I’ve often wondered, why is there no phosgene therapy in CAM? Such a beautifully derived name and as delightful to the nose as a Bach flower remedy. Aromatherapy with a kick. Ground floor opportunity. Government suppressed!
I came here to post exactly what wintermute did. Funny, I learned about the term just a couple of weeks ago and now I am seeing it!
I will add though that many times I have demonstrated the disutility of some dubious CAM claims by exactly this method (i.e. that the concentrations achievable in vivo are either negligible or do not correspond the the concentrations eliciting the effect in vitro). More often than I would expect, especially from fellow medical students, I have been rebuffed by saying something to the effect of “that doesn’t matter” and/or “well, it can’t hurt and it still may help a little.” They desperately cling to this single poorly done or very preliminary study as if it really meant something. I once had a classmate get downright angry at me for pointing out such errors and how poor a few of her citations were. She then retreated to the “medicine is an art” defense coupled with a claim that “poor people” may not be able to afford pharmaceuticals so a cheaper alternative should be available (i.e. whatever her “artistry” pulls out of the nether regions).
Here’s fun, take the word “peroxide” or “hydrogen peroxide” in this post, and replace it with the word “attention”. It works surprisingly well. I venture you could play this game with nigh-all CAM treatments and the resulting articles would be both more accurate and more honest.
Doesn’t work as well in the calculations and chemistry sections, but CAM hates science anyway.
This morning I used hydrogen peroxide to remove traces of a nosebleed from my daughter’s pajamas. Watching it foam up on contact with the blood had me, as always, wondering why the hell anybody would want to inject that stuff.
I don’t know why those who feel getting patients properly oxygenated do not give them supplemental oxygen, except, of course, they can’t charge for that.
So oxygen bars are all bankrupt? They can absolutely charge for giving supplemental oxygen, and given how freely they mark other stuff up, I’m sure woos could find a way to fleece their patients with that. The real problem with supplemental O2 is that it’s too mainstream, I suspect. It lacks that fashionable cachet of “hidden secret They don’t want you to know” if it’s exactly what the hospital would do if you turned blue and then passed out on the floor. Studies have shown that the more unusual the remedy, the more potent the perceived effect (even when there is no actual effect), and I suspect there is also an economic correlation — the more unusual the remedy, the more you can get away with charging for it.
If the hydrogen peroxide makes it to the arterial side before undergoing degradation, there is essentially no unsaturated hemoglobin to take up the oxygen and plasma can at best dissolve 20 ml of O2; the rest will have to form bubbles
That’s not how I read the linked article by Saul Green.
If you put H2O2 in the veins, then it produces oxygen that is absorbed by the hemoglobin. The result will be that by the time it reaches the lungs, the lungs will put a tiny bit less O2 into the hemoglobin.
If you put the H2O2 into the arteries then the O2 will form bubbles if there is too much H2O2 in the blood, because it can’t go anywhere. However, I understand that the equivalent 100 ml (= about 30 seconds of breathing) gaseous oxygen is administered in an intravenous drip of 500 ml. That takes a considerable amount of time.
The experiment of Johnson described by Green is difficult to understand because I don’t know the meaning of ” 0.006 volumes peroxide per 100 ml ” or ” 0.006 volumes percent, ” * but let’s assume it means 0.006 ml of H2O2 per 100 ml blood. 5 cc solution of 3 percent H2O2 is 0.15 cc (or approximately 0.15 ml). If you put that into 2500 ml of blood (about half the total amout of blood of a human) then you have the same concentration. So if you put that amount into the blood within a time it takes for the blood to go round once, you are quite near the danger zone. But distributed by drip over a period of one or two hours seems at least not very dangerous. In Germany there have been cases where O2 ‘enriched with O3′ – another oxygenation method) was administered by injecting the gas directly into the veins! (-> not only possibility of painful gas embolism in lungs, but some people have unbeknowst to themselves small holes in the heart between the left part and the right part, so the air bubbles can go directly from the venous blood into the aorta and reach the brain resulting in dizziness or worse.
Note. The computation of 15 ml H2O2 = 100 ml gaseous oxygen isn’t really hard.
Step 1. 0.15 ml of H2O2 is 0.17 gram of H2O2.
Step 2. 0.17 gram of H2O2 is just 0.005 mol (1 mol H2O2 = 1 + 1 + 16 + 16 gram)
Step 3. 1 mol of gas = 22.4 liters (at 0 dgree Celsius), so 0.005 mol = 0.112 liter = 112 ml.
If the H2O2 concentration was given on a weight per weight basis you skip step 1 and start from 0.15 gram, and you get a little less than 100 ml in the end.
I once had a classmate get downright angry at me for pointing out such errors and how poor a few of her citations were. She then retreated to the “medicine is an art” defense coupled with a claim that “poor people” may not be able to afford pharmaceuticals so a cheaper alternative should be available (i.e. whatever her “artistry” pulls out of the nether regions).
Invoking art (whether as tekne or as the more modern definition of the term) does not excuse sloppy methodology. Most artists and poets I know tend to be very rigorous in their practice (we’re not big on “inspiration”). But your classmate does bring a salient point, namely that treatment in the United States might not be affordable (even with insurance). Yes, cheaper alternatives should be available, but often times, it is predatory practices that fill that space (also see the post on Functional Endocrinology from a couple of days ago). Often enough, those predatory practices may even be covered by your insurance plan. Acupuncture, for example, is by some PPOs in California. CAMs are covered by the healthcare system in some provinces of Canada. There is also a push by some (wealthier) conservatives to have them covered in France.
It should be interesting to conduct a socio-economical study of CAM prevalence in the United States, and compare it to the cost of medical treatment, region by region (insurance coverage rates should also be included).
Not that it matters that much, but the volume of O2 produced would only half of the volume you calculated (approximately 50mL), since it takes two molecules of H2O2 to produce one molecule of O2 and 2 molecules of H2O.
“I think they are partly correct. There are multiple universes that have split off from functional reality, the reality I inhabit. We can see the alternative reality, measure it, but oddly despite being able to interact with these realities, we cannot alter them. More terrifying, but not as dull, as the shrimp worlds are the alternative worlds of SCAM, where all the known rules of by which we understand the natural world need not apply. Like the world that uses hydrogen peroxide as a therapeutic intervention.”
I have another interpretation. There are multiple reality that contain alternate versions of us all with all possible variations. So there must be an alternate reality where I am on an internet board vehemently arguing the benefits of vitamin C with the logical proponent of SBM, Dr Weil, who routinely makes fun of the SCAM artist, Mark Crislip and his supporters nybrgus, weing, etc.
I probably watched too much Star Trek when I was a kid.
I went shopping with my daughter today and when I picked her up, thanks (in part) to hydrogen peroxide, she sported long flowing PINK hair. She has some tattoos as well and I don’t mean some little flower behind her ear or on her “hip”. Her nickname is Tiberius (yes, THAT Tiberius) and while she has a hint of a mustache (only between waxings), thankfully there is no goatee. But maybe it’s just an alternative universe and in the “real” one she looks like other people’s daughters and is called Nichole. At least she hates the woo in any universe.
Indeed. In fact, I often point this out when such arguments come my way. I am a big fan of Wassily Kandinsky and when I went and saw an exhibition of his work at the Centre George Pompidou in Paris I bought his book Concering the Spiritual in Art. It is an excellent example of how rigorous thought and planning is involved in something that most people would call “pure art” with no basis in science – impressionistic painting. If you (as in vous) have not read it, I would highly recommend it. It is short and goes through careful explanations of what feelings different colors and shapes tend to invoke, how one can best combine them in order to achieve an effect, get the eye to move where the artist wants it to, etc. He breaks it down into small parts and describes how to combine them in ways to produce effective art. He also stresses that it is not simply random swaths of color, but a carefully thought out process.
