other until time itself is confused. 

Although our perception of time passing can alter through life, our body has a remarkable ability to mark time. It knows exactly when it’s time to go to sleep, time to eat and time to defaecate, and when we change time zones, it is some time before this body clock can be reset. we have some kind of accumulator in our brain that records the oscillations of temporal neurones, or the beats of the heart?  Probably not!  Nobody has identified a cerebral clock, but neuronal and hormonal activity is responsive to environmental cues or zietgebers like day/night cycle, day length and temperature.  So while real time is relatively static in our bodies, our perception of time is elastic.  When I am running, the same route goes much more rapidly if I am in a relaxed meditative state than if I aware of my performance, even though my pulse rate is much the same.  Time is like a river; the flow may be constant, but the calms, rapids and waterfalls of our thoughts can make seem to slow it down or speed it up.   

It has been suggested that our perception of time depends on our degree of arousal.    During extreme arousal, time slows down and intensity of experience is magnified, our memory expanded.  The more energy the brain spends in representing an event, the longer it lasts.  We can get more done in the morning when our level of arousal is at its optimum.

Think of how slowly time goes during a crisis. If we are going to crash, everything seems to go into slow motion. You have an argument with your lover and then part; you remember every word, every gesture, every look. Time dilates  Psychologists call this amydala memory.  When the panic button is pressed, the brains cine film speeds up.  If you’re laying down a lot of memory, time goes by a lot more slowly, but does it just seem that way in retrospect because there’s more to play back? 

Generally time passes much more slowly if you are waiting for something, but that too depends on your perspective. Take two men at a football match. The score is 1-0. There are ten minutes to go.  To the one whose team is ahead, that ten minutes is an eternity of dread, but to the others desperation to score accelerates the final whistle.

It would seem that our perception of time is an emotional quality.  Time is suspended when you are in the thrall of love, but if you know you must part, then it speeds up alarmingly.  Samuel Johnson said that there is nothing like a hanging to concentrate the mind, but he could have equally transposed ‘time’ for ‘mind’. 

So is our perception of time a factor of the emotional energy of our thoughts?  The more energy we devote to things, the more we are conscious of time. Take boredom, for example, or depression.  Boredom is not passive or boring. Far from it, boredom is an active state of anticipation and frustration; an urgent need for something to happen, a  desire to kill time and attack your situation. Similarly most depression is a highly aroused state of anxiety and despair.  Driving my car down the motorway is the most boring thing I do. A journey to London is like a trip to the moon.  But if I listen to an audio-book at the same time, then I hardly notice it.  Children (of any age) who can lose themselves in creative play are rarely bored.  Boredom more usually applies to administrative tasks that I resent, like writing a grant application, filing a report or completing the tax return. Such a waste of time! But if I am preoccupied by some concern, that anything that takes me away from it, becomes boring. Perhaps time passes so slowly for the young because their lives are so occupied by the anxious frisson of change, that for nothing to happen is intolerable.       

Time races by if we’re absorbed in a task.  It’s a form of meditation. I have spent two hours writing this article and yet it seems I have only just started. The same phenomenon occurs if we watch a good film or when we’re relaxed at a dinner party, talking to friends.  This acceleration of time is enhanced by alcohol and recreational drugs.  I can lose time having a good time. During therapy, the 50 minute hour goes very quickly when the client is engaged and relaxed, but if he’s defensive and resistant, it drags.  We can spend seven hours asleep completely unaware of time yet if anxiety keeps us awake all night,  the slow blind slither of night-time is exquisite torture.  

So how should we spend time?  Should we seek solace in creative activity and allow time to speed by unnoticed?  Or should we seek to extend it with stimulus and novelty in an accelerating desperation to avoid the end?   What is the bigger waste of time?

Time is the measure of things moving.  It’s like history; one bloody thing after another, but if nothing happens there is no time, ho history, nothing.  We know by determining the rate of decay of radioactivity in rocks that the earth came into being 4,558 million years ago.  This sounds a bit like Archbishop Usher, who calculated that the world was created 4,404 years ago. 

 Time cannot be thought about with considering space as well.  Time is the fourth dimension.  We only need to go out and look at the night sky to see it happening.   The light that reaches us tonight set out from the nearest star 5 years ago and from the most distant galaxy, many thousand years ago.    

