I finished watching a movie tonight that was all togehter unremarkable. That is to say there was nothing in the movie worth remarking. What follows are my thoughts regarding a discussion after the movie I had with two friends….
We were discussing mathematics, logic, reason, music, and this is the kicker – art.
“I’ll know it when I see it.” We weren’t talking about porn – we were arguing about whether or not logic and reason could explain music, and the brilliance in music. It ABSULUTELY explains why some music is brilliant, pleasing, and RESOLUTE. If fails to explain the origin of the music, and especially the mother fucking response. WHy do we swear, make a fist, and throw the hammer once striking the thumb (by accident – some of you reading – if anyone reads – might be into that. Different can of worms).
The piano is digital – it is remarkably digital. It is perfectly digital. Every octive has pre-determined frequencies for each of the notes. They are finite – and this is the key (pun intended) to the brilliance of the piano – in the method and way they can be combined. But the number – if we’re looking at stitistics – is more complicated than 2^88th. It is more complicated than the math of the potential combination of any of the componenets. It becomes EMOTIONAL. It becomes fucking emotional.
The right and wrong combinations are pleasing or unpleasing to the hear – the people who have made musci that stands the test of time are outliers to be certain. I’m talking about people who re-combine tones in a finite system (88 keys) to make a sound that makes a human sad. Or makes a human happy. Or soulful. Invigorated. Lethargic. Woeful. Adventure. I love it. I am entralled by music and its intracices. I’m amazed by how complex it can be. I am utterly in awe of how a sound, or a collection of sounds can elicit a feeling.
I’m getting away from my point.
A theme in healthcare and wellbeing is evidence based medicine. This to me, is wonderful, but far from revolutionary. It’s worth looking back to Hippocrates and competing models of medicine. The godfather (or grandfather, or whatever) was concerned with the ultimate wellbeing of his fucking patients. He concernend himself less with the “mechanism” of illness. This made his school of thought and human care successful, even if the methodology or paradigm for action was wrong.
What I am saying is that PAIN, as a human experience, is more complicated than a set of variables – at least more complicated that set of variablers any double blinded randomized control study is capable of measuring. Understanding a collection of predictors is a good start, but it’s not the same as a mechanism. And finding a mechanism for something like pain is fine, until it isn’t – as is the case with anyone who has ever read “negative MRI, normal lumbar spine” in a chart but still has a patient who can’t walk or function in daily life. You have to abandon some rules, logic, and reason, to try to find something that the patient VALUES.
In summary, logic, math, and reason are not compatible with human values, and most certainly not with human interpretation and understanding. Evidence based and science based practice are a start. Helping a human being goes SO FAR BEYOND the scope of constructs created by human beings invented to measure help, quality, and existance. Listen to your fucking patients. Find out what matters to them. VALUES > VARIABLES. Help them with that first. Worry about documenting “long term and short term” goals after that.
Open for discussion. I’m begging people to blow my mind.