Monthly Archives: February 2015

Leadership – Is Nelson As An Admiral Better than A Fleet of Nelsons As Sailors

Along with our School of Medicine senior management team, I attended an excellent symposium by Professor Erwin Schwella from Stellenbosch University on leadership skills this week as part of a Leadership course we have developed. On the same day I received a letter from a University I had previously worked at asking why I had left, presumably as part of the routine human resources practice of that University, and my answer to them was that I had left because of what I perceived was poor leadership at the University in question that had created a negative and hostile work environment, where creativity had become difficult to translate into academic output as a result of the leadership-generated negative environmental milieu, amongst other reasons. These two separate events this week got me thinking even more than usual about leadership and what makes a good leader. I have worked to date in a number of different University (and Hospital and Research Institutions) environments, both as a member of different leader’s teams, and as a leader myself at different levels of the University organizational structure. In these different roles I have seen examples of both good and bad leadership, and how the good leaders create an environment where it is exciting to work in and one feels one is part of a team working for the common good and ‘doing’ something special, and how in contrast bad leaders can tear apart a previously healthy work environment, creating conflict, suspicion and unhappiness, and eventually mass resignations of staff, either due to their personal leadership style or due to the processes they enact that are not well received by the staff they manage. I have been on many leadership and management courses to date, and read a number of books and scientific articles on optimal management and leadership behaviour, and while it is easy to describe the effects of good and bad leadership on teams they manage, incredibly, given how indelibly part of our societal behaviour the concept of leadership is, it appears to be very difficult to ‘pin down’ exactly what makes a good leader, or indeed, what a good leader is.

A leader is broadly defined as a person who is followed by others, and to lead is defined as to cause others to go with one, by guiding or showing the way or by going in front. A leader cannot exist as an independent entity – essential to a leader is an organization or group of people that either require leadership or look to someone to lead or guide them. Organizations can be formal, such as is often found in work environments, or informal, where a group of people live together and which are often managed by a leader in an informal manner, such as a family, community, or friends interacting together. In the formal environment, the leader would set the strategic plans and goals for the team they manage, attenuate conflict between team members, and ensure the work environment is optimal to allow both maximum productivity of the team and wellbeing of the team they manage. In the informal environment, a leader would make decisions that would optimise the functioning of the group of people attempting to live harmoniously together, whether as a family unit or in a community. There has long been a debate on whether leadership is needed and whether teams, either formal or informal, would function better with or without a leader. When looking at primates and animal organizations, most appear to function with clearly defined leadership and hierarchal roles and environments. While in most animals these leadership roles are strength related, this is not always the case. In most self-organizing groups that have not existed before, leaders are usually self-selected by the groups to manage the group dynamics, but of course one can never be sure whether this occurs due to innate requirements and practices of the group members, or are the result of the previous or current experiences of the members of the group in other areas of their life which are emulated in the creation of an new group structure. Whatever the case, it is clear that leadership is an inherent characteristic of nearly all human and animal organizational structures, and therefore there must be a teleological reason for having leaders in any organizational team.