Isaac Newton thought time was always there; a God given fact, space was the constant stage upon which things happened, and light always travelled in straight lines. It was not until Albert Einstein that anyone dared to question these ‘facts’.  Einstein deduced that things that seemed to take place at the same time from an observer on earth, would occur at a different time if you were passing in a rocket. Events are perceived at the speed of light and if we were to pass through space near or at the speed of light, time would slow and stop.  Both time and space are relative to the observer.  Moreover light could ‘bend’.  The sun, 8 light minutes away probably did not exert an attraction on the earth but it warped space so that objects had to move in a fixed trajectory around the sun and light had a trajectory too. But it was Arthur Eddington that came up with the ‘proof’ by studying the light from stars behind a solar eclipse that light could appear to bend around massive objects  Eddington illustrated this by throwing a melon into the middle of a tautly held tablecloth and then rolling a walnut around the depression created.  Eureka!

If things are completely inert and nothing changes, then there is no time.  As soon as things change, there is time. So time and space are a continuum.  The approved wisdom states that time started with The Big Bang some 5000 billion years ago.  Since then matter, galaxies, stars, planets are speeding apart and getting colder and colder.  At one time, it was thought there would be a limit to the expansion and as mass  decelerated, gravitational forces would cause it to start to implode and then time would run backwards.  That’s what the equations would predict.  And how can we begin to understand what caused the big bang originally is it wasn’t some coalescence of mass and energy.  Nevertheless, physicists now seem convinced that there was a big bang and everything sped apart and is still accelerating and must eventually disappear.  Then nothing will change and time will cease again. Part of the evidence of the big bang came from the analysis of interference or white noise on television monitors.  I maybe an old cynic, but in astronomical physics as with everything else, what value evidence?              

So do we move through time or does time move through us?  We may be able to see time past, both in cosmological terms and what is fixed in memory, but we cannot see what is to come.  And there’s a problem, if time passes through us, then everything is preordained.  There is no free will.  To a certain extent that is true.  After the first few years of life, we create for ourselves a template for the way we will react, the choices we are likely to make, how our future is likely to be.  As the Jesuits said, give me the child at 7 years of age and I will show you the man.      

But doesn’t this all depend on the assumptions we make.  How do we know?  Physicists talk confidently about the distance of stars, how far galaxies are away, but how do they know?  Is there any independent measure of this that doesn’t depend on assumptions about time and space?   If space is curved like a doughnut,  could we not be looking at ourselves coming back?   Does Einsteinian geometry predict astronomical observations or does it just explain them?  Just as the design of a camera, the curvature of the lens, the shape of the aperture, determines our perception of the object, so image we have of our universe depends on the instruments by which we observe it, the assumptions of our  computers and the conceptual limits of our frontal cortices. The ancient Egyptians believed that the sun travelled across the sky every day and the moon did the same every night.  How much more satisfying life must have been then.

Ida1,property=Galeriebild__gross (Large)Ida was no more than two feet in length, she had a cat-like face, a long tail and judging from the shape of her ankle, walked upright.   Cladistic analysis might have suggested she was probably related to lemurs, but she was heralded as a missing link between other mammals to primates.   

The issue raised by Dr Martin Whyte’s paper, entitled ‘Ida; new light on Palaentology,’ was not so much about the validity of these claims as by how scientific discovery should be publicized. 

Ida was extracted from the Messl Lakes, fossil rich deposits of brown coal in Germany, and sold to a collector, who kept her in his private collection before selling her on to the Museum of Oslo for a very large sum of money.  To recoup their investment, the museum engaged a team of scientists to investigate her.  They published their ‘findings’ in an on-line journal at the same time as the film and the book were released.    

The publicity of findings in other sciences;  physics, medicine and zoology, for example, depends on peer review and publication in reputable scientific journals. Some scientists and indeed some journals may wish to issue a press release on discoveries they think are particularly important, but for the most part, whether a finding is publicized is a matter of luck.  Somehow, publicity is seen as pandering to commercialism.  Science, like religion, is above all of that . 

Palaentology is different. The commercial opportunities are too great.  Fossils all too often find their way into the hands of illegal entrepreneurs who will prepare the specimens for collectors, who purchase them for large sums of money and may then, like the Oslo Museum, seek to recoup the scientific capital of the discovery.  With so much money involved, there is too much temptation for fraudulent claims, like the Piltdown hoax of the thirties. 

