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  • CT Keith's Korner

    Okay...this thing/thoughts I have been working on seems to fit well with some of Barrett's recent threads (including the Simplexity Sundays and Something Grand, and was first mentioned in Joe's Interesting Discussion Proposal Thread). Selfishly, I wanted to bring it here and to share, but didn't want my egocentric righteousness to muddle in/distract from those already good threads.

    Hopefully the title of the thread will allow me to place the occasional tangential thoughts/questions here as well, should it be okay with others...if not, it can fall into the chasm too.



    I recently had the opportunity to listen to a truly wonderful podcast by Radiolab titled Seeing in the Dark. It offers the perspectives of two individuals who were once sighted, but now find themselves blind.

    The first gentleman we meet is John, who has made a conscious effort to “to forget about his vision altogether; he decided to live without pictures at all.” Why?

    “I meet a new person, I no longer wonder what they look like. I don’t know what my house looks like. I am honoring the truth and the truth is (that) I cannot really know what my wife looks like. I can put my hand on her face and try to feel my way across, but any images that I conjure up would not be real, it would not have all the details. In effect, it would be a lie, and when it comes to my wife, I cannot bear to lie.”
    . . . .


    Zoltan feels that images are essential, so when he lost his sight he took a different approach than John (whose viewpoint he considers ridiculous). He says, “I decided to repopulate the world with images and reconstruct reality for myself.”

    Now, when Zoltan walks into a room he says, “I see the furniture correctly in the manner in which you see from the corner of your eye.” He places his hand on the couch, chairs or a table when he enters a room and states with confidence, “I see the furniture correctly, in the manner which you would see it from the corner of your eye.

    According to Radiolab, “He paints pictures of everything that he touches, everything that he hears, even smells in the room to help them visualize the room.

    'The smell of the place will tell me about cleanliness or the use of the place. The echo of the place would give an estimation of windows or open spaces and alcoves. I re-create.'
    And Zoltan now says that he is so good at this sort of thing, that he believes what he “sees” in his own mind is actually, and literally, and verifiably in the world.


    . . . .


    The most interesting portion of the podcast features a conversation between John and Zoltan that was arranged by the producers of the show. In this exchange, they have a discussion (initially) about the appearance of Zoltan’s wife, who he had not met prior to his blindness:

    Zoltan: Her eyes are brown, slightly flecked with yellow spots and they are large, expressive eyes. I have years and years and years of experience of people’s responses that get all get factored into the construction of a complex image.

    John: But you cannot actually, literally, see her. You can only imagine that you can see her. So, why does it matter?

    Z: Because emotionally we do not react (and cannot react) properly to things that we cannot visualize. The whole human organism is constructed to react to pictures.

    J: You are trying to impose a visual totalitarianism upon the human brain.

    Z: No, we are visual creatures.

    J: Blind people are not visual creatures.

    Z: You said that you lost the visual world. Actually, I just think that you let it go.

    J: I did not just let it go. I extinguished it. For the sake of the greater reality.
    What is the greater reality? The truth.

    “When you investigate anything, I don’t care what it is…complications result. Thinking causes complication…but it’s part of that process of what we go through to figure what’s out there in the world…[It] is about truth, absolute truth, and …the pursuit of truth (properly considered) shouldn’t stop short of insanity. -Errol Morris
    Therapists work blind, left only with a sense of touch and a the story from the patient to guide their decision-making. For some, there is an acceptance of the uncertainty inherent in their craft, never knowing what it is that they are necessarily mobilizing, manipulating or catalyzing. Meanwhile, there are others who continue on a path toward a scientifically unjustified explanation for what they are doing when their hands land on the skin of another.

    These are the clinicians that Zoltan would find most relatable. They have an innate sense of hypo- and hypermobility of one spinal segment on another and easily distinguish the hypotonic muscle from the hyper-. They feel the pulse of cerebrospinal fluid through the cranial sutures of their patients skull and the release of restricted fascia. In each instance, it is years and years of experience and patient’s responses that factor into the construction of a complex explanatory model for care.

    Decades of research has taught us that we should know better; John already does. For example, when he had to reconcile the notion that he would forever remember the visage of his wife as she was the last day that he was sighted, he came to a remarkable conclusion:

    “How am I to live with this woman? Am I to live in nostalgic memory every time I am with her? I said, ‘No’, I will not live in the nostalgia. I will live with this woman as a living, sighted woman and I as a living blind man. We will live together in the present moment. We will accept each other as we are, across the abyss that divides us.”
    As John noted earlier, anything less would be a lie; he understands that his wife deserves better.

    Don’t our patients deserve better too?

    Respectfully,
    Keith
    Last edited by Keith; 24-11-2012, 02:21 PM. Reason: not except, accept...I still LOVE my dragon, though
    Blog: Keith's Korner
    Twitter: @18mmPT

  • #2
    Hopefully the title of the thread will allow me to place the occasional tangential thoughts/questions here
    i look forward to them, keith

    Comment


    • #3
      Keith, I stuck the thread to make it easier for you/us to find.
      With writing this good, we should see about getting you your own folder.

      Que pense tu Bernard?
      Diane
      www.dermoneuromodulation.com
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      @dfjpt
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      "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

      “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

      “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

      "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

      "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

      Comment


      • #4
        No folder necessary, but I appreciate the sentiment (heck, the pin alone is too much pressure )

        Those who wish to can simply go the blog itself without adding more "stuff" to Bernard's server....besides most of my stuff isn't this good anyway.

        Respectfully,
        Keith
        Last edited by Keith; 24-11-2012, 01:10 PM.
        Blog: Keith's Korner
        Twitter: @18mmPT

        Comment


        • #5
          [S]Grasshopper[/S] Keith,

          I've long felt that not enough of us have been reading your stuff. Now that will end.

          One thing: Near the end of this first piece you've written "except" when I'm sure you meant "accept."

          No need to thank me.
          Barrett L. Dorko

          Comment


          • #6
            Funny how my brain "hears" what how I say things to myself...I pronounce the two the same, Dragon hears them the same, and then I fail to catch things like this often when proof-reading. I have nick-named my dragon Augie...my manager will occasionally call me out when I miss similar items in my documentation at work.

            Augie teaches me to think before I speak and to do so clearly. I suspect that this is helpful more often than when I am simply dictating to my computer.

            Respectfully,
            Keith
            Blog: Keith's Korner
            Twitter: @18mmPT

            Comment


            • #7
              You use a Dragon?

              I got the first version of this many years ago and found it couldn't understand my NE Ohio accent at all.

              Maybe I'll try again.
              Barrett L. Dorko

              Comment


              • #8
                Originally posted by Barrett Dorko View Post
                I've long felt that not enough of us have been reading your stuff. Now that will end.
                My numbers are admittedly dwarfed by your own, but I still wonder...in the US alone there are over 210,000 PT-professionals. A good ROM thread hits 900 views (and many of those are the same people going back in to read and post again). What the heck are people reading? I what other web-savvy folks get for traffic on their respective sights...anyone care to share?

                In the end, I have become "wired" to think of things to blog about...fortunately, the endorphins are released when I click "publish" not when another clicks on the link.

                Respectfully,
                Keith
                Blog: Keith's Korner
                Twitter: @18mmPT

                Comment


                • #9
                  Originally posted by Barrett Dorko View Post
                  You use a Dragon?

                  I got the first version of this many years ago and found it couldn't understand my NE Ohio accent at all.

                  Maybe I'll try again.
                  For these board postings, no (it is a pain with links, and my thoughts happen as I type, resulting in A LOT of cut/paste and editing.)

                  But, for blog postings and my work docs, it is a life-saver. There was a learning curve (it training me, me training it), and it still gets some things predictably wrong (and, an, in) but at the end of the day it saves me TONS of time. For instance, the home care notes that I have to complete (once transcribed) are 8-10 pages long (in total) in a .doc with a font size of 11 and 1-inch margins. I would much rather proof read that much material than I would type it.

