Rather Suspect

Recently I heard the term “band-aid medicine” used to describe much of so-called Western medicine and I must say it resonated with me.

The concept is that a medical professional, when presented with a set of symptoms, looks to allieviate the symptoms rather than identify the root cause. I’ve experienced this myself recently and found it confusing. Why would this be?

It feels to me one key to this is, sadly, simple the incentive structure built-in to our medical system. In my experience anytime I’ve seen a doctor, they are paid per visit (and in a very opaque way, wherein my portion is the “copay” regardless of what it is they did during that visit.) If I had a business where I got paid each time I interacted with someone, guess what? I’d find ways to see 20, 30, 80 people each day. And during each visit, I’d be thinking “the clock is ticking.”

This summer I saw an orthopedic doctor regarding some lower-back pain. At the start of the visit I mentioned that I had an old injury in my upper-back and wondered if that might be related. Exasperated, she replied, “how do you expect me to examine both your lower back and your upper back in only 40 minutes? Please schedule another appointment for that.”

Who said anything about 40 minutes? And since when is the state of the upper back “outside the bounds” of an examination of the lower back? But, of course, she was “on the clock.” I have no insight into her compensation but I wouldn’t be surprised if she received a bonus based on the number of patients she saw in a given quarter.

Given this, is it any surprise a doctor wouldn’t want to put a “band aid” on your ailment as quickly as possible and send you out the door?

But — certainly there must be a solution to this. An incentive structure which rewards healers (note that word) who actually succeed in identifying and treating the root cause of any issue.

Does this exist anywhere in the world I wonder — at scale? Yes, I would imagine if one has the means, one can always hire the appropriate individuals. I doubt Bill Gates or Jeff Besoz lack for medical care. But what’s the appropriate solution for the other eight billion humans on the planet?

This morning over Sunday coffee I was thinking about thinking. What are the components of thought?

I landed on the following:

1. Identifying. This is here, that is not. “An apple exists.”

2. Grouping. These are similar to those. “These are all apples.”

3. Relating. This item is linked to an item on another dimension. “There is a thing called an apple. There is a thing called red. The apple is red — or, the apple has redness.”

From there I thought, well, of course this is logic, mathematics, right?

So — what tools do we have? Well, each of these is a dimension.

The first dimension of identifying is a dimension that spans from “less existing” to “more existing.” The least amount of existence we call “zero.” The most amount we call “one.” We move here from negation to affirmation.

The second dimension of grouping is called counting. The “least amount” of anything in this dimension is “one” and the most is “many.” We move from singular to plural.

The third dimension of relating is really simply linking something from one dimension to another dimension. There are two kinds of linking: is and has — and that maps to the above. “Is” links to identifying and “has” links to grouping.

In other words, when we think we can do one of three operations: identify, group, or relate.

What I find interesting here out of this is that our idea of “zero” doesn’t fit into the grouping dimension. Zero is a “level of existence” not a “level of grouping.” You can’t have a group of zero.

Which means (I believe) that the number line (0, 1, 2, 3…) we were taught in elementary school is incorrect. There are, in fact, three “number lines” — one mapping to each of the above dimensions. Imagine the first as the x-dimension, the second as the y-dimension and the third as the z-dimension.

What’s cool to me is the so-called challenge of physics in the past century has always seems to be that we’re trying to merge the very small (quantum physics) with the real world (Newtonian physics) with the very large (relativistic physics.) And so this falls out nicely:

1. Quantum physics is the study of the “level of existence” and goes from zero (it does not exist) to one (it fully exists.)

2. Newtonian physics is the study of “how much” and goes from “one” to “many.” Here we have calculus.

3. Einsteinian physics is the study of “relating” (literally: relativity) and shows “level of connectivity” from one dimension to another.

Why is it so hard to get our heads around the first and the last? Because we’re using “grouping” and “counting” tools to try to analyze them. Foolish! Imagine listening to a symphony and trying to describe the sound of a tuba as “greenish-blue.” Or imagine smelling a fresh-baked apple pie and describing the smell as “loud.” We can sort of “make the leap” but it’s not natural. We should use the language that maps to the domain.

And here’s the beauty of this. It’s not that there are three planes of the universe — it’s that our minds have three senses.

We believe our body has five senses: sight, hearing, touch, taste, smell. Here I propose our mind has three senses: identifying, grouping, and relating. So it’s not that the universe is “quantum” or “Newtonian” or “relativistic.” It’s that just as we might touch, smell and taste a chocolate chip cookie, we are identifying, grouping, and relating our environment.

So: three number lines, three dimensions, all intersecting not at “zero” but at what I’ll call more generally the “origin.”

Zero is not less than one any more than “sour” is less green than “blue.” Two different parts of the brain sensing two different things.

This week, Jeff Besoz announced that he would give away most of his $120 billion in his lifetime. Hoorah! What a magical world we live in where a man not only can create a business which generates such vast amounts of wealth but then have the generosity to commit to giving it away.

Except…why does all this feel so awful?

Simple. Because we don’t live in a monarchy anymore. And this approach to both wealth-building and distribution is incompatible with democracy.

Because what will happen now? He and his partner will form a foundation. They’ll hire a very talented team of advisors. They’ll make “strategic bets” based on their well-researched “theories of change.” And then, in the upcoming years, some very deserving non-profit leaders will receive massive grants to help them pursue their missions. What’s not to love?

Only this. We don’t do this anymore.

We don’t — or we shouldn’t — have to bow before the king in order to ask for funds to address the failings in our society. We should — as a society — be able to do this on our own by forming and funding the institutions necessary.

A billionaire committing to “giving away” his fortune is not Free Money. It’s money with plenty of strings attached, and worst of all these strings aren’t transparent. Should we put this money toward addressing the environment, improving education, or creating new economic opportunities? It’s not for us to decide: that’s the domain of the King. Behind closed doors, he (just like Gates, Zuckerberg, and the others) will decide what areas they deem worthy.

But isn’t it better that he do this than keep the fortune himself? I contend, no. To introduce a new source of funding at this scale encourages and promotes an asymmetry in addressing societal issues which would be much better addressed through open, transparent approaches. In other words, through democratic approaches.

Let’s respect our social impact leaders and remove this spectacle of them having to kiss the ring. Instead, let’s all of us take up the power we already have, and get to work.

On the one hand, you have your body, that strange and wonderous vessel into which your soul was poured. What do you know of your body? Special things, intimate things. How you feel when you place a chocolate mint on your tongue. That warm shiver in your back when someone special takes your hand.

On the other hand, you have this thing we call the healthcare “system.” And a system it is: buildings and machinery, administrators and online portals, charts and graphs and beeping machines that poke and prod. And somewhere — I guess — inside that machine, a set of professionals in special uniforms who analyze and treat, so often by prescribing chemicals that have been studied extensively in trials and are almost certainly what you need.

And of course that is what you need, right? Because your body is physical, biological — and so it’s time for the full weight of good old science to come to your rescue.

And the thing is, that science? It’s amazing.

But.

There is a disconnect here, a weird one. You take one thing, the most intimate of all things, and how do you care for it? Easy. Eat well, and experience that. Move well, and feel that. Love well, and envelop yourself in that.

Oh, and then, occasionally? Plug yourself into a trillion-dollar capitalist machine, book a few appointments, run some “labs.” Pre-approval with your insurance is of course key. Slide yourself into million-dollar devices if you’re able, the “tech” will show you how.

Must it be this way? Must if feel like this? There are necessary evils in this world, other “systems.” AT&T. United Airlines. Amazon. We utilize them, but we don’t connect with them.

Does healthcare need to feel like AT&T? Couldn’t it feel like our local grocery store? Like the coffee shop at the end of the block?

Doctors are busy, nurses are busy, everyone is busy. But…why? The coffee shop is busy, and then it’s not. Plenty of slack times. Those are my favorites times, actually. A coffee at 10:30am, or 2 in the afternoon. Time to enjoy, to linger.

But you don’t understand, they might say, there is such demand. No. No. There’s such demand like there’s such demand for the flight to Phoenix.

It’s a full flight. It’s always a full flight.