But publicity occurs in other branches of science too.  How pervasive would the philosophy of Sigmund Freud had been without the efforts of his publicist, Dr Ernest Jones?  And would we have been celebrating the bicentenary of Darwin’s birth this year were it not for his champion, Dr Thomas Huxley?  All great discoveries need to be discovered by somebody who can get them into the public arena.  Some scientists are also great self publicists.  Among contemporary examples are Baroness Susan Greenfield, Lord Winston and Richard Dawkins.  Never discount the role of PR and commerce in science, even though many scientists regard self publicists with envy and disdain and put their faith in peer review.

But peer review is not a council of truth.  Think of Dr Andrew Wakefield’s proposal of a link between MMR vaccine and autism.  The data was seriously flawed but The Lancet still published it. 

And peer review can be quite corrupt.  Journals often ask authors to suggest their reviewers and, of course, they volunteer their friends, who reciprocate the favour.  You scratch my back and I’ll scratch yours.  There are often just a few people around the world working on a given research topic.  They have a self interest to ensure that their work is kept in the public eye and continues to raise funds.  Scientists often come of unspoken agreement to support each other.  Any interloper whose work threatens to undermine this cosy arrangement, is likely to see their papers rejected for publication.  Drug companies recruit teams of ‘independent’ opinion leaders to investigate their products.  The results are nearly always presented in the best light for the company and supported through the peer review system by other scientists working on the same drug.  Nobody is keen to bite the hand that feeds them grants, sponsors their journals,  underwrites their academic positions and arranges and pays for their attendance at key conferences.  Having been invited on the international merry go round, scientists would do almost anything not to fall off it. 

A few years ago, an eminent colleague of mine, Professor Juan Malagelada from Barcelona, proposed that given the exponential expansion of papers, everything should be published on the internet.  Peer review by friends and other ‘interested’ groups, would be abolished and replaced by a much more open public review, similar to the reviews and critiques of new artistic works.  In this way, he concluded, only the genuine and valuable would be quoted and rise to the surface – a kind of populist peer review.  This system is would have its abuses, of course, the publicists would continue to push their own finds.  Money would change hands as scientists would try to ensure their work gets maximum exposure.      

So maybe it’s Palaentology that’s the missing link, sitting awkwardly between arts and sciences.  As a science, Palaentology is underfunded; it needs museums and private investors to fund the field work and the high tech scientific analysis.  New findings need hyperbole to excite interest in the area.  In that regard, the subject is not unlike art critique. Indeed, many fossils are very beautiful. If Van Gogh had had to rely on peer review, his work would never had been discovered.  He needed the support of his brother and friends to bring his paintings to public attention.  In a similar way, The Museum of Oslo had to hype up Ida to get visitors though its doors and encourage other museums to spend large sums of money to loan the specimen.  Peer review is too cautious and unlikely to excite public interest.  On the other hand, the more the hype, the greater the risk of exposure.  Public appraisal can turn on a sixpence!          


The problem of Ida was the topic of a talk given by Dr Martin Whyte of Sheffield University at the Chapel Allerton Cafe Scientifique on June 22nd. 

IMG_0002 (Large)Arcadia is perhaps Tom Stoppard’s best play.  Its eclectic blend of literary history and science bubbles and fizzes with ideas and wit.  Stoppard not only explores the shifting mindscapes between between science and literature, he tackles the divisions between classicism and romanticism, and deterministic and unpredictable theories of the universe.  

The play spans two centuries and is set in Sidley Park in Derbyshire, the large country home of the Coverleys.  What makes the play intriguing is that while one group of characters seeks to determine the future,  the other tries to reconstruct the past. But as the play builds to its tragic conclusion and a kind of truth is revealed, past and present converge and the quest for knowledge itself becomes the essence. 

The play opens in April 1809.  Thomasina Coverley, aged 13, is in the midst of a lesson with her tutor, a Mr Septimus Hodge.  Thomasina is precociously clever; she is not taken in by Septimus’ ‘literal’ evasion of her enquiry about carnal embrace.  But Septimus has his reasons to be evasive since it is he who has been observed in carnal embrace with Mrs Chater.  And now Mr Chater demands satisfaction.  To Septimus, this is tiresome.  

‘Good God, Man!  First your wife wants satisfaction; now you!.  I can’t be spending all my days satisfying the Chater family.’ 