As I said above, what makes a good leader is very difficult to define. There are a huge number of different theories on both what makes leaders and what specific ‘leadership’ attributes they possess (trait theory, basic style theory, situational theory, transactional theory, transformational theory, for example, amongst many others, for those folk that are interested in academic theoretical work on leadership). But, my experience after many years in academia and science is that when there are many different theories on any subject or concept, it means that the fundamental ‘basic’ mechanisms underpinning the concept have not been elicited to date, or that the concept is so complex and multifactorial that it will probably never be defined or clarified in any single way or by any single theory, and Leadership probably fits into this latter perception. For example, during several leadership courses I have attended in the past, my personality has been assessed by the Myers Briggs method (amongst other assessment methods), and I have a pretty strong ‘ENTJ’ profile (Extraversion, Intuition, Thinking, Judgement), which apparently is the classical ‘leader’ personality profile. But, actually only between 10 and 20 percent of leaders have ENTJ profiles, and it is only perceived to be the classical leadership profile because a high proportion of folk with ENTJ profiles are in leadership positions compared to how many of them there are in the general population. As much as this is the case, one can also say that 80 percent of leaders have different types of profiles to that of the ENTJ profile, and indeed a percentage of just about every Myers-Briggs profiles are leaders, and probably do as good a job, but in their own way, as compared to us ENTJ folk. Equally, a high percentage of leaders (to a greater degree than in the general environment) have been shown to be sociopaths, or have sociopathic traits, but obviously that does not mean they are good leaders – I think all of us have experienced the nightmare of working for a sociopathic leader at some point in our life – it just means that more of them are leaders than are present in the general population. So, despite a huge amount of research on what makes a good leader, it is still not completely clear from a definition perspective what makes a good or bad leader. Equally, a good leader is only as good as the team he or she leads, and a leader can lead an organization in a magnificent way, but if the wider social environment is negative or dysfunctional, the leader will likely ultimately fail due to external pressures from the wider environment that have a greater negative effect on the organization than that of the positive ‘pressures’ generated by the leader. Thus, the organization will fail whatever the leader does, or how good they are as leaders, if the organization they are leading is operating in a ‘toxic’ external / wider environment.

So going back to my own experience of what makes a good leader – my experiences at my previous places of work, and indeed my own social and family environments, have shown to me from a personal perspective what good and bad leaders are, even if it is hard to define what makes them such, and I am aware that what for me makes a good leader may be an example of a bad leader to others. I left the University whose human resources folk sent me the follow-up letter because of what I perceived to be poor leadership, however well-intentioned it may have been. I currently work at a University who has an extremely charismatic leader who is to me is an example of a good leader. However, how one personally becomes a better leader based on the examples one has is not straightforward, as all situations are different and all environments change constantly. I remember a good friend and academic colleague of mine from Australia, Professor Frank Marino, gave me the advice when I first took up a formal leadership position that the leadership is not about being a ‘boss’, but creating the best environment or ‘playing field’ to enable the folk in it to be the most creative they can be, in a strategic and planned way, but doing this in a way that it is not perceived to be either strategic or planned by the folk one is leading, which to me was very good advice, and has been through most of my career to date. One’s team will pick up very quickly if one is doing something for selfish reasons, or to further one’s own career. One’s team will pick up very quickly if one is being unfair or playing favourites, or if one displays evidence of a lack of integrity or honesty. They do respond positively to clear messages and good planning. They do respond positively to enthusiasm and support. They do respond positively to apologies for mistakes and behaviour on ‘bad hair days’ which all leaders have. Just about every person has periods of their life when they are leaders, and periods when they are in someone else’s team, often at the same time, depending on the different roles they play at work, in social and in home environments. How each person performs as a leader depends on their capacity to learn from their mistakes, improve themselves, and constantly self-reflect on their daily actions and interactions, and who their role models were in the times when they were in another’s team, and they will quickly be made aware by the behaviour of their team how they are doing as a leader. But defining the ‘true’ / absolute leader profile will perhaps always be a quixotic enterprise, and relative to each different environment and society / organizational structure. So to answer the question of whether a fleet would do better with Nelson as it’s Admiral, or if the fleet would do better if it was made up entirely of sailors with Nelson’s talent, but with no Admiral, is perhaps a question still waiting to be answered, let alone us understanding exactly what traits led to Nelson being so great as a leader in his time and situation, or at least him being perceived as such. Each person has to find their own leadership style and manner, and how the ‘sailors’ in their ‘fleet’ respond to them is perhaps most important in, and will surely lead to, each well-led team attaining ‘victory’, whatever this means and is for each different organization and team.

