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COMPLEXITY-PRIMARY-CARE  2004

COMPLEXITY-PRIMARY-CARE 2004

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Subject:

Re: What it means to be MODERN - remaking humanity

From:

Jon Bennett <[log in to unmask]>

Reply-To:

Complexity and chaos theories applied to primary medical and social care <[log in to unmask]>

Date:

Sat, 12 Jun 2004 15:32:00 -0400

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text/plain

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Interestingly, the Bible teaches the end times as being chararcterized by a dramatic increase in knowledge, and then goes on to say-but this will not save man. The Bible also speaks of learning and learning and never coming to a knowledge of the truth.

This era we are in is certainly about the end of certainty. If I might use another Biblical allusion, it reminds me of the tower of Babel. The web,information technolology etc. and all it spin offs ,is our new tower.

In a message dated 6/3/2004 4:19:48 AM Eastern Daylight Time, [log in to unmask] writes:

> 
> 
> 
> 
> I am rereading John Gray’s “Al Qaeda and what it means to be Modern”
> Thanks go to him for the first part of what I am going to say.
> 
> He describes with mordant irony the sect of positivists and there worship of science and technology. He unpacks previous episodes of “remaking” humanity such as the Nazis and the Bolsheviks. He describes the history of positivism and the fantastical beliefs of Americans thinking they can remake the middle east. The counter drop he offers is the modernism of Al Qaeda.
> 
> He shows the myth that the advance of science will bring 
> With it a single set of values and reminds us  that in our pagan past we had a deep understanding of how flawed humanity is, which today we appear to have forgotten. In Euripedes knowledge, cannot undo the workings of fate and virtue gives no protection of disaster.  (interesting the attraction of disaster movies these days ...) It is a short, well written book and I thoroughly recommend it.  
> 
> <http://www.amazon.co.uk/exec/obidos/ASIN/0571220355/qid=1086248249/sr=1-1/ref=sr_1_26_1/202-5813457-4148600>
> 
> 
> I guess engaging with humanity is something that we endeavour to do in medicine. Sometimes we are lucky enough to be able to move things along a bit other times less so. I rediscovered some of my own flaws yesterday with patient I found very hard to deal with ... 
> 
> Regards
> 
> Alasdair
> 
> ___________________________
> 
> Dr Alasdair Honeyman MB BS BSc MSc MRCGP 
> Independent Health Process Consultant and GP
> (mobile) +44 (0) 776 0221780
> 
> 
> On 2/6/04 6:31 pm, "Ceri Brown" <[log in to unmask]> wrote:
> 
> In a message dated 02/06/2004 12:58:02 GMT Daylight Time, [log in to unmask] writes:
> 
> 
> 
> 
> 1.When this shift is initiated from those that actually do the work it is known as a revolution; when it occurs within the academic community it is known as a paradigm shift; when it originates from the political elite, we call it modernisation. (But watch out for the latest wheeze - social movement theory. Top-down modernisation re-packaged as bottom-up revolution.)
> 
>  AND
> 
> 
> 2. If you insist on a word to encapsulate your experience, how about McDonaldisation?
> 
> 
> -----------------------------------------------------------------
> 
> Thanks for the first paragraph of your reply which was very rewarding.
> 
> Another long reply I'm afraid, but my response has a neat circularity.
> 
> 
> Point 1
> 
> Can I suggest that 'revolution, paradigm shift and 'modernisation' from a political elite' are all variants on the same power theme. Each require a body of 'experts' who 'know' what to do based on their ideology, which I'll define (for the sake of this argument only) as a fundamental set of ideas - correct, unalterable and universally applicable (eek! modernism?). Revolutionaries and politicians refer to their political ideologies, while academics refer to ideology of science. (Academic lurkers reply now).
> 
> What is missing is the concept of "revelation" which does not require an external expert, but rather a 'coach' or 'facilitator' and opportunity to think/reflect on action and then act differently in the future, with or without the involvement of others. This takes us back to Boyd' Rodger's “reflex interaction, reflective dialogue, and reflexive dialogue.” (Argyris and Schon, Stacey etc). The latter term is relevant and the example which comes to my mind most readily is Hazel Stutely in Falmouth. No 'expert' with a plan, but a 'community facilitator' or 'enabler,' and thus neutralising the power discourse implied in the terms 'revolution, paradigm shift and 'modernisation' from a political elite'.
> 
> I suppose that by its nature, revelation is uncontrollable because it is so dependent on context. It probably also requires an effort of will and the need to connect  with many others. The metaphor of Complexity. But here's my paradox, the circumstances for 'revelation' have to be organised - weekly meetings in a local hall for example. In other words, can modernity only be transcended by modernist techniques? Which is where John Holland may fit, with computational artificial life.
> 
> Point 2
> 
> I suggest that some regularity is essential. It is known that there are errors of omission and commission in healthcare systems (there's another word laden with inferences of power - 'system'). It is these particular irregularities which are concerning me at the moment, especially in view of the recent Lancet series on Inpatient Safety. I may hate the taste of the Big Mac, but it tastes equally foul everywhere across the globe. I may have coeliac disease and am therefore excluded from McDonald's everywhere across the globe (Leigh-Starr passim). Modernity as exclusion - if you don't fit in the system, you're out. Thus, is Complexity fundamentally inclusive, conferring no particular position to an elite, and antithetical to power? (P Kropotkin, Mutual Aid?)
> 
> Ceri
> 
> 
> Dr Ceri Brown
> 
> Critical Care Programme
> Project Development and Research
> 0116 222 5119 (Secretary)
> 07659 120 038 (pager)
> 07876 230 561 (mobile)
> 
> visit www.criticalcare.nhs.uk for details of the Critical Care Programme's work
>  
> Postal address:
> 
> NHS Modernisation Agency,
> Critical Care Programme,
> 3rd Floor,
> St John's House,
> Leicester. 
> LE1 6NB
> 
> This email, and any files transmitted with it, is confidential and intended solely for the use of the individual or entity to whom they are addressed.  
> 
> Any views or opinions presented are solely mine and do not necessarily represent those of the Modernisation Agency or Pennine Acute NHS Trust.
> 
> If it has been delivered in error, let me know, and any further use, dissemination, forwarding, printing, or copying of 
> this e-mail is not allowed.  
> 
> 
> 
> 
> 
> 
> 
> 
> 
> 
>

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