To evade unnecessary bloodshed, he flatters Chater by praising his latest book of poetry, ‘The Couch of Eros’, even though he has previously written a damning anonymous review of his previous work.  Septimus knows about poetry.  He is a contemporary, a friend even, of  Byron.  Byron’s home, Newstead Abbey, is close by and Byron has been a shooting guest at Sidley. 

Fast forward two centuries.  Hannah Jarvis, a successful author is researching her book on the Coverleys.  Bernard Nightingale is interested in the possible reasons why Byron fled to Portugal shortly after his stay in Sidley Park.  Finding the letters from the Chaters, he assumes that Byron has killed Chater in a duel.  He is wrong.  There is no duel.  Chater and his wife go plant hunting with Captain Brice.  Chater discovers a new kind of dahlia but dies abroad after being bitten by a monkey.  Brice marries Mrs Chater.  Byron has his own reasons for his dash to Lisbon; probably fear of exposure of his ‘illegal’ homosexual liaisons.  

There is a tangible sexual chemistry between  Bernard and Hannah that manifests itself in  a lacerating repartee, so wonderfully created by Neil Pearson and Samantha Bond.  In fact the whole play seems to sizzle with sexual opportunity.  Septimus is clearly a red blooded romantic.  Not only is he susceptible to Mrs Chater’s rural charms, but he is infatuated by Lady Croom and, by the end of the play, is clearly not averse to his pupil’s budding attractions. In a clever interweaving of plot and time, Thomasina persuades Septimus to teach her to waltz on the eve of her seventeenth birthday, as Gus, in period costume, also invites Hannah to waltz,  but we already know that on that same night, Thomasina is consumed by a conflagration in her bedroom.   Septimus becomes the mad hermit in the park.  Byron prowls in park and gazebo.  Valentine conducts a futile wooing of Hannah.  Even his autistic brother, Gus, is entralled by Hannah and presents her with an apple to go with her computer.

The plot is set against a back drop of change.   The Enlightenment and the Millennium are  exciting times to be alive.  The intellectual landscape was changing along with the physical.  In many country houses in England, the formal continental gardens of the 16th and 17th centuries had been ploughed and planted with grass and trees, streams had been dammed up to create lakes, sweeping vistas have been opened up. The aristocracy were no longer hemmed in by the continental confines, of hedge and flower bed, they were  now masters of all they surveyed.   Lancelot ‘Capability’ Brown has created an environment that represented the freedom and confidence of an expanding empire.  But hard on the heels of empire, something different is taking place.  The sweeping vistas are being turned into something romantic, picturesque, clandestine even.    Rocky hillsides are being planted with trees, grottos are being created, ruins are preserved,  waterfalls constructed.  This is an environment of privacy, secrecy where assignations can take place and the feminine principles of sex and romance can prevail. The formal appearance of the great house is preserved, but in the garden, there are more exciting opportunities. Nancy Carroll’s Lady Croom simmers; she doesn’t approve of the changes, her new landscape architect, Mr ‘Culpability’ Noakes is wreaking on the estate.   

A similar change is occurring in the mental landscape of ideas.  Newton had created the formulae for a new order.  Thomasina is precociously aware of Newtonian calculus and philosophy.  ‘You cannot stir things apart.’  Two centuries before computers will do the job for her, she conceives the iterative algorithm, an algebraic equation the describes the nature of natural phenomena by encapsulating the forces acting on them, and then putting the solution ‘y’ back into the equation as ‘x’, to create a three dimensional model.  She uses it to build a model of an apple leaf, but two centuries later, the intense Valentine uses the same approach to describe fluctuations in the populations of grouse on the estate.    Everything, it seemed, could be described by mathematical rules.  If we knew the rules we could predict the future; the weather, politics, financial markets, illness, the natural world – everything.  The solutions may be complex, but a confident, emerging Empire understood these and could control them.  Since the outcomes were predictable, the future could be controlled.     

Two centuries later, it is so different.  We cannot predict the weather accurately, any more than Valentine can predict the populations of grouse on the estate because as Valentine expresses in his frustration, there is too much fucking noise. The new mathematics is the mathematics of unpredictability, chaos; how a seemingly disconnected event occurring a long way off can set in train events that make a fundamental change in whatever we are studying.  A butterfly flaps in wings in China and a hurricane occurs in North America.  A building society goes bust in America and creates a world wide credit crisis.  A junior minister has a meaningless sexual liaison with a call girl and brings down a government.  We are beginning to understand the how minor, seemingly disconnected chance events, can have profound effects.   

