Leandro Herrero: “An enlightened top leadership is sometimes a fantastic alibi for a non-enlightened management to do whatever they want”

Auto reblogging is perhaps a little narcissistic but this is something that has relevance far beyond healthcare…. Dr Herrero’s blog is highly highly recommended.

A Medical Education

From Leandro Herrero’s  website, a “Daily Thought” which I am going to take the liberty of quoting in full:

Nothing is more rewarding than having a CEO who says world-changing things in the news, and who produces bold, enlightened and progressive quotes for all admirers to be. That organization is lucky to have one of these. The logic says that all those enlightened statements about trust, empowerment, humanity and purpose, will be percolated down the system, and will inform and shape behaviours in the milfeulle of management layers below.

I take a view, observed many times, that this is wishful thinking. In fact, quite the opposite, I have seen more than once how management below devolves all greatness to the top, happily, whilst ignoring it and playing games in very opposite directions. Having the very good and clever and enlightened people at the top is a relief for…

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Preferring soiled banknotes to new 

A little snippet from the Institute for Money Technology and Financial Inclusion  blog , taken from an article promisingly titled “Micro Insurance Claim Payments through Pre-paid Cards: Technology and Regulation Driven Financial Inclusion in India” I found this finding on the valued placed on tangibility and how trust is indicated by the evidence of prior use fascinating – and surely reflects a phenomenon seen in other contexts; the reassurance of not being the first.

An interesting finding was that people often preferred soiled banknotes to new banknotes for fear of counterfeit currency. This emphasis on tangibility and trust based on physical signs of repeated use explains in part why mobile money has not taken off as a mode of payment and why some did not take as well to the pre-paid cards. A female respondent from a village near Varanasi said, “I don’t believe in new notes. The MFI agent once refused to accept them because the metallic part [the machine readable security thread and electrotype water mark] were damaged in the new currency note I had as part of my fortnightly deposit. The new notes have not been used before and I don’t know if they are genuine. I think many of my friends share this feeling too.”

Hannah LeGrand (and Dante) on sloth, thoughtlessness, intellect and reason 

At Comment Magazine, an essay by Hannah LeGrand on “thoughtlessness, sloth, and the call to think.”

It is well worth reading and reflecting on. LeGrand begins with Hannah Arendt’s famous account of the trial of Adolf Eichmann. This is best remembered for Arendt’s observation on the “banality of evil”, and LeGrand takes this for a starting point:

The story that the world anticipated hearing from the trial, and indeed, the story Arendt herself expected to find, was the story of a villain, the final act in a grand and horrifying life of evil. However, presented with Eichmann in the flesh, Arendt found no trace of such a narrative. Eichmann was not Iago. His testimony had none of the drama or torment of Macbeth. He had no grand evil motives. Indeed, he seemed to have no real motives at all. He insisted that he had just followed orders. He was striking exactly because of his thoughtlessness.

Arendt’s “Eichmann in Jerusalem” is the most famous text to emerge from this trial, but LeGrand’s essay then follows another of her works: 1971’s The Life of the Mind:

There is something in the act of thinking itself, she argues, regardless of content and conclusions, that constrains evildoing and plays a key role in our ability to make moral judgments. And she ponders a worrisome possibility: What if, in an age of so much stunning advancement, we have somehow forgotten what thinking really means? In seeking to recover the meaning of thinking, Arendt sounds less like a German philosopher and more like a desert father. Her insight into the habit of thinking and why it must be incorporated into a society so prone to thoughtlessness is as contemporary as ever.

This leads to the core of the essay:

For Kant, reason and intellect are two distinct aspects of our mental life. The intellect, on the one hand, is driven by our need to know and, accordingly, is properly concerned with those things that can be known—sturdy and graspable truth. It is our intellect that drives our science and makes our technology possible.

Arendt worries that in the modern age, while we have been wildly successful in the use of our intellects and our knowledge about the world has grown more rapidly than ever before, the work of reason has been dangerously neglected. For reason, on the other hand, is never fully satisfied in the realm of what can be grasped. While our intellect drives our need to know, reason equips us with an “urgent desire to think,” an inclination to cast our minds far beyond the capacity of our intellect, to push farther and deeper.

While it is tempting to think that such a grand gesture should produce even grander results, we shouldn’t mistake this activity of thinking for an elevated science. Nothing can be built on what cannot be grasped, and when I have finished thinking I have nothing tangible to show for all my mind’s wanderings. For Arendt, the activity of thinking is more like a conversation with a friend than mapping the human genome. If our intellect is building a house, then thinking is cleaning the kitchen. It is daily work. As Arendt writes, “The need to think can never be stilled by allegedly definite insights of ‘wise men’; it can be satisfied only through thinking and the thoughts I had yesterday will satisfy this need today only to the extent that I want and am able to think them anew.”