As y’all have pointed out, however, the term “art” is commonly used to mean something along the lines of “divine inspiration” leading to useful and magnificent outcomes, divorced from any sort of rigorous scientific process. I’d be the first to agree that impressionistic art has many more degrees of freedom and the outcomes Kandinsky describes will be much more heterogeneous than, say, an engineer designing the flow system for a rocket test stand. But it is still necessarily rooted in a scientific – i.e. rigorous and methodical – basis that is continuously refined through practice, trial, and error for a better outcome.
In the case of the classmate arguing for cheaper alternatives… I of course absolutely agree. But those alternatives should not only be cheaper but should actually be effective. Simple absolute reduction in cost is useless. It is the “bang for the buck” that is of interest. I can sell you a cancer treatment for $10 vs the thousands it normally costs, but if it is pomegranite juice, it is not a usefully cheaper alternative. (which of course, most people around these parts should know quite well and why I did not fully explicate this in my original post.) So while FL’s idea of cost comparison is interesting, it (perhaps inadvertently) does not address the more salient aspect which is efficacy in relation to cost.
As for watching too much Star Trek… I agree – that is scientifically impossible. I have seen every single episode of every single series at least twice as well as every single movie ever made at least twice as well.
Lastly, FL – IIRC you are in the Bay Area of CA, but on the off chance you happen to sojourn to Southern California between Nov 26 and Dec 3 let me know. I will have a couple of days free there at that time and would love to pick your brain over a libation or two.
How to recognize a cat owner? They always have a big supply of hydrogen peroxide on their bathroom shelf. And I’m no different, I use it to rinse scratches and here it works miracles. But the very thought of injecting myself with it (even as a part of a slow drip) makes me shudder.
nybrgus “As y’all have pointed out, however, the term “art” is commonly used to mean something along the lines of “divine inspiration” leading to useful and magnificent outcomes, divorced from any sort of rigorous scientific process. I’d be the first to agree that impressionistic art has many more degrees of freedom and the outcomes Kandinsky describes will be much more heterogeneous than, say, an engineer designing the flow system for a rocket test stand. But it is still necessarily rooted in a scientific – i.e. rigorous and methodical – basis that is continuously refined through practice, trial, and error for a better outcome.”
The problem with “art” is that everyone has their own definition, so it is difficult to compare art to science. Amoung my friends, art (as in visual art) is usually considered to be something that is unique and attempts to communicate an emotion, experience, opinion or visual principle. I have never thought of art having a scientific process, although art techniques certainly use scientific principles, chemicals, color theory, construction, physics may all be needed depending upon the type of art.
But the core of art, in my mind, is that it is unique to the artist and subjective. You can not prove art is good and there are an infinite number right answers to a question. The core of science is that it is objective and provable, the correct answers to a question are constrained by evidence. In that way, in my mind they are opposites.
There is certainly an art to medicine. But, I suspect that art is going to be in elements that are unique to the practitioner, like how individual doctors communicate with patients. I’m sure that medical folks can think of other aspects of medicine where unique approaches are valuable or acceptable. But, clearly the ways to make most things cheaper is to standardize the most efficient processes and mass produce the nessasarily supplies. Science has great value in that endeavor, but art, not so much.
One could go in another direction and say that art is based on creativity and obviously advancements in medicine are based on creativity too. And creativity can be a part of making things cheaper, through innovation…but you are still going to come up against that subjective-objective difference between art and science.
Of course, that’s why it’s so attractive for folks who are basically promoting placebo’s to call medicine an art, yes? Because then the subjective experience is emphasized and the objective forgotten. But that’s not what I want from my medicine.
I’m lacking in time for a proper response, but in brief I do not think they are as dissimilar as you do.
To become an artist one must learn artistic techniques. As you pointed out there is a science to this in terms of mastery of basic technique, knowledge of how different materials act and interact, how to best achieve the effect one wants in various mediums, etc. From there, the art is getting the effect one wants.
It is quite similar in medicine. We learn the basic principles of physiology, biochem, studies, etc and then must apply that to get the effect we want.
How this is similar to art is that just like in art, while one cannot typically objectively say “that art is better than this art” because there is disagreement, one can say “this artist is better than that artist.” If I tried to paint like Kandinsky nobody would be fooled. Same as in medicine – is one orthopod better than another? We can only tell the really bad ones from the rest – the idea is to get the outcome you want, whether artist or doctor. If a sculpter tried to paint, the outcome would not be what he envisioned and most people could tell it of lower quality. If an orthopod tried to do neurosurgery the result would be the same.
In both cases (art and medicine) we use the basic principles of scientific rigor to craft the myriad unique outcomes we desire. I know that lowering lipids will improve heart disease risk. How I can achieve that in my specific patient is the art – which drugs (which work more or less effectively depending on the person), which lifestyle advice, how to deliver it, how to engage my patient.
In art, the artist tries to achieve a specific goal and convey something. The fact that not everyone agrees the art is “good” is merely parallel to different types of medicine and different effects on different people. The artist is targeting an audience as is the physician.
But, in my limited experience, the truly succesful artists are generally the ones who have applied rigorous study, effort, trial and error to their work to achieve really good results. This is identical to a physician. The difference is, as I said, the artist has more degrees of freedom since “bad” art can just be chucked away, but “bad” medicine leads to mortality and morbidity. If a physician were free to to “bad” medicine and learn through trial and error (leaving a trail of bodies and tears along the way) then the process would be faster, require less rigor in advance, and be even more analagous to art.
In other words, when somebody says that Kandinsky sucks that isn’t just a factor of the art being purely subjective with no scientific underpinning. It is merely analagous to my patient who doesn’t reduce his heart disease because I gave him the wrong medicine and/or approached him in the wrong way.
(I apologize for the rambling and perhaps incoherent nature of this reply. I really am in a rush. Hopefully you were able to grok my meaning. If not, I may take a more careful approach in the future)
No worries, nybgrus- I get what you are saying and I see where you are coming from. Somehow, I am looking at the two, art and medicne from a different angle, but I can’t quite express the difference. Although I do agree that both require rigorous study, effort and trial and error. Oh well, I will have to think on it.
Amoung my friends, art (as in visual art) is usually considered to be something that is unique and attempts to communicate an emotion, experience, opinion or visual principle. I have never thought of art having a scientific process, although art techniques certainly use scientific principles, chemicals, color theory, construction, physics may all be needed depending upon the type of art.
This romantic notion of art is actually a fairly recent phenomenon (and one, sadly, that refuses to die). It all started in the Renaissance, when a group of painters wanted to be paid more because they argued that their art was something more than just a craft (such that of a cobbler or a vase maker). Sure, Aristotle does mention emotions in his Poetics (where he speaks of drama), but he does so in the context of katharsis, the getting rid of emotions. Similarly, when Plato speaks of painting and poetry in The Republic, he does so in negative terms. Painting is primarily a mimetic practice. It attempts to copy the World of Perception, which in itself is an imitation of the World of Forms (or Ideas, depending on which translator of Plato you are reading). This notion of art was still prevalent in the Renaissance (see Vasari’s definition of painting in The Lives of Painters).
But whatever definition of art you are reading, it is dependent on the socio-historical context, which is itself dependent on technological context. The novel, for example, couldn’t become popular until the 19th century when the printing press became cheap enough. Sure, there were novels before the 19th century (Don Quixote, Sei Shonagon’s Pillow Book, Murasaki Shikibu’s Tale of Genji), but they didn’t enjoy the distribution or the availability of Moby Dick, The Scarlet and Black or Madame Bovary during the lifetime of their respective authors. Similarly, much of Romanticism can’t be read without the context of the French Revolution (I’ll have to get back to you on this, Romanticism is not my specialty).