The greatest sounce of perturbation and noise confounding the outcome of human endeavour, is love.  And in Arcadia, the very air sizzles with sexual energy.  Bernard bounces with it, Septimus, his friend Byron, and Mrs Chater, Hannah fears being overwhelmed by it and defends herself strenuously,  but the innocents, Mr Chater and the tragic clever Thomasina are destroyed by it. 

Love can confound the most robust equations, generating chaos out of order,  threatening to disrupt the most ordered lives, but at the same time, making what seems remote and impossible, a frightening, risky possibility that could lead to destruction but also, if one keeps one’s nerve,  re-creation. 

Stoppard is one of most exciting living playwrites because he, like Septimus, Thomasina, Hannah and Valentine, has the sheer balls to expose the destructive forces within our society while at seeking to harness them to discover a kind of truth.

As I wrote in a previous blog (Inheritance, how we are carriers for our genes as well as our culture,  2nd January 2009) , human culture evolves by different mechanisms compared with biological evolution.  Cultural evolution conforms to the principles of development by use and disuse, laid down by the French soldier and biologist, Jean-Baptiste Lamarck, who was commissioned  for valour on the battlefield when just 17 years of age.  So promotion ensured his own personal development in much the same way as, according to Lamarckism, the giraffes neck would grow longer to reach the leaves it feeds on.  And once a certain characteristic is established as useful within the culture, it tends to stay until modified or replaced or until a change in fashion or technology creates a new way of looking at things. 


The rate at which cultural evolution occurs differs according to the topic or aspect. In science, there are long periods of stability where nothing much changes. Most scientists like to study what is in fashion; what other scientists are doing.  They compete with each other top add a small brick to the edifice.  And when they can think of nothing else to do, they test what is already known by ever more rigorous means.  Then suddenly an Albert Einstein comes along or an Alexander Fleming makes a breakthrough that opens up a new channel of enquiry, a rich vein that may lead to a whole new way of seeing things.      


Science favours the prepared mind.  Something usually occurs to anticipate discovery; a serendipitous observation, a discovery in another field, a new way of thinking or an advance in technology, such as nuclear magnetic resonance imaging. Then, rather like the change in climate that propelled tool-using  humanoid bipeds out of the forest onto the savannah, the scene is set for rapid evolution of ideas.   


Art is more idiosyncratic. Artists are influenced by each other but most try not to copy each other.  They are fiercely individual and are constantly looking for original ways of seeing and expressing things.  It’s probably no coincidence that political radicals of the nineteen seventies and eighties had often been to art colleges.  An advance in technology, a new medium, may provoke a flurry of invention as each artist uses it to develop their own creative opportunities, but as soon as they are successful, an artist’s style tends to become fixed to fit with cultural expectations they have created.  They become trapped by the success of their retrospectives.     


Literature changes more slowly, less radically.  For many years, good prose and poetry had to conform to rules of syntax and grammar as well as a certain accepted rhythm and music. Change could only take place within that container. Now, with the advent of electronic communication, the medium is changing.   New forms are being introduced with bewildering frequency and with these, new opportunities of expression.        


Music and the theatre, the performing arts, are also somewhat split.  There is an increasing amount of experimental, avant garde theatre, some radical new styles of composition, innovations in dance. But most theatre and music performance is traditional, a re-working of the classics. The content is fixed. All that can change is the style and interpretation.  That depends on the director, the actors and the musicians.     


Musical performance affects the way the sounds are expressed, the emphasis, amplitude, rate, timbre and tone.  Performers can take a certain amount of liberty with the composition; a different combination of instruments can be used for example, whole sections may be omitted. But performance is more than innovation and artistry. It is competitive in a similar manner as ice dancing, synchronised swimming or gymnastics. The bar gets raised all the time, sounds get crisper and clearer, the fingering more complex and technology creates new opportunities.  The performance has to keep pace with and in most cases exceed the demands of increasingly discerning and critical audiences.  Musicians often regard the concert as blood sport. The audience is looking for mistakes and the penalty for failure is death.


