The Paradox of Progress revisited
The gifted blogger Richard Emerson has recently done me the honour of making me one of the first to be featured in his new podcast ‘Conversations about philosophy, science, mythology, good life, travels, and the big questions!’
In this conversation we revisit my 1995 book The Paradox of Progress together and discuss striking links with Iain McGilchrist’s The Master and His Emissary (2009), and what has turned out to be its magisterial follow-up, The Matter with Things (2021).
This has taken me back to the period of several years in the 90s during which I, a perfectly ordinary NHS GP, was asked to write about the book, give formal lectures and address numerous meetings, including one in The Hague – when the President of the Dutch College of GPs invited me to give the opening keynote of their annnual congress with the wonderful words, ‘Your book puts words to feeling that are felt by many Dutch GPs‘. A third of all the GPs in Holland were in the hall – 1,500 of them – and I remember they all arrived by bicycle or public transport.
With his friendly, informal style, his distinctive Norwegian accent, his wide-ranging erudition, and his insight, Richard Emerson is the ideal intervewer. I found he had picked out perfect extracts from my book to guide our conversation, showing the links with McGilchrist and showing how much we were on the same wavelength as we explored these fascinating and immensely important ideas.
Here is one extract he picked out:
We use the word ‘unbalanced’ to describe an insane mind. Thus the accumulated wisdom embodied in the very language we speak acknowledges the fundamental role of balance in the definition of sanity. So when I say that the common mind of our society is unbalanced, I am making a very serious diagnosis. I am saying that the common mind of society is, to some extent, insane. But that is what I do say.
The Paradox of Progress, Chapter 11 : Good Intentions
I’d love people to hear my conversation with Richard. I think it puts words to feelings that are just as widely shared as they were 25 years ago, and are no less crucially important: Link to the conversation/podcast
My book was reprinted three times by Radcliffe Medical Press, one of their most successful titles ever, but has been out of print since they were taken over many years ago. I have long sought ways to make it available once again. So the other thing that Richard has done for me is to introduce me to Payhip – a simple way to publish a pdf version of a book and make it available for download for a modest charge:
Link to downloadable pdf of The Paradox of Progress
This complements the online version which has been free to read ever since I placed it on my website some twenty years ago. It is complete with a clickable index of ideas in the book, which as far as I know is rarely used, but might help some people:
‘Truth and Reason are part of the Authority they are challenging.’
“Thank you for helping me to remember that.“
“I don’t think I said very much. I was looking at the little horse “
I had suggested we stopped walking for a moment, ostensibly to look at the little horse (and photograph it, complete with its stumpy legs, as you see in the picture), but actually so that I could write down my precious new idea before I forgot it again.
Something about Reason – that was what I had been saying as we walked together yesterday morning – Authority, and what was happening in today’s world to Truth. There was some new way of putting it together that had come to me suddenly last night when I was in the last stage of consciousness before going to sleep. Too close to sleep to summon the willpower to rouse myself and write it down. In case it evaporated in the night.
Which of course it did.
Read more…
Mending things
I just mended my grand-daughter’s clarinet.
One of the notes wasn’t sounding and we played around until we’d tracked it down to one of the bottom key covers not closing snugly onto its sound-hole. (Apologies if this isn’t the correct nomenclature, I’m an amateur) When you looked closely you could see a fatal gap remaining under the pad when you pressed its key higher up the instrument. If you held the cover down directly with your finger (we discovered) the note came out perfectly. Lift it off again and it stopped. You could play a little trill like that. And we did.
The diagnosis was clear – the ‘close that cover’ message wasn’t making it through the intricate arrangement of shiny levers.
There was a concert imminent and phone calls were being made to try to find a spare clarinet. People were unhappy.
Now I have something of a reputation for this sort of thing which I cherish. Ever since, many years ago, when I did some trivial mending job – putting a wheel back on a toy car or something – and its little owner went toddling around the house holding it up to people and explaining ‘Gran’pa fix it‘.
Life doesn’t get much sweeter than that.
But now that treasured reputation was on the line – musical instruments being on a different level of delicacy and complexity from model cars. The best I could come up with was to suggest weakly that the pad might be dry (did that happen with clarinets?) perhaps we could make it plumper by moistening it with something? The young owner mentioned the special grease she used for the cork-lined joints of the instrument, and that sounded the sort of thing. I duly smeared some of that about with a wooden toothpick.
Absolutely useless.
So I put the instrument down while we attended to other things. Until stubborn curiosity drew me back for another look. And this time, as I pressed the keys idly up and down, I saw something new – one of the pivots seemed to be slightly sloppy. It looked, it seemed to me, like wear in that joint. Did that happen with clarinets? Were they supposed to be oiled?
Not sure, but it never had been.
Perhaps that was it?
One way or another, it was looking like a professional job.