Fractals – The Beauty Of Life As Evidence Of Underlying Purposive Control Design Processes

Reading an excellent research article on the effect of fatigue on the fractal nature of force output by my fellow academic and friend Mark Burnley, and seeing the large tracts of snow that covered the United Kingdom the last few weeks got me thinking of fractal theory, a concept which I have become increasingly interested in during the last decade or so of my research career. A broad definition of fractals are that they are rough or fragmented geometric shapes that can be split into parts, each of which is an approximate copy of the original whole. Examples of fractals are all around us, from snowflakes, to the branching of a tree or vines, to the coastline of a country, to our own lungs, intestines and blood vessels, to the patterns of weather and tides, all of which exhibit fractal geometry and dimensions. Fractals have become popularized in art and paintings, and many folk will be aware of fractals through curtains, floor mats or wall art that display fractal art in all its beauty.

While fractal theory, and its twin theories chaos theory and complex system theory have been studied for many years, the concept of fractals was popularized in the 1970’s by the pioneering work of Benoit Mandelbrot, who coined the word from the Latin term ‘fractus’, which describes a ‘broken stone’. He used this word to describe ‘fractured’ shapes and geometry that focused on broken, wrinkled and uneven shapes, which of course is what most shapes around us in nature are. In the ‘normal’ geometry we learn at school and most remember geometry as – Euclidean geometry – shapes are regular, for example triangles, rectangles and squares. Fractal geometry is a description and a way of measuring irregular shapes and qualities that have no clear way of being measured using classical Euclidian mathematical techniques, such as degree of roughness, ‘brokenness’ or irregularity of an object. Mandelbrot first worked in economics, where before his work economists believed that small daily changes in share and stock prices had nothing to do with large / long term changes. But he looked at the patterns of share fluctuations over first years, then months, then days, then hours, and found astonishingly that the variable curves for each time period of share price data he examined were almost perfectly matched. In other words, despite the share prices fluctuating seemingly randomly when viewed over a set period of time, the changes were ‘self-similar’ whatever the time duration examined was varied. This indicated that some organizational ‘pattern’ or principle was occurring with the stock prices that ‘cut across’ / was universal to whatever time frame of change which had occurred. In what he became most well-known for, Mandelbrot showed similar self-similar patterns occurred when examining the coastline of the United Kingdom. The pattern of the entire coastline is never a straight line and is always variable and constantly different when viewed on a map, but when he looked at a section of the coastline compared to the whole coastline, it had a similar looking ‘fractal’ pattern, and when he looked at an even smaller section of that sub-section, it looked the same / had the same ‘pattern’. So as he described, this is the key feature of fractal shapes, that they are ‘self-similar’ no matter how much one ‘zooms in’ on them. As one zooms in on a fractal shape, no new detail emerges and nothing changes pattern wise, with the same pattern repeating no matter how small an area one zooms in on. So if one looks at a snowflake or part of a human’s lung, then zoom in on a component of each of them, the sub-contents will have a similar pattern and organization that will occur similar to what was seen at the initial scale of viewing of it.

What is perhaps even more interesting than the concept of fractal geometry in physical and anatomy structures is that there appears to be fractal geometry to the patterns or traces of our daily activity and physiological function over time, for example our heart beat, walking patterns, or our brain’s neuronal function. If you graph all these parameters at a high enough data capture rate, they exhibit a variable pattern that seems random, but has a fractal, and therefore ordered structure to them that looks similar if you look at either the entire physiological activity data trace or a component of it. Working with Andre Bester, Ross Tucker and other folk in the lab I worked in at the University of Cape Town several years ago, we showed that the power output trace of cyclists performing a 20 km time trial had fractal characteristics, and Mark Burnley’s interesting data described above showed that when extending the knee in an isometric (non-moving) contraction against resistance, the natural variable fluctuations in muscle activity one has when doing such an ongoing muscle contraction also have a fractal dimension. So during all activities of daily living, while we are not aware of it, our bodies appear to perform activities and have physiological function that is very structured and is performed according to some geometric design principle which seems random and variable when viewed with the naked eye, but is fractal in nature.

From a ‘control of life’ perspective, the most astonishing thing about fractals to me is that when scientists, mathematicians and computer programmers began working in the field of fractal theory, they found they were able to generate intricate fractal shapes, and reproduce the fractal geometry found in nature and our bodies, on their computer screens, using fairly simple non-linear equations and computer coding programs. For those mathematical minded folk, the key component of the computer programs and equations that generate fractal design is that they have feedback components that are iterative – namely when the equation generates an outcome value and it is fed back into the equation in a repetitive (iterative) manner, the equations outcomes when graphed shows the beautiful fractal shapes that are all around us, in our bodies, and which are evident as the coastline of the United Kingdom and how it developed for example, or how stock prices fluctuate during a day, month or year. This concept of an iterative equation underpinning life form and function becomes a concern for geneticists, from the perspective that the ‘language’ of regulation for those working in the gene field is that life is controlled and regulated by individual or arrays of specific genes activated sequentially in time. However, when looking at life and its regulation from this fractal ‘nature’ perspective, there would need to be an equation type activity occurring which would ultimately regulate and ‘synchronize’ the activity of all components of our life and earth structures, and it is of course perhaps impossible to ‘find’ an equation in any gene structure or physical domain. So where these ‘equation’ based life processes come from and how they are controlled are some of life’s big questions – which come first, the equation controlling the ‘whole’ of life, or the specifics of life which then built up to a ‘whole’ that incorporates the equation. In either scenario, one can’t get away from the concept that an equation-related process underpins all current and past life activity, and it difficult to get one’s ‘head around’ this concept, using the current theories of how life began and is regulated. When I describe these concepts in academic lectures I give, with a half-smile I always end my lectures by saying that God, or whoever created us, must surely have been a mathematician. Each time one sees snow fall, or clouds develop in an otherwise blue sky, or feel the pulse of a patient to determine their heartbeat characteristics, one should and can only marvel not just at the beauty of life itself and its manifest detail all around us, but at the intricate processes and requirements which appear to ‘govern’ both its development and its very existence. It’s going to be fascinating to see how these concepts help us uncover and understand the ‘big concepts’ in life, which to this point in time have been beyond our capacity to understand, and which remain mysterious, even if they are beautiful mysteries at that!

The Stanford Marshmallow Test – Civilization and its Discontents

A great discussion this week during a training session on conflict management and optimising communication by Professor Johan Le Roux, as part of a leadership course for our School of Medicine’s Heads of Departments we initiated when I began my current job, got me thinking of Sigmund Freud’s ground-breaking book ‘Civilization and its Discontents’ which I read in my late thirties and which made a significant impression on me. As a way of making the team think of the need to understand that one’s own impulses and needs play their part of any conflict an individual is involved with, Johan described the Stanford Marshmallow experiment to the team. In this study, children under the age of ten were offered a choice of either one reward which could be eaten immediately – a marshmallow (or in some experiments a cookie or a pretzel) – or double the reward – two marshmallows – if they waited for a period of time (15 minutes) before eating them, during which time the scientist left the children alone and they were filmed. The resulting video was fascinating (and both funny and sweet) to watch, as some of the children who did not immediately eat the single marshmallow tried a number of tactics to try and last the full 15 minutes, such as putting their hands over their eyes, walking around, and picking up and putting down the marshmallow in a continuous manner. Approximately two thirds of the children ate the single marshmallow immediately or could not last the full 15 minutes, and one third managed to maintain their self-control through the full 15 minutes and received their double reward. The interesting scientific part of the experiment was that the scientists then followed up the children’s development and life outcomes over the next few decades, and found that those that waited the full fifteen minutes tended to have better exam scores, educational levels, body mass index values and other life measures indicative of ‘success’. The study was therefore about the effect of delayed gratification of needs, and the effect on future life success, and there was indeed a correlation between these two parameters.

