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Med Humanities 33:110-117 doi:10.1136/jme.200X.10.1136/jmh.2007.000260
  • Opening the word hoard

Opening the Word Hoard

  1. Gillie Bolton,
  2. Yvonne Yi Wood Mak, Palliative Care Physician,
  3. Tim Metcalf, Poet and Parl-Lime GP,
  4. Ann Williams, Health Visitor and Lecturer,
  5. Sinead Donnelly, Consultant in Pallatlve Medicine,
  6. David Greaves, Retired GP
  1. 15C Bury Place, Bloomsbury, London WC1A 2JB, UK; gillie{at}gilliebolton.com

    UNCERTAINTY, IGNORANCE, LISTENING

    Opening the word hoard is edited by Gillie Bolton. Items should be sent to her address at the end of her introduction.

    The function of the writer is to act in such a way that nobody can be ignorant of the world, and that nobody may say that he is innocent of what it’s all about.

    JP Sartre (p14)1

    Cut doors and windows for a room

    It is the holes which make them useful.

    Therefore profit comes from what is there;

    Usefulness from what is not there.

    Lao Tsu (p11)2

    Life offers few certainties; three are birth, death and uncertainty. No one knows when or how exactly birth or death will take place (unless it is controlled); what another person feels, thinks or remembers; why we are born; where our essential self goes when we die; or what death and being dead are like. Yet we have responsibility for our own lives3 and our own practice, despite current trends towards blame and litigation, performance indicators, targets, protocols. Given this social, psychological and spiritual tug-of-war between responsibility and accountablity it’s not surprising that suicide rates and work-stress have increased.

    Like dandelions pushing through lifeless concrete, however, age-old understandings and strategies are being practised and put forward. Mindfulness, a conscious exclusion of elements of life apart from that which is being attended to,4 is achieved when senses and awarenesses are tuned in to present action:5 the opposite of multitasking. Being mindfully aware develops communication, ability to use implicit knowledge in association with explicit knowledge, and insight into others’ perceptions.

    Arthur Frank speaks of practical wisdom, from Aristotle: “Phronesis is the opposite of acting on the basis of scripts and protocols; those are for beginners, and continuing reliance on them can doom actors to remain beginners” (p221).6 …