My Self Isolation Flashback (TBC)

At some point in the past a friend of mine had a foot injury. He was laid up, unable to walk, for about a week whilst the injury healed, sufficient to bear his weight. He was bereft. He could not work, he could not leave the house. He took it badly.

At the time we were fond of looking for stories in myth which may inform events in our current or past life event. We naturally looked to the story of Achilles. In myth he was dipped into the River Styx by his mother to make him invulnerable. She held his foot to facilitate this. His invulnerable heel was his weakness and this is where the spear that killed him hit him in battle. Today, a weakness can be referred to as a persons ‘Achilles Heel’. After suffering an injury to my own eponymous Achilles Tendon, I can attest to it’s disabling capacity. Achilles was a warrior and for a warrior and foot injury could be a potential fatal weakness.

We reflected on how neither he nor I were warriors. It was some comfort and a useful antidote to equating masculinity with combat. Myths are useful in the way they contain archetypal forms, patterns of phenomena or behaviour that transcend the time of the original story. They are like signposts from the past that point to the present. My recollection of the exchange with my friend seems to include some reference to another myth which pointed to the idea that a foot injury is a sign to rest and reflect. But numerous searches have not revealed any such myth.

In reality Achilles would have seen out his days resting his heel in carpet slippers if he had rested and reflected instead of going into battle. Indeed, maybe the myth points to a warrior resting and avoiding battle should they get a tendon injury in their heel.

On Tuesday the 19th October I tested positive for Covid 19. The government in their infinite wisdom decreed that give such an injury I should rest for 10 days. They wrote to me and said “You have tested positive for COVID-19. You must stay at home and self-isolate until 29th of October (including this date at midnight).”

I could still smell stuff. I had no temperature. But 2 flow tests showed positive. After a while I felt like a large dog was sitting on my chest. I got no worse but was exhausted and slept a lot. I was laid low for about a week. The chest restriction was scary and I could see that if it got worse it would this that killed me. CV19 is an upper respiratory illness. Untreated it would be a terrifying way to go. You would slowly suffocate.

I couldn’t do much bit sit, rest and reflect. So I reflected on Achilles. I figured that for 10 days at least my fighting days were over. The myth told me it was ok to be out of action.

My art making had reached a bit of a hiatus. I have been having a battle with my ‘Imposter Syndrome’. My art making included photography, performance, walking art, painting, poetry and prose, collage, music making, digital art and all manner combinations of the above. But fine art it was not. It had become, in the eyes of my imposter self, a meaningless mishmash of mixed-media. Given an opportunity to rest and reflect I decided to reflect on all the weird things I had done in the name of art, and pick a few to concentrate on. Be a proper ‘Artist’.

How to do it though. I decided to make a book. I would call it ‘Here’s One I Made Earlier – Retrospective of a Non-Artist’. It could be a work of fiction. I would be the unreliable narrator. I remembered a story about artist Joseph Beuys, about how he claimed his plane was shot down in flames and he was badly injured, and a band of nomadic Tartars had saved his life by wrapping him up in felt and fat. It was only partly true. But Beuys built his reputation as an artist on this story. He did lots of stuff that could be considered ‘not-art’, like living in a cage with a coyote. Beuys created his own myths. His story is told in ‘Fat, felt and a fall to Earth: the making and myths of Joseph Beuys’ here.

In the article, Olivia Laing the author says “All the same, by turning his injury into a fable, Beuys did make a clear statement of intent. War, fascism, nationhood, trauma and repair: these would be his subjects, but his approach would not be that of a historian or social scientist. What he was interested in was discovering and communicating in mythic terms how damage might be transfigured or transformed.”

The power of transformation is the power of art. Art preceded science but both act as forms of research. Science of the material world, art of the immaterial. Science is a form of art. John Berger is quoted in the article and says “In matters of seeing, Joseph Beuys was the great prophet of the second half of our century. Believing that everybody is potentially an artist, he took objects and arranged them in such a way that they beg the spectator to collaborate with them … by listening to what their eyes tell them and remembering.”