Once we begin to understand this distinction between the intellect’s knowing and reason’s thinking, then we can also begin to see that the thoughtlessness which concerns Arendt is not mere ignorance. For Arendt, it was not that Eichmann did not know what he was doing. It was that he did not think about what he was doing. The thoughtlessness that allows evil to flourish cannot be dispelled with new facts or better information, and the society that has forgotten how to think needs to do more than inform its citizens. Instead, like stretching unused muscles, it must relearn the daily habits of thinking. Like rekindling old friendships, it must nurture thoughtfulness as a disposition toward the world.

This distinction between the knowing that is acquiring new facts and new information,  and the use of reason, is worth reflecting on. One can sometimes marvel that any first year physics undergraduate “knows more” than Newton (and is unlikely to be into alchemy) or indeed a Psychology 101 student “knows more” than Freud (and is unlikely to be into the dodgier bits of Freudianism). Of course, they have more information, and this information is verified more extensively.

This discussion of Arendt leads into one of Aquinas, via a consideration of sloth, which is far more than mere laziness:

 

 

However, as Rebecca Konyndyk DeYoung points out in her book Glittering Vices, the vice of sloth is really more than mere resistance to work or exertion. First articulated in the monastic tradition, sloth originally refers to the weariness solitary desert monks would feel with their commitment to the spiritual life. Sloth, as fourth-century monk Evagrius of Pontus writes, the spiritual life. Sloth, as fourth-century monk Evagrius of Pontus writes, is the “noonday demon,” which seizes the monks, making them despair in their calling and long for their old lives in the city. One aspect of this despair was often an apathy toward monastic duties, and so it is not hard to see the fruits of this vice reflected in our modern understanding of sloth as rather harmless opposition to a strong work ethic. However, the roots of this noonday demon were much more serious.

Aquinas opposes sloth not to work but to charity, which, as Aquinas writes in his Summa theologiae, is “a kind of friendship of man for God,” which aims for “the fellowship of everlasting happiness.” Sloth, for Aquinas, is not primarily a sorrowing in our work, but a sorrowing over our friendship with God.

The vice of sloth when understood in this way is at once something serious and baffling, for it picks out a human aversion to the spiritual good in us. It names, as DeYoung writes in her essay “Acedia’s Resistance to the Demands of Love,” “the overwhelming urge to stay with the comfortable and the known rather than risk change, even if it promises improvement.” Sloth is not simply becoming weary of doing good works. Rather, sloth is remaining complacent in the present and the status quo. It is preferring to accept a lackluster life rather than responding to the demands of a relationship with God.

It is interesting, as a sort of accompaniment to this essay, to consider Dante’s treatment of Sloth in Canto 18 of the Purgatorio. The Columbia University “Digital Dante” commentary linked to above focuses on the poetics of this canto which discussion of Love, and particularly distinctions between Dante’s previous stance that Love is a force that cannot be opposed – and can become attached to unworthy or actively harmful objects of affection – to a more mature one with a subtle role for Free Will. 


The slothful purge their sin by the opposite of what they indulged in in life – unrelenting speed. The commentary suggests that the compressed treatment of Sloth – the whole terrace within Purgatory being disposed of in half a canto – is a structural reflection of the purgation of sloth. In the commentary, one gets the sense that the depiction of slothful is very much secondary to the opening discussion of Love. However, reading LeGrand, especially her sections on Aquinas, I wonder if the slothful are more central to the discussion of Love than the commentary might suggest.

From “The Hidden Life of Trees: What They Feel, How They Communicate – Discoveries From a Hidden World”, Peter Wohlieben

Scent as a means of communication? The concept is not totally unfamiliar to us. Why else would we use deodorants and perfumes? And even when we’re not using these products, our own smell says something to other people, both consciously and subconsciously. There are some people who seem to have no smell at all; we are strongly attracted to others because of their aroma. … So it seems fair to say that we possess a secret language of scent, and trees have demonstrated that they do as well.

 

For example, four decades ago, scientists noticed something on the African savannah. The giraffes there were feeding on umbrella thorn acacias, and the trees didn’t like this one bit. It took the acacias mere minutes to start pumping toxic substances into their leaves to rid themselves of the large herbivores. The giraffes got the message and moved on to other trees in the vicinity. But did they move on to trees close by? No, for the time being, the walked right by a few trees and resumed their meal only when the had moved about 100 yards away.

The reason for this behaviour is astonishing. The acacia trees that were being eaten gave off a warning gas (specially, ethylene) that signaled to neighbouring trees of the same species that a crisis was at hand. Right away, all the forewarned trees also pumped toxins into their leaves to prepare themselves. The giraffes were wise to this game and therefore moved farther away to a part of the savannah where they could find trees that were oblivious to what was going on. Or else they moved upwind. For the scent messages are carried to nearby trees on the breeze, and if the animals walked upwind, they could find acacias close by that had no idea the giraffes were there.

Similar processes are at work in our forests here at home. Beeches, spruce, and oaks all register pain as soon as some creature starts nibbling on them. When a caterpillar takes a hearty nibble out of a leaf, the tissue around the site of the damage changes. In addition, the leaf sends out electrical signals, just as human tissue does when it is hurt. However, the signal is not transmitted in milliseconds, as human signals are; instead, the plant signal travels at the slow speed of a third of an inch per minute.

From “The Secret Life of Trees: How They Live and Why They Matter”, Colin Tudge

Perhaps this is why we feel so drawn to trees. Groves of redwoods and beeches are often compared to the naves of great cathedrals: the silence; the green, filtered, numinous light. A single banyan, each with its multitude of trunks, is like a temple or a mosque – a living colonnade. But the metaphor should be the other way around. The cathedrals and mosques emulate the trees. The trees are innately holy. Christians with their one omnipotent God may take exception to such pagan musings; but the totaras and the kauris were sacred to the Maoris, and the banyan and bodhi and the star-flowered temple trees (and many, many others) to Hindus and Buddhist, and the roots of this reverence, one feels, run back not simply to the enlightenment of Buddha as he sat beneath a bo tree (in 528 BC, tradition has it), but to the birth of humanity.

But Christianity did give rise to modern science. The roots of science run far back in time and from all directions – from the Babylonians, the Greeks, many great Arab scholars in what Europeans call the Middle Ages, the Indians, the Chinese, the Jews, and the much underappreciated natural history of all hunter-gatherers and subsistence farmers everywhere. But it was the Christians  from the thirteenth century onwards, with an obvious climax in the seventeenth, who gave us science in a recognisably modern form. The birth of modern science is often portrayed by secular philosophers as the ‘triumph’ of ‘rationality’ over religious ‘superstition’. But it was much more subtle and interesting than that. The great founders of modern thinking – Galileo, Newton, Leibniz, Descartes, Robert Boyle, the naturalist John Ray – were all devout. For them (as Newton put the matter) science was the proper use of the God-given intellect, the better to appreciate the works of God. Pythagoras, five centuries before Christ, saw science (as he then construed it) as a divine pursuit. Galileo, Newton, Ray and the rest saw their researches as a form of reverence.

From “The Long, Long Life of Trees”, Fiona Stafford

 

In spring, you can feel life stirring in the barest twigs and the silhouetted catkins look as if a diminutive duck has run across the sky. One day the twigs are just beginning to thicken and brighten and bulge; by the next they are covered in pincer-paired leaves and pale, lime-white or pink-tinged blossoms. There is nothing tentative about these vernal explosions. When the days are longer, it is all sap and fresh smells, and the liquid calls of birds hidden in the drifts of thicker foliage. The bark has been through it all before, but the craggy faces of cherry tress seems less pinched in the bright light. By early November, when it is all dank and dark, the woods have a different taste, which does not quite match the ember-fall, sugar-brown shaken leaves.

George Orwell and the “process of life”

From Dan Hitchens, Orwell and Contraception
In all of Evelyn Waugh’s novels up to Brideshead Revisited, ­Orwell detected a consistent theme: Waugh’s “private ideal” of “a middle-sized country house.” In each of Orwell’s novels, his own private ideal is voiced by his characters: It is what Dorothy Hare in A Clergyman’s Daughter calls “that mystical joy in the beauty of the earth and the very nature of things.” In Coming Up for Air, George Bowling gazes into a pond crowded with living creatures and is overcome by “the sort of feeling of wonder, the peculiar flame inside you. It’s the only thing worth having, and we don’t want it.” ­Orwell’s essay “Some Thoughts on the Common Toad” asks whether this delight in nature might distract us from the struggle for justice. He responds that there is not much point in political change if we lose “all pleasure in the actual process of life.” That process itself resists the money-god and the totalitarians: “The atom bombs are piling up in the factories, the police are prowling through the cities, the lies are streaming from the loudspeakers, but the earth is still going round the sun, and neither the dictators nor the bureaucrats, deeply as they disapprove of the process, are able to prevent it.”

Orwell was drawn to remote places, to an existence close to the “process of life.” (In the thirties, for instance, he decamped to a tiny village where he tended a garden and kept goats.) His villains, “they,” are against it. In Nineteen Eighty-Four, Orwell’s last novel, O’Brien predicts that “the intoxication of power” will obliterate everything else: In the future there will be “no enjoyment of the process of life.” In Orwell’s debut novel, Burmese Days, Flory is impressed by “the whole life and spirit of Burma,” but to his racist fellow Brits he cannot say anything. “It is a corrupting thing to live one’s real life in secret,” he muses sadly. “One should live with the stream of life, not against it.” George Bowling recalls that his childhood home had a routine “like clockwork. Or no, not like clockwork, which suggests something mechanical. It was more like some kind of natural process. You knew that breakfast would be on the table to-morrow morning in much the same way as you knew the sun would rise.”