Why? Because how would the airlines make money if they flew you to Phoenix and the flight was only two-thirds full? Preposterous!

But preposterous is what I want. Doctors who have the time to linger. Nurses who are relaxing. Humans, meeting humans, being human.

What would it take, I wonder, for this “system” to change? For us to acknowledge: this thing, this special, intimate, magical thing we call our body — deserves something else. Not a “system.” Connection. Love. And care. Deep, slow, lingering care.

When you see the word god, what feeling first arises in you?

The Catholic way, to a young boy: hushed tones, darkened churches, men (only men, always men) in layered robes, sauntering from the back room to the altar before a service. God is Love the priest says later in his sermon, as if that clears up anything. It’s like saying Zero is One, a mathematical proof that is somehow supposed to convey some grand mystic truth but in fact conveys only ignorance.

Better, much better to say We Don’t Know but that’s an entirely different god. That would require the priest sit low on the steps and say I’m a human just like you, boy. And we are all in the dark.

That would feel real. That would feel honest.

But at that point I didn’t yet know the extent of the corruption. Or, actually, that’s not quite it. I should say I didn’t yet realize adults were capable of such corruption, that anyone had it in them to orchestrate such a grand and awful farce.

In college I took a physics course and they taught all the usual hits. A cannonball fired into the air follows a parabolic path. A ball rolling down a plane accelerates in such-and-such a way. I remember at the time thinking: yes, okay, fine, but…why? Things just want to stick to each other, is that it? Little things like big things? And big things like bigger things?

I was too shy to ask that question. Nobody else seemed to ask it, so I didn’t either.

God is Love. Gravity just Is.

No. You see? It’s not that it’s right or wrong, it’s that it’s a shortcut, a cheat. Just because it’s simpler to say it this way does not make it true. It could be. But you don’t get to own it. You have to prove it. Not hide behind your power.

I wish I could see that word god now without recoiling. But I cannot. They broke it for me, layered so many lies onto it, just like their robes.

How many lies, how much propaganda can you shovel at a young boy? They could have come clean from the start and think what connotations that word could have had. Trust, love, faith, joy, a willingness to accept and explore. So many possibilities. But, no.

The good news is, it’s just a word. A human word. And we have so many others to work with that feel so much better. Beauty. Wonder. Mystery. Excitement.

They took a word and tried to own it. A shame. Language has a power of its own. You can rent the words. But they’re not yours to buy.

There is our internal world and the external world. But why should this be?

Or to say it another way, how (and why) would self-awareness arise?

From an evolution perspective, perhaps it might have gone like this. A set of nerve sells begin to sense the external world, and these aid in finding better food and evading more predators. And then — perhaps — over time a few of these cells accidentally mutate, and instead of sensing the outside world, they sense the other nerve cells. Nothing intentional here (as with all of evolution), a cell just gets mis-wired and connects to another cell rather than the outside world.

So now, what? The first cell smells food. The second cell senses the first cell smelling food.

A third cell mutates yet again and this one senses the second cell sensing the first cell smelling food. Tangled wiring is mathematically more likely than neat, ordered wires, and so of course the axons and dendrites end up all intertwined.

I suppose from here the key is, this tangling must lead to some evolutional advantage. And it likely does: to use a physics example, the first cell feels pressure but the second or third will track the acceleration or deceleration of that pressure. So now we have two data points about a food source rather than just one, and can better distinguish between nourishment and poison.

What’s interesting in this model is the concepts of “time” and “self” emerge again, the two components of consciousness. Notably, neither are hard concepts in the external world, but simply emergent properties of this organically-grown sensing machine. Time arises only because the information travels in a serial path from first cell to second to third and back to second; if the second cell had positioned itself properly, on the surface of the organism, there would be no need for this serialization. And the “self” then arises when the information goes around the loop a second time.

In this model, neither Time nor Self exist in the external environment, but only because of these loops.

Today we create so-called AIs by building neural networks filled with feedback loops. Makes sense, but two questions arise from this. First, what is needed for those systems to create those properties of Time and Self? And second, what other wiring geometries could lead to an evolutionary advantage that don’t involve loops? The second would enable “thinking” that is both timeless and selfless.