The one measure that is not well discussed in the literature resulting from the experiment is the children’s level of happiness during their lifetime, as compared to the more formal indices of success used and most often described as outcomes of the Stanford Marshmallow test, and it was trying to find these data after Johan’s excellent leadership session that got me thinking of Freud’s book, in which he examined what he described as the fundamental tension between civilization and the individual. In Freud’s viewpoint, an individual at a deep level has an always present desire for instinctive freedom and satisfaction / gratification of their basic needs, and when the individual lives for a prolonged period where their basic needs are met, this would create a feeling of contentment in the individual, which Freud described as the ‘pleasure principle’. While there are a number of basic needs (food, shelter, security for example), to Freud the basic needs were the desire for sex, and the predisposition to violent aggression towards authority figures and sexual competitors, both of which could obstruct or deny the capacity of the individual to gratify their personal sexual needs. Obviously these basic instincts and desires of an individual described by Freud, if acted out, would be harmful to the well-being of the community in which individual lives, and therefore civilization creates laws that prohibit killing, rape and adultery for example, and punishes individuals severely for these acts in order to maintain the integrity of the community. Therefore, according to Freud, these laws would restrict the ‘pleasure’ that would result from satisfying these basic desires, and therefore he suggested that it is an inherent quality of living in a civilized environment that it creates a feeling of discontent in its citizens. Freud further suggested that such basic drives and the desire for instantaneous gratification of all needs is evident in young children, and during their development these basic needs are over time suppressed by their parents and teachers according to societal expectations. With time, as children develop into adults they develop consciences, which both regulates their activities and suppresses their basic drives as per the norm of the society in which they live. However, the ‘price’ of this suppression of desires as part of conscience development are the feeling of remorse developing in response to transgressions of the developed conscience and ‘absorbed’ societally condoned rules, and the feeling of guilt developing in response to wishful thinking about their basic needs individuals have which are counter to that of society’s rules and expectations. In some people these feelings of remorse or guilt become perpetual and damaging and lead to the development of a neurosis.

Of course some folk would say that there is clearly a feeling of contentment that comes from living in a well regulated society, but most folk if honest would also say that at some point in time in the privacy of their own reflective thoughts they have been aware of this paradox which underpins our daily life, and that at times that they felt a strong desire for some need gratification that they have had to exercise self-control to overcome. As part of my brain related research talks I give I often ask the audience if we scientists developed a device which could monitor their internal thoughts continuously and clearly (I remain hopeful from an academic perspective that this will indeed happen), would anyone volunteer for the study where we could record every single thought they have. To date I have not had one volunteer / person who says they would be happy to be involved in such a trial, which is telling in itself related to these concepts of ‘basic drives’ which folk are embarrassed and guilty about, even if they are part of each individual’s personae and mind. There is also the issue of what occurs in civilizations which have rules or which acts in a way that is damaging rather than protective of individuals that live in them. There are a number of well documented historical and current examples, where cruel and barbarous acts are committed by states and individuals in positions of authority, or indeed in the mass actions of one community towards other communities in the name of protecting their own community, or against people in their own community who are regarded as ‘outsiders’. As William James, another pioneering psychologist pointed out, when commenting on a spate of lynchings which occurred in the community in which he lived, a problem exists when the capacity for ‘murderous excitement’ in a group of individuals becomes collective, and murder is regarded as punitive or a protective societal duty. It then would paradoxically provide the greatest danger to, rather than future protection of and for, it’s own community. He used examples from his period of life (the late 1800’s/early 1900’s) such as ‘hereditary vendetta’, the custom of duelling, and religious massacres, as being examples of personal homicidal customs which had become societal and when are such are very difficult to attenuate or exterminate from the particular society which endorses these hostile acts. In a paradoxical way, these examples would allow an individual to satisfy their own basic desires in a way that is endorsed by a state, and create both a personal and societal pleasure principle environment, and it needs brave individuals and other societies or states to involve themselves in changing these type of hostile environments to one that is more / again civilized, given the primal nature and ethos of such aggressive societies and state. History is full of stories and honours those that have sacrificed themselves while acting against aggressive states in the past, though of course history is mostly written by those that ‘win’ conflicts and thus often underplay their own contribution to the societal or national violence they became involved with.

