C/o Medha Cherabuddi & Intima: "Each quadrant houses its own diversity, ..."

... and these seem to converge in the middle beautifully." *

 INDIVIDUAL

|

 INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC   

SOCIOLOGY  :   POLITICAL 

|

GROUP

© The Common Thread by Medha Cherabuddi. Acrylic
Poetry and much more invited ...

Image: © The Common Thread by Medha Cherabuddi. Acrylic.

"Each quadrant houses its own diversity, and these seem to converge in the middle beautifully. This piece honors women's myriad of roles in medicine and their common thread. The constant throughout my life is art, especially when I find meaning in it.

Medha Cherabuddi was born and brought up in San Jose, California, and moved to Hyderabad, India, with her family at 9. After growing up with the best of both worlds, she completed medical school in India and moved to Detroit, Michigan, during the peak of the pandemic to begin her Internal Medicine residency at Henry Ford Hospital."

My source: Intima

Intima: A Journal of Narrative Medicine
36 N Moore St. #4W
New York, NY 10013
USA

*Yes they do! No endorsement implied.

Hodges' model: a blanc space, neutral for structure & content

On twitter today I mentioned the discovery of the book Panaesthetics by Daniel Albright. It was a buy in the end. A great discovery saddened to then learn that its author is no longer with us. Although I have not read it there will be much to draw from it: literally. I have often written about Hodges' model being initially a neutral space, a blank sheet. What is a starting position is always political as with Hodges' model. Its structure regiments the paper it is drawn upon. The presence of a political care - knowledge domain makes a statement. Structurally and in content the sense of neutrality is broken. Albright points to historical support as he discusses "What is painting?".

"White, said Superville, is an innocent peaceful color, calming us in the way that pure snow or moonlight calms. Black implies "silence and solitude, sadness, death, and oblivion"; red is "the hieroglyph of life and movement . . . the excess of luminous rays, just as the colour black is its absorption and annihilation." But this correlation of color with emotional state is less original than Superville's belief that color and lines are "the identical signs of one invariable language, and the associations of the one automatically imply the associations of the other" - every color corresponds to a linear pattern, every linear pattern presupposes a certain color. Superville provides a diagram to prove his point: red throws its arms into the air; black is stooped, submissive; "white , an invariable, pure sign, like the horizontal line, occupies the middle space between two extremes" (fig. 27)." p.102.

This is not the exact figure from the book but the meaning is relayed (I think).

A contact from the OU and 'The Difference that Makes a Difference' Conferences David Chapman kindly commented on this post on Facebook:

David Chapman "White is an innocent, peaceful, color". Except when it is the colour of the KKK, colonialism and slavery? I like the use of the shapes and can see that there may be ideas you can use in the quad, though.

Unlike · Reply · 1 · March 4 at 8:44am

I've expanded on my Facebook response below:

Thanks David, Yes I realise there's a potentially racist tone to this "white as pure". It is of course about the ideas, structure and form. I still refer implicitly to Michel Serres' work and the significance of 'blanc' and in previous posts. There are many ethnocultural connotations as to how black, white, greys and colours are interpreted and what they mean. As a tool it is important that Hodges' model conveys neutrality. In this case no emotional, value-based stance is taken.

Another thought from the past I recall is the BBC micro wordprocessor View and its appearance on a monochrome (Phillips) screen. Green on black (the new 'blanc'?) worked best. The penultimate blanc is the night sky...?

Albright, D. (2014) Panaesthetics On the Unity and Diversity of the Arts. New Haven: Yale University Press.

Diagram: http://www.dezenovevinte.net/obras/av_rc_baile_en.htm

Musings... on 'local', 'global' and 'glocal'

Glocal is an index.
Glocal is the designator of change.
Glocal is the terminator, the divide between the local and global that is simultaneously inclusive and exclusive.
Glocal is penumbral.
Glocal is a convulsion of the internal and the external; near and far; micro and macro; past, present and future.
Glocal - tipping - presaged.
Glocal is all dichotomies all times.
Glocal is blunted affect (distributed (diluted (detached (emotion))))
Glocal is the leading – bleeding - edge of change:
The virtual bus: information
Glocal is conceptual triangulation.
Local is a place in code
You better know what is Global
Glocal is the school of the informatics and literacies.
Local to Global to Local is the road: Glocal is the road twisted;
1 Mobius Strip
2 Everywhere
Glocal = Biosphere and N.E.O.
Glocal is mobile – mobil - mobi - mob - mo - m -
Glocal is remembering all and remembering to forget.
Glocal is the transience of the fixed point (anchors aweigh, relative, displacement)
I am local.
You are local.
We are global.
Are refugees glocals?

