Perhaps the bottom line – in science, medicine and life – is that perception is where it’s at!

This month we celebrate the start of this website’s second year. . . To mark the occasion, Kevin Eakins and I have decided to alter the name and homepage slightly but significantly. As a part of our process of frank sharing and exchange with you, this blog is about the how and why – with reference to our most dramatic original claim: that we represent a movement which forms part of a scientific and medical revolution.

Along the way, I’ll share some insight into the thought processes of those behind this website and its ideas – in case you ever wondered how these two wackos came to put together such an eccentric collection of ideas, and the background to it! More importantly, I’ll quote from one of the most inspiring books written in the history of the philosophy of science – a landmark work first published in 1962, perhaps marking the dawn of the modern era and since earmarked as a modern classic – and once labelled by the Times Literary Supplement as one of the “hundred most influential books since the Second World War”:  Thomas S. Kuhn’s “The Structure of Scientific Revolutions”.

You guessed right, it’s fresh on my mind because I’m reading it at present. . . at last! It’s one of those books I’ve been eyeing up for years but hadn’t yet read, and although I haven’t finished it, I’m already keen to write this blog in reference to some of its inspired line of thinking. But who cares about what’s on my reading list, anyway? Well, as our medical mentor Savely Yurkovsky, M.D., has said many times, no one in today’s world can practise any form of medicine responsibly without also acquiring a profound understanding of the nature of science. . . This means that in addition to books on medicine, we should have books on science on our reading list too. . . Furthermore, patients and the general public would also do well to develop a basic understanding of science principles, to avoid being duped and to become at least partially fluent in today’s main popular “currency” of thought. . . !

Changes in this Website’s Title and Homepage

Originally we launched this website under the following title: “The Living Systems Revolution – Transforming Medicine and Science”. The next sentence on the homepage then read: “Welcome to the future of medicine and science.” Dramatic? Yes. . . Baseless? I think not. . . Nonetheless, our perspective has made a subtle shift in one way.

First I noted the following objections from my colleagues Kevin Eakins and Savely Yurkovsky, MD (and yes, we don’t always agree but frequently challenge each other, on the road to improvement!) By showing you a momentary insight into our private dialogues on these topics, I’m also opening it up to your views – and aim by this to demonstrate the care we give to refining our definitions as precisely as possible over time, and the love with which we approach both the overview and the details of what we are writing about.

Dr Yurkovsky felt that the word “transforming” was the only part that he wasn’t so keen on. He proposed it had a sub-optimal emphasis; in particular he felt that although we are transforming medicine, science itself has always been there simply waiting for us to understand it better.

“Transforming Medicine Into Science”!

He then went one step further, in an effort to help, and suggested our new title could be: “The Living Systems Revolution – Transforming Medicine Into Science”!

At first we were excited by this, and considered it – because we loved its polemic, daring challenge to the reader.

However, after sleeping on it, we realized that we did not want our website to be primarily focused on demonstrating that the new medicine is scientific. Much as this fascinating theme interests us, we prefer to allow ourselves a wider subject matter on this blog – since not all of our blogs are about this.

Nonetheless, we liked the clever turn of Dr Yurkovsky’s new phrase (the irony or unexpected twist of which also reminded me of Leonard Cohen’s song chorus from a few years back, where he droned, “Democracy is coming. . . to the USA”, in typical polemical fashion, presumably hoping to challenge his listeners’ complacency or assumptions!) So we have invited Dr Yurkovsky to write an article about it because we would love to publish his thoughts about this in a future blog here.

Clearly he feels that, in spite of what we are told, medicine is not currently practised in a truly scientific manner – and we would welcome the views of readers on this question, too, in either direction. It’s a refreshing and surprising topic of debate, perhaps – a discussion to relish. . .

How about you – do you believe there are forms of modern or alternative medicine that are practised in the world today scientifically?

For many years, some (not all) parts of the conventional medical establishment have been rejecting most forms of alternative medicine as “unscientific” – and so what a surprise, now, to see Dr Yurkovsky turning this same lens or criterion onto all forms of medicine, of whatever creed, to ask fundamental questions about the nature of science. Is it possible that the very people labelling others unscientific have themselves been significantly less than scientific all along as well – and here I don’t mean only in the theories or studies, but also above all in clinical medicine? Has anyone escaped this criticism? Is anyone in the world really practising medicine scientifically? To achieve this, what would be required?

My take would be, that utilizing certain aspects of science does not make what you do a true science if it is incomplete and leaves out key areas of science – such as systems science, including complexity theory. There are some fundamental scientific gaps in existing forms of both conventional and alternative medicine, and Dr Yurkovsky has been working for some time on a new DVD about this topic, and the nature of science. This does not mean that any forms of medicine (either conventional or alternative) need to be rejected for this reason; rather, it highlights the ways in which they need to evolve, and how the Living Systems Revolution is assisting that process.