Modernism in the arts came with the advent of the Industrial Revolution and urbanization (in the 1850s in France, with Baudelaire, the turn of the century in the US and England with Pound and his friends, Victorian literature being an extension of Romanticism). Much of modernist painting should be seen in the invention of photography and cinema. Hence Seurat’s theory of color, Kandinsky, whom nybgrus mentions, Fauvism, Post-Impressionism, Supremacism, etc. Why paint an absurdly realistic image to capture a moment when taking a picture with a daguerreotype might be easier? What’s the point of poetry in the age of the printing press? With the French poet Stéphane Mallarmé, you see the start of shift in poetry away from writing-as-imitation-of-speech (which you still find in Wordsworth) to writing-as-writing-in-itself. Mallarmé also talks about the “architecture of the book.” It is those concerns that have preoccupied many poets since, with the Objectivists (Williams Carlos Williams’ “No ideas but in things” (oh hey, Williams was a doctor too)), the German and French post-WWII avant-gardes (Paul Celan, Ingeborg Bachmann, Hans Magnus Enzensberger, the recently deceased Anne-Marie Albiach, Claude Royet-Journoud, Emmanuel Hocquard, all of whom I am heavily indebted to), and the American Language poets (Rae Armantrout, who recently won the National Book Award and the Pulitzer Prize, Lyn Hejinian, Michael Palmer, Ron Silliman, Carla Harryman).
But what I think nybgrus means by art being science-like is that it is based on a rigorous process of inquiry and experimentation (which is why I find Billy Collins overrated and tedious. Sorry, I couldn’t help but bash Billy Collins). For every poet and artist, there is a poiesis or poetics, a set of principles for creation (which goes beyond craft) that has been justified by prior practice or that has been postulated in reaction against prior practice. Think of them as axioms and hypotheses. And every poem and painting will work as an experiment that lead you to accept or reject this hypothesis. Using the Language poets as an example, their work builds upon the prior work of the New York School of Poets (Frank O’Hara, whose work was quoted in Mad Men, John Ashbery, who strangely enough, was the MTV Poet Laureate), the aforementioned Objectivists, and the Black Mountain Poets (Robert Creeley). But it also works in opposition to the Confessional mode that was prevalent in the 1960-80s, in that the Language poets argued that poetry did not have to just be the description of an interior life told from a unified self. Or that it had to be narrative.
There is of course much more than what I just explained. But then, I wouldn’t be able to stop
I was not clear; that was the formula from a website of proponents of hydrogen peroxide, not the real formula. I had intended to have a paragraph or two after that, but life and all that got in the way and I forgot.
FL said “For every poet and artist, there is a poiesis or poetics, a set of principles for creation (which goes beyond craft) that has been justified by prior practice or that has been postulated in reaction against prior practice. Think of them as axioms and hypotheses. And every poem and painting will work as an experiment that lead you to accept or reject this hypothesis.”
This clarifies to me how you (nybrgus) and I are in disagreement.
FL’s point about the set ofprinciples for creatio show exactly how art is different than medicine. Because appreciating the art (or accepting or rejecting the hypothesis) is based upon the viewers cultural experience.
If I transport an artist from the Italian Renaissance to today and show him Picasso’s Guernica*, how will that painting “work” for him. If that painter gets strep throat or pneumonia or develops diabetes, how will standard medical care work for him?
The medical care will work much better, I would guess. Because proven medical treatments work, whether you accept the scientific principles they are based on or not. Whether you accept any given piece of art as “working” is going to be heavily influence by your culture and expectations of what art is.
First off, it is quite amazing to me how much more slowly and with less comprehension I read what FL wrote vs something of equal complexity on a (squishy) scientific topic.
However, I think we may not be that far apart Mouse.
My contention (and I am aware of how horribly unqualified I am here) is that your final analogy is incorrect. You draw the comparison between Geurnica versus treating asthma in different historical times. Geurnica will be well received and convey a message at some times and not at others and depends on the culture to which it is presented. Ashtma treatment will always be the same, no matter the people and no matter the culture, because the underlying physiology and treatment principles are objective and do not vary (they actually do vary, but for simplicity’s sake it is a close enough approximation to say they don’t in order to serve our purpose here). So far I am in complete agreement with you.
Where I differ is the final analogy here: that Geurnica in early 20th century Europe is the same as Guernica in 18th century French Polynesia. (bear with me here). However, asthma in 20th century Europe will respond the same as asthma in 18th century French Polynesia. My contention is that in the latter case you are providing an example of a treatment targeting the same outcome, whereas in the former you are not. Guernica was painted to address a specific audience about a specific topic in a specific time. Trying to apply (if you will) Guernica to 18th c. French Polynesia is more analogous to trying to apply asthma treatment to diabetes.
In either case there was scientific rigor and understanding, with an intentional and quite deliberate process to achieve an outcome. In one, it was to provide social commentary on the Spanish Civil War and the atrocities of war in general. In the other it is to reverse reactive airways. That is why I say that trying to apply Geurnica’s message to a context wholly removed from the message does not illustrate a Romantic artistry, but rather illustrates the specific target in the same way that albuterol puffer target asthma and not diabetes.
To broaden it a bit, why is it that certain art is “timeless” and that generation after generation can appreciate it (whether visual, print, or otherwise)? Sometimes the interpretation remains the same, sometimes it varies, but it always manages to capture the audience. Some art, however, is quite faddish and disappears rather quickly (like I hope Instagram will, lol) with people wondering why it ever existed or forgetting it entirely (this is where my experience is limited and I cannot really provide good examples, but hopefully you or FL can). And of course there is some art that some people just never get (like me and Andy Warhol, for example).
I contend the “timeless” art is timeless because the artist was able to tap into fundamental basics of artistry that are common to most people. The faddish stuff is so because it didn’t – it is the artistic equivalent of CAM. And the stuff that some people never “get” is like the difference in response to drugs we see where most people have an effect, but some just don’t (like metformin for diabetes – most people find it lowers their glucose effectively with few side effects; some have no positive and/or significant negative effects from it).
And that is also what I mean about degrees of freedom. Not only is there more room for error (the equivalent of a therapeutic window) but there are also more “diseases” to target – more messages to made, more situations to comment on, more ways to do it due to cultural variation. But the process to get there is inherently scientific, though obviously some pay more attention to that than others.
In medicine new disease states arise and sometimes old ones disappear (this is most evident in things like infectious disease and cancer, but also autoimmune disease and many others). This is because of changes in our environment coupled with human evolution (yes, we are still evolving). Those processes that are amenable to rapid evolution will experience rapid changes. Art experiences rapid evolution because culture can (and does) evolve much more rapidly than physiology. But at base, the underlying principles are the same – just the time scale is different.
At least, these are my thoughts on the topic from someone distinctly non-artistic (I kid you not that I failed my first every undergraduate microbiology lab report because I drew the bacteria I saw under the microscope so poorly!). Since I am so out of my depth here my ideas are not quite as cogent nor articulate, but hopefully my message still came across. I am curious as to both your take and FL’s.
So, whether the poem or painting “works” for the artist leads them to accept or reject their original hypothesis? Is that really how you work, writer must have a very different process, then?
No, I don’t agree with that. A painting can not “work” for many reasons that may lead the artist to conclude that the original hypothesis is sounds but the technique or execution needs revision. In fact I can’t imagine a hypothesis in visual art that can be concretely rejected, one artist may think a hypothesis has failed, only to have another artist execute that hypothesis brilliantly.
Regardless, my point about art primarily working in a cultural context and medicine primarily working within a physical context stands.
@nybrgus – sorry, your posts were there when I posted. My above comments are in response to FL’s.
You, on the other hand, are hurting my brain, to because you are not cogent or articulate, which you are, as usual, because your perspective requires an Escher-esk switch from where I am. But, I think this paragraph is the core of what you are getting at.