So how does knowledge of the marshmallow test results and the philosophies and principles described by psychologists like Sigmund Freud and William James (amongst many others) help us in developing leadership skills, conflict management capacity and indeed enhance one’s everyday life. For me I guess it is about being aware of the constant ‘conflict’ in oneself between the desire for instantaneous gratification of one’s needs and the desire to be an accepted member of society / the need to feel protected and safe from the gratification of other’s impulses which could be associated with a negative impact on one’s own life. Each day we live we are faced by a large number of decisions and choices that this conflict lies at the root of, and each day we probably ‘win’ some and ‘lose’ some of these decisions and choices. Of course making the ‘right’ decision is in the best post-modern sense dependent on each individual’s own personal valence of their need for self-gratification of their urges against that of the need to be a respected member of society. Therefore perhaps the level of ‘happiness’ of each person relative to each of these decisions is related to how much they value either of these ‘sides’ of the eternal conflict between passion and reason which resides in all of us. Each day we face decisions similar to that of the children and the marshmallow test, no matter what our age, and these decisions are made more complex by the current status of the community in which we live and the rules it has that are there to guide us, but which can paradoxically be primeval rather than protective of those that live in or around them. So is it one marshmallow now or two later – the choice is ours to make every day, in every situation we face where we interact with others as part of a community or society, and our level of happiness or discontent related to those choices is surely relative, but surely also important both to ourselves and those around us. Two marshmallows for me, please. Or did I mean one but say two!

Existentialism And The Absurdist Paradigm – Adding Complexity To Each Individual’s Search For Meaning

A management discussion at work this week on the need to improve perinatal and child mortality rates in our clinical training platform hospitals, and cleaning up my bookshelf and picking up a book I haven’t thought about for a long time, got me thinking about Existentialism as a concept, something which occupied a lot of my thoughts and philosophical reading in my twenties, but which I have not thought of for a long time. I became aware of the philosophy of Existentialism while travelling round Europe on a holiday as an early ‘twenty-something’ with my good friend from my medical student University days, Simon Anderson. After a particularly hedonistic few weeks touring around, and wanting a bit of quiet down-time, at a bookshop in England I bought Albert Camus’s epochal book depicting existential philosophy but written as fiction – ‘The Fall’. I read it seven or eight times sequentially during the rest of the trip, and it changed my life and career choices thereafter.

Existentialism is broadly defined as a philosophical theory emphasizing the existence of the individual as a free and responsible agent determining his or her own development. Existentialism is conceptually underpinned by the Absurdist paradigm, which Camus described as defining the basic paradox or ‘confrontation’ between an individual’s search or desire for significance and meaning in their life on one hand, and the ‘silent, cold universe’ on the other. In other words, while it seems like the things we do in our daily lives have meaning, in the context of the universe they are purposeless, and indeed, it is difficult to ultimately define any purpose or meaning to the universe itself – the universe is essentially indifferent towards humankind. The reason for calling this an Absurdist paradigm is thus that it is therefore absurd to ascribe meaning to anything in life, given that our lives are so irrelevant in the context of the universe, and there is no meaning in the world beyond the meaning we ourselves personally give it.

Understanding, or becoming aware of, this Absurdist paradigm can create what is called an ‘existential crisis’ in the individual when they become aware of it. This existential crisis comes from wanting to have meaning in one’s life, yet having become aware of its meaningless. A person faced with this existential crisis has several ways of resolving the dilemma, including, firstly, one can commit suicide, and end it all, though as Camus suggested this would not counter the absurd, but would merely be playing out a part of the absurdist paradigm itself. Second, one can embrace a religious, spiritual or transcendental belief and us this as a life viewpoint that would counter the concept of the Absurd and one’s existential crisis, and give oneself a sense of ‘meaning’ again, though doing so would require a ‘leap of faith’ and a belief in something that is impossible to prove. Thirdly, one can accept the Absurd and continue to live one’s life in spite of being aware of it’s absurd nature, which would mean that one would live continuously aware of the inherent meaninglessness of all of one’s actions, while still performing them.