Nevertheless, performance style can only change within the limits of what is acceptable.  Evolution in this context occurs by listening to others, adopting certain nuances, rejecting others, practicing, performing, obtaining feedback and readjustment, a gradual remodelling that accommodates current cultural demands. For example, high fidelity recordings have created a desire for crisp, clean sounds that can be amplified and adjusted, whereas in the past a soloist or singer would need to hold their own against the orchestra with prodigious amplitude and the elaborate use of vibrato and arpeggio.  Musicians adopt what musicologist, Daniel Leech-Wilson called ‘optimal foraging principles’, which explains, he asserted, why prima donnas have declined in favour of opera singers who can work well with others in a team.  Nevertheless, musicians, like artists, have to develop their own style as they learn, change and make it their own.  In that respect, performance is rather like practicing psychotherapy or what used to be called ‘the art of medicine’.  Any innovation of the culture of performance has to fit current norms but add something fresh, like Catrin Finch’s recent rearrangement of The Goldberg Variations for the harp (see my recent blog, entitled, ‘What is Music For?’ 26th February, 2009). .


Cultural evolution has parallels in biological evolution. In stable, traditional societies, biological as well as cultural evolution occurs very slowly, if at all, by small adaptations.  Genes that favour overconsumption may well be weeded out, but other ‘genetic’ diseases may increase with effective treatment.  As societies become more cosmopolitan, the blending of racial characteristic creates more adaptability to change, both in a biological and cultural sense.  


It is only when humanity is decimated by a change in the environment, a deterioration in the climate so catastrophic, an infection so devastating, that survivors will create a new race with particular characteristics of resistance. This might be compared with exposure of populations to a completely new way of perceiving the world, a cultural revolution.  Only those, who are able to adapt their thinking and behaviour, will be able to keep up.   So as the current financial crisis continues to bite, only those who have a clear understanding of what is happening, will be able to use it to their advantage.    


And not all biological evolution is Darwinian.  A new symbiotic relationship that confers a distinct advantage on both species; a beneficial bacterium in the human colon, the association of soil fungi with tree roots, a virus that gets incorporated into the human genetic apparatus; these all behave in a Lamarkian manner and are taken up at the rate of cultural evolution.  Nothing is absolute. This begs the question, ‘for cultural change to survive from generation to generation, how much of it is transmitted according to natural selection.’  At one time in our history, a gene encoding for musicality or a surrogate for it, might have conferred a selective advantage in terms of promoting societies.  But that’s for another day.




Is man just a hungry animal or has the environment in which we are living conditioned us to behave in a hungry way?   Raymond Tallis, scientist, philosopher, Professor Emeritus of Geriatric Medicine at Manchester University believes we are naturally hungry.  ‘It is the human condition,’ he asserts, ‘but the way we live has exaggerated it.’ 


Speaking at the joint meeting of the Cafés Scientifique and Philosophique at Chapel Allerton last Tuesday,  he explained that there were more hungers than hunger for food.  There is hunger for pleasure, hunger for others (desire and attachment) and the fourth hunger, hunger for a truth for meaning, purpose in life’.  I might also add a hunger for things or consumerism and a hunger for prestige or ambition. These are of course not separate hungers; they are all connected. 


Tallis’ talk was like a rich meal, consisting of carefully chosen assertion and cultivated eloquence, liberally seasoned with philosophical quotation.  He served it in a cultured manner and a rapid delivery that demanded instant consumption.  It was a repast concocted by a man, hungry for attention and presented to an audience greedy for insight and knowledge.  His assertions challenged absorption and assimilation; his arguments threatened indigestion.    


‘Starvation preoccupies the mind,’ Tallis stated emphatically. ‘When you are hungry and starving,  it becomes the essential meaning and purpose of life.’  To support his argument, he described how the most cultivated people, doctors, judges, rabbis, were reduced to grubbing around in rubbish dumps when starving in Auschwitz.  ‘People went insane through hunger.’     


In his gastro-centric discourse,  Tallis appeared to express the view that hunger in all its metaphorical and philosophical connotations was the motivation for life.  ‘We are driven by our appetites. They give us life.  We suffer a kind of death if those appetites are satiated.  It is not the object of our appetite that is important,’ Tallis asserted, ‘but the process.’   