My book making is going OK. My imposter has coughed, interrupted me, and opined that my retrospective ideas about my past as a non-artist are inaccurate. “I think you might just find that your ideas of yourself are just a myth.” he says. I am getting uncomfortable with the process I embarked on. But this just means the process is working. I am (as Berger says) taking “…objects and arranged them in such a way that they beg the spectator to collaborate with them … by listening to what their eyes tell them and remembering.” and I am the spectator.

In retrospect my past is being transfigured and transformed by my act of making. Not sure what it will be transfigured and transformed into. But that is what art and research is all about. I am in the right attitude. I am available for outcomes but not connected to them. I am in adventure.

Performing Distancing

Social distancing was introduced to the UK around March 17, 2020

On March 18, 2020 I did a walking art performance to explore the then new idea and practice of ‘social distancing’.

On reflection, a year on, it is interesting that this simple act gave me insight that evening into the way that ‘social distancing’ would very quickly become normalised in society, as did the sensation of coming to avoid or mistrust the proximity of other people.

It just reinforces for me how performance and art as research may be able pre-empt experience and give insight into experiences to come, but do so through feelings, not through empirical data.

Be careful what you think you see.

This reminds me of Cassandra, who was able to see the future, but was cursed by nobody believing what she said. She was cursed by Apollo for lying when she said she would get jiggy with him. She was cursed for lying, so the curse made her words became an untruth.

Maybe the moral is then is to not lie to yourself about what you may see, but beware that to say what you see may help nobody. And if you do speak, maybe only speak to people who see the world the way you do. Therein is the dilemma of holding your own counsel or speaking only to become stuck in a bubble. Trump and Brexit and QAnon all rolled into one.

Or maybe the moral is simply that words are not accurate representations of feelings, and interpreting feelings is an art not a science.

Below is my account of that performance written somewhere around the end of March 2020.

Performing Distancing March 18, 2020

(Written end of March 2020.)

On the basis that art and performance can be used as research, to explore and express personal experience, I wondered what would happen if I walked through Carlisle town centre maintaining 2m social distancing, but do it as performance, choreographed like a dance or with applied dramaturgical principles, and record it with GPS.

A simple algorithm was devised to work like choreographic directions.

Walk in a straight line until I was within 2m of another person, then turn away until the distance exceeded 2m, then resume the straight line.

Where I met an obstacle turn through 90+ degrees and continue in a straight line.

Limit the walk to the central shopping area.

Walk for 1 hour.

I imagined this visualised as a faux maths formula, because moving an idea between forms, like turning word into image, can sometimes reveal a new aspect to the idea.

Faux math formula

Where P is the path of the walk, as an iteration or repeat of p, which is each leg as a straight line a-b until this is changed by meeting a person (the m is an aboriginal sign for a person, basically, the bottom mark left in the sand where a person was sitting) in which case the path p changes (the triangle) by n degrees.

The basic principle of art as research is to make art, in this case performance, and pay attention to what happens when you do.

On the 18th March I did a social distancing walk for an hour in Carlisle city centre, and payed attention to my thoughts and feelings and other peoples response. I tracked it with GPS tracker.

This is the raw GPS visualisation of that walk.

This shows the path I followed as the green line. The dots are simply GPS way points.
This is a satellite view. The image is old and some things were absent in March.

I worked with a GPS track editor and removed as many intermediary waypoints as possible to leave only turns in response to social distancing or turns in response to an obstacle, like a shop front.

I got this, edited down as three images joined together.

Simplified social distancing walk.

What the walk/performance did as research, was give me insight into social distancing, then a very new phenomenon.

Over the hours walk, I started to become anxious when I got close to people. As a person approached me and I anticipated the need to distance, I felt a rise in my level of anxiety. I felt isolated and distanced. I felt sad.

I was also nervous about wandering around in circles for an hour on CCTV. In the end nobody even batted an eyelid. I was utterly uninterrupted and fully ignored.T his added to a sense of aloneness.

Part of the creative process is the period of incubation, in which the creator moves away from the art making and does some other thing. On returning to the theme or the artform, after incubation, new insights emerge. The form created is seen in a new light. I noted this sadness and anxiety at the time, but on writing this, months later, another aspect of my experience of performance/art as research came into play.

I reflect now that this experience gave me insight into how social distancing would feel. Now, months later people are not rushing back to contact, many people appear reluctant to go back to the shops and the pubs and the office. This week, mid-June, the MP is now imploring people to go back to the office and the shops and the pubs. The anxiety prevails.

Also there is growing anger in the UK and clear riotous anger in the USA in some quarters of society. Today I found the following meme.

My experience of children in care is that many are angry and this is just a product of sadness and anxiety. Whilst different, both are connected to loss. Anxiety may be an anticipation of discomfort and danger, but also the anticipation of the loss of safety, the familiar, and the predictable. Our stress response is fight, flight or freeze. We have been unable to flee in lockdown, which leaves fight and freeze, anger and sadness.

On March 18, the day of my social distancing walk, the experience of social distancing was new. This art based research could not be seen as producing a clear empirical evidence based outcome, but I did experience feelings in myself which could have anticipated feelings shared by other people once the lockdown deepened in its impact. I anticipated sadness and could, in retrospect, have anticipated anger.

This work is highly influenced by the arts therapies and dramatherapy and by experiential learning. In the arts therapies, whilst art is made, the role of the artform as an end product, for sale, or for viewing by an audience, is not significant. What is significant is the experience of art making on the part of the art maker. As such it is a form of experiential learning in which direct experience of art forms the basis of learning or research in which the art making is both the mode of research and the outcome of the research. It is part research, part performance, part personal therapy, part play, part experiential learning but is never fully any of these things.

Undertaken with the intention to make this as art, invites the creative process, and as such it is unique, not in any grand way, but in a way that invokes creativity as a simple and easily available act accessible to anybody. The act that makes it art in intentionality and this intentionality can be learned.

My hope is to use this website and my own art making to show ways to learn this. We cannot all be artists but we can all make art. What this experiment revealed was simple and oddly mundane, but also complex and profound. I want to show how art making can help you explore and express your experience of the world.

Solway Walk – Map Art

Sul Waths Crossing the Iapetus Ocean

Following on from my exploration of the Solway I wondered if I could make an object that captured the way it was a real objective place, but was open to a number of subjective impressions.

For a while I have experimented with weaving Ordnance Survey maps, with the grid squares becoming the warp and the weft of the created object. In the past it has been two different maps, but for this I wanted to experiment with two maps of the same place, but shift them so the Solway became kind of extended and ambiguous. Like it is. So I made the object above.

It will never win a Turner Prize but my interest is not in creating ‘Fine Art’, but in using art-making to explore ideas and express experience. What I wanted to express was…

  • Blurring the boundary between England and Scotland.
  • Showing how the Waths crossed this boundary.
  • Make something that looked recognisable from a distance but changed before your eyes as you approached it.
  • Make you kind of wonder what it was, a picture, a map, some weaving or needlepoint.
  • Shifting your sense of time. The Iapetus Ocean was the water between the two tectonic plates that mashed together to make the Borders. The Solway is all that is left. I liked it as an archaeological object.
  • To also have bits of it that were from the time it was made. I liked it as a contemporaneous object as well.
  • To work with text and image and object and colour as things to stand in for something else.

Sometime I would like to return to making this as a more aesthetically sophisticated object. But as a starting point, it is a good place to start.

Einstein on the Political Power of Art

“Nothing can equal the psychological effect of real art — neither factual descriptions nor intellectual discussion.”

Good article on ‘Parade’ by Si Lewen. From brainpickings.

True use of art as an expression of experience and a reminder that art making can contribute to cultural health as well as personal health given a recent preponderance for ‘parades’ as demonstrations of power.

Original article here


Einstein on the Political Power of Art

“Tyrants always fear art because tyrants want to mystify while art tends to clarify,” Iris Murdoch wrote in her arresting 1972 address on art as a force of resistance. “Those who tell you ‘Do not put too much politics in your art,’” Chinua Achebe told James Baldwin in their superb forgotten conversation at the close of that decade, “are the same people who are quite happy with the situation as it is… What they are saying is don’t upset the system.”

