Multiple causes, multiple responses

16/02/2013 § Leave a comment

For every complex problem, there’s a simple solution. And it is wrong.” Anon

I have been having lower back pain recently. It has happened occasionally in the past but this is the worst I’ve had – on Tuesday I had to walk with a stoop.

I am fascinated by how many possible causes there are. One friend suggested it was about me needing “support”, another that it was to do with finances. I read in a book that a stagnant liver is often a cause of lower back pain. Then there is the physical side. A couple weeks ago Dasha had a new treatment couch delivered – it must have weighed over 120 kilograms – and I dragged it across the lawn in its cardboard box to her therapy room. I’ve also been chopping logs for the woodburner recently and I don’t really have the build or the strength for swinging a heavy axe. So perhaps I strained something. I might need to strengthen my stomach muscles, as my brother suggested.

It could be any one of these causes, but I suspect it is a combination of them. I do feel the need for a bit more support at the moment, our finances are not in the state I would like them to be, I had overloaded my liver just before the back pain was at its worst with heavy and rich food, and my stomach muscles aren’t as well toned as I’d like them to be.

We are complex systems, we humans. Although some seem to think we are merely physical bodies, most of us intuitively know that we are far more than that — we have an emotional body, a mental body, a soul and who knows, maybe more. And the subtle interaction of all these different parts is far too much for one person to properly understand. When looking to respond appropriately to a mini-crisis in a complex system such as lower back pain, a systems approach that addresses multiple causes is the right one.

I think about all this when I hear that the government is, yet again, planning to make radical changes to the health service. Whatever the intentions, and whatever the thinking, we know that they will get it wrong, because they are not viewing the NHS as a complex system. They believe that they can fix it from on high. It is like trying to grow a plant by physically rearranging the atoms, rather than by gentle nurturing. A healthy health service can only emerge from millions of individual actions by those engaged in it every day, making decisions as semi-autonomous, empowered individuals.  We need to get the management system out of the way, and free up those who are dying to simply do their job and serve patients. What will then emerge is multiple different responses to the crisis at multiple levels – and from these responses, a healthier system will emerge.

Yet many dismiss such an approach. Take a painkiller, they say, find a quick and easy solution so we can move onto dealing with the next crisis. They don’t have the patience for these slower, longer term but ultimately more effective approaches. Funny, there seems to be a high percentage of such people in politics (although, of course, there is an aspect of this in all of us). No doubt this is in large part due to the nature of the political system! Certainly the interaction between the health service system and the political system seems to be an unhealthy one.

As individuals watching all this, all we can do is intervene in the system where we can. Be kind to the nurses who treat us, resist unnecessary vaccinations and routine application of antibiotics, take greater responsibility for our own health. In short, be the change, as Gandhi put it, and trust that our little intervention can make a difference, even if only a small one. This has to be more effective (and certainly more healthy for us) than searching for or advocating a single, simplistic solution.

As for my back, it is feeling a lot better already. It is great when you find one solution that addresses multiple causes. Dasha came home and gave me a treatment, meeting my needs for support, and also providing physical relief. I have also cut out cheese and meat for Lent – my liver is grateful. The longer term work is to do regular exercises to strengthen my stomach muscles. It is adopting these longer term, regular healthy habits that can really make a difference to our lives.  And aren’t those the hardest ones?


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