                  Respectfully,
                  Keith
                  Blog: Keith's Korner
                  Twitter: @18mmPT

                  Comment


                  • #10
                    Okay. I may try this.

                    I heard a while ago that Google's calculation of the typical views of a blog post averaged out to one, so about four hundred during the first twenty-four hours for my own comforts me.

                    Still, I wonder what all these therapists are reading and, as far as I can tell, it's nothing. Heck, they don't even know that this is my estimation, nor do they care.

                    I'm reminded of sitting on top of Blueberry Hill outside of Anchorage Alaska a few years ago I pointed into the distance at a mountain top and said, " You know, McKinley was an Ohio boy." Neither of the two college-graduate PTs with me knew this, and neither could have possibly cared less.
                    Barrett L. Dorko

                    Comment


                    • #11
                      Still, I wonder what all these therapists are reading and, as far as I can tell, it's nothing.
                      A few read abstracts and the "Discussion" section of articles published in JOSPT, JMMT and the like. Anything that will feed the left hemisphere.

                      These are the ones teaching con. ed. to the rest who read next to nothing.

                      Very nice piece, Keith. I'm sharing the link on FB, but, unfortunately, the only PT friends I have who might read it are already here.
                      John Ware, PT
                      Fellow of the American Academy of Orthopedic Manual Physical Therapists
                      "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson
                      “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot
                      be carried on to success.” -The Analects of Confucius, Book 13, Verse 3

                      Comment


                      • #12
                        Thank you, John. I like the focus on the left hemisphere today...I am going to have to pick up that book. If nothing else, writing can (and does, for me) serve as an exercise to learn to more freely access the right side...something that I often struggle with myself.

                        Originally posted by John W View Post
                        I'm sharing the link on FB, but, unfortunately, the only PT friends I have who might read it are already here.
                        Over the past 250+ posts on my own blog, I have been referenced/linked to by quite a few people who I consider to have more than the few limited friends that I have, but it almost NEVER garners any attention with people even curious to click on a link on their friend's FB or twitter feed. In the rare event that it does get some attention, almost no one comes back (and the ones who do, all seem to reside here as well). That they don't come back is okay, I am glad they stopped in to visit at all...but...it brings me to take pause when (as you mention) I consider that the "science" of what we do seems to be explored exclusively through the review of a few RCTs from a handful of self-referential publications alone. And that is the small percentage of therapists who DO read something.

                        It makes me wonder: I am the only one out there who realizes how bad he sucks at what he does? Am I the only one who wants to serve more patients better than I already am (am not)? After sighing deeply, I collect myself and come here. I doesn't always make me smile, but I usually feel a little better learning a little more everyday...and, by the way, many of those days are filled without reading a single RCT.

                        Respectfully,
                        Keith
                        Blog: Keith's Korner
                        Twitter: @18mmPT

                        Comment


                        • #13
                          Hi Keith,

                          They say it is lonely at the top. Maybe they should define what the "top" is on.
                          I sure am happy to read your writing and be influenced by it.
                          Byron Selorme -SomaSimpleton and Science Based Yoga Educator
                          Shavasana Yoga Center

                          "The first principle is that you must not fool yourself - and you are the easiest person to fool" Richard Feynman

                          Comment


                          • #14
                            Serendipitous timing of this post and my post Thanksgiving road trip as this Radiolab came up in my queue.

                            I did not read Keith's commentary before hearing the podcast. The podcast is interesting on many levels. I am not sure if Keith wants this thread to contain commentary or to be more exclusive to your own thought processes but I will post here and if it is inappropriate I can re-direct my comments toward another thread.

                            What is the greater reality? The truth.
                            The truth I took away from the podcast is that. Both men create their own subjectivity of their blindness in order to compensate with the trauma of the loss. I don't think Zoltan denies that he cannot see or that he creates images. Nor do I think is he being nostalgic per se as his wife whom he visualizes, he met after she became blind. Additionally, due to the visualizations that Zoltan creates he is able to repair his roof and gutters by himself--his neighbors think he is crazy.