A generation earlier, in the final years of his life, Albert Einstein sat down at his desk in Princeton, New Jersey, to compose a letter of consonant sentiment — a stirring letter of appreciation and assurance to the Polish Jewish artist Si Lewen (November 8, 1918–July 25, 2016), who had just quietly released a staggering work of art and resistance.

Si Lewen

Born days before Armistice Day, Si was five when he decided to become an artist — or rather (as such elemental self-awarenesses tend to bubble up) when he knew that he was one. In those formative years, his family fled from place to place as the situation for Jews in Europe was darkening by the minute. During a period of refuge in Berlin, while ostracized and bullied at school for being Jewish, he began receiving his first formal art lessons from a disciple of Paul Klee’s. His young imagination and his understanding of the world were being imprinted as much by his refuge in art as by the thickening political atmosphere of animosity that would soon erupt into the world’s grimmest war yet. 

Art by Si Lewen from The Parade

Lewen was still a teenager when his family fled to America as Hitler usurped power. When he arrived in New York, he was at first elated at the prospect of a new life full of art and free of persecution. He began taking drawing classes and going to the Metropolitan Museum every day. But when an antisemitic policeman beat him nearly to death, the terrifying thought that he would never be free from bigoted brutality and that the life of art could never be separate from the troubled life of the world drove him to a suicide attempt. And yet, like Lincoln, Lewen rose above the self-destructive impulse and turned the darkness into a motive force for action, for revising this broken and brutal world with his particular light.

Art by Si Lewen from The Parade

He enlisted in the American Army, in a secret intelligence unit of German-speaking immigrants who were flown into Germany for the invasion of Normandy that backboned D-Day, the liberation of France, and the ultimate defeat of the Nazis. There to do translation work and to illustrate posters and pamphlets rallying the troops, Lewen walked into one of the major concentration camps the day after it was liberated and saw what had happened to countless people who looked like him, who spoke the same language and dreamt kindred dreams — saw the would-be destiny he had narrowly escaped by making it to America as a refugee. 

Art by Si Lewen from The Parade

When he returned to New York with a wounded body and a scarred soul, he spent six months recovering at the VA hospital, then poured his surviving spirit into a stirring narrative suite of fifty-five drawings titled The Parade — a wordless, intensely emotional, consummately illustrated black-and-white charcoal meditation on the grim and abiding paradox of armed antagonism: that every war appeals to some primal part of the human spirit in order to gain its destructive momentum, and every war ends up destroying what is most buoyant and beautiful in that spirit. 

Art by Si Lewen from The Parade

Einstein, who had spent the years between the two wars making an emphatic case for the interconnectedness of our fates and corresponding with Freud about violence and human nature, saw The Parade — unclear how, but very probably through the trailblazing photographer Lotte Jacobi, who was soon to exhibit them in her New York gallery. Einstein had sat for her more than a decade earlier and remained in touch. 

Albert Einstein by Lotte Jacobi, 1938. (University of New Hampshire Museum of Art.)

And yet despite how stirred those who saw it were by Lewen’s work, it fell into obscurity until it was rediscovered more than half a century later and resurrected in the final year of Lewen’s life in the stunning accordion volume Si Lewen’s Parade: An Artist’s Odyssey (public library), envisioned and edited by Art Spiegelman. It opens with the letter Einstein wrote to Lewen on August 13, 1951 — his most direct and impassioned statement on the political power of art:

I find your work The Parade very impressive from a purely artistic standpoint. Furthermore, I find it a real merit to counteract the tendencies towards war through the medium of art. Nothing can equal the psychological effect of real art — neither factual descriptions nor intellectual discussion.

It has often been said that art should not be used to serve any political or otherwise practical goals. But I could never agree with this point of view.

In consonance with his contemporary and fellow humanist Anaïs Nin’s ardent case for the centrality of emotional excess in creativity — “great art was born of great terrors, great loneliness, great inhibitions, instabilities, and it always balances them,” she wrote to a seventeen-year-old aspiring author whom she was mentoring — Einstein adds:

It is true that it is utterly wrong and disgusting if some direction of thought and expression is forced upon the artist from the outside. But strong emotional tendencies of the artist himself have often given birth to truly great works of art. One has only to think of Swift’s Gulliver’s Travels and Daumier’s immortal drawings directed against the corruption in French politics of his time. Our time needs you and your work!