I look forward to hearing what he has to say on his forthcoming science DVD.

What, actually, is being transformed?

I saw Dr Yurkovsky’s logic, regarding our original phrase, was on one level sound – can we really claim that science is changing? How can something that is a fundamental philosophy and methodology, such as the scientific method itself, change in its core?

Yet at the same time, in an attempt to counter his observation about this, I expressed the view that science itself is undergoing a major transformation, which we are not creating ourselves, but which we are benefiting from in medicine. My thinking during this period was especially influenced by systems biologist Ludwig von Bertalanffy whose thought-provoking 1969 classic work “General System Theory” I was reading, in which he wrote exciting sentiments such as:

We believe that the future elaboration of general system theory will prove to be a major step towards unification of science. . . Less advertised than the contemporary revolutions in technology but equally pregnant of future possibilities is a revolution based on modern developments in biological and behavioral science. For short, it may be called the “Organismic Revolution”. Its core is the notion of “system” – apparently a pale, abstract and empty concept which nevertheless is full of hidden meaning, ferment and explosive potentialities.

Certainly, the way that science is being practised is radically transforming. Yet perhaps, to pose another view (and I reserve the right to freely contradict myself or offer various perspectives, and take pleasure in doing so, within such a complex and multi-faceted world as we live in!), it’s not necessarily enough to say that we’re part of a movement which is transforming medicine or science, since perhaps we could say that this movement is helping to make it possible for the first time for genuine medicine to be practised! (as I argued in an earlier blog) – and likewise, that the systems scientists have made it possible for the first time for genuine science to be practised, since before systems science, science itself and the scientific method were incomplete, i.e., were applying incomplete definitions, means and methods. Therefore what we are marking may on one level not even be a transformation so much as a creation. A birth!

Of course, often in life there are two perspectives which are both true. So regarding science, on the one hand it is true that it undergoes periodic revolutions (subject of Kuhn’s book – more on that below), while on the other it is also true that the essence of science is constant, behind these changes.

The Science of Perspective. . . and New Perspectives on Science

I have in earlier articles coined the phrase “science of perspective” as my attempt to define systems science using a visual concept. Over the years I have also searched for images to convey the concept in as everyday a manner as we could, such as “Russian dolls” or “horizons” or “landscape” or even “rainbow”.

I don’t know whether or not Thomas S. Kuhn (who was professor emeritus of linguistics and philosophy at MIT) would have thought of himself as a “systems scientist”. A lot of what he was writing about pertained to the same subject which forms the object of systems science – perspective.

He famously proposed that, contrary to popular belief, the progression of knowledge in “normal science” which is merely incremental (alongside the gathering of large quantities of mostly inconsequential data) is not actually the main process which brings about significant evolution of science. It is merely the process (not in itself bad, of course – but a useful process) whereby an existing paradigm fills in the details; imagine a picture which has already been drawn, but needs some detail added. This is the sort of thing that needs to be done, as a process of refinement.

This “bread and butter” of scientific studies is all well and good – so long as you’re not expecting any new solutions to unsolved problems and enigmas! Of course, in a field like medicine which is rife with heartbreakingly unresolved chronic degenerative diseases sweeping the globe, it will be a grossly inadequate and inappropriate form of science

So what form would be more adequate? The form which is capable of evolution, breakthroughs; the introduction of new ideas, fresh solutions.

This is not achieved through the “normal science” of what I might call “incrementalism” (is that a word?) Rather, he described the periodic process of “paradigm shift” – which is essentially a change in perspective, rather than a change in data – and sought to specify how it works with plentiful examples.

My own perspective has shifted in one way since a year ago. I would like to hope it is an improvement, but I’ll leave you to judge! With each year that passes, I hope we all find our perspectives evolving, rather than stagnating. . .

Instead of viewing ourselves as fixed points – benefactors of medicine and science – while these two are changing, I have realized that perhaps a slightly truer or higher view on this is that it could be expressed the other way round, i.e., far from being fixed benefactors, we are the ones changing. The true essence and practice of medicine and science are not necessarily evolving in and of themselves – they are only evolving in our perspective. In other words, it is our perception which evolves in a “scientific revolution” (and Kuhn argues the same is true of all paradigm shifts in history). It is our perspective which is being “transformed”.

This thought crept up on me and crystallized the other day while I was out for a jog. And interestingly, it was this realization which led me to pick out Kuhn’s book from my bookshelf’s reading queue and start reading it at last. Here was an example of exactly what Kuhn writes about in his book – how we “see” things when we look for them – they do not tend to simply find us like passive recipients of “science” being served to us on a plate!

You do not tend to find or see what you do not look for; and in turn, you do not tend to look for what never existed in your mind in the first place as an idea. This, in essence, is also what Dr Yurkovsky refers to continually in his medical training sessions as “mental software”.

Likewise, I had the private “insight” first and this led me to his book for assistance in understanding it more deeply; he gives many examples in his book of how ideas and perceptions change inside, or at least new possibilities open up inside our minds, and THEN we both seek and become capable of seeing new evidence out there to corroborate those thoughts or suspicions. First there is the possibility in our minds; then the evidence (or, just as importantly, counter-evidence!) is looked for. . .

Of course, misconceptions about the nature and process of science abound – which is no doubt what prompted Kuhn to write his book – and likewise me to write this article now. Most scientists seem to delude themselves into believing that incremental gathering of minutiae of data is what science is all about, and practise so-called “science” largely without focusing their attention on questions of perspective. Those scientists who have been exceptions to this rule have, of course, often numbered themselves among history’s greatest – and for the same reason are frequently neglected at the time by their “incrementalist” peers.

Modern-day examples, in my view, might include neglected scientists who are, or were, breaking vital new ground such as Boyd Haley, Ph.D., Robert O. Becker, or Professor Olle Johansson, Ph.D. At exactly the moment such scientists begin to do some of their best work – is exactly the moment when the mainstream institutions seem to start cutting them loose! I believe also, therefore, that many of the scientific institutions themselves need also to review Kuhn’s work, revitalize their priorities and put a leash on their myopic incrementalist tendencies. . . ;-)

Is Evidence Based Medicine an Invalid Approach?

Touching for a moment on “Evidence Based Medicine” (EBM) – Thomas S. Kuhn’s book could also be viewed as an apt refutation of EBM, exposing it to be a hollow shell of an approach to medicine, even though the author himself doesn’t mention it.

In short, EBM is a trendy modern approach which espouses the view that medical practice should follow the evidence. Sounds brilliant. . . agreed?

However, as Kuhn presents in his volume with many examples, that is not the way science works.

What actually happens is that the evidence follows our perceptions – or, in other words, everything starts with the paradigm, the possibilities in our minds, and then we are largely only able to perceive the evidence from within it. The other way round, as an effective primary principle, is an impossibility, hence invalidating EBM as the first principle of medical practice.

Thus on this website, we say that evidence – although undoubtedly important – is secondary, and, in its place, paradigm analysis is primary – and that EBM has therefore got it backward. There is something that precedes evidence, something that allows us to find and see supporting or contradictory evidence like the shadow cast by sunlight – and, to borrow a phrase I like from the Landmark Education movement, that something could be said to come from the “Realm of Possibility” – the place in our minds where new ideas or perspectives take seed, from which all of science and medicine (as well as our life perspective) flow.

Otherwise it would be like trying to bake and then taste test a meal for which the recipe not only does not exist yet, but does not even have any precedent; all cooking must start in the chef’s mind, and will emerge within his or her style of cuisine – and if you want to taste test a different sort of meal, the chef will first need to explore a different sort of style. After all, it would seem senseless to set up a new school of cookery labelled “Taste Test Based Cuisine”. . . ! You could do so, and the idea itself appears to have value upon superficial consideration, but ultimately you’ll end up taste testing only a narrow existing range of meals (thus you will become yet another deluded culinary “incrementalist”) because this school of cookery places no emphasis on analyzing the chef’s style or any possible ways to innovate new recipes of value, and nor does it allow for any other “food values” besides taste, such as for example nutritional value.

Or, in short, instead of advocating “Speed Based Transport” it would make more sense to talk about train and lorry designs – and that will moreover be a process which takes into account multiple factors, rather than just speed. By emphasizing only one component of the end result, it narrows down and distracts from the process of true innovation of design at the level of source, which ought to be the focus instead. . .

Birth Contractions?

Returning to our website title: I then realized that Dr Yurkovsky’s instincts were right all along (as they often are, I have found over the years!), because instead of placing our emphasis on the transformation taking place in medicine and science, it would be even better to emphasize the transformation in our own perspective, which allows us to perceive a new type or practice of medicine and science, or maybe even (I would argue) their birth.

After all, human life exists and grows for nine months prior to birth, and likewise, science and medicine existed before the Living Systems Revolution – but such a dramatic shift is taking place that I think of it as like a birth. We are not the source of that birth. We are not even the midwives of it! But we do see ourselves as playing a humble role in observing and contributing to a part of it. It is a process that had already seeded before any of us were born – but now we are witnessing increasingly frequent birth contractions taking place around the world. Thus now, more than ever, we want to write blogs like this one to do our best to help define, understand and encourage what is being born. . .

A New Landscape

As of last week, our website heading now reads: “The Living Systems Revolution – A New Landscape of Medicine and Science”.

Our intent here is to shift the emphasis ever so slightly, so that now what we are most interested in is not only the changes in medicine and science but, also, pre-eminently, in our perspective. We wanted to find a visual image to capture the concept – which led us to the idea of a view over a whole landscape which we are looking at and exploring for the first time, a view fresh and expansive.

This is meant as a symbol of, perhaps, a window through which we had not looked before, and thus a landscape outside of the room which we had not discovered or studied until now. On a private note, I confess I was also secretly pleased to be able to link in the core concept of our medical work with the image of a searching poem (albeit posing more questions than answers, perhaps!) which I wrote many years ago ;-) :

Weary of self-interest, I turn my head –

with curtains parted and lights off –

to look –

look out of the window –

then attempt the most difficult of all things:

without expectations or notions –

to see –

just see what is there.

More Changes

Kevin Eakins has been a close part of this dialogue about perspective, which, as usual, has evolved collaboratively between us. He too has therefore also been pondering the subject of perspective increasingly (such as in his recent blog on the subject) – and on that note, had another suggestion too. Instead of saying “Welcome to the future of medicine and science” on our homepage, he has modified it to, “Welcome to a future perspective on medicine and science.” I like his change, as again we get to introduce the idea of perception prominently – and even the key word “perspective” itself.

By the way, our emphasis on perspective is not in itself new, of course. . . Many have emphasized it before us, and as for us, it’s not a new part of our work. We made it the central idea of projects launched years ago, such as “Brave New Horizons” and “The Wisdom Foundation”. And the second time we taught the FCT Graduate Programme, in 2007-8, Kevin and I modified the syllabus by launching the course with our new idea of “Seven Key Tenets of Medicine” (as a way of attempting to define some of Dr Yurkovsky’s work), which we presented as being based on the core systems principle of perspective – and from which the rest of the course, and FCT, was – we argued – all ultimately derived.

Somehow, I enjoy this sort of effort to find our way to the heart of a subject with as much simplicity as possible, even though it took us several years to distil this, and another few years since then just to begin to corroborate and deepen our understanding of an idea so big that I see it stretching out into a lifetime’s work ahead and beyond; so we do our best to apply our lens, terms and methods, even though it’s not an idea we created, and it’s an idea that will long outlive our small role in highlighting it for a while.

Back to “The Structure of Scientific Revolutions”

In one fell swoop, through these changes, we feel we are subtly re-defining (or rather, seeking ever greater clarity of definition about) the essence of our work and, in turn, our medical mentor Dr Yurkovsky’s work, from which ours is directly derived. Everything comes down to perspective – and on that note, rather than boring you with my own thoughts about Thomas S. Kuhn’s book, I will simply quote the following passages from chapter 10 (“Revolutions and Changes of World View”) which I found thought-provoking and well put, wrapping up some of the key points of this blog better than I could:

During revolutions scientists see new and different things when looking with familiar instruments in places they have looked before. It is rather as if the professional community had been suddenly transported to another planet where familiar objects are seen in a different light and are joined by unfamiliar ones as well.

. . .What were ducks in the scientist’s world before the revolution are rabbits afterwards. The man who first saw the exterior of the box from above later sees its interior from below.

. . . Looking at a contour map, the student sees lines on paper, the cartographer a picture of a terrain. Looking at a bubble-chamber photograph, the student sees confused and broken lines, the physicist a record of familiar subnuclear events. Only after a number of such transformations of vision does the student become an inhabitant of the scientist’s world, seeing what the scientist sees and responding as the scientist does.

. . . Therefore, at times of revolution, when the scientist’s perception of his environment must be re-educated – in some familiar situations he must learn to see a new gestalt. After he has done so the world of his research will seem, here and there, incommensurable with the one he had inhabited before.

. . . Surveying the rich experimental literature from which these examples are drawn makes one suspect that something like a paradigm is prerequisite to perception itself. What a man sees depends both upon what he looks at and also upon what his previous visual-conceptual experience has taught him to see. In the absence of such training there can only be, in William James’s phrase, “a bloomin’ buzzin’ confusion.”

. . . Can it conceivably be an accident, for example, that Western astronomers first saw change in the previously immutable heavens during the half-century after Copernicus’ new paradigm was first proposed? The Chinese, whose cosmological beliefs did not preclude celestial change, had recorded the appearance of many new stars in a telescope, the Chinese had systematically recorded the appearance of sunspots centuries before these were seen by Galileo and his contemporaries. Nor were sunspots and a new star the only examples of celestial change to emerge in the heavens of Western anatomy immediately after Copernicus. Using traditional instruments, some as simple as a piece of thread, late sixteenth-century astronomers repeatedly discovered that comets wandered at will through the space previously reserved for the immutable planets and stars. The very ease and rapidity with which astronomers saw new things when looking at old objects with old instruments make us wish to say that, after Copernicus, astronomers lived in a different world. In any case, their research responded as though that were the case.