When I feel anxious, I have just one goal: to stop time.

The job seems an easy one at first. I see the sun taking its familiar walk across the sky and so I simply stand up tall and get up on my toes. I reach my arms up and I grab the sun between my hands. Got it! I hold the sun there for a moment, then two, hold it firmly in its place. It burns my hands but I grit my teeth and continue to hold it, to stop it from its path.

But it’s not the sun that’s moving, of course. It’s the planet under my feet that’s rotating and so I try to hold that still with my toes, bracing my body against the sun. But how can this work? It’s like trying to hold back every mountain, every river. It’s like trying to stand on the coast and shove the Pacific back from the shore. Impossible.

And so, at the last possible moment — not by choice, but because I’ve reached my breaking point — I collapse, I fall in a heap to the grass, hands still burning from trying to hold the sun, muscles aching from contorting my body. I lie there for a moment, defeated. When I look up, I see the red cardinal standing before me, cocking his head.

I didn’t like how things were going, I tell the bird. I was scared. I just wanted to stop everything.

You fool, the bird says. You think your job is different than it is.

What is my job, I ask the bird. I’m struggling. I don’t understand where I fit.

The sun shines on your head, he replies. The wind blows across your face. The grass grows up between your toes. All this is because this planet is turning, rotating, dancing — endlessly — for you, you fool. For you.

Why do you need to try to fit, the bird asks. You already fit, in every possible way. This is all yours. You are home.

For a long while I’ve tried to work through the deep trauma of losing my mother when I was a young boy.

Trauma is a sneaking, insidious creature. Its first job is to hide, and it does this by burrowing deep into your identity. There’s no better place to conceal itself. Trauma is the computer virus that interweaves itself into the operating system so that no matter how many times you later run that anti-virus software, you won’t uncover it.

The metaphor is an easy one of course: you need to study yourself to uncover the trauma. And with enough examination, you do see it. First just a little, then more and more.

I always thought that becoming aware of that trauma was “the work.” I thought once I spotted it in myself, doors would unlock. Those doors might have rusted shut, of course, but the key was to break those locks and then it was simply a matter of time: open a few and find the joy on the other side.

But there is another layer to the process — and that’s extricating yourself from the trauma or, rather, it from you. And that is delicate, difficult surgery, because over time it’s wrapped its tentacles around so many different parts of you. It’s not that you can point at an action you’ve taken and say “that wasn’t me, that was the trauma.” Those actions were yours, and the results your life. So where is the boundary?

For example, I value qualities like strength and independence. I admire people who stand up for themselves and for others. But — why do I say I value those qualities any more than, say, the ability for one to be vulnerable and to work alongside another? Do those values I admire belong to “me” — or did the trauma tell me those qualities were important because I needed them to survive when I was younger?

And if that is the case — where does the trauma end and the “me” begin? Easy enough to say, of course, that it’s all “me” — that we are the total of all our experiences, no matter how sharp or negative. But I think anyone who has felt the effects of something so difficult will find that statement unsatisfying. There is a point in which there is a desire to free oneself from the beast, to drive a dagger into its tentacles and wriggle free.

But perhaps one doesn’t feee oneself by killing it. Perhaps you need to speak to the trauma, to tell it to release you, to let go. Or — perhaps — you need to speak to those parts of you that you wish to develop and give them the strength to break free of their own accord.

When you’re faced with something poorly-defined and fuzzy, which direction do you most naturally go? Or, perhaps more importantly, what do you run from?

Do you feel the need to make order out of things, to fit loose ends into an over-arching framework or strategy? If so, I propose that you’re more of a convergent thinker.

Conversely, if things aren’t particularly clear, do you find yourself gravitating towards speaking to more people, gathering more information, or trying new things? In this case, I propose you’re more of a divergent thinker.

I used to have a bias but over time I’ve shifted. I don’t think the best is to do one, or even to do “a little bit of both.” I think the best is to do a lot of both — but, ideally, to swing, like a pendulum, back and forth between the two. If things feel “all over the map,” then it’s often valuable and satisfying to spend some time trying to redraw the map itself. This is convergent thinking at its finest, because you are essentially identifying the model or strategy that makes the whole mess easier to understand.

