Keywords: Health, Career, Philosophy, Care Philosophy, Care Domains

Citing this page:

Jones, P. (2006) Searching for the Middle: Information to Care

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Language to Care

Both Serres and Hodges raise the question of whether there is a point midway between the sciences and humanities. Serres’ work steps over the disciplinary boundaries; or rather he dismisses them as with an astronaut’s view of Earth. Serres grasps the bottles stuffed with their messages [see forward: Genesis; Serres, 1995b] and smashes the bottleneck. The input – output gates are open. The health and social care equivalent with h2cm is what I have termed holistic bandwidth – the need to facilitate holistic care, addressing physical, psychological and spiritual needs (Jones, 2004). Only then can we concentrate on meaning. Yours, theirs and mine: ours.

In addition to boundaries, a further point of fusion between Serres (1997) views and Hodges model is evident in The Troubadour of Knowledge. We can remain safe never venturing, never taking a risk for new experiences, new knowledge. Serres likens this to swimming a river and reaching halfway, a decision must be made, to continue or turn back. In the middle choices become stark, a challenge, a rite of passage, when a venture becomes an ad-venture. Suddenly, inner resources must come to the fore, dare we rely on them, so many characteristics and attributes, handedness, gender, learning styles... Does a change of knowledge (care) domain or even a shift towards another domain signify change of contexts? Passing from one care domain to another is akin to reaching mid-river, an opportunity to reflect and (re-)appraise.

In conversation with Latour, Serres (1995a) questions the ascendancy of concepts above prepositions. Psychology and cognitive science have produced a wealth of research (Rosch, 1981) built using concepts as the fundamental unit. To bridge the disciplinary divide, to understand the role of noise Serres argues that prepositions also have importance, locating us in time and space: before, after, until, during, on, later, across. In caring prepositions assume humanistic prominence, giving quality and meaning to goals, priorities. Concept analysis has a central position in nursing theory. Are concepts sufficient for dialogue between disciplines, individuals and global communities; between the sciences and humanities?

Our whole experience is grounded in time, hence the mythic status of timelessness. In h2cm career refers to life chances defined by Hughes (1958):

… the moving perspective in which the person sees his life as a whole and interprets the meanings of his various attitudes, actions, and the things which happen to him. p.63.

The concept of career in h2cm is future oriented, the idea of life chances having a direct correspondence to Serres’ description of life and choice – freedom. As we get older there is less scope for our path to meander. Choices become fewer, windows of opportunity pass and may be grieved for such is the sense of loss that accompanies them. Time is of course embedded in each of the h2cm’s domains: interpersonally in the subjective passage of time and healing of the psyche; in the sciences in chronological age versus pathological age, physical healing processes, life and death. Our older people, those not yet ephemeral have become peripheral, their personal space an adjunct to furniture. How far the middle for them? How dynamic is their time? Is corruption limited to politics and foodstuffs? New quantities in life, beg questions of quality, especially quality of care, what it means to care, responsibility and capacity of people to exercise grace and no longer fight to belong.

The act of caring involves the self, being self-aware, expunging critical judgements other than those necessary to direct care and therapeutic intervention. It is this translation within the self that - strangely – facilitates specialised access to others. To emphasise a point about our linear view of time, Serres crumples a handkerchief, to link the past with the present for example, Lucretius and modern fluid dynamics (p.60). As noted previously, both h2cm axes negotiate time, subjectively, chronologically, pathologically, socio-politically and culturally. Therapists often reach for the handkerchiefs, but catharsis is no longer enough. The most powerful form of learning is self-discovery. Using Socratic questioning therapists assist self-discovery in their clients. The Platonic idea that a dialogue can help people recover knowledge they were born with. Therapists crumple the client’s thoughts helping them see things for themselves, how their thoughts connect to beliefs and behaviours, how the legacies of the past can have a bearing on today and tomorrow.

Mental health and general medicine have always been awkward dance partners. The Diagnostic and Statistical Manual of Mental Disorders Version 4 suggests a clear scientific epistemology, yet as Andreasen one its founders has stated a diagnosis is much more than the presence or absence of a set of diagnostic criteria (Else, 2005). The dichotomous, black and white, sane and insane, sees the truth behind Harlequinesque appearances. Mental health is complex. Illness and wellness need to be defined and described in terms of a continuum. The holistic and spiritual aspects of the individual need to be included, multiple contexts and rationalities must be addressed. There is no space for dependency; to what extent should services adopt the role of parasite? Does health belong to people or pharmaceutical industry? Is your health a commodity?

This extra baggage can be a burden, a distraction to those who prefer the status quo. Perhaps the baggage also signifies the presence of Serres’ parasite? It used to be that an unattended bag may be the sign of an invisible passenger; a stowaway, a parasite. Now all baggage is suspect. There is a fundamental difference for Serres’ parasite, for while making mischief his parasite is also an agent for change.

If these multiple rationalities must be addressed, then new means and slack resources must be identified. Hermes may be everywhere, but information must be acted upon. To what extent can the integration of disciplines and teams of (care) professionals improve efficiency? Once empowered through access to knowledge, to what extent can clients assess and help themselves. We are all learners and retain responsibility, though our capacity to exercise this varies, but needs to be maximised. Thus we return to contracts…

Intro : Serres : h2cm : Fused : Info2Care : Art-Science : You are here : Global Reach & Close

References:

Brown, S.D. (1999) Caught up in the rapture: Serres translates Mandlebrot,
[http://www.keele.ac.uk/depts/stt/cstt2/comp/rapture.htm] Accessed Mar 30 2006.

Connor, S. (1999) Michel Serres’ Five Senses;
[http://www.bbk.ac.uk/english/skc/5senses.htm] Accessed Mar 30 2006.

Else, L. (2005) Interview: Ailing psychiatry needs some attention, New Scientist, 19 November, 2526.

Hughes, E. (1958) Men and their work. New York: Free Press.

Jones, P. (2004) Viewpoint: Can informatics and holistic multidisciplinary care be harmonised? British Journal of Healthcare Computing & Information Management, 21, 6, 17-18.

Rosch, E. (1981) Prototype classification and logical classification: the two systems. In Ellin Scholnick (Ed.), New Trends in Conceptual Representation. Hillsdale, N.J.: Erlbaum, 73-85.

Serres, M. (1995a) Conversations on Science, Culture, and Time. With Bruno Latour, trans. Roxanne Lapidus, Ann Arbor: University of Michigan Press.

Serres, M. (1995b) Genesis, trans. James, G., Nielson, J., University of Michigan Press.

Serres, M. (1997) The Troubador of Knowledge. S. Faria Glaser & W. Paulson (trans). University of Michigan Press.