Eating a meal conforms to the law of diminishing returns.  The first mouthful is a relief; it assuages the tension of hunger.  The next mouthful also but less so.  The third mouthful less again.  We finish the meal although we are no longer hungry.  What stops us the uncomfortable feeling of being replete, satiated.  In a philosophical sense we might be said to be bored with the meal.  Physiologists have the concept of sensory specific satiety, meaning that we soon get tired of the same food,  but if we relieve the boredom by stimulating our taste buds and the cilia of our olfactory cells, with different ingredients, then we can maintain the ‘hunger’ and eat and prolong the meal. Gastronomy was created to relieve the mini-death of eating. 


Although an incredible 820 million people, an eighth of the worlds population, still exist ‘on the bread line or lower’, for people living in ‘civilised countries’ food is readily available in abundance.  They don’t need to hunt for it or gather it from forest and marsh, they collect it from the supermarkets and store it in their fridge.  The overwhelming majority of people living in the towns and cities of affluent countries do not know the physical pangs caused by lack of food,  but that does not mean they don’t feel hunger.  Instead, Tallis asserts, hunger is transferred on to other ‘objects’, material objects, thrills, excitement, sex, companionship, love,  power, prestige  meaning and  truth. Civilisation and culture followed the conquest of hunger through agriculture and farming. There is so much to be hungry for.      


But if human life is driven by hunger, then it must never be allowed to be satisfied.  Satisfaction inevitably leads to a state of boredom, which Tallis cleverly defined as a hunger for hunger.   When it is no longer necessary to search for food, when material objects lose their appeal, thrills cloy, love affairs become tedious and there is nothing convincing enough to believe in, then what is the purpose of life? 


So does the modern epidemic of depression represent a permanent state of boredom,  the near-death inertia of satiation?  Are we permanently conditioned by our success either to accept a life of diminishing returns, where food, objects, family no longer satisfy our needs and we coast gently towards death?  Or are we condemned to a neurotic search for an essential meaning in life?   Have human beings become so successful at satisfying their basic biological and psychological needs that they are sated, overweight and under-motivated?  Is that the essential precondition for a decline of civilisation?   


Tallis’ suspicion was that epidemic of depression exists in the minds of the media and the drug companies rather than in any real change in people’s psychology.  I question that.  The psychoanalyst in me wondered how much he was projecting his own nervous appetite for life, his fear of the depressive death of boredom on to the rest of us.  All writers and philosophers project; it allows them to stand aloof from the maelstrom of humanity and survive. 

Tallis seems a very hungry man.  Perhaps he has to be hungry to ward off the dread of meaninglessness.  His physique, slim and energetic at 62 years of age, indicates that he has solved his hunger for food,  but he certainly demonstrates a enormous hunger for ideas and meaning and a desire for recognition – as if without this essential focus in life, he would cease to exist as a hungry animal.  A recent article in The Times (September 20th , 2008) told how he depressed he became after he retired from Manchester University and lost the focus of his job. ‘I was completely taken by surprise how worthless I felt.  Suddenly I had lost the thing I valued myself for.’  So Tallis needed to be needed;  he needed to be in peoples’ minds, the object of their attention, their envy, their desire even.  In the same article, he described himself, albeit tongue in cheek, as ‘the thinking woman’s crumpet!’    



Tallis views life from the philosophical vantage of physical hunger.  It is a useful and instructive perspective.  His book bubbles and sparkles with wit and erudition.  Do buy it!   But there are as many perspectives on human life as there are metaphors.  Some are so appropriate for some observations, others may fit better for different situations.  Tallis’ metaphor has its limitations


His premise, I thought, broke down when applied to perhaps the most obvious manifestations of hunger – the eating disorders; the modern epidemic of obesity and the dangerous deprivation of anorexia. 


Why are so many people driven to eat long after they are sated with food?  Why do they eat themselves into a state of complete boredom?  Is it a death wish?  I have interviewed a few patients with morbid obesity who have told me that they are eating themselves to death, but that is not the general rule.  Most people overeat, not to satisfy their biological hunger, but to fill other gaps in their life.  Many fat people are needy, even greedy, not for food but for love.  Many have been deprived of care, love and attention when they were growing up.  Many have felt worthless.  Many have not felt listened to.  Many felt they were not wanted.  For all of them, love and security are the essential need; food is a surrogate.  They ate to fill the emotional hole inside of them.     


