In this conversation, applied systems philosopher and independent researcher Alice Jing Shan joins the Uncharted podcast to explore what happens when formal systems don’t see this wider picture. Drawing from her original work in Relational Dynamics as well as her personal encounters with healthcare - navigating complex systems as a mother, a daughter, and carer - Alice examines the unseen friction between institutional design and lived human experience.

Together, we look beyond the rigid boundaries of professional roles to ask more fundamental questions about care:

• How do downstream symptoms reflect unexamined upstream pressures?

• What happens to the invisible, unpaid labor of family caregivers who bridge systemic failures?

• How does information actively shape meaning, relationships, and emotional well-being rather than remaining neutral data? How is information closer to in-formation?

When healthcare systems focus strictly on localized problems, they risk ignoring the very conditions that produce them. By tracing how care moves through complex social systems, this conversation offers a fresh perspective on how we might invite systems that are more responsive, adaptive, and genuinely supportive of human life.

I have always had a troubled relationship with names. Not the people themselves. The names attached to them. I forget them. With astonishing consistency. You do not want me hosting a party unless someone has provided those sticky name tags.

We are told names matter. Every sales seminar, leadership retreat and networking guru seems to agree on this. Remember someone’s name and they will feel seen. Use it frequently and they will feel valued. Use it three times in the first five minutes and they may even buy something. Sales-y people are particularly gifted at this:

“Mark, it’s wonderful to see you, Mark.”

“So, Mark, tell me, Mark, what are you looking for Mark?”

Mark is looking for the exit.

There is something almost magical about names. We treat them as if they contain the person. As if somewhere inside the syllables is the actual human being. Which makes it curious that I am so bad at them.

Many years ago, I played a round of golf with an older couple who became convinced that my name was Richard. I didn’t have the heart to correct them. I surrendered: “Just call me Dick.” And so I was Dick for eighteen holes. They were lovely people. Which may tell us something about how kindness can overcome being a Dick. Perhaps being correctly named is not quite as important as we think. Or perhaps it is.

Names are in the news again.

Lake Ontario / Lake America. Before that Gulf of Mexico / Gulf of America.

The world appears to have entered a period of geopolitical label-making. It is as though the adults have left the room and the children have discovered the label maker.

THIS IS MINE.

NO, THIS IS MINE.

I WAS HERE FIRST.

DID NOT.

Maybe nations are simply very large children with better stationery.

But there is something underneath the comedy. Something tender. We become strangely agitated when names are disturbed. My social media feed is full of AI-generated videos defending Lake Ontario from its imagined transformation into Lake America. People are outraged. Patriotic. Sarcastic. Sometimes apocalyptic.

A lake has apparently become a frontline. Which is odd. Because the lake itself seems remarkably unconcerned. It continues being wet. It has not convened a committee. It has not issued a statement. The fish remain silent.

And yet something has been touched.

Perhaps the name is not simply a label attached to the thing. Perhaps the name is where the thing touches us. We know this intuitively. Call someone by the wrong name and something happens. Call them by a name they hate and something else happens. Call them a douche canoe and, depending on the relationship, you may have either initiated a fight or deepened a strange intimacy.

Names can wound. Names can seduce. Names can summon.

I rename people constantly. I give them nicknames. I make up songs about them. I insert their names into existing songs. I invent ridiculous jingles. My dogs don’t escape this practice. I rarely call them by their actual names. They have accumulated an astonishing number of aliases. And yet they know when I am calling them. Or perhaps they don’t. Perhaps they have simply learned to recognize the particular sound of my voice when I want something from them. Which raises a slightly inconvenient possibility: Maybe the name was never doing as much work as we thought.

The person exceeds the name. The dog exceeds the name. The lake exceeds the name. The name points. But it is not the thing. There is an old image in Hindu philosophy: mistaking the pointing finger for the moon. We become fascinated with the finger. We argue about the finger. We defend the finger. We form political parties around the finger and then raise a middle one to each other. Meanwhile, the moon is doing something else entirely.

Perhaps names are fingers. They point toward histories we cannot fully contain. Lake Ontario was named within Indigenous histories that preceded the invention of Canada. The name carries traces of worlds that preceded the nation-state and violent histories that the nation-state has often tried to smooth over.

The name, then, is not merely a name. It is an opening. A disturbance. A reminder that the place was here before our stories about the place. And perhaps this is why renaming becomes so charged. Because to rename something is not necessarily to change the thing. It is to attempt to change the relationship. To rearrange the story around it. To say: Look here. See it this way. Forget that. Call it this. To pin down the thing that resists pinning down.

Careless Kings may imagine that changing a name changes the world. But perhaps the world is more stubborn than that. Perhaps Lake Ontario will continue to exceed every name we give it. Perhaps the lake has no particular interest in our borders, our presidents, our so-called governors, our maps or our wounded national identities. Perhaps it is quietly refusing the whole enterprise. It was here before us. It will likely be here after us. And in the meantime, it will absorb our names, our arguments, our sewage, our nostalgia, our treaties, our wars and our summer cottages without once asking what we would like to call it.

There is something humbling about this. The lake doesn’t need us to name it. We need to name the lake. We need to place a little piece of language between ourselves and the vast, unruly thing. Perhaps naming is one of the ways we make the world feel holdable.

But sometimes the name becomes a cage. We forget that it was supposed to be a gesture, not a possession. A pointing finger, not the moon.

So I find myself wondering whether the real question isn’t: What’s in a name? Perhaps it is: What happens to us when we believe the name is the thing?

We might start believing that changing the word gives us ownership of the world. That putting a new sticker on something means we have somehow changed it. That if we can rename the lake, we can rename the history. And perhaps that is where the trouble begins: when the name becomes more important than the thing it points toward.

The lake does not need our permission to be what it is. It does not need the right name. We do. We need names to make the world legible, to make it ours, to draw a line around something vast and say: this is what this is. But the lake keeps exceeding the line. It always has. And perhaps that is the trouble with names: we mistake our pointing for possession and in doing so raise our middle finger to the moon.

What if the rare and the lasting are not opposites, but an invitation into another way of seeing? On Sept 10th, we’ll gather to explore.

MPN Awareness Day is September 10th.

MPN — myeloproliferative neoplasms — is rare. And chronic.

Two words that seem to belong to different worlds.

Rare asks us to imagine something unusual, something that doesn’t happen very often. Chronic asks us to imagine something that keeps happening.

So what kind of thing is it that is rare and keeps happening?

Perhaps this is one of the strange territories of living with MPN. Something you did not invite has found a way to stay.

It lives in the blood.

It lives in the bones.

It enters the ordinary rhythms of a life and, somehow, becomes part of the company we keep.

There is a temptation to make sense of such things quickly. To name them. To locate them. To turn them into something we can manage.

But perhaps there are things that ask for a different kind of attention.

On September 10th, we’ll gather around a Warm Data practice. Not to arrive at an answer, but to become curious about what appears when we place our stories beside one another.

• What is happening beneath the thing we have named?

• What becomes visible when we look from somewhere else?

• What might we discover about the strange companions we carry?

Warm Data is a practice of making room for the living complexity of our experience. Stories meet stories. Perspectives disturb perspectives. Something that seemed chronic begins to move.

Perhaps this is where another kind of possibility begins; not by fixing what is here, but by becoming available to what else might be here.

If something uninvited has become a lasting companion in your life, come sit with us. Bring the story you know. And perhaps also the story you haven’t found yet.

September 10th we gather and we hope what is rare and lasting in you will join us.

YOU CAN REGISTER HERE: https://www.eventbrite.com/e/1999092000989?aff=oddtdtcreator

____

Hosts:

Mark Stolow, Founding Director of People Before Patients

Francis Laleman, Certified MPN Research Foundation Patient Advocate

____

This event is being co-organized by People Before Patients and Agile Facilitation Beyond Borders with the support of the MPN Research Foundation.

Trade was once a word for crossing. For the strange generosity of things moving beyond themselves.

A thing leaves one hand and enters another. A grain crosses a border. A story crosses a sea. A life is altered by what it encounters.

Perhaps currency, before we made it into an abstraction of worth, was closer to this: a current. Something moving through us, between us, reminding us that value was never entirely ours to possess.

But something has happened.

We have become very skilled at making the living world into quantities.

We have measured the immeasurable, priced the unpriceable, drawn lines around what cannot really be contained.

And now even the seam, the place where two things meet, can become a site of suspicion.

A seam becomes a border. A border becomes a wound. A wound asks for protection. Protection hardens into separation.

And suddenly, the very lines we drew to organize the world begin organizing us.

Perhaps this is the strange violence hidden inside our abstractions:

That what was meant to help things flow can become the architecture of what keeps them apart.

He once described it as trying to pull yourself up by your own bootstraps: the very thing you’re grasping for is also the thing that keeps you tethered. And perhaps there is something of this paradox in our endless pursuit of becoming better versions of ourselves. What if the project of fixing ourselves is, in some strange way, keeping us from experiencing the fullness that is already here?

In this Uncharted conversation, I speak with Steve March, founder of Aletheia Coaching, about what becomes possible when we begin to understand change not as a project of fixing what is broken, but as a process of unfoldment - one that begins from wholeness rather than deficiency.

What might become possible if we stepped out of the endless project of self-improvement and entered our lives from a place of fullness? And how might we quiet the hungry ghosts that continually nudge us to prove our worth, while still remaining open to the mystery of who we might become?

This conversation is an invitation into that paradox: to explore how we can become without first deciding that we are not enough.

We spend so much of our lives figuring out how to be ourselves. We perform ourselves across roles, listen to ourselves speak and think, notice ourselves moving across different thresholds of experience. We see our faces reflected back at us in Zoom windows, in mirrors, in the eyes of those who love us and those who don’t. We become familiar with the contours of our own becoming.

And then someone asks us to be ourselves. As if there is a self somewhere waiting to be faithfully expressed.

But what if the invitation is otherwise? What if, for a moment, you didn’t have to be you? Not because you should become someone else. Not because there is a better version of yourself waiting on the other side of transformation. But because perhaps the borders of the self are less certain than we have been taught.

Perhaps the stranger is already here. Moving through you. Speaking through you. Arriving in you. The thought you did not intend to think. The feeling that came before you could name it. The person who changed something in you without asking permission. The place that made you feel, briefly, that you belonged to something you could not explain. Perhaps these are not interruptions to who you are. Perhaps they are evidence that you were never quite as distinctly you as you imagined.

To not be yourself, then, is not to disappear. It is to loosen. To loosen the story that says: this is who I am. To loosen the reflex to know what you think before the world has finished speaking. To loosen the need to recognize yourself in every room you enter.

And what happens then? Something strange begins to gather at the edges. A space that is not empty, but crowded with unfettered possibility. A space without the familiar coordinates of memory and assumption, where things have not yet been sorted into what belongs to me and what does not.

It is a space that loiters. It waits at the edges of the self. It does not ask to be understood. It asks only that, for a moment, you stop insisting on being you. And perhaps this is where another kind of becoming begins. Not the becoming of a more authentic self. But the becoming that happens when the self yields to no self at all.

But what if the search itself obscures what has been quietly waiting all along?

There is a different kind of becoming. One that does not ask us to transcend this moment, but to enter it more completely. Not as perfected beings, but as participants in a life that is already unfolding with extraordinary generosity. Here, enoughness is not the end of growth. It is the soil from which all genuine growth emerges.

This conversation with Jim O’Dwyer and Roger Duck did not begin with an agenda to solve anything. It wandered. It listened. It allowed itself to be surprised. And perhaps that is why something unexpected became possible.

When we loosen our grip on certainty, we create room for something else to arrive - not answers, but aliveness. Not conclusions, but relationships. Not the satisfaction of finally becoming enough, but the quiet recognition that we have always belonged to something larger than our striving.

Perhaps this is what conversations can be at their most generous. Not vehicles for getting somewhere else, but places where we remember the ground beneath our feet. Where nothing is missing. Where we discover that what we have been seeking has been patiently waiting for us all along.

In the Service of Life

by Dr. Rachel Naomi Remen

In recent years the question how can I help? has become meaningful to many people. But perhaps there is a deeper question we might consider. Perhaps the real question is not how can I help? but how can I serve?

Serving is different from helping. Helping is based on inequality; it is not a relationship between equals. When you help you use your own strength to help those of lesser strength. If I'm attentive to what's going on inside of me when I'm helping, I find that I'm always helping someone who's not as strong as I am, who is needier than I am. People feel this inequality. When we help we may inadvertently take away from people more than we could ever give them; we may diminish their self-esteem, their sense of worth, integrity and wholeness. When I help I am very aware of my own strength. But we don't serve with our strength, we serve with ourselves. We draw from all of our experiences. Our limitations serve, our wounds serve, even our darkness can serve. The wholeness in us serves the wholeness in others and the wholeness in life. The wholeness in you is the same as the wholeness in me. Service is a relationship between equals.

Helping incurs debt. When you help someone they owe you one. But serving, like healing, is mutual. There is no debt. I am as served as the person I am serving. When I help I have a feeling of satisfaction. When I serve I have a feeling of gratitude. These are very different things.

Serving is also different from fixing. When I fix a person I perceive them as broken, and their brokenness requires me to act. When I fix I do not see the wholeness in the other person or trust the integrity of the life in them. When I serve I see and trust that wholeness. It is what I am responding to and collaborating with.

There is distance between ourselves and whatever or whomever we are fixing. Fixing is a form of judgment. All judgment creates distance, a disconnection, an experience of difference. In fixing there is an inequality of expertise that can easily become a moral distance. We cannot serve at a distance. We can only serve that to which we are profoundly connected, that which we are willing to touch. This is Mother Teresa's basic message. We serve life not because it is broken but because it is holy.

If helping is an experience of strength, fixing is an experience of mastery and expertise. Service, on the other hand, is an experience of mystery, surrender and awe. A fixer has the illusion of being causal. A server knows that he or she is being used and has a willingness to be used in the service of something greater, something essentially unknown. Fixing and helping are very personal; they are very particular, concrete and specific. We fix and help many different things in our lifetimes, but when we serve we are always serving the same thing. Everyone who has ever served through the history of time serves the same thing. We are servers of the wholeness and mystery in life.

The bottom line, of course, is that we can fix without serving. And we can help without serving. And we can serve without fixing or helping. I think I would go so far as to say that fixing and helping may often be the work of the ego, and service the work of the soul. They may look similar if you're watching from the outside, but the inner experience is different. The outcome is often different, too.

Our service serves us as well as others. That which uses us strengthens us. Over time, fixing and helping are draining, depleting. Over time we burn out. Service is renewing. When we serve, our work itself will sustain us.

Service rests on the basic premise that the nature of life is sacred, that life is a holy mystery which has an unknown purpose. When we serve, we know that we belong to life and to that purpose. Fundamentally, helping, fixing and service are ways of seeing life. When you help you see life as weak, when you fix, you see life as broken. When you serve, you see life as whole. From the perspective of service, we are all connected: All suffering is like my suffering and all joy is like my joy. The impulse to serve emerges naturally and inevitably from this way of seeing.

Lastly, fixing and helping are the basis of curing, but not of healing. In 40 years of chronic illness I have been helped by many people and fixed by a great many others who did not recognize my wholeness. All that fixing and helping left me wounded in some important and fundamental ways. Only service heals.

© 1996 Rachel Naomi Remen, Noetic Sciences Review, Spring 1996 source: http://www.rachelremen.com/service.html

Over these past months I have been listening to people speak from many different places in the landscape of healthcare; people living with illness, family members, and healthcare professionals.

Every story has been unmistakably its own. We call them healthcare experiences, but the name is far too small for what they contain. They are stories of marriages and migrations, shame and courage, loneliness and unexpected kindness, childhoods that never really ended, futures imagined and futures lost. Health is only one thread woven through them.

Of course, one begins looking for patterns. That is almost irresistible. What themes are emerging? What do these stories tell us about healthcare? Curiously, the patterns rarely live inside the stories themselves. They appear in the explanations we offer afterward. We speak of patient-centered care. Humanizing care. Burnout. System pressures. Partnership. Access. Communication. Useful words. Necessary words. But the stories refuse to stay inside them.

Stories remain gloriously disobedient. They overflow every category we create for them. A story is not data waiting to be organized. It is a living ecology, continuously making and remaking the people within it. Explanations are our attempt to domesticate that wildness; to make the uncertain manageable, the singular repeatable.

But what if we resisted that impulse? What if we lingered before naming? What if we walked more slowly through the landscape of another person’s life, allowing ourselves to be changed before deciding what it means?

Perhaps the deepest practice missing from healthcare is not better diagnosis or better explanation. Perhaps it is the discipline of noticing. Noticing what has never happened before. Noticing what does not fit. Noticing the particular life standing before us instead of searching for evidence that confirms what we already know.

To listen deeply is not to move efficiently toward a conclusion. It is to accompany someone to the edges of their own experience; to the places they long to enter and the places they fear to go. Those thresholds often reveal more about health than any explanation ever could.

I sometimes wonder whether the greatest loss in modern healthcare is not simply time. It is our capacity to remain in the presence of complexity without rushing to reduce it.

Every algorithm seeks a pattern.

Every diagnosis seeks a category.

Every protocol seeks repetition.

But every life arrives as an exception.

And perhaps the future of healthcare depends less on becoming better at recognizing patterns than on recovering our capacity to meet what refuses to become one.

Recently, he told me he was struggling with patience. The moment he said it, I recognized myself.

Patience has always been elusive for me. I have spent much of my life moving toward things - projects, ideas, goals, responsibilities - with a kind of relentless forward energy. Unfinished things exert a peculiar gravity. What remains undone often calls to me louder than what is complete. Waiting can feel less like stillness and more like a low-grade agitation.

Over the years, I have examined that feeling from different angles: its relationship to anxiety and control, its discomfort with uncertainty, its desire to arrive before the journey is complete. I have come to suspect that impatience is rarely about speed. More often, it is an inability to remain comfortably inside a world of forever becoming. We want the answer before the process has finished speaking. And, it doesn’t stay quiet for long.

There have been two experiences in my life that have transformed my relationship with patience more than any others: moving to the countryside and practicing bonsai. At first glance, they seem unrelated. Yet both altered my experience of time and space.

When you live far from everything, distance regains its weight. An errand becomes an outing. A visit requires intention. The world stretches. The expectation of immediacy begins to loosen its grip. You stop measuring life exclusively by efficiency and begin to experience it more through rhythm.

Bonsai teaches a similar lesson, though in an even more intimate way. A tree does not negotiate with your timetable. A branch may take years to reveal its direction. Growth arrives gradually, often invisibly. Attempts to hurry the process usually leave scars. The tree teaches, again and again, that things unfold according to realities larger than desire.

Golf belongs to this family of practices as well. The ball does not care how badly you want the shot. Progress refuses coercion. Some lessons require repetition. Others require time. You can practice diligently, study carefully, and remain fully committed, yet improvement still arrives on its own schedule.

This is why I think patience is often misunderstood. We tend to treat it as a psychological skill, something that can be summoned through discipline or restraint. There is truth in that. Patience certainly has an emotional dimension. Restlessness, urgency, frustration; these are all energies that deserve our attention. But the deeper shift occurs when we enter relationships and practices that reorganize our sense of time itself.

Certain pursuits invite us into a world where growth cannot be rushed, where outcomes emerge slowly, and where the process matters as much as the destination. In such places, patience ceases to feel like deprivation. It becomes a form of participation.

Watching my nephew struggle with patience, I found myself hoping he discovers what I am still learning. Patience is not simply waiting calmly for what you want. It is learning to inhabit time differently. The tree grows when it grows. The swing arrives when it is given space to arrive. Life unfolds according to rhythms that rarely conform to our preferences. The task is not to force the process forward, but to create worlds large enough to live inside it.

The term is usually meant to distinguish one kind of knowing from another: the knowledge that arises through a person’s life and the knowledge produced through scientific inquiry. One is considered personal and subjective; the other objective and generalizable.

A rainbow offers a familiar example. Your experience of seeing one is singular. The physics of light and water droplets can be tested and verified. Both reveal something true. Neither diminishes the other.

Yet I wonder if the distinction itself has quietly become misleading.

Many traditions of inquiry, ancient and contemporary alike, have long suggested that experience is never simply housed within an individual. It is relational. It emerges between bodies, histories, cultures, ecologies, and worlds. Experience is not something we possess. It is something continually unfolding.

Perhaps, then, we need a different phrase.

Not lived experience, but experience that is alive.

The difference is subtle but profound.

“Alive” has no opposite here. There is no such thing as dead experience. Experience exists only in the ongoing movement of life meeting life. It is always changing, always responding, always becoming.

This is what draws my attention in healthcare.

Not merely what happened to someone, but what is happening now. What comes alive between a clinician and a person. What is spoken, what remains unsaid, what shifts in posture, tone, silence, hesitation, curiosity, relief. The living moment carries an extraordinary density of information that no record, diagnosis, or questionnaire can fully contain.

We necessarily abstract experience into categories, diagnoses, measurements, and evidence. These are indispensable tools. But they remain maps, not the territory. They help us navigate life without ever becoming life itself.

If we begin to attend to experience that is alive, healthcare changes. The question is no longer simply, What is your lived experience? It becomes, What is alive here, between us, now?

In that living field, the boundaries between me, you, and it become more permeable than fixed. Something is always crossing those borders; emotion, meaning, fear, trust, memory, hope. Those crossings are not noise in the system. They are the system speaking.

And perhaps the future of care depends less on becoming better collectors of experience than on becoming more faithful participants in its aliveness. For it is there, in what is coming alive between us, that new possibilities for healing first begin to appear.

We are curious about what is alive in your experience. Dialoguing is a new People Before Patients initiative exploring the stories, tensions, and possibilities that emerge in healthcare encounters. If something in you is stirred by this invitation, we'd love to hear from you.

The name of the organization might give you pause. It invites an immediate question: When did the climate develop a psychology?

That question opens into a much broader conversation about how we understand mind, not as something confined to the individual, but as something that is always shaped by relationships, culture, and the living world.

Many dominant approaches within modern psychology draw sharp distinctions between individual and collective responsibility, and between inner experience and outer conditions. While these distinctions can be useful, they can also reinforce fragