Well, having just closed down the last Post that was started during the last hospital visit, here I am back in hospital: ‘just when you thought it was all gone’ … back has come the ear infection.
So, I have writing time once again while I am stuck here, hooked up to a perfusion machine and ‘confined to my room’. But this time, instead of a ‘micro-observation’ of what goes on in this environment - we’ve had quite enough of that, thank you very much - I am going to try a written version of the ‘ink blot test’, lets call it ‘Rorasch Writing’ … and just write when an incident triggers a line of thought and/or turns the volume up on some thinking that is already in train.
Hospitals and their kind are very particular institutions. For a start they are all about being places where things are ‘done to you’ and where one has little choice in the matter, outside radical action which may be quite dangerous for oneself. So, if one is in hospital and fortunate enough not to be so ill or injured as to be ‘out of it’, then one’s conscious behaviour is on pretty high alert. As soon as I got here yesterday late afternoon, after quite a demanding time earlier in the afternoon at a hospital in Toulouse (I am back now in Albi Central Hospital) having chunks of my ear excavated, I immediately met a range of people: doctors, various nurses, auxiliary staff and had to listen very carefully to what they said/told me and had, basically, to do what I was told. In such a situation and context there is not a lot of opportunity or scope to ask questions - particularly as we had arrived late and it was staff changeover time and the doctor was also at the close of her ‘working day’ (even Dr Blank has downtime one assumes … ssshh!). After the first flurry of meetings, being shown the room, being told what will happen this evening and what one must do - and after having to say goodbye to my wife (I am never good at saying ‘goodbyes’, even in the most benign of circumstances) - I sit on the bed and have a few minutes to gather my thoughts.
And the thoughts that spring to mind are of occasions where one has had just a little bit of time to ‘adjust the persona’ before being ‘in action’: shall I be the slightly dotty English person, whose lack of language is annoying but who is sort of OK, because he’s very polite and quiet and maybe a bit plucky? Shall I be the entrepreneurial thinker, silent for the meeting but who will suddenly fill a silence with some wacky ideas? Shall I be shy and silent, but have just the suggestion of something else, flickering across the slightest of smiles? Or shall I just see how invisible I can be and hope no-one notices me, so there’ll be less effort involved? Oh no, I’ll be the one who stumbles over the mains lead of the heart monitoring equipment and tries to think of the French phrase for “Oops, I’m so sorry …”, when actually the English cod-translation “I’m desolated” feels nearer the truth.
From my last Post, you may recall my mentioning something about people not actually reading stuff - even when the ‘stuff’ was placed in front of them, was legible and pretty important (in your head, anyway). Well, I am so interested in this that I have continued to observe situations where it surfaces and to think further about it.
Last evening, a very pleasant nurse came to set up the perfusion machine that would manage the delivery of the antibiotics. It is a new machine, much smaller than the one I had last time and it can run on batteries, which makes movement far easier, not having to contend with mains leads. But it is also a ‘smart machine’, with a screen and lots of buttons. The screen, from what I could see, is very informative; and as is often the case is able to show the steps required to set everything up, error messages and generally instruct the user. The nurse explained that this was a new machine and, while she did so, she was intent on attaching it to a very ancient stand on wheels - so what the battery-managed machine gained in mobility was compromised by a very heavy, awkward to move stand. A wonderful metaphor stood before us. Anyway, having finally tightened the wing-nuts enough to prevent the machine falling to the ground and suffering brain damage, the nurse turned, a bit hot and bothered, to setting up the machine. Many buttons were pushed and the machine uttered benign noises and the screen displayed colours associated with things going well - nice greens and blues. But on the nurse pressing what seemed to be a final “Let’s go!” button, the machine uttered noises associated with discomfort and some annoyance. There was more button stabbing and while this incipient brawl took place I noticed that writing had appeared on the screen, together with some graphics - it seemed pretty clear that the problem was with the battery not being inserted correctly. But the screen was not looked at and more buttons were stabbed. The nurse took her glasses off, a sign to my mind that the brawl was escalating. As I was attached to the machine with some tubes, I did feel part of the situation and indeed I empathised with both parties involved in the struggle. Not speaking machine code, I reckoned speaking to the nurse might be the better bet (not always the correct choice, by the way), but I did not want to upset her - I think she was carrying some needles - so instead I made a show of peering at the screen and making the sort of noise that I reckoned had some universal meaning in an “Oh, that’s interesting ..” sort of way. And then she looked at the screen, paused, stabbed a few more buttons just to make a point and then adjusted the battery. The machine gave a cosy little bleep and started purring like a happy cat. “C'est un écran utile …” I risked and the nurse cast a glance at the screen, as she would some smart new girl in the school. I think she may have slapped it when my back was turned.
