Bureaucratic Ritualism in Medicine

Source: http://whatculture.com/film/blu-ray-review-the-trial-orson-welles-guilty-pleasure

Having once been a student of cultural anthropology, I still find myself taking the discipline’s participant-observer lens to  everyday social situations. It makes me kind of weird at dinner parties, but I just love the anthropologist’s calling to “make the familiar strange and the strange familiar.” Opportunities abound. Perhaps especially in the modern medical world in which I work.

I’d like to share a prime example of a professional interaction I had last week that I found fascinating (at least in retrospect). In part because of episodes like these, I’ve come to suspect that our world is full of symbolic rituals hidden in plain sight.


Adaptability in an Accelerating World (1 of 3)


“Life is flux.”

-Heraclitus of Ephesus (c. 500 BCE)

“The only lasting truth is change.”

-Octavia Butler, Parable of the Sower (1993)

Accelerating Change

The philosopher Heraclitus lived about 2,500 years ago, back when most people could generally expect to live a life much like their parents and grandparents, and then fully expect to pass along a similar life to their children and grandchildren. In fact, most of humanity until quite recently lived in such a time. Plant in the spring; harvest in the fall. Bring the goats to high pasture in the summer; shelter in the valley below in the winter. Celebrate the annual rituals in the well-known ways over and over, generation after generation, and the divine will provide. Et cetera. Yet even with that slow, cyclical pace of life, observant people like Heraclitus could see that nothing ever really stays the same. He famously pointed out that even though a river may appear the same one day to the next, you can never truly step in the same river twice. So part of being a wise adult is learning how to deal with the inevitability of change.

So what about us? We, the frazzled masses of the 21st century? As we can see before our very eyes (and, like, on graphs and stuff), the rate of technological change in our world is rapidly accelerating. Furthermore, despite some potential hold-ups involving the physical limits of computer processing speed, overall technological change is likely to continue at a breakneck speed for the foreseeable future. Unfortunately for us planner-aheader types, we can’t predict exactly how it will develop, but we can be reasonably certain that it will develop. And it should go without saying that technological change drives forward economic, social, and environmental change, for better or for worse.

Yet humans, for all practical purposes, are staying exactly the same as we’ve ever been. We’re the same as we were in the 1990’s when Octavia Butler published her chilling and prescient Parable of the Sower, quoted above. We’re the same as we were when Heraclitus was wandering around the Mediterranean countryside, musing on the nature of the universe while generally trying to avoid everybody in it (he was famously misanthropic). For that matter, we’re basically the same as we were circa 200,000 years ago when our ancestors were moseying around the grasslands, snacking on roots and berries and the occasional woolly mammoth or whatever. Same old homo sapiens.

Yet wherever and whenever we find ourselves – in a prehistoric savanna, an unexplored arctic tundra, a theocratic city-state, a sanitized modern suburb, or a maze-like city of 20+ million others – humans have always found a way to survive and sometimes even thrive. How?


On Tolerance (It May Not Be What You Think)

I’m extremely worried about the growing power of hatred and intolerance in the United States right now. I imagine you’re worried too. Every day, the headlines seem to evince a swift march toward an increasingly frightening future for our country: the growing influence of neo-nazi ideology, deeply concerning supreme court decisions, children being torn from parents and whole families being imprisoned for seeking asylum or simply a better life… It’s almost too much to comprehend.

So I’ve been asking: How can I make sense of what’s going on? How did we get here in the first damn place? And how can I possibly be part of changing the trajectory we’re on to something better?

I’m trying to crack into these big questions simply at this point, by seeking clarity of terms. By clarifying the language I use – even if just with myself – I at least have some words to properly think with. A lot of the rhetoric out there right now is really heated and disorienting, chock-full of super-charged buzzwords. I want to cut through the malarkey and try to clear up at least one little word right now. That word is tolerance. Tolerance may not be what you think.

Here’s what I’d like to shout from the rooftops: Tolerance (much like civility) isn’t a personal virtue; it’s an interpersonal contract. As an interpersonal contract, tolerance cannot be practiced when you are alone; it requires the participation of another party. It takes two to tango.


Dirt, Carbon, Shit & Saving the World

Image source: Beiler, K., Durall, D., Simard, S., Maxwell, S., & Kretzer, A. (2010) Architecture of the wood‐wide web: Rhizopogon spp. genets link multiple Douglas‐fir cohorts. New Phytologist. 185 (2). p543-553.

What on earth possessed me to move into an apartment without a damn dishwasher? I hate – really, it’s not too strong of  a word – I HATE doing dishes. It’s mind-numbingly boring task without end. Ugh. I guess I was bamboozled by the picture windows and the “old world charm.”

Anyway, the only thing that gets me through this onerous domestic task is listening to captivating podcasts. For a podcast to capture my antsy mind, it generally has to be (1) sciencey or philosophical in nature, (2) somewhat unpredictable, and (3) well-produced and scripted. I rarely have the patience to listen to any unscripted (i.e. rambling chit-chat) podcast all the way to the end, regardless of content. That said, I do sometimes enjoy Russ Roberts’ wide-ranging, off-the-cuff, nerdily-titled interview show EconTalk. He has a wonderful way of selecting interesting guests, and then just totally geeking out with them on their area of expertise in a really authentic way that I find endearing, and occasionally even captivating.

This week I scrubbed and lathered away to a lively interview with Moises Velasquez-Manoff about his recent article on regenerative agriculture and climate science in the New York Times Magazine. I actually listened to the end. (You could too!) Here’s my take on Velasquez-Manoff’s story.


Hello Darlings

Hello darlings! As you can see, I am about to launch a new blog. This will be a space for heterodox analysis and longform ramblings on current science, political developments, and visions for the future. Words and bubbly will be flowing soon; I do hope you will join me! – Cara Pierian