Thoughts informing a paper ...

http://www.amnesty.org.uk/
http://www.refugeesinternational.org/

N.E.O. Near Earth Orbit (at least)

'Gaps' a poem by Philip Holmes - Journal of Humanistic Mathematics

Gaps

Philip Holmes

pholmes at math.princeton.edu 

Take a line and take away
the middle third, and then
the middle thirds of two thirds
left behind, and middle thirds
of those four ninths remaining.
Go on and on: what’s left at last
is utterly disjoint – beginnings,
ends – each point divided from
the next, but oh! so close,
infinitely numerous
as what you started with
and carefully have pried apart.
Will there be time to measure up
this dust of unremembering?

* *

Take a line and take away the middle third,
and then the middle thirds of two thirds
left behind, and middle thirds of those four
ninths that still remain. Reiterate:
what’s left at last is utterly disjoint –
beginnings, ends and more – each point
divided from the next and yet uncountable
and numerous as what you had before.
Take a life and take the most part out,
for so it happens; only the best-rehearsed
of memories remain: a voice transformed
among the absences, a face, a hand.
You brought me here, but there was more:
dust that blows away, gaps that captivate.

Journal of Humanistic Mathematics Vol 1, No 1, January 2011.

Editors: Mark Huber, Claremont McKenna College; Gizem Karaali, Pomona College

Used with permission of Philip Holmes and JoHM with thanks.

The art and science of Serresian spin

To Michel Serres:
- the middle is a point of reflection, a point at which questions - the question - must be asked. In fulfilling the purposes of the health career model:

• bridging the theory - practice gap;
• facilitating holistic practice;
• supporting (personal and group) reflection;
• enabling curriculum development;

- the model's four domains are constantly (re-)visited in turn. Motion is constant. Conception - birth provides that initial impetus. Health status. Life - momentum. Centered on the person the movement is usually self-correcting, seeking balance. Health care. Questions and answers whether whole or in part follow, leaving a trail of care delivered and care planned. A record.

There is definite synergy between our use of the health career model, the dynamic quality and quantity of health and social care and Serres' description of the spinning top:

"The behaviour of the cone or the top is worth analysing. Throw this toy and describe, as Plato did, what happens. It is in movement, this is certain, yet it is stable. It even rests on its point or its pole, the more so as its movement is rapid. All children know this. But its rest is still more paradoxical. The top may move about, by translation, without ever losing its stability. To repeat, it can do so as long as it turns very quickly.


Even better, its axis may lean, take on an inclination, without putting the movement of the whole in too much danger. It may again rock, by nutation, oscillating around a mean location. This very ancient and quite childish machine is marvellously instructive.

First of all, it combines and the movements known and thinkable at the time: rotation, translation, fall, leaning and swaying. An integral model, additive, overcharged, yet simple. Second, and above all, it conjoins in a simple one-off experiment phenomena judged or presumed to be contradictory. It is in movement and rest, it turns and yet does not move, it rocks and is stable. The simplicity of a complexity, first and foremost, an additive machine; a synthesis of contradictions, beyond anything else. Now it may serve as a little model of the world, for a naive simple and local orrery. It quivers, at rest, it moves forward, turning, like the heavens, like the stars." p.28-29.

Michel Serres, (2000) The Birth of Physics, Return of the Model, Turba, Turbo. Clinamen Press.