                            In the podcast it is impossible to ascertain if John has less compensatory abilities available to himself because he does not recreate visual images. Yet it would be interesting to look at if there is any objective difference in there ability to spatially orient/map and create mental imagery.

                            Following this train of thought, the other interesting observation, is how hard John has to work to suppress and extinguish his own tendency for visualization. Which may have helped him emotionally deal with the loss of his visual sense. For an excellent review on the topic see here Effects of peripheral and central visual impairment on mental imagery capacity (If wanted I can post in Sound of Silence if there is interest).

                            I am of the current opinion that we imbue/create out surrounding environment with our own subjectivity; that subjective reality is uniquely our own. That regardless of attempted extinction of visual images or the creation of visual images in the absence of visual stimulus both involve this process (of creating ones own subjective reality). So they both have equal merits of validity, IMO. If one subjective viewpoint can be shown objectively (by a third party outside of the two men) to be better functionally then there can be some argument about which lays a superior claim to the underlying "reality". So far as I can tell repairing your roof is pretty high functioning for a blind person.

                            I don't think my commentary bears any impact regarding the extrapolation that there are a number of practitioners and teachers whom have difficulty expanding/changing their current subjective bias despite an overwhelming amount of objective evidence to the contrary.

                            Eric
                            --------------------------------------------------------------
                            Body is imbued with mind, and mind is embodied.

                            Comment


                            • #15
                              Originally posted by Milehigh View Post
                              Serendipitous timing of this post and my post Thanksgiving road trip as this Radiolab came up in my queue.


                              Originally posted by Milehigh View Post
                              I am not sure if Keith wants this thread to contain commentary or to be more exclusive to your own thought processes but I will post here and if it is inappropriate I can re-direct my comments toward another thread.
                              I am glad you decided to contribute...the board is Bernard's not mine. I am thankful for his provision of this environment for us to have conversations such as these.

                              Originally posted by Milehigh View Post
                              ...the other interesting observation, is how hard John has to work to suppress and extinguish his own tendency for visualization. Which may have helped him emotionally deal with the loss of his visual sense. For an excellent review on the topic see here Effects of peripheral and central visual impairment on mental imagery capacity (If wanted I can post in Sound of Silence if there is interest).
                              This fascinates me in a way that I am as yet unable to wrap my head around, but how John dealt with actively suppressing his natural inclinations...well...are we back to McGilchrist again today?

                              Thanks for the link...I will try to get to it the next day or so as it pertains directly to this posting.

                              Originally posted by Milehigh View Post
                              I am of the current opinion that we imbue/create out surrounding environment with our own subjectivity; that subjective reality is uniquely our own. That regardless of attempted extinction of visual images or the creation of visual images in the absence of visual stimulus both involve this process (of creating ones own subjective reality). So they both have equal merits of validity, IMO.
                              I understand what you are saying in the bolded portion, but is there a fundamental difference between actively creating an image and actively squashing another, is there not?

                              Personally, I felt that the word "truth" was a bit heavy for this line of thought when writing this but decided to stick with it. I suspect I could have probably done a better job exploring certainty/uncertainty, rather than true/false. John is certain that he doesn't know something, Zoltan is certain that his imagery compensates for his vision loss. It is his certainty that I find unjustified. I doubt that he is walking on the roof as if he were sighted, but I would love to watch, to see how certain he is. Heck...I am scared of heights and would probably do better if I couldn't see, to be honest.

                              Originally posted by Milehigh View Post
                              If one subjective viewpoint can be shown objectively (by a third party outside of the two men) to be better functionally then there can be some argument about which lays a superior claim to the underlying "reality". So far as I can tell repairing your roof is pretty high functioning for a blind person.
                              To go back to the analogy of the therapist...couldn't we look at the positive outcomes of clinicians who utilize a strictly ostepathic/Greenman-esque approach and compare them to the blind roofer?

                              I ask these questions out of curiosity...I know that there are some on here who are far more philosophically inclined than I, pushing to learn and (try to) understand more.

                              Respectfully,
                              Keith
                              Blog: Keith's Korner
                              Twitter: @18mmPT

                              Comment

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