Lewen died days before Spiegelman’s gorgeous resurrection of The Parade was published, in the politically precipitous months leading up to the 2016 American election. He never lived to see the country that had given him refuge crumble into a republic of racism and xenophobia for four years, but also never lived to see the redemption of the republic in the subsequent election of a President who, in another time and another place, would have perished in a concentration camp. 

Couple with another Nobel-winning Albert, Camus, on the artist as a voice of resistance and an instrument of freedom, then revisit Adrienne Rich on the political power of poetry.

Curiosity. Are you curious enough to read on?

Photo by Bicanski on Pixnio

Curiosity is a key part of experiential learning, art, research and many other domains.

This is about the value of curiosity for health professionals. Just go look at Table 1 below and see the obstacles in the work environment and the attitude of the care givers. They are linked.

Also the closing paragraph describes for me some of the core components of expereintial education. It says

Curiosity should then be evaluated among medical school candidates as part of the selection process and nurtured throughout medical school by interventions that focus on training the eye and the mind as in visual art observation, small-group learning, accomplishing a genuinely patient-centred encounter founded on listening and reacting to the patient and developing habitual mindfulness and reflection.

Part of the key theme is the idea of noticing. That means being detached and present at the same time, which is mindfulness.

Original NCBI article here.

by Ami Schattner and

This article has been other articles in PMC. cited by

Curiosity is a universal and omnipotent, predominantly human trait.1 It underlies child development and plays a major role in learning, discovery and art. In between, it is the spice of daily life and a strong bonding element between people. For clinicians, curiosity makes the difference between tiresome ‘automatic pilot’ practice2 and keenly expecting to meet a new challenge, a new learning opportunity and a new person on each encounter.3 To feel and be able to impart this element of renewal and enthusiasm is perhaps the greatest achievement of medical educators, and curiosity is the sine qua non of this and of any meaningful research. No wonder that curiosity (i.e. ‘inquisitiveness’) is an established primary goal of medical education4 and an acknowledged component of professional competence.5

Yet, ‘curiosity’ as a key attribute to success is not mentioned during residencies and research fellowships. Although curiosity and Observation (importantly, one begets the other) can be acquired and cultivated,6,7 its ingrained presence must be a valuable asset, but it is not evaluated among medical school candidates. In tandem with the scarcity of curiosity as a focus of teaching or training, but the term is relatively poorly represented in the medical literature. A PubMed search for ‘curiosity’ AND ‘medical education’ yields only few publications, mostly irrelevant. Although highly humanistic physicians identified a genuine sense of being curious about their patients as an essential fuel sustaining their humanism,8 and the patients’ perspective is no different,9 research evidence is practically non-existent. Considering the key role of curiosity in medicine (Figure 1), these deficiencies are surprising.

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Five major domains are strongly affected by curiosity (an original perspective): A. Data collection – more comprehensive, better elicitation of the patient’s history, narrative, contextual factors and improved observation and detection of examination findings. B. Learning opportunity – patient-oriented, reflexive problem-based learning. Curiosity facilitates finding the best available answers for the patient, underlies a habit of obtaining follow-up, and ensures continuous professional development. C. Research – potential trigger of formulating a general research question and developing future original research. D. Personal view – understanding the patient’s identity and ubiquitous emotional aspects, whether primary or reactive to the illness. Sensed by the patient, it leads to reciprocal trust, adherence and improved health outcomes. E. Mindfulness, introspection, reflection equal self-directed curiosity that improves indicators of patient-centred care and physicians’ well-being.7 A (data), B (learning) and C (research) are predominantly cognitive, while D (personal) and E (mindfulness) are primarily emotive and promote empathy. A (data), B (learning) and D (personal) are all patient-centred (highlighted). C (research) is science-centred, and E (mindfulness) constitutes self-centred-curiosity. Only excellence in C (research) is considered prestigious and associated with career advancement.