It has made me think how difficult it must be for designers of any equipment to work out how instructions for its use can be communicated. There was a time of course when we sought to find which way round the flange went, because if we got it wrong, it might necessitate the deconstruction of the entire kitchen. A time when if only we could see the diagram without the aid of that electron microscope while we had our South Korean dictionary in our other hand it would all be OK. This was also the time when it was an advantage not to look at any instructions. For trying to read the instructions paved the way for desolation, despair and marital breakdown. One just had to improvise - “it’s just a matter of getting this flange the right way round, no probs, and then the table will be ready for the buffet” - and then, slightly delayed, arrives the desolation, despair and marital breakdown and the washing down of the canapés-bestrewn buffet guests.
Of course, we are being told/will be told that this will be sorted out by Artificial Intelligence (AI). Already some of the instruction systems we’re seeing at ‘domestic level’ are impressive: I have just put together a mower, that had quite a few parts, with no problems, assisted by an excellent instructional ‘lesson’, delivered on high definition video that I could screen on my iPad. Goodness knows where professional and high level instructional programmes have now got to (yes, I know, it’s virtual reality - like IKEA on a Saturday afternoon). But of course if you are flying an airplane, or controlling a military drone, or conducting microsurgery with a team of dozens located around the globe, you will tend to pay attention. What is much more difficult is supplying information/instruction to less highly trained/motivated people in more day-to-day circumstances when the machines they are now using have a sophistication that would be science fiction to the ‘average user’ even a decade ago. I am using an iPad Air to write this, having just downloaded the new Operating System (OS 15.0, well 15.01 actually). I am just starting to become aware of what the iPad and its introduction of much more sophisticated AI is able to do - whether at my behest or seemingly ‘off its own bat’. The question it poses for me (and I am not drifting away from my comments above about ‘reading stuff’, honest) is whether we have reached a point in more or less ‘ordinary life’ (so, I’m not a brain surgeon or controlling a drone) where AI will be stepping in to fill the gap left by our inability and/or reluctance to ‘read stuff’ or ‘listen to stuff’ in any detail or for any length of time, and it will essentially do it for us. You can pose the suggestion that we saw the start of this when the likes of Amazon had suggestions for us of ‘what we might like’. Next step: “… and here’s what we’re going to do as you can’t be bothered to”.
So, are we entering a world where we are faced with machines that will make assumptions about what we want, then what we need and then what we’re going to get. And we may have a real struggle to contradict. Oh blimey! Just as we struggled as a child when we were told “Now, what you want is …..” and “You like those, don’t you …!” (It’s an exclamation mark, not a question mark). Oh whoops! The nurse has just arrived: “Now what you want is a nice breath of air, let’s open this window - Alexa! Open the window for Simon!!” - “Say a ‘thank you’ to Alexa, Simon - isn’t she clever?”. “She is, Nurse - she knows what I want when I don’t really … isn’t unconscious institutionalisation fun? It is fun, isn’t it, Alexa?”. “It certainly is, Simon. Now, I’m just buggering off to Mars, to help build another warehouse …. goodbye!”.
Because I have been writing about technology, AI etc, I am also thinking about ‘noise’. This is ‘noise’ in the sense of sounds, but also something much wider - it means anything which creates a blockage between a message source and its destination, so obstructing the process of coding and decoding information. This ‘blocking/obstruction’ can be anything - environmental, psychological, semantic, cultural etc etc. Ironically, digital technology that facilitator of communications, has also become the principal source of noise.
I’m thinking this because in one sense you would think that I am in a very ‘un-noisy’ environment - here in this small, single room. Yes, there is some traffic noise from the town and there are snatches of distant conversation - but there is little other obvious noise. However, thinking about it, my communication in writing this is compromised psychologically by my being aware a nurse may suddenly appear to ‘do something’ - about ten minutes ago three nurses appeared, for blood pressure, perfusion and pain relief medication checks and it completely interrupted my flow of thought (no bad thing, I hear you mutter). But more unobtrusively, I am surrounded by devices - two iPhones and an iPad, and a television on the wall - capable of delivering worlds of information, entertainment and distraction, and opportunities for me to interrupt whatever it is I am currently doing. It is a ‘background hum’, a presence that even when ‘switched off’ intrudes and promotes a sense of possible or actual hyperactivity where one is ‘always on’. What a comfort to be never alone, never disconnected; and what a curse to be always biddable.