However, the converse of that — and equally important — is to put more pieces on the board. Run a few experiments, try a few more things, speak to a few more people. The outcome of this is a picture that perhaps is less ordered but more complete.

At a personal level I sometimes find myself trapped or stuck on one side of the pendulum — I redraw the map, then again, then again — but it never quite comes together. This is super frustrating but also a sign: I’m missing information. Enough map-drawing, I need to go out and scout out the landscape more thoroughly.

It’s also true however that I can get stuck on the other side: collecting more and more information. This is also a trap. Imagine a scientist running an experiment over-and-over: a few times is good, but once the data starts to repeat itself, it’s likely time to leave the lab and write up the results.

I also find this happens a lot in teams I manage — too many thinkers of one type or the other tends to feel unsatisfying (and the result is often not very exciting.)

As with so many things I feel a lot of this comes down to awareness. What is the state of things, where is my comfort zone, and am I gravitating that direction because it’s the best, or is it because that’s just where it feels most “natural” for me to go?

Try taking a walk with Death, the speaker said. See what that feels like. He was an impressive person, a Buddhist who had devoted his life to servíng those whose lives were ending.

I took him at his word and the next morning I imagined, as I stepped onto the sidewalk, that I wasn’t alone, that Death herself was walking alongside me. She wasn’t the grim reaper in a black cape and holding a crooked walking staff. Instead she wore sneakers, jeans, and an expensive jet-black hoodie, amused and just slightly annoyed I would “call her up” so early in the morning.

The first thing you notice when you walk with Death is what I expected: everything starts to feel more fragile, more special. “I’ll destroy that tree,” she said just as I noticed the green buds on it. “I’ll destroy that bird,” she added just as I heard its morning song. “Better pay attention, they won’t be here for long.”

But the second thing you notice when you take a walk with Death — and this I did not expect — is damn is Death funny. She’s like the snarkiest hipster girl you know, the one who calls out everyone. Destroying the trees and the birds feels tragic, but destroying the humans? That’s another story.

We saw a woman in heels running to catch the subway car — clearly concerned she might be late for — for what? “Hope she makes that meeting,” Death said. “Obviously it’s very important what she’s up to. Before I turn her into a little cloud of smoke I mean.”

We saw one man in his car honking at another, so angry the other man had turned left in front of him prematurely, had slowed his drive by three seconds. “Also smoke,” Death said. “Poof.” She held out her hand like she was going to snap her fingers, but then stopped, grinning. “Not today,” she said. “We better let him get to his destination. Maybe he’s meeting that woman and they’re gonna, you know, do something super important.”

We saw a man standing outside the drugstore, annoyed he was a few minutes too early, annoyed he had to stand there until they unlocked the door. “Hmmm, no smoke for him,” Death said. “Well, not just for him I mean. But I am going to pick this whole neighborhood up, flip it over, and shake it like an Etch-a-Sketch. But I’ll let him get those paper towels and that deodorant first.”

We walked down the hill to get a coffee. As we sat out on the café’s patio Death seemed relaxed and confident, no negativity, no malice. I asked her what she enjoyed most about her job.

“Nearly everything,” she replied. “People misunderstand what it is I do. They think I’m out to get them, that I’m some sort-of a bogeyman. But pain and suffering, that’s not my department. I don’t trade in those. My jam is way, way simpler.

She paused to take a sip of coffee, two slender hands wrapped around the mug for warmth, closing her eyes as she savored the liquid as it hit her tongue.

“I just make things precious,” she said, opening her eyes and looking at another tree with its tiny buds. “And that’s a pretty satisfying gig.” She stopped for a beat, letting me reflect on that before speaking again.

“OK but now look at this idiot in line at the counter, staring at his phone,” she said. “What should we do with a guy who doesn’t even have the time to look up at the barista?”

“You’re kind of an asshole,” I said.

“Not true,” she protested. “It’s just when you do this whole destroyer-of-worlds thing for a while you get…more attuned to things I guess.”

She paused again, then spoke. “Did you hear that bird earlier? I mean, come on, nothing better. An entire symphony in three notes.”