“My contention is that in the latter case you are providing an example of a treatment targeting the same outcome, whereas in the former you are not. Guernica was painted to address a specific audience about a specific topic in a specific time. Trying to apply (if you will) Guernica to 18th c. French Polynesia is more analogous to trying to apply asthma treatment to diabetes.”
I DO see what you are saying better here. Whether a piece “works” is measured by how well the specific goal is addressed, not how well it is appreciated by any given audience. I can agree with that.
I’m just struggling though, with the objective/subjective thing. I can not think of one objective measure of art – other than monetary value, which is only a surrogate for a subjective measure. While medicine and science, seem at their core guided by objective measures. How can that NOT be significant? Particularly when we are talking about the difference between CAM and SBM, the first of which makes it’s argument based on subjective measures, the second of which values objective measures?
Agreed that art makes use of physical methods and materials, but isn’t that where one can make a distinction between art and craft? Craft, imho, stops at a simple depiction without any interpretation, but art in the puristic sense goes past simple representation and tries to use the representation to convey or express something. The means are only means … paint, a violin, the English language … necessary for communication with others, but not in themselves significant.
A lot of paintings and novels are craft items, not art, surely. They don’t even try to be original, and never go beyond the obvious. That’s not necessarily a fault! When I’m tired and stressed out I want a nice simple library book to read, with a predictable happy ending, not some deep-thinking, highly-challenging classic.
Another essential of art to my mind is that it’s a collaboration between the artist that makes it and the artist the sees or reads or hears it. In music, that can be a 3-way circuit, the writer, the player and the hearer. But without an audience, the effort of conveying or expressing falls into futility, like rain falling into the ocean.
I sometimes wonder how science and art relate to each other, as I’m equally interested in both. I know it’s rather far from the subject of this article … I apologise to the writer! who is not getting much collaboration from this one reader. But this seguing into the topic of science/medicine vs art has triggered off a train of thought (urk, an ‘orrible mixed metaphor). And it is Sunday night, without anything much else to do …
As an aside – I wanted to add, I’m note sure that “timeless art” actually exists. Many artists we consider timeless now, were considered weird, aberrant, faddish, obsolete, etc at one time. A number of great artists works have at one time been neglected or even painted over. I think much of the timeless nature of art is gained by education and shared cultural values.
No worries Mouse. I realized we cross posted. Also, I do accept to a degree your contention about timeless art.
And sorry for making your brain hurt. lol. But that is why I am actually enjoying this conversation – my perspective is fundamentally different than yours and yours than mine. I most certainly do not think I am “right” on this topic, at least not as far as I would like to take it. I think I am not wrong at base, but I realize that I am extrapolating in many of my assertions. I just don’t know enough about art to really hone in my understanding and explanations like I would about, say, evolution.
As for the objective vs subjective issue you raise – I agree, this is the thorniest part of my attempt at sounding intellectual in a field so far removed from my expertise ;-P
At the moment, my only response would be that our resolution of “objective” in art isn’t as good as it is in medicine. As I try and think about how to explain this, I realize it can only be either nearly uselessly brief and shallow or quite involved and long. And I also admit that parts of it rely on a little speculation, but I genuinely think it is very reasonable speculation which fits all the evidence we have to date. I’ll try for the brief and if necessary can expound on request.
In medicine, we first started treating asthma with various home remedies. Some worked, some didn’t. We had no idea why, but we figured out what worked. But it didn’t work on everyone and it had varying side effects. Now we understand a very detailed molecular basis and can target it indivudally and truly objective gauge response and effectiveness (lung function, biopsy, blood, etc). As opposed to earlier when there was just a vague subjective gauge of response. It grew step by step, and we could observe that.
In art, we try and convey something. That means interacting with a consciousness (whether that be your own for purely self-expressive art or others to convey a message). Consciousness is a product of the specific neural michroarchitecture of a brain. This is plastic and changes and thus undergoes objective physical changes. We just don’t have the resolution to fully quantify and characterize it (yet). When an artist makes art, if it achieves its goal (as I said above in regards to Guernica) then some consciousness has changed as a result. The artist works in a rigorous manner to convey that “something” and uses feedback to adjust for better outcomes. If the artist could “see” the objective physical changes in the neural cytoarchitecture and process the bajillion (that’s a fancy scientist word for “a whole buttload) systems interactions to accurately predict outcomes of changes based on input, she could target the art that much more effectively for desired audience and outcome. She can’t, so she works like much of science does and break down technique and understanding over time to produce desired outcomes (“good” art to her desired audience, message understood, what-have-you). Just because she is working by proxy with low resolution doesn’t mean that’s not what she is doing and it is not scientific (there is a reason to go to art school, isn’t there? and those that don’t, still read or learn something on their own, right? Genuine questions…). A lot of medicine is that way as well – depression therapy for example.
And of course this is a dynamic system with evolution on various timescales, so different objective outcomes will change over time as will desired outcomes. That also does not negate the fundamentally scientific and objective nature of it, since this is how the universe works.
It wasn’t all that brief, I suppose, but there is a lot I left out. I do agree a fair bit of it is still in need of empirical confirmation so I am open to changing my thoughts. But I do think quite a lot of emprically verified data we have supports my thoughts. That’s why I am curious to and value both your and FL’s comments on it.
@mouse & nybrus: I am tremendously amused that a post on hydrogen peroxide has turned into a discussion on art, science, and medicine. I think that medicine is a mediation between art (tekne) and science in that, while much of medicine is science-based, there are parts of medicine that are not determined by science. Medicine is also a social act in which the doctor will impart his knowledge to the patient, and in turn, the patient will act on this offering based on the social norms that regulate the relationship between doctor and patient. Most importantly, the doctor plays a most special role within society, in that he is the one stranger we allow to enter our most intimate space, the space of the body.
Art (with a capital A) is also a social act. I don’t think this is a question of objective vs. subjective. The space of objectivity (of things as they are) is the space of science and of science alone. Instead of this binary, what’s at work is the play between the objective, the collective, and the subjective (I think I stole this from Karl Popper). The way we, as creator or spectator, approach the practice of art is always mediated by social norms (the collective). And this collective also contains its history and technology. By technology, I mean my mishmash of Marx’s and Heidegger’s definitions, that is to say for the former, and how we think of the world and what this allows us to do things within the world. Okay, I’m shortchanging both Marx and Heidegger here.
But because the way we think of the world has changed and will always change, I wonder how much our conception of some works of art as being timeless is influenced by the mechanical reproduction (to use Walter Benjamin’s phrasing) of such works of art. After all, we only have fragments of Simonides of Keos and of Sappho, nothing of the painters Plato mentions, while all of the Seven Wonders of the World lie in ruins, if not worse. So who can we call them timeless? More importantly, works of art belong to the physical world and with this comes degradation and loss. Think of the cathedrals of Strasbourg and Bremen. The former was recently restored. None of the bricks or windows that are part of the original edifice. The same could be said of the recent restoration of the Sistine Chapel’s ceiling or of Damien Hirst’s shark. Much of what we see of works of art are only reproductions or facsimiles, and much of our impressions of timelessness is due to the amount of dissemination those works receive.
Which brings me back to Walter Benjamin and his essay “The Work of Art in the Age of Mechanical Reproduction,” in which he talks about the “aura” of a work of art. But this aura has nothing mystical to it. It’s the entire history of a work of art from the moment it was produced to the moment we laid our eyes on it. It includes who made it, who owned it, who wrote about it, etc. And so, would the Mona Lisa be as valuable, had it not been François I of France’s most favorite painting? There is also a famous story about Guernica, which might be apocryphal. We know that Picasso painted it in reaction to the bombing of its namesake city by the Wehrmacht during the Spanish Civil War. When Germany invaded France, an SS officer saw the painting and asked Picasso who made it. Picasso replied “You did.” This too, even though it may be aprocryphal, is part of the aura of Guernica the painting and why I doubt someone in the Renaissance would get it. For starters, the Renaissance is when painters started becoming rock stars.