But again I couldn’t resist one more look, and suddenly the penny dropped – that glorious eureka! moment: A little silver rod projecting from the mechanism, which I had noticed earlier and assumed was meant to be like that, was in fact the axle of the faulty key which had become detached from its socket. So the whole bearing wobbled slightly when you worked the key. I pressed on the end of the little rod with my finger and sure enough it started to move. Not the whole way in, but that was OK because I could now see a tiny screw slot across its end. All I needed, I announced to the company, was a suitable screwdriver to finish the job.
While my wife was searching in her handbag for the little glasses-repair kit she always carries (!) our young musician remembered that her equipment did indeed include a tiny screwdriver, for which she had never found a use. Exactly what I needed, this enabled me to screw the little axle securely home, completely abolishing the fatal floppiness.
And lo, the clarinet was sounded, and a torrent of melodious arpeggios poured into the grateful air.
Emboldened by a similar success with a drain plug in our bathroom sink (not to mention the hall clock triumph which I described in an earlier post) I recently volunteered my lack of expertise for the new Repair Café at our Community Centre.
Arriving with a few tools on the inaugural morning I was so conscious of the presumptuousness of what I was doing that I very nearly turned away and went back home.
But I did go in, and the first person in the queue happened to be a former patient of mine who greeted me like a old friend. And before I had time to demur, he and his broken item – his Father’s old mantelpiece clock – had been allotted to me.
The clock had three problems – it hadn’t run for 25 years, two pieces of wooden molding had become unglued from its case, and it needed a thorough clean.
I told him I had absolutely no expertise with clocks and he urged me to go ahead anyway – it was broken and there was nothing to lose. So I freed up the nuts that held the movement in place and eased it out.
It appeared to be fully wound, and as I gently prodded the balance wheel it oscillated a few times before slowing and stopping. It seemed to me that somewhere the mechanism was sticking. So I told him I did have a cheap and cheerful fix which had worked with a clock at home, and again he told me to go ahead.
So I gave it one judicious blast of WD40.
And that was that. It worked. I prodded the balance wheel again (this, I suspect, is again not a technical term) and this time it didn’t stop. I set the hands and it was still showing the right time when he left.
Dismantling the face, cleaning it, and replacing the fiddly-little screws that held it in place was the second and by far the longest job. And then it came to mending the wooden case.
It was obviously a simple gluing job, but I didn’t want to send him home with everything swathed in tape while it set. So I used a tip I once found on the web: we didn’t seem to have any PVA glue, so I mixed up some Araldite (epoxy resin) which we did have, and put a good blob of that in the middle of each piece of loose moulding. Then, and this is the clever bit, I put superglue in several different places on the same joints, and then pressed the pieces together until the superglue held. Handled gently, this would give time for the epoxy resin to develop its tremendous strength. Bingo!
Well. To say he was delighted is putting it very mildly. He wrote the most fulsome and heartwarming letter of appreciation anyone received that day.
Our Member of Parliament turned up at the next Repair Café the following month. Recognising me as a retired doctor and a persistent correspondent about issues very far removed from the mending of clocks he expressed surprise to see me there as one of the repairers.
But I pointed out that I had been a GP – a generalist – and that the mending of people in general practice had meant that doing things for the first time, using that amazing thing, educated common sense, had been the daily currency of that job. Or words to that effect. And that was why I had loved it so much.
I opened my book The Paradox of Progress with an anecdote about mending a dislocated kneecap (for the first and only time in my career) on a house call in the middle of one night, to make a similar point. It is here for anyone who is interested.
GP Obstetrics in ‘the good old days’. Reminiscences of good and bad after half a century.
We talk about the good old days – but they weren’t always good.
Way back in 1972, one of the things which attracted me to coming to work here in Alton was the availability of a local GP maternity unit where I would be able to look after my mothers when they had their babies.
Brexit: We are all more susceptible to persuasion than we like to think.
I was a young doctor. I had it in my power to help this guy. So I did.
He was a drug rep. Sitting opposite me in my consulting room. Half a century – most of a lifetime – ago. He had been waiting outside for much of my morning surgery, as reps used to in those days, hoping I would see him before I started on my paperwork and visits. As usual it had worked – me being too soft-hearted to say no and send away a fellow human being with a wasted morning. ‘There but for the grace of God’, and so on… Read more…
To Reykjavik for the Nordic Congress of General Practice
Back home now after a week in Iceland. Primarily for The 20th Nordic Congress of General Practice, a huge event with 1,500 delegates in the magnificent new Harpa Conference Centre and Concert Hall for which I and four fellow GPs ran a workshop on the subject ‘Doctors as Social Activists’. Link to my presentation
Main staircase with welcome message on the risers
Astonishing building for a country of 300,000 people
Complex double-glazing
The main hall at the opening ceremony
Views of the astonishing Harpa conference centre
I was describing my efforts since retirement to challenge organised climate change denial. Link to my presentation
This was the very opposite of a freebie because we paid all our own expenses and discovered, having dutifully followed the advice to book flights and accommodation well in advance, that all five of us would have to pay the £700 registration fee for the conference.
This was on top of Reykjavik being, with Tokyo, currently the most expensive capital city in the world, even without the devalued pound, so that everything – food, trips, entrance to exhibitions, goods in shops – was more than twice as expensive as at home. Nonetheless, Lesley and I gritted our teeth, tightened our belts (I lost 3½ lbs on the trip) and took the opportunity to see something of this fascinating country and its admirable people.
Apart from the conference we were lucky to be in Reykjavik for Iceland’s National Independence Day (from Denmark : 1944). In spite of a cold wind and intermittent downpours, the atmosphere was festive and friendly. We felt it a real privilege to be there. We heard the President give a speech and then an actress gave a beautiful recital of a poem in Icelandic. Then there was a parade to the fair-ground around the lake, where there were circus acts and the world’s oldest strong-man competition.
Formidable police – but no guns
The President
An Icelandic poem – beautiful even when no understood
Traditional costume
Charmingly informal compere
Young patriot
After the parade
Downpour imminent
Very strong men
The town outside our room
The houses and buildings in Reykjavik were extraordinarily varied, often brightly painted, and quite a few had large murals painted on them.
The famous Hallgrimskirkja cathedral dominated from the top of the city, It was striking outside, although the concrete was currently under repair – testifying to the extreme harshness of the climate. The inside was serenely beautiful, with the most magnificent modern organ I have ever seen, being played while we were there.
We were unlucky with the weather, but we shared a car for a day out to the Snaefellsjoekull National Park north of the city, and took a coach trip around the ‘Golden Circle’ on our last day – our only really sunny day.
The Golden Circle is very much a tourist route but you see the junction between the American and the Eurasian tectonic plates (separating at about a centimetre a year) at the Þingvellir National Park, the magnificent Gullfoss Falls, and the geysers at the Haukadalur Geothermal Area.
Everywhere you see beautiful blue lupins, apparently a recent, deliberate introduction to stabilise and enrich the soil (lupins of course being nitrogen-fixers) which are proliferating at an incredible rate and seem to be broadly welcomed. You can see them in the foreground and in the hills in the picture bottom right above. We were told that the country was 85% covered by trees when the Vikings arrived, but they cut them all down for fuel, housing and ships.
One thing which surprised us was the sheer size of the country – more than 300 miles East to West and 200 North to South. So we only saw a small part close to Reykjavik.
And this yellow door was the entry to our little room, with its blind to make it dark when it ought to have been night.
Our yellow door
A tribute to Robert M. Pirsig
Talking in some depth about things that seem important – by J A R Willis
This article appeared in the December 2000 issue of Medical Humanities in the series Medicine through the Novel. It is repeated here as a tribute to one of my greatest inspirations – Robert M. Pirsig – who died two days ago (24 April 2017)
‘Unless you are fond of hollering you don’t make great conversations on a running cycle. Instead you spend your time being aware of things and meditating on them. On sights and sounds, on the mood of the weather and things remembered, on the machine and the countryside you’re in, thinking about things at great leisure and length without being hurried and without feeling that you are losing time.’ (p 17 of 416)
The gentle voice is incredibly familiar, heard now for the third time, a voice that seems to have got itself into my deepest being. Read more…
Old talks that still seem relevant
I am still working out how best to use this site.
Although it got several likes, which were much appreciated, I think my Sea Monster and the Whirlpool address is much better placed on its own page rather than here on the chronological blog. So I have moved it to its own page, tidied up the formatting and added some of the slides. That lecture, which I gave as the keynote on ‘Science’ to the 50th Anniversary Symposium of the Royal College of GPs, attracted thousands of hits when I posted it on my first website www.friendsinlowplaces.co.uk and was largely responsible for me coming up as the first ‘James Willis’ on Google for several years a decade or so ago – not bad for what is a fairly common name.
I have now added another talk which meant a lot to me and which I still believe said something important. Professionalism – Red and Grey – discussing the meaning of that confusing word and arguing that we need to restore respect for its more subtle, but ultimately more fundamental, colour. Flavour, if you like. Of course, I would love to receive comments, contributions and discussion. To this end, I have appended the complicated Venn diagram of the two aspects which I and my colleagues developed at the time – you can see that it is very much work in progress. If you are intrigued, have a look at the talk itself.
What happened to the nation that bred Lord Nelson?
Every spring the Alton Society which I belong to organises a voluntary litter-pick to tidy up the town. This year it has been decreed from on high that all the volunteers must now sign a legal disclaimer before taking part.
Rather than accepting that this is another step on the great march of progress I thought that it was completely misguided. I care deeply about the dreadful problem of littering in this country and in our town and as an active member of the committee of the Society I have always seen this event one of the best things we do. I definitely wanted to contribute as usual. So I made a point of doing my litter-pick that morning (last Saturday) on my own responsibility, using my own equipment, and I didn’t sign anything for anybody. So there.
Here are my reasons why I think this apparently naughty behaviour is establishing an extremely important principle.
First a picture:
Here are my reasons:
- The document is not signed to protect the volunteer, it is to protect the organisers from the fear of litigation
- It is assumed that failure to perform this ritual would invalidate the organisers’ insurance, but this protection is illusory because insurance companies are notorious for finding reasons not to pay out.
- This is an example of treating a tiny relative risk (the risk of the organisers being sued by a volunteer who hurts themselves) as an absolute risk which must be protected against, irrespective of the cost, financial and otherwise (see below).
- Signing the form does not make it the slightest bit less likely that an actual accident will happen.
- By taking responsibility for my own actions I was able to clear rubbish in a place which would probably have required a road closure if done by a public employee, and in another which probably involved trespass.
- I am told that many of the volunteers who did sign the disclaimer agreed that it was completely bonkers. This brings proper precautions into contempt and breeds cynicism.
- It also feeds the growing trend to see all accidents as someone else’s fault and for people to feel they are victims and entitled to compensation.
- Cultivating the belief, particularly among young people, that you can only pick up litter if you have joined a group, donned protective clothing and signed to make someone else take responsibility for your actions, is counterproductive to the real object of the exercise – to change the culture so that we have a litter-free town.
- It is noteworthy that people who believe proper precautions and rules should be strictly adhered to, as I do, are the same ones who oppose the paying of lip service to token precautions.
- This kind of obsessional aversion to minute, theoretical risks is an affront to people, again like me, who are properly concerned about the all-too-common denial of the unimaginably-larger risk of global warming.
- I worry about the next logical step – the next click of the ‘ratchet of progress’. I understand those who signed the disclaimer, including the MP and other dignitaries, mainly did so without reading it. And that it was actually a general-purpose disclaimer which included the hazards of cliff edges and seashores.
I worry that when the next step is taken down this logical road it will be just as impossible for people like me to argue against it without appearing equally irresponsible.
For example: it is not hard to imagine that in a few years time someone will decide that it is no longer good enough just to obtain token signing of a meaningless mantra in this way, and organisers will start being required to provide video evidence that they really did line the volunteers up and show them how to cross the road. It will then be just as impossible to argue against this increment of progress and avoid accusations that you have failed in your duty of care by not going along with it. Especially in court after an accident, with a lawyer bent on apportioning blame, however freakishly unlikely that accident may actually have been. At that time the manifest failure to comply with the ludicrous ritual automatically becomes the crime, regardless of any other circumstances. - As I said in my 2001 book Friends in Low Places, after giving an imaginary example of mindless regulations blighting the professional lives of teachers:
“That is hardly an exaggeration and certainly not a joke, the reality is beyond parody – and certainly beyond a joke.“ - And that’s my last reason – I wrote two books and numerous articles about this sort of thing, and lots of people said they agreed with me. So I simply had to make a protest last Saturday to be true to myself – even though it added loneliness to the squalor of the morning’s work.
But, as I said in my first book, The Paradox of Progress, one person taking a stand achieves something amazingly powerful – it stops anybody ever saying again that ‘everybody goes along with it in the end’. That’s why I solemnly record that one person didn’t go along with it this time.
The age of foolishness
A key change in the ‘new way of doing things’ is a wholesale substitution of externally-imposed rules for personal judgement and common sense. This is not so much a tyranny by the arbitrarily powerful as an abdication of responsibility in which we all are complicit.
This dutiful subservience to rules gives us a seductive excuse for abandoning the immensely difficult task of building up and then maintaining throughout life a soundly-based personal understanding of the way the world works. This is particularly true in the fields of technology and science, which are now deemed by many, if not most people, to be too advanced and abstruse for non-specialists to even attempt to understand. Thus, at a time of unprecedented freedom of access to information we have the perverse phenomenon of people everywhere, and at all levels of society, actually making a virtue of ignorance. And in consequence we are seeing everywhere, and at all levels of intelligence, the fatuous certainty which is normally characteristic of the very stupid. Nowhere is this more starkly and terrifyingly apparent than in the organised denial of the science of evolution and climate change which has become the orthodoxy throughout the immensely powerful American Republican party.
It is my instinctive recognition of this looming problem – and heaven knows where it came from – that has underlain my opposition to the systematisation of professionalism (for example in the form of blind subservience to ‘Evidence Based Medicine‘) which has dominated my career and motivated me to write my two books, numerous articles, and to give so many ineffectual lectures.
Generally Speaking 