Image source: https://www.cbsnews.com/news/spinvox-or-someone-like-it-keeps-spinning/

(many) Care Transitions and The Little '-' That Could

Some people looking at Hodges' model may believe that the model perpetuates the dichotomies of old:

Human --- Machine
Individual --- Group
Sick --- Healthy
Supply --- Demand
Home --- Hospital
Self care --- Nursing care

In the 1990s as a community mental health nurse I was involved with a group of general nurses looking at ways of improving:

• discharge planning
• continuity of care

These issues remain and with the dichotomies of care above we can see how Hodges' model can assist our thinking and planning about transition. Not just one transition, but several.

This past week I was fortunate to attend one of a series of workshops -
Delivering High Quality Health Care for All: Bringing the social and technical together for a joined-up approach to deliver supporting systems and technologies
10th/11th December 2009, Leeds, UK

Organised by the UK Faculty of Health Informatics and the BCS Socio-Technical Group

The event was very good, stimulating and challenging. In the closing debate the appeal of 'socio-technical' and how to market a much needed joined-up approach in health IT came down at one point to the difference between:

'socio-technical' and 'sociotechnical'

In trying to find an alternative title, the hyphen was lost, and whilst it is not a crucial issue - for me that hyphen represents the axes of Hodges' model. Hodges' model acts as a high level aide-mémoire and that little hyphen can perform the same trick. The hyphen reminds us of the differences. The dichotomies that need to be navigated and negotiated in our dialogues about care AND caring. These are most evident in transfers and transitions (after all - "getting out of bed is a risk").

There are mini and macro transitions. Care pathways are not yellow-bricked unbroken splines from cottage to cottage hospital. They should be tortured if they do reflect person-centered experiences and needs.

Some transitions are process laden and repetitive, such as drug administration and must be protected - free from interruption. Although grounded in a social exchange of (correct) identities: a registered nurse, the right patient, right drug, right dose, right duration and right time these can be framed within the SCIENCE domain. That is where (for me) the conventional 'drug round' can be found. Counselling is another transition (if effective it also moves people on). 'Counselling' can be found in the INTRAPERSONAL domain - close to the border with SOCIOLOGY.

Other transitions and transfers are more involved:

• person's home to attend day care (for the first time!)
• person's home to residential home
• hospital ward to home
• home encounter with the crisis team
• telecare consultation
• ...

Care is constantly passed hence the need to write and record. Passed from -

person-to-person
team-to-team
team-to-carer
time-to-time
discipline-to-discipline
self-care

This is the outcome that is sought. Ultimately passing responsibility back to the individual and when applicable their family. Having formal integrated care pathways is one thing, but they are never truly continuous, clear and true. And as they say crossing bridges you may have to break step and surely different disciplines march to different tunes? Today though the most audible tune must be socio-technical. ...

Additional link: The Little Engine That Could
Image source:
Drug round tabard http://internet-workwear.co.uk/acatalog/Drug_Round_Tabard.html

Health care and handedness

The word legerdomain featured on Wordsmith's Word.A.Day as listed below:

PRONUNCIATION:
(lej-uhr-duh-MAYN)

MEANING:
noun:
1. Sleight of hand.
2. A display of skill.

ETYMOLOGY:
From French leger de main (light of hand), from leger (light) + de (of) + main (hand). Ultimately the from Indo-European root man- (hand) that's also the source of manage, maintain, maneuver, manufacture, manuscript, and command.

It is a shame and a matter debated at large that specialists - whether medical or of other disciplines - are not held in the high esteem that they once were. And yet when you come across a leader and specialist in their field the way they deploy their knowledge, insight and skills remains something to greatly admire and respect. I mean knowledge and experience that transcends sole reliance on interpersonal skills and blinding people with jargon and 'science'. Such are the outcomes of what the specialist brings to the (operating?) table, that it may even seem like a sleight of hand. Not in the sense that it is a trick, but there is an effortless transparency to not only what they achieve, but how they make people - their patients, clients feel. Not just feel, but how these people react and may find themselves.

If there is a sleight of hand it is in how while a specialist, they can and do cross boundaries. They see and can count the important numbers (evidence) in their discipline, but they know (from some no doubt hard-won lessons) that frequently some of the numbers in the very sequence they need lie outside their comfort zone.

RIGHT-handed (mechanistic)

or

(humanistic) LEFT-handed

- they know there is a

middle

and they cross it, without anyone noticing.