I also don’t think we should divorce Art from money and patronage. Much of what is valued in the arts comes from who has been willing to fund it and who’s buying. Think of how much of a boost Abstract Expressionism has received when the CIA funded its traveling exhibit. Who reads those days Robert Hayden or Alfred, Lord Tennyson? Or any of the US Poet Laureates for that matter (with the exception of William Carlos Williams)? Alfred Agache was once considered a great French painter during his lifetime. He was most popular during the French Second Empire in the mid-19th century. His work catered to the taste of the nobility and high bourgeoisie. But his popularity started to wane with the advent of Impressionism and the more democratic tastes of the French Third Republic. Now, he’s just a footnote in the history of French painting (described as an academic painter).
But to return to the idea of medicine as a social act, I see the rise of CAMs as the result of changes within social norms, in which science is devalued, but also due to the rise of free-market economics (which also affect social norms). CAMs are less regulated than medicine, and as such, are free to make many outlandish claims. Those two things allow CAM claims to receive equal value as medicine in the eyes of society. And so, in the end, it’s all about who has the better marketing budget (just like the arts!).
@ nybgrus, kathy and François Luong – such intriguing perspectives brings to mind a myriad of other angles to consider. I really wish I had time, now, to try to put them into words. But, I don’t, I’ve gotta try to get something done before the kids get off school for the holiday and then there will be baking, etc.
I felt rude to completely not respond to such thought provoking comments, though. But I guess I will have to just respond with a thank you for all the material you all have provided for expanded musing.
No worries at all Mouse. Life gets in the way of commenting on a blog, sometimes I guess. I myself will have less time as well in the coming weeks as I will be traveling around seeing family and friends and surfing
I agree it was a thought provoking conversation which I am sure we will end up picking up some way or another down the road.
Happy Holidays to all!
(hopefully that wasn’t interpreted as a War on Thanksgiving )
FL wrote “@mouse & nybrus: I am tremendously amused that a post on hydrogen peroxide has turned into a discussion on art, science, and medicine.”
I am also pleasantly amused but not surprised. Science is dependent on poetry since all scientific description is metaphoric. The very notion that there is a division between things like art, science and medicine is in itself a metaphor which changes with the individual. I love the art of medicine, the science of poetry and the way art and science combine in medicine in the treatment of individual people.
It is also interesting to me the way “medicine is an art” is used in the sCAM and SBM communities. In the former it means mysterious ancient things that work despite any evidence while in the latter it means that much has been discovered, much is yet to be known and in the meantime it is best to apply the method of science to move forward. Same phrase, so different their meanings and application!
scientific description is metaphoric. The very notion that there is a division between things like art, science and medicine is in itself a metaphor which changes with the individual. I love the art of medicine, the science of poetry and the way art and science combine in medicine in the treatment of individual people.
Here is someone after my heart
That being said, it’s not rare to see doctors who are also poets. Americans all know about William Carlos Williams, one of the central figures of American modernism. There’s also C. Dale Young, an oncologist in San Francisco and the author of two books. Louis-Ferdinand Céline was also a doctor (although he was a novelist, not a poet). John Keats was also a surgeon. André Breton, Paul Celan and Pierre Joris all attended medical school.
On the other “side,” I heard Louis Pasteur and Alexander Fleming were all very competent painters. (Okay, they were not doctors)
“That being said, it’s not rare to see doctors who are also poets.”
And that is a nice sample list, too, to which I’d add Henry Vaughan. I was influenced by many novelist-doctors especially Walker Percy, Somerset Maugham, Kōbō Abe, and Chekov. Percy especially as he was presented with John Kennedy Toole’s “Confederacy of Dunces” and the great sense and fortune to see it published.
Huh. Isn’t it funny to think that while many doctors have been poets, writers and artists of all kinds one doesn’t see that so much in CAM circles? Probably an unfair comparison as there have been oceans of physicians while CAM remains scattered bogs, but still interesting to note.
@FL: Yes, I too know poets and writers into CAM and now that I think about it yep, it is a peculiarly American affliction.
But I was thinking of CAM practitioners who are also artists or the like. When a person of modest intellect is already seeing things not there and basing a pseudo-medical practice on it, it seems that is often the limits of their creativity. I guess after a day of seeing subluxations, for instance, the urge to go home and paint an entire imaginary person just isn’t there. What craftsmen must die within them!
Ah well. For art I shall seek an artist, for poems a poet, and for a back ache a doctor. I shall resist any attempt to treat a real problem with non-existent solutions, especially 30C ones.
And since to end on my own words would be a bad thing, here is a quote from St. Mark (Twain) I think you & others here might enjoy.
“What a lumbering poor vehicle prose is for the conveying of a great thought! …Prose wanders around with a lantern & laboriously schedules & verifies the details & particulars of a valley & its frame of crags & peaks, then Poetry comes, & lays bare the whole landscape with a single splendid flash.
– from a letter to William Dean Howells, February 25, 1906
@Quill – I don’t recall any visual artist (fine artists or designers) who is/was a medical doctor or chiropractor or other CAM doctors.
Historically, you see a lot more crossover between science and visual arts. The naturalists, like Audubon come to minds, I’ve known a few artist/science folks (Day job in a lab, create art after hours). These are usually folks who’s education is in science and have taken classes in art on the side + art self education.
For visual artists who went to art school, it’s good to remember that their formal academic background may be limited. Some art schools are very art focused and offer very minimal academics. University art school programs offer a high range of academic programs, but time spent in the studio (at my University 6 studio hours per 3 credits) can limit the availability of academic classes. Which is not to say that some folks don’t get a college education in both art and science, I knew one painter in school who was a dual major, but it’s not standard.
Of the visual artists I know, a few are into CAM treatments, but I wouldn’t say that they are any more so than the general public. Chiropractic is not big at all. Most visual artist I know are quite frugal and the whole ‘weekly treatments with no end in sight’ maybe doesn’t appeal.
I would argue that the recognition of artist as someone special stemmed from a bunch of guys wanting better pay. First, one of the first outstanding artists who had quite some personal recognition as someone more than a mere craftsman was Cimabue who predates Renaissance a bit, second, it had something to do with the whole Renaissance thing which stressed individuality in contrast to Medieval thinking, which was, as it’s more usual in the world, conservative and preferred things done in ways that had been used since time immemorial.
Also, art as we perceive it, an unique way of expressing author’s individuality, emotions and stuff, is quite a recent phenomenon. In Museo Bardini in Florence, there’s an entire wall covered by madonnas from Donatello’s workshop and they look pretty much the same – while there were people who would appreciate originality up to the level of extravagance and eccentricity, many wanted their Madonna done in a traditional and immediately decipherable way. Originality as the most important part of art work is pretty recent.
Actually, painting could be compared to medicine in a slightly clumsy way. Donatello, M. D. would cure asthma in similar ways, as patients are not the same, one has more severe problems and needs a bigger Madonna painting, erm, bigger dose of meds, is scared of some experimental treatment which may bring better outcome, or may not afford it, while a Mr. Medici is audacious, wants some not-yet-entirely proven treatment and has the bucks… and now we have the modern ages when every quack calls themselves something that sounds like M. D., they all go on and on about individuality of patients and how the treatments cannot be standardized evah, and as for contemporary art, I have an universal description: The author is trying to express his existential insecurity vis-a-vis the excruciating realities of the complicated post-modern world.
@ mousethatroared: While I can’t remember a medical doctor or someone in related profession who would also be world-renowned artist, I have a few friends in the medical field who do pursue one art or another, one is an avid and darn good singer and sometims gets a minor role in the local opera, for example, I knew a medical toxicologist or some such who was a good wood carver – I remember at least two exhibitions of his miniatures and jewellery. And, I have a book called Anatomy for Artists, written and illustrated by a professor of anatomy of the local university. As far as I can judge, the drawings are damn good and no-one could do them with quite a skill and knowledge. I believe that it’s rather the lack of time than lack of will or talent why doctors don’t make outstanding artists.