If defined as an innate attitude of sincere, widely applied interest in other persons encountered and in things observed, curiosity is associated with a desire to know more and ideally has seven important characteristics. It is omnipresent, and not just clinical. It is target-independent and applies to numerous everyday observations and encounters, often to small details, and not only to grand or unique experiences. It is a lifelong trait, and not temporary or occasional. It is friendly, and not intrusive, felt by the other person and very likely to elicit a warm response. It is bidirectional, mostly directed outward but also bearing inwards as in introspection, reflection and mindfulness. It is conceived as pleasurable, and not a nagging duty. Importantly, it always leads to thought and action, and is not just passive.

In the patient–provider encounter, these broad characteristics ensure substantial curiosity-driven cognitive advantages for the physician, as well as emotive opportunities for both parties (Figure 1). Their application will yield better quality of communication and elicitation of the patient’s history, concerns and signs (Figure 1A), and frequent search for patient-tailored evidence yielding improved decision-making. Curiosity also underlies tracking belated tests and verifying patient outcomes, establishing curiosity as key to imperative feedback, habitual learning and advancement (Figure 1B). Moreover, the physician’s interest will soon translate to knowing and acknowledging the patient,8,10 and correctly identifying common emotional and contextual problems that need attention. Increasing empathy and commitment naturally follow. Thus, curiosity begets emotional engagement and greater therapeutic efficacy:11,12 patients are quick to sense when their provider truly cares (Figure 1D, bidirectional arrow) and respond by better coping and increased satisfaction, trust and adherence, that may achieve significant improvement in patient’s quality of life and clinically important ‘hard’ health outcomes.1215 A curiosity-based approach can therefore advance health outcomes by two distinct mechanisms, cognitive and emotive, strongly enhancing a currently hampered patient–provider relationship16 and the provision of patient-centred care, a major Institute of Medicine goal17(Figure 1A, B, ​B,DD).

These substantial multiple benefits contrast with the often-prevailing cursory history and examination; infrequent search for evidence-based solutions; inattention to patients’ concerns or feelings; and inadequate patient-centred care or shared decisions.1721 Expected providers’ gains are no less important. Up to 60% of physicians report symptoms of burnout (defined as emotional exhaustion, low sense of accomplishment and treating patients as objects) impairing their quality of life and the quality of care they provide.22 Arguably, a curiosity-based approach (including self-directed curiosity as in reflective, mindful practice; Figure 1E) may constitute an effective antidote,7 infusing daily practice with experience and meaning: physician’s job satisfaction is likely to increase together with diminishing stress, burnout and fatigue, improved wellbeing and enhanced professional performance involving fewer errors and greater empathy.

Given the immense impact of the five domains of curiosity in medicine (Figure 1) and its manifold prevalent barriers (Table 1),23 bland declarations4,5 need to be supplemented by action. Curiosity is conspicuously absent from either the Royal College of Physicians report on ‘Changing doctors in changing times’ (2010) or the General Medical Council ‘Good medical practice’ update (2013), although central to their imperative goals. Curiosity should be much more in the currency of educators’ and providers’ thoughts, since current medical education may in fact have a suppressive effect on curiosity (Table 1).2426 However, no tools exist that capture this intangible qualitative aspect of the patient–physician interaction. Further research is clearly indicated, since current evidence on methods of measuring and cultivating curiosity throughout medical education remains in its infancy.

Table 1.

Postulated major obstacles to the expression of curiosity in today’s clinical practice.a