As children we were programmed to seek out not just food, but our entire life support system of shelter, security, comfort that included food, and as we grew and became increasingly separate and independent,  those essential needs became more abstract as they were sublimated into achievement, prestige, recognition and meaning. 


As Tallis pointed out, eating a meal is so much more than the consumption of food.  The family dinner is an occasion that affirms the essential emotional bond; it is redolent with the memory and meaning of family.  The banquet is an essential component of any congress; it brings people with disparate views together, it fuels human discourse and understanding.  The setting, the entertainment, the rituals of speeches and toasts, the presents, let alone the food, are about community, security, love and understanding among peoples. 


Tallis was quick to emphasise how much more meaningful and civilised his meal was compared to that of his cat.  I am sure that is true, but the point seems a hollow one.  When you examine eating behaviour among animals carefully, you see that it is part of a complex grooming sequence. Chimpanzees, glutted on a monkey they have caught and dismembered, will not only share out the food according to strict hierarchy but will also indulge in a post-prandial mutual grooming and cuddling before they fall asleep.  Cats in the wild, pack dogs, indeed any social mammal and many birds have rituals around food that serve functions of security and group cohesion as much if not more than the biological needs for nourishment. 


So I would contend that eating is not just about nourishment, it is part of the complex of  behaviours that make up what we call nurturing.  When a mother feeds her infant, she delivers a complete care package, shelter, warmth, safety, comfort, understanding as well as food and drink.  Which one of these takes biological precedence is not clear, but my guess is that is not food.  When Harry F. Harlow placed infant monkeys with two different surrogate mothers; one composed of a wire frame that delivered meal through a nipple and the other covered in fur that delivered no milk, they invariably went to the furry one and starved. 


Nutrition could be compared to a hijacker on a pleasure cruise.  The consumption of food stimulates the pleasure centres of the brain. Experiments carried out in rats have demonstrated that when the putative pleasure centre, the nucleus accumbens, is stimulated directly by electrodes inserted through the skull and attached to a lever which the animals can operate, they do not bother to eat; they just press the lever repeatedly to give themselves a buzz of satisfaction. There is evidence that certain addictive drugs may work on the same centre.           


Indeed, if hunger were the primary drive, then why are so many young girls anorexic?  It seems that for them, the desire for the security of childhood outweighs the drive for food. 


So is it food that is the essential need, as Tallis has suggested, or is it attachment, as the psychoanalyst, John Bowlby has asserted?  Are we not so much the hungry animal as an insecure animal?  We need the company of others, in reality or in our imagination.  If that is not there, we will crave a surrogate: food, thrills, possessions and sex. 


We are also a perverse animal. As much as we crave security, when we have it, we want to get away.  The anxious drive for freedom and change can be as strong as the yearning for security.  That is when ambivalent illnesses, such as anorexia, can supervene to sort out the dilemma.  Human beings would not have been so successful if civilisation had not conspired to make them so neurotic.    


So are we, as Tallis seems to suggest, living in a permanent state of anxiety, preoccupied with the lack of what we feel we need to support our lives?  Are we all like Sisyphus, condemned to roll the boulder up the hill, obtaining a grim kind of satisfaction in the effort?  Or does that only apply to the neurotic majority?   If Tallis is right, he presents a very bleak view of human life; permanently driven, never satisfied, constantly striving to avoid boredom and depression. 


Are our notions of peace and contentment just goads to drive us on in an ever futile quest for an illusory satisfaction?   And if we see through it all and lose the illusion and see our striving as merely the way we are programmed to avoid entropy, do we just succumb to a loss of meaning? 


I retain the touching belief that humans are capable of blissful states of peace and contentment, conditions of being without striving, the freedom from all needs and desires that the Buddhists call nirvana.  Babies are probably in that state for much of the time.  But for the rest of us, we have to find it in nature, the companionship of others, music, poetry, reading in front of the fire, listening to the radio and paradoxically, rhythmic exercise like running.  


I think both states of being exist and alternate within us like yin and yang.  They are  expressed in the body via activity in the sympathetic and parasympathetic nervous systems.  The sympathetic creates the tension for change to endeavour to satisfy our needs, while the parasympathetic conserves energy by promoting rest, companionship, digestion, growth and sleep.  For a complete life the two must be in balance.  The problem is that the way we lead our lives these days is destabilising and encouraging us to strive for illusory goals more than is healthy.   


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