@Kultakutri: Yes, we did mention that the romantic notion of art was a recent phenomenon. I also appreciate your comments. Thank you for what you have added. Yes, the intellectual changes from scholasticism to humanism did also play a major role in how we now perceive artists, as well as the changes it brought to medicine, and more importantly to science. What I posted here is quite simplified. I’m sure you and I could talk for hours on end about art history from the Renaissance to today, but wouldn’t be able to cover a fraction of what we know on the subject.
@Kultakutri – Yes, If I had to guess, I would think that time constraints are at least one of the major reasons you don’t see the medical doctor/visual artist combo. Some visual arts take a pretty big investment in time to gain competency and get satisfaction from. Many folks find learning to draw or paint as adults very frustrating. Their vision of what they want to produce is very different than what any beginner can produce. Some people do find things like fiber arts, clay, metal arts, woodworking, etc more rewarding on a beginner level and there is an incredible amount you can do with those, they are good medium if you are looking for a visual artistic outlet and have access to the supplies/tools…but it really all depends upon what appeals to the individual.
Like your professor of anatomy, it’s good to note that there are professions that require esthetics or visual artistic skill and science/medical skill. Off the top of my head, things like; Medical Illustration, Cosmetic Prosthetics, Orthotic/Prosthetics (Engineering too), Plastic Surgery.
If I had more time, money and was younger, I would be sorely tempted by a profession in Orthotics/Prosthetics, that, to me, seems like a fascinating blend of science, art and engineering with the added benefit of actually making a difference in someone’s life. Much more interesting than the profession that I pursued for years – graphic design and illustration.
@mouse: Not really. Have a look at Anselm Kiefer or Damien Hirst. Of course, we are talking about those who have made it. But it does influence many artists while they toil in poverty. They too hope to have the big payday that Damien Hirst receives every time he makes something (even though they all hate him).
Sorry, I used the wrong word, individualistic (as in unique), not individualism (as in versus the collective).
I would argue that society perception that art is unique to the artist is from observation of the innovative and exploratory nature of art (as well as the fact that people generally are somewhat unique, unless they are intentionally imitating) rather than a response to the marketing efforts of Reniassance artists who wanted to earn more than tradesmen.
I can’t speak for everyone. I can tell you how I get to know about an artist’s existence and work.
I set up a booth at an Art Fair, then chat with my neighbor artists and those who come in to see my work. I nip out to see the work of other artists when I get a chance. I keep in touch with old artist friends from previous jobs and look at their work when I get a chance. I meet artists through the occassional workshops I teach and see their work in class, often they bring pictures of their other work or if I get a chance I go to a show they tell me about. I look at the work of art instructors I’ve taken classes from. I look at other work at the Art Center that shows my work. I go to local galleries when I get a chance or galleries or museums or churches or other art sites when I travel. When I’m bored I google things like “mixed media artist” or “altered books” images. If I go to a party and someone asks what I do, I say “I’m a mixed media artist” and often there’s another artist there and then we need to exchange urls or look at art. Sometimes I look at magazines, although, to be honest, I’m not into the New York/West Coast art scene and that’s what a lot of the magazines are about. When I go to the children’s hospital where my son’s doctors are (where I have also shown work) I look at the art. About 1/2 my art history I learned from art history professors with books, slides or in museums (mostly London museums) the other half from my art professors with books/slides with an occassional museum/gallery visit (Detroit or Toledo).
Sometimes I look at magazines, although, to be honest, I’m not into the New York/West Coast art scene and that’s what a lot of the magazines are about. When I go to the children’s hospital where my son’s doctors are (where I have also shown work) I look at the art. About 1/2 my art history I learned from art history professors with books, slides or in museums (mostly London museums) the other half from my art professors with books/slides with an occassional museum/gallery visit (Detroit or Toledo).
Right. Those are actually the ones I am interested in, since I am very interested in the dissemination of things. Why is it that the New York/West Coast art scenes are more talked about than artists in say, Detroit, Toledo, or Houston, all of which all have valuable art scenes (and art collections)? How did the artists featured in magazines and museums get to be featured there? Because I don’t think this has anything to do with individual talent. Not that I am denigrating individual talent. I’m sure there were a lot more talented painters in the Renaissance than what is represented in the canon, just as there are many worthwhile artists in places other than New York or San Francisco. I remember a conversation I had with a French poet and philosopher of mine, who came to San Francisco. He asserted there were at least 500 good poets living in the United States at the moment. He was of course lowballing that number. But that idea excited him tremendously.
But sadly, not even half of those poets will get a book deal. Much like there are many artists who will never have a breakthrough. Because none of them will have the financial backing to be able to be promoted and therefore enter collective consciousness. Think of how much the Surrealists owe their fame in the US to the Menils for example (the Menil Collection in Houston probably has the largest collection of Surrealist art right now, including world famous pieces by Max Ernst and Giorgio di Chirico). Or the artists who managed to thrive thanks to the patronage of Don Fisher (the founder of GAP).
Yes, talent should be part of a conversation about the arts. But it is not the only factor.
Luong wrote “Let me ask you this. In non-ideological terms, how do we get to know of an artist’s existence and work?”
Advertising, relentless, unblushing and expensive.
If you don’t have the money to advertise, then word of mouth. But it’s a chancy method, that. Two anecdotes – ‘pologies! – from my own experience. But they point in opposite directions, so I shall post them as examples of the unreliablity of personal experience.
The first one is an elderly Zulu man, a sculptor of religious themes in wood, living far out in the bush, a long way from universities and museums, who was “discovered” by a visiting nun who just happened to be the sister of some big wheel in Germany. She proceeded to do everything in her power to publicise him including showing off his work to everyone that came to the convent (that’s how I heard about him), and opening up a market for him in Germany through her many high-level contacts.
The second anecdote that “proves” the opposite … some years ago I stopped off at a small ropey hotel in a small ropey African town, and while I was waiting for someone to help me, I looked around at the foyer. There were two medium size original watercolours on the wall and they were superb (imho!). Clear, authoritative, sensitively done, not at all like the usual hotel decorations. But the signatures at the bottom were indecipherable. When at last I got someone to serve me, I asked where they came from and was given an indifferent shrug, “Dunno, they’ve been there for ages”. Seems no-one had ever “discovered” this particular artist and they were fated to “waste their fragrance on the desert air”.
FL – Yes the art scenes like to select certain types of work based on regional bias, connections, stylistic trends, personal narrative, etc. But please explain how this shows that…
“Kultakutri “I would argue that the recognition of artist as someone special stemmed from a bunch of guys wanting better pay.”
Or that my notion that art is “usually considered to be something that is unique and attempts to communicate an emotion, experience, opinion or visual principle. I have never thought of art having a scientific process, although art techniques certainly use scientific principles, chemicals, color theory, construction, physics may all be needed depending upon the type of art.”
elicits you comment – “This romantic notion of art is actually a fairly recent phenomenon (and one, sadly, that refuses to die). It all started in the Renaissance, when a group of painters wanted to be paid more because they argued that their art was something more than just a craft (such that of a cobbler or a vase maker).”
I genuinely want to know if you believe that the uniqueness I see in the work of all the artist that I spoke of above, is actually the result of a few guys in the Reniassance who wanted to make more than cobblers?
It not like art that can be traced back to individual artists starts at the Reinassance. There are identifiable artists from ancient Greece and Early Medieval period on. Maybe before, unfortunately, I don’t have a lot of early art history.
Kathy – I want to say something knowledgable about your comment, But all I can think is ‘Oh boy, I want a nun to take over my marketing.’