I. Educational deficiencies
 • Curiosity ‘below the radar’ – poor awareness
 • Too little time spent at the bedside
 • Too few role models
 • Deficient training in communication and ‘narrative competence’
 • Impaired cultural competence skills vs. increasing diversity
 • Overwhelming clinical information and detail vs. poor preparation
 • Over-emphasis on efficiency, focus and restraint
 • Exam-centred learning
 • Passive ‘spoon feeding’ ≫ independent learning
 • Atmosphere promoting anxiety and detachment
II. ‘Culture of medicine’ factors
 • The ‘Hidden curriculum’ – no marks for Curiosity-driven excellence in patient-centred care
 • Technology-focused and test-focused encounter, not really patient-centred
 • Patient-centred care perceived as time-consuming, unrewarding and non-prestigious
 • Patients perceived as wanting prescriptions, tests and referrals – not a ‘Curiosity’-driven encounter
 • Defensive practice
III. Work environment factors
 • Overburdened schedules vs. time constraints
 • Stress from frequent interruptions, administrative burden
 • Short ambulatory encounters and short hospital length of stay; poor continuity of care; fragmentation of care
 • Diminished sense of control; regulators stressing form-filling and restrictions
IV. Physician’s personal factors
 • Preoccupation with personal problems
 • Focus on other preferences (e.g. remuneration)
 • Poor tolerance of uncertainty
 • Worry about possible malpractice litigation – seeing the patient as a potential adversary
 • Build-up of unvented work-related emotions (faulty feedback and reflection)
 • Overconfidence; remnants of paternalism
 • Attrition, fatigue, burnout, cynicism

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Based on extensive literature on patient–physician relations, clinical excellence and medical education.

Curiosity should then be evaluated among medical school candidates as part of the selection process and nurtured throughout medical school by interventions that focus on training the eye and the mind as in visual art observation,6 small-group learning,27 accomplishing a genuinely patient-centred encounter founded on listening and reacting to the patient14,25,2830 and developing habitual mindfulness and reflection.2,7,16 Reading Fitzgerald’s classic monograph31 often leaves a deep impression on students. Since true curiosity that is detached from the patient is hard to envisage, increased exposure to bedside teaching rounds is likely to foster curiosity,32,33 particularly when led by effective clinician role models.29 Curiosity could be evaluated by using standardised patients with ‘half-hidden’ clues amenable to curiosity. The common accumulating barriers to curiosity (Table 1)24,31 can perhaps be overcome by Continuing Medical Education programmes incorporating interactive quiz-based folding case presentations,34 simulation exercises,35improvisational workshops,30 Balint groups,36 reflective writing and narrative-focused exercises37,38 which need to be more widely disseminated.6,7,38 Training providers to non-verbally express curiosity, interest and empathy is important and feasible,39 although most nonverbal communication is subconscious, and sincere curiosity will be instinctively felt by the patient (Figure 1D). System changes are also called for (Table 1, III) but may take more time to implement.16 For now, educational changes, awareness, self-training and a change in attitude can readily accomplish much in reinvesting medical education and our patient–provider relationship with more curiosity.


Competing interests

None declared


None declared

Ethical approval

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Sole author




Not commissioned; editorial review


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Solway Walk – A Last Word

Walking the World

On the Solway, so flat and otherworldly
I walked and remained fixed in space.
The sea, the sand,
the storm
approaching over Glasson Moss
moved past me
as I rotated the Earth with my feet.

Looking closely
and photographing,
I moved slowly.
But on my turn and return to Browhouses
walking faster,
the same thing occured.
The white windmills in the sun
sped towards me.
The earth turned under me
like a ball under a circus dog.

In the Renault it stopped.
Feet no longer on the floor.
The pedals, a, b, c
were depressed, and the car
sped past Metal Bridge and the services,
back to Brampton and my house.

In the house, out of my boots
in slippers
the crockery in the cupboard
rattled and chinked with each step.
I toyed with a short sprint.
The milk in the jug
like a storm…
in a milk jug.
Teacups were the same.
Tea sloshed over the rim.
Little waves on a bone china shore.

I filled the bath and on walking from the bog
a tsunami formed.
I walked the dog round the block,
and the planet rolled in a raggedy right turn
the size and shape of my neighbourhood,
back to where she started.
I sat still at last to watch the news.
Natural disasters around the world.
Unexplained tectonic movements
unforeseen by experts.

I went to bed.
I awoke.
And it had gone.

I moved.
The Earth did not.

I retuned to the Solway
to seek the spot where it happened,
and in it’s vastness the spot was lost.

But somebody some day
will find it.
And the earth will move again.

