Friday, January 12, 2007

Holistic thinking

I've been wanting to write a more substantive comment on the recent discussion ranging from here to ibid's and S. Lee's blog and back on neuroscience. Unfortunately, every time I try to string something coherent together, I am unable to express what I'm thinking. I keep returning to what one of the commenters said on ibid's post, "neuroscience is the frosting on the cake...analyze while you eat." Which, at first reading, was unsatisfactory. I thought the poster was ignoring the the issue at hand. But when I thought about it some more, I realized that's precisely the point. It is easy, I think, to become so wrapped up in details that the picture fades. As with a Magic Eye poster, you have to step back, and use the right filter, and suddenly the picture makes sense. Reality, similarly, is best appreciated holistically, and though the details are important, they are not the picture. To use another poster-metaphor, it is possible to make a photo mosaic of almost anything, using smaller, more detailed, but incomplete versions of the whole.

Returning from the world of metaphor, though the details are important to understanding, what is more important is the reality of which they are a small part. Even though the details, in this case neuroscience, may seem to give contradictory information, I am confident that the balance of reality will prevail, and that over a long enough time course, the scientists will find themselves saying, with Eliot:
We shall not cease from exploration
And the end of all our exploring
Will be to arrive where we started
And know the place for the first time.

Every piece of the whole, eventually, leads us to a greater understanding of it. Einstein's famous theory may have changed the way we understand the orbit of Mercury, but it does not change the singular experience of watching that beautiful planet arrive over a ridge line just before the sunrise. Bernoulli's famous principle may have allowed us to fly, but it does not alter the wonder with which we watch a flock of geese winging south.

Though on the balance, I dislike the man, Walt Whitman reached a similar conclusion, and summarized it better than I can, when he wrote the following:

When I heard the learn’d astronomer;
When the proofs, the figures, were ranged in columns before me;
When I was shown the charts and the diagrams, to add, divide, and measure them;
When I, sitting, heard the astronomer, where he lectured with much applause in the lecture-room,
How soon, unaccountable, I became tired and sick;
Till rising and gliding out, I wander’d off by myself,
In the mystical moist night-air, and from time to time,
Look’d up in perfect silence at the stars.

We can do little less. I may know progressively more about the way my patients think, and the fact that they are crying before a procedure may tell me their amygdala is working overtime, but it doesn't change the reality that they are scared, and it doesn't change my responsibility to hold their hand and talk them through it. The reality of our perceptions is where each of us must live, and as a Christian, I must interpret that reality through the lens of Christ, who asks each of us to act as if we had free will, whether or not we truly do. He asks each of us to have compassion, whether or not that can be reduced to a set of electrochemical principles. Doing less, on the basis of conjecture, would be irresponsible and wrong. And those are two things for which we cannot write an equation. We must simply know their reality.


Ibid said...

'tis true. And, by the way, the "frosting on the cake" comment was by my dad, who is also a reflective person in the medical field... only he's getting old.

arcturus said...

That's a rather beautiful thought, actually. It's easy to wrap ourselves up in the little things when, regardless of what the scientists say, we have an exquisitely glorious duty to live as Christians.

The Angry Medic said...

Whoa. Very Zen, Nathan. Nice post. I can see now why you previously said you had more of the patience and thoroughness suited to an internist.

Okay, I haven't been checking in here for a while, but I'm catching up on your posts and I have to say, you are my new hero. Neurosurgery has always been one of my favourite specialties, but I don't get to get down and dirty for another 2 years, so in the meantime any med student doing it gets my adulation. More posts! Give us more!

The Angry Medic said...

Oh, and one final point: I liked how you tied in your Christian values with practising medicine. It may just be my rose-tinted glasses, but I find that my Christian colleagues practise medicine with a lot more compassion and tirelessness. You sound like you'll make one heckuva doctor, whether you choose the physician's path or the surgeon's.

Nathan said...

ibid - Ah, that makes sense.

arcturus - thanks, and I think you're right on. Additionally, I love the word "exquisite." Nice. So, do you have a blog?

Angry Medic - I'll definitely be posting more neurosurgery stories, if only because, as I commented a while ago, this is a great way to vent. Thanks for the kind words, and though I would hesitate to say Christian docs are more tireless and compassionate, faith definitely helps put things in perspective, and gives us a strength others must find in less dependable ways.

Anonymous said...

There is a continent that lies before you on this odyssey of yours, and I can only guess from a few blog interactions that you have not yet reached that shore. Like the auditor in Whitman's poem, it will be very much like stepping out of the lecture hall to gaze at the night sky, realizing that, paradoxically, you are seeing something for the first time. The new country is Fatherhood, and when you hold your own miracle in your hands and day by day behold that growing life you will increasingly find careful, Medicus, to be there. GTB. Very nice post, by the way.

arcturus said...

It took me some time to come up with the right word. I'm glad 'exquisite' was a good choice.

SnowQueen said...

Beautiful posts. I just stumbled upon your blog.
You seem to have the heart exactly in the right place.
I did want to comment on one thing, which I know is not the point of your post.
About being a Christian. Isn't it more about being Spiritual. As we know there are so many religions out there, that truly are divine, yet may not relate to Christianity.
I'm not from USA, nor am I Christian. I just wish people would open up the dialogue about being spiritual, and spiritually minded. I believe we can all relate to that, Muslims, Hindus, Buddhists, Jews and all others.

Compassion is taught in all religions, in all faiths, and I believe that is where we ought to open up the dialogue.

Beautiful blogs!