I do know artist who are natural self marketers, but it is a balance that is difficult, because the marketing could be a full time job. Some of the self-promotion is enjoyable. When I’m showing work, I enjoy talking to folks who come in to look, because it’s helpful to see how people are reading the work. In fact, that’s part of doing the artwork, the conversation between the artwork, myself and the viewer.
The things that is really intrusive is the endless paperwork of applications, correspondence, photographs of works, self-promotional materials, show planning.
That probably relates to the medical person as artist too…everyone just wants to do the actual work and leave all that promotional stuff to someone else.
@Kathy also – I would add also, My feeling is that the only art that is “wasted” is the art that remains unseen in a studio or attic. Maybe this is just a personally philosophy, but for me the value comes from the experience I have creating the art and the experience people have viewing the art and they are integrated, I can not have a good experience creating art that I feel won’t be viewed.
You saw those watercolor paintings, you remembered them, in a tiny way they changed you, if only by how you view watercolors in the future. The fact that the artist’s career wasn’t advanced is sad, but that just means that the artist isn’t making a bunch of money for his work. Most artists could pursue a different line of work, if they wanted to make more money, but for some crazy reason we want people to see our work and be affected by it in some way…even if it is a tiny way.
I am now on holiday in Nevada so I will try and keep my comments short.
I don’t think I have the knowledge or time at the moment to really engage in this very interesting conversation, but I few thoughts….
I know a few physicians and med students I know are quite capable artists. One makes his own guitars, another is a talented painter, and another is quite skilled at drawing. In fact, I learned a fair bit of anatomy from a YouTube user named HyperHighs who is a very talented artist.
Some visual arts take a pretty big investment in time to gain competency and get satisfaction from. Many folks find learning to draw or paint as adults very frustrating. Their vision of what they want to produce is very different than what any beginner can produce.
This to me is evidence of the refining processes which is the same as scientific refinement and inquiry. I think it is more than just technical skill, but also thinking about what effects you want to elicit from your audience.
As for how we recognize artists… once again, there is a scientific process to this. Some artists want their work seen and appreciated by as many people as possible. Some want a specific narrow niche. Some actively market and some don’t. How they go about it to elicit the responses they want is at base a scientific process. Some are better at certain aspects than others. My argument is essentially that, just like the science of medicine, certain artists can get lucky and stumble back asswards into an effect they want and the noteriety they wish but those who systematically work at it will achieve better results more often.
In any event, I hope everyone has a wonderful holiday (well, I guess the Americans here). The fiance and I are in already in a constant struggle to keep the family from making vastly too much food. Happy problems to have.
nybrgus, A quick remark while boiling lactaid to make pumpkin pie for my lactose intolerant husband.
Firstly, You get the award for medical doctor/student visual artists! I’m kinda relieved, actually It was beginning to seem weird.
Secondly, If medicine is an art, that probably explains why every time I meet with my Rhuematologist I have the same sensation as coming out of a theater after watching a really avante garde play, that seemed deceptively simple but leaves me so completely without closure or certainty that I think “I must have missed something.”
Really, in my mind, every doctors visit should be like a formulaic children’s mystery novel. Introduction, mystery and clues, mystery solved, resolution. Charming characters are nice.
This may be why I’m so resistant to your idea. Perhaps in the back of my mind I hold medicine apart as that one thing that should be decipherable with certainty*, but reality creeps in.
I think I will start approaching my doctor visits with the same attitude that I approach art (of different types), Which is to rely on this Billy Collins poem**.
But I admit, after all that I’m still curious about the art of medicine. Here is something that might help, if you have time. How is medicine different than art? What is that point in medicine where science switches to art? Is there a point? I don’t know if I can answer this for my work, so apologies if that’s too odd.
*Of course I know better, but knowing is different than accepting, I guess.
**I’m really sorry FL, But it’s true, I even bring the poem for my students to read when I do a workshop.
first off, to be clear, I am not artistic. I just know a few people in my field who are. lol. I have now, for the first time, been able to play 4 chords on a guitar. I’ve been learning some photography (and gotten actually a few good photos) and that is the extent of my artistic capacity.
As for your question, I believe it was quill who said that they are quite interwoven concepts with much fluidity.
For me, the “art” of medicine is getting the desired outcome, often with incomplete information. The way I envision this is as follows:
Lets say I am a painter and I want to express some idea in my head. I’ve been to art school and been painting for many years so my technique is quite good. I also have had a number of art openings and seen people’s reaction to my art and various other people’s art and have read book on the topic as well. So now, I want to achieve an effect. First, I decide what effect I want and what I would be happy with. I picture it in my head and then pull from my vast repertoire of technique, theory, experience, and start formulating the piece in my head. I think about how I expect people to react and then I make my art and put it out. I gauge the response, both in person and from critics, and then determine if I achieved the goal or not. I adjust technique and strategy as necessary. Repeat.
Lets say I am a doctor (a little less of a stretch here) and I want to help my patient live with asthma and improve his life vis-a-vis this condition. I take the plethora of knowledge I have on the topic, my skills in picking appropriate medicines and interventions, and then my experience in dealing with patients and what their typical response is to certain interventions. For example, I know that Pulmicort is actually rather difficult to use effectively since it is simply technically more challenging to do so. If my patient strikes me as better able to comprehend and do this, I may go for that. If I determine he isn’t, then I may go a different route. I then think about how typical people react to being diagnosed and to various treatment options and decide where this person might lay in the spectrum. I tailor my rhetoric and “pitch” to try and engender the most engagement with his disease and treatment since I know this will help achieve the best outcomes. Then I gauge the response, both in person at the time, and at follow up visits. If possible I seek comments from family or friends if they happen to be around for the consultations. Then I judge how effective it all has been and decide if I need to amend my plan, change my rhetoric, or whatever to engage my patient and improve outcomes. Many times we (as physicians) settle for sub-optimal outcomes because we recognize that for myriad reasons a particular patient simply won’t be able or willing to adhere to an optimal regimen and would be lost to follow up.
To me, that is the science of art and the art of medicine. It is taking all those little cues and fusing it up with evidence to generate outcomes we want.
Medicine without art is the doctor who knows everything, but has terrible outcomes because his patients think he is an a$$hole.
Art without science is the artist who keeps failing and making bad art (i.e. technically poor or simply always unable to convey the message the artist wants) time after time after time.
Where I go even further is to say that all of these variable could theoretically be known in advance and the best outcomes in both art and science can be realized. If an artist knew every variable involved with the creation and perception of art, then it would become trivially easy to target the art for the optimal outcomes (no matter what that may actually be). If a physician knew every variable involved with the management of John Doe’s disease, then it would be trivially easy to generate a treatment and plan for maximal outcomes.
This is why I say it is all fundamentally rooted in science, it is just the resolution we are capable of in determining the variables, our ability to predict outcomes based on them, and how far removed the surrogate markers we use are from the thing we actually want to measure varies quite a bit (but is constantly improving).
The one underlying theme here is that the universe is statistical in nature. Having perfect knowledge of every variable doesn’t mean we can predict with 100% certainty anything. It just means we can be close enough to 100% for any purpose we may want. All we do is improve the accuracy of our predictions by adding in more and more detail and using less removed surrogate markers in our endeavors. In another thread it was commented that we can never predict the decay of a single uranium atom. This is true, but we can say how likely it will be to have undergone decay in a certain time frame (though never 100%). So it isn’t just accepting that medicine is not decipherable with certainty, but that the whole universe is not. But we can get close enough that rounding error makes it pointless to fret over the uncertainty.
I should also add that, of course, this hypothetical omniscience does not mean all outcomes are possible.
The phsyician that knows every variable is no more able to craft a therapy for asthma that will work for every single person than an artist with the same knowledge could craft a piece of art that will convey the exact same message to every single person.
The higher variability in the “subjectivity” of art (is it good, bad, convey the intended message?) is because there is more variability in the neurobiology, cultural milieu, and personal experience than in leukotriene receptor polymorphisms. Biology is more constrained than culture and is certainly less plastic than neurophysiology and the cerebral cytoarchitecture.
I have a somewhat different perspective on the difference between “art” and “science”.
I see science as primarily a reductive process, the attempt to understand reality in an algorithmic way. I am using algorithm in the sense of a Turing Equivalent process, algorithms are what computers do. Algorithms manipulate facts and data using logical and mathematical rules.
I see “art” as a non-algorithmic process. There are no algorithms for communicating with language or with any other medium.
Humans and animals have the ability to estimate quantity. This estimation ability works pretty well, but it is not exact. Humans also have the ability to implement the counting algorithm. The counting algorithm gives exact answers (when implemented correctly), but there is significant overhead associated with counting if the numbers to be counted are large, thousands or millions.
I see doing science as the equivalent of implementing the counting algorithm. Art is implementing the non-algorithmic estimating ability. Another term for that is intuition.
In my work, I use both. For most things, there isn’t enough data, or the systems are too complicated to be able to understand them algorithmically. Just because the systems are too complicated to reduce them to algorithms, doesn’t mean that you can just make stuff up.
Human brains are fundamentally non-algorithmic in the sense that Turing Equivalents are algorithmic. Humans can emulate a Turing Equivalent, but doing so is clunky and slow.
Medical intuition is what comes from practicing medicine. There can be good practice that leads to good intuition (that is when wrong intuition is noticed and corrected) and bad practice. Intuition is good for hypothesis generation. You still need to do the hypothesis testing. If your intuition suggests something, you test it and are confirmed, then you can strengthen your intuition. If it is not confirmed then you can strengthen your intuition also.
Intuition is like art. Every piece of hand made stuff is “art”. The question is always is it good art. Every medical idea is a type of medical intuition. For medical intuition to be useful it has to be good. This is where controlling and keeping track of confirmation bias is most important. CAM practitioners have their intuition and don’t recognize that it is all confirmation bias. Good doctors have good intuition, but it is always “trust but verify”, that is you trust your intuition until you can verify it and you always test it to verify it.
I don’t think we are too far off in our ideas on the topic.
You are using the term “art” to denote educated guessing with incomplete information or when complete information is to onerous or unecessary. I see it the same way. (correct me if I am wrong in your assertion)
However, when you say:
There are no algorithms for communicating with language or with any other medium.
I disagree. I think that those algorithms as merely very complex, much more dynamic than most scientific algorithms, and we have much less resolution to derive them.
I am certain that you and I agree that neural cytoarchitecture is what dictates consciousness as well as our actions and perception of the world around us. If we had more resolution and could process it, then creating “art” in the common sense (visual media, etc) can be reduced to these algorithms. My argument was that on top of all of the limitations in doing this I have listed before, there is significantly more heterogeneity in neural cytoarchitecture and more pathways to achieve the same desired outcome.
“science” is merely the term we use to describe how we re-iteratively refine our resolution for any outcome on any topic whilst minimizing bias, confounders, and fallacy.
@mouse, FL: now you are moving into my familiar territory, i.e. poetry. FL: Billy Collins isn’t a great poet, merely a good one, but I’d challenge your statement that he is overrated and derivative. How about this for overrated:
“I wandered lonely as a cloud
That floats on high o’er vales and hills,
When all at once I saw a crowd,
A host, of golden daffodils;
Beside the lake, beneath the trees,
Fluttering and dancing in the breeze.”
How pedestrian! And the rest of the poem never rises above this mundane level. But shock! horror! Wordsworth is considered one of the greats! and this is probably the best known of all his poems. But taking an unbaised, un-culturally-influenced view … read it as if you’d never heard of Wordsworth … would you call this a great poem, or its writer a great poet?
So what makes the difference between good art and great art, in any medium?
What makes the difference between a good doctor and a great one? Can a young inexperiened doctor be considered “great”, or must he/she wait till they have twenty or thirty years under their belt?
Btw – @mouse – thanks for the comments on my two contrasting experiences of art from Nowhereville. Yes, I have always remembered those two watercolours and always will. Just how to interpret the remembering sometimes exercises my head, though, and your contribution to my internal debate is much appreciated.
Nybgrus wrote, “Some artists want their work seen and appreciated by as many people as possible. Some want a specific narrow niche. Some actively market and some don’t. How they go about it to elicit the responses they want is at base a scientific process.”
To my little mind what characterises good science is repeatability, predictability and clearly stipulated measurable outcomes. A deeper knowledge of the basics, and of the methods, will certainly help with these. So practice will make, if not perfect, then certainly better.
But how would an artist apply these principles, though? If I am a poet, how would I get repeatability, predictability and a measurable outcome whenever I published a book of poems? If the desired outcome is to sell many copies, then I would turn to advertising of various types – that makes sense, no? And the outcome can be measured at least, though not always predicted or repeated. If the desired outcome is to touch many people with the meanings of my poetry, however, that is not such a clearcut outcome … pretty difficult to assess and not easy to promote.
Question: Art that is repeatable and predictable … is it good art? Here’s another anecdote (I must be entering my anecdotage) … I was wandering round an open-air art fair once when I saw a painting, a watercolour (I have a thing for watercolours as you’ve probably gathered), that I immediately liked – more the theme than the execution, but the execution was acceptable. It was even within my very moderate means, so I bought it and hung it in my hallway at home.
A couple of months later I went to the fair again and lo-and-behold!, the artist had painted some 6-7 repeats of the same painting in various sizes. Presumably she’d been encouraged by one sale to hope for more. I.o.w., she was trying for repeatability and predictability … at least as far as sales went.
Mpf! Why should I feel less than impressed? She had a living to make, after all … but …
I think we agree, we are having nomenclature issues. I am using “algorithm” in a specific sense as what Turing Equivalents do. A Turing Equivalent is a substrate-independent abstract device for manipulating data. The “data” can be either data-data or program-data and it is manipulated by the Turing Equivalent with no difference.
Human brains are not Turing Equivalents, they are neural networks that do computations in ways that are not substrate independent. Brains do not store “data” in substrate independent ways and then manipulate that data with math and logic. How neural networks store memories, manipulate data and do computations is not understood, but we do know that it is not like how a computer stores data where any type of data or program can be stored in any type of memory.
A Turing Equivalent can be used to simulate a neural network, but that is not the same thing. An algorithm being run by a Turing Equivalent will always produce the same output given the same input. This is not the case for a neural network.
In principle, a human brain can be simulated on a Turing Equivalent (because a Turing Equivalent can be used to simulate anything). But that is not how human brains operate (as an algorithm being run on a Turing Equivalent).
A problem (and feature) with human brains is that they self-modify and implement “short-cuts”. In the thread on anecdotes, if the Sun is observed to rise every day for 10,000 days, a human brain would self-modify to expect the Sun to rise every day in the future and to come up with rationalizations as to why the Sun God drives His chariot across the sky every day. Usually self-modifications like that are ok and adaptive (that is why evolution configured human brains to be that way), but not always.
Unless you have a theoretical construct for the behavior, you don’t have justification for extrapolation. Observing the Sun rising every day in the past and expecting the Sun to rise every day in the future is no different than observing that in the past, if you poked people with needles they got better, and then expecting that if you poke people with needles in the future they will get better.
In your needle poking experiments, if you notice inconsistent results, you can try to understand the underlying physiology of needle-poking (eventually understanding that it is a placebo), or you can add epicircles of needle-poking mythology (flow of chi in meridians, humours, yin and yang). The same with the Sun rising, you can modify your theoretical construct to explain why sometimes it remains dark (opaque clouds), why the Sun sometimes disappears (solar eclipse), or you can add self-serving epicircles (the Sun God is angry and wants His Prophet to be given gold).