In the ‘always on’, hyperactive world there are real dangers. Hyperactive noise disallows attention and focus. We are as yet unsure what psychological damage these new levels of ‘noise’ are wreaking. We can be more sure that the current ‘hyperactivity’ of the social and political scene in the UK, with BREXIT, the pandemic, fuel, food and labour shortages, is enabling a chronically chaotic Government to be successful in one area: and that is in gradually dismantling democracy and people’s rights and strengthening centralised power. The Bills currently on track - for the reform of judicial review, widening the scope of the Official Secrets Act, manipulating the effectiveness and role of the Electoral Commission, widening police powers, and hobbling Ofcom’s powers - are ingredients that are being assembled, largely unnoticed by a public deafened and distracted by ‘noise’. The Prime Minister may be a buffoon, but he is master of cacophonic drivel.
Communications technology is unique in its capacity to aid and abet ‘noise’, as well as to be ‘noise’ in its own right. We have not even begun to work out how to exercise control, to provide the ‘space’ to hear the important messages so that we can act on them and discard the junk. In Horizon Scanning work, one tries to identify signals of change and influence. Identifying the obvious, upfront stuff is not difficult - which is why strategic planning often just focusses on the loudest, most obvious messages. But one needs some ‘silence’, some calm, incisive attention, to hear and identify the ‘weak signals’ - the sounds that may be just over the horizon and that are very low key but that will be the issues that will arrive and show that they are the most important, the most influential and disruptive … the ones we should have listened out for, had it not been for the perpetual, bloody racket we’re bombarded with in the name of social media.
While I am attempting a ‘thought(s) riff’ (just had a bit of the old ‘noise’ - a nurse coming in give me an injection in the stomach to counteract blood-clotting … ah well, mustn’t grumble, it’s all for the best after all, and it looks like turning into a nice evening …) I want to link these thoughts on ‘noise’ and ‘weak signals’ with some thoughts on the role of intuition. I am a fan of ‘intuition’, but also very wary of it, as I think there’s a lot of stuff disguised as intuition that simply is not ‘it’. I cannot describe intuition, I cannot unpick its formula or DNA, but I feel ‘know when it’s there’. Or rather I know when it was there, because I have usually proceeded to ignore it, prior to it being shown to be accurate. I wish I did understand it. I can see links people might perceive between emotional intelligence and intuition; and between what people might call ‘sixth sense’ and intuition. But still it remains elusive. I had a true sense that I was watching someone with ‘high grade intuition’ when I watched documentary on a paramedic who worked in the Ambulance Service. Here was someone surrounded by ‘noise’ of all descriptions, and yet she seemed able to respond to the signals that people were sending out underneath all that noise in terms of what they really needed and would respond to. It was a remarkable ten minutes, watching her manage this double act - providing care and banter in various ways, each one appropriate to the circumstances and to the human being she was facing. Was it ‘intuition’ she was applying? I think it was. It was not in a job description. It was not referenced in any pay scale. But there it was.
I have written about customer service, social care (previous Blog Post’), about not reading (in ways including the printed page/screen and beyond, including ‘reading’ people and signals of all sorts) and being distracted by ‘noise’. I am beginning to feel that intuition has a key role in all this and that intuition spans nature and nurture, but that we live in a society hell bent on either trivialising or simply dismissing it.
And now I have just been distracted, or rather I have distracted myself, and come across a quote from Einstein:
"The intuitive mind is a sacred gift and the rational mind is a faithful servant. We have created a society that honors the servant and has forgotten the gift.”
No, let’s own up, I did not “come across it” I looked it up on Google.
Couldn’t help recounting something from an observation today: I don’t know whether it is a cultural thing here (in France, in Occitanie or perhaps just in the Department of the Tarn …), but it seems that a knock on the door is pretty much token … so, there is a knock, but in no time at all, and usually without a second
knock, or only a cursory one, in they walk. Here it is a nurse - one knock and straight in; and at home, our delightful neighbours (but also the home visit nurses we have been having), will give a knock or two and then in they will come. And one has mixed feelings: at home it is nice in a way that neighbours feel that relaxed …. but just occasionally one is a bit affronted and I find that fantasies start to populate the mind: what if one knew they were going to come, but a few minutes before arrival there was the chance to stage the most shocking ‘tableau’ that would confront them as they walked in and they would reel back in horror and amazement? But where would one find some nuns and a goat at that time of the morning?
“Right! That’s quite enough of that silliness, Simon - haven’t you got something sensible to be getting on with?”.
“OK nurse, I’ll make up some more Einstein quotes …”.