Chris Reed

Solway Walk – Dorothy Margaret Paulin – Writing

An unco sough i’ the gloamin’ 
An’ a flaff o’ risin’ win’,
A glisk o’ stoundin’ waters
By the weirdly licht o’ the mune, 
An’ the fell dark tide o’ Solway 
Comes breengin’, whummlin’ in. 

Whaur glistenin’ sands lay streikit 
Ablow the sunset sky
Noo a wan wide sea is reestin’
An’ the yammerin’ sea-birds cry, 
An’ a wheengin’ win’ rings eerily 
I’ the salmon nets oot-by. 

Solway Tide

by Dorothy Margaret Paulin

from Country Gold and other poems (The Moray Press, 1936)

Scottish Poetry Library

For the Annan Haaf Netters

Solway Walk – Helen Cox – Writing

I found a number of writers and poets who know the Solway. I want to include them in this bit about the Solway and will post their writings with links for visitors to follow. Please support these artists by paying attention and buying their writing.

Helen Cox has been writing professionally since graduating from her MA in Literature and Creative Writing at the University of York St John in 2006 . Between now and then, Helen has written editorial for TV, radio, magazines and websites providing commentary on a range of topics including film, literature, travel and feminism. The publications she has written for include The Guardian, The Spectator, Film Fatale Magazine, movieScope Magazine and Film4.Com.

Visit her website here

Of the Solway, in her debut poetry book ‘Water Signs’ she says…

(the last paragraph is a killer)

I was raised on the edge of the Eden River, at the point where her mouth opens out to the Solway Firth. The Solway is a fault line, marking the brink where two continents once kissed and swallowed an ancient ocean – the Iapetus, a long-lost ancestor of the Atlantic. On a still day, this saline mirror reflects the jagged lines of Scotland, where martyrs were once bound to rocks and drowned, and the English saltmarshes on the other side where the last ammonites laid down to die.

On this windless November afternoon, when the frosts have yet to scratch their nails down the backs of the distant hillsides, you can almost smell the chill in the air. But despite the coldness of this landscape, and its cruelty, despite the firth’s deadly quicksand and the way it hold hands with its radioactive sister: the Irish Sea, even now there is a feverish singing in my blood. A siren call that lures me back to this shoreline.

Like these tides I know of old, I will always return.

Nearby in St Michael’s graveyard, the corpses of Georgian smugglers who pirated brandy and tobacco are buried beneath the Yew trees. Their ears unable to listen to the bells chime in the church tower. Bells stolen from Scotland by English raiders. Bells that sang to me on playtimes and lunchtimes when I was a student at Bowness-on-Solway – a school that stands just a hop, skip and a jump from the skeletons of dead buccaneers.

My old school gate is an Ouroboros; the end and the beginning of Hadriain’s Wall – an eighty-mile frontier where rebels and Romans shot bronze arrows through each other’s hearts.

Here is division, threat and death, and for the time I lived here that is a truth I was never allowed to forget.

Hiking the periphery of the firth, twenty-five years after I left this landscape behind, I watch eroding earth flirt with the dislocated jaw of the estuary. I mark progress by the hazard signs posted every half mile. Warning strangers about the merciless tides that grip and twist the Eden until she no longer looks like her true self. I am reacquainted with the silence that lives here on the outer rim. The only sound: the intermittent rattle of trucks clattering over cattle grids.

When dusk closes in, mauve clouds threaten to smother and in my bones I know I wouldn’t resist. Through the mist, an invisible hand inks the silhouettes of bare trees on the horizon. The only other witness: a creaking gate the farmer refuses to oil. He’d rather save the fuel for his furnace. For the day the hearth wolfs down his last block of fire wood, when he cannot bear to chop hawthorn bark with chapped hands in the snow.

While we walk through the last shred of sunlight, chased by the icy breath of the coming solstice memories wash up on the foreshore like fragments of old pottery and river glass, and with them some dead bodies.

Looking back over my shoulder at the expanse of silver water, I think about the yawning void between information and wisdom. By the age of ten, when my parents left Cumbria for Yorkshire, the universe had taught me everything I need to know. It took me another quarter of a century to truly understand what to do with that gift.