Camus believed that by taking this third option, one paradoxically achieved absolute freedom from all societal, moral, or religious restraints, and therefore this option of living with ‘doubt’ and awareness of life’s essential meaningless would allow one to ‘create’ a life in which one could determine how and be responsible for living life however one chose, and this is essentially what and how an Existentialist life and world view is defined. Therefore, by recognizing and embracing the position of the absurd gives one ‘freedom’ from all of life’s ‘constraints’, and the ability to choose whatever meaning one wants in life, while understanding it is essentially meaningless whatever one does, and indeed any ‘meaning’ is created by an awareness of its absurdist condition. Camus insisted that one must maintain an ‘ironic distance’ between the created meaning and the condition of the absurd, lest the created meaning ‘beguile’ one in to losing one’s perspective of the absurd.

In an Existential life therefore, one is not necessarily ‘immoral’ but rather ‘amoral’, and one can build a life however one chooses – we are ‘condemned to be free’ in all the choices we make because of the inherent Absurd nature of life. This paradoxically creates more responsibility on the individual for each of their choices and actions, given that one cannot assign blame for their outcomes to any external agent or belief, whether religious or secular, and this ‘allows’ one to create any life one chooses for oneself, and to set any goal one chooses, free of any external pressure or requirements. If one did not maintain an understanding of the Absurd in all of one choices, this could create a paradoxical feeling of pressure and fear of the responsibilities associated with each choice needed to be made during one’s life, without recourse to an external agent which could (and is often used) to absolve us blame for each of these choices and their consequences. So, in effect, an understanding of the Absurd can be liberating rather than depressing, though the opportunity for the latter emotion is obviously high in those contemplating the Absurdist paradigm, as evident in the use of the words existential ‘crisis’ or ‘angst’ in those contemplating Existentialism and the Absurdist paradigm.

So coming back to why the discussion with my colleagues on how we can improve neonatal and child mortality rates generated Existential thoughts in me – the thought of a child dying, and even more so a neonate a few minutes or hours after they are born has always raised the question large in my mind (apart from the feelings of grief and sadness for both the child and their parents) of what was the ultimate point of their short lives, and how on earth they could have been ‘struck down’ so soon after starting their lives. In many ways accepting the Absurdist paradigm is the only relief and ‘balm’ that one can have to attenuate and come to terms with these challenging concepts, and feelings of helplessness that come from not being able to help more these children in their distress. As with the three choices described above, one could commit suicide, but that would be ultimately a selfish act, one could turn to religion for salvation, but then one in confronted by the notion of an angry or uncaring deity for allowing suffering in a small child, or one can acknowledge the Absurd in all of it, and that there is no meaning or reason for these children’s death, and yet still in the best Existential tradition, work as hard as one can, and dedicate one’s life to trying to improve and enhance the practice associated with the care of such children and the prevention of their death’s to the best of one’s ability, even if one has to live with the knowledge that one ‘hopes for nothing, fears nothing’ and that in the broad context of the universe, a child’s death, and our actions in this life, are essentially meaningless, and the Universe surely unaware of the tragedy that occurs each day all around us. A thousand years from now, surely all we do in our lives will be absolutely forgotten and unknown, and potentially the earth could itself not exist, and we live ‘condemned’ to be aware of this knowledge. But, paradoxically, with this awareness comes our own individual freedom to choose to live our lives as we wish to live them, and the capacity to choose to be as best we can and to act with the best personal integrity we can without the restraint of any external influence when confronting all life and situations we are involved in. The challenge perhaps to each person is to fill their life to the best of their ability while realizing personal ambition, goals and desires are all ‘straw’ in the winds of time, and that the concept of ‘meaning’ in life is potentially ‘absurd’ – and if one is able to, then one can indeed call oneself an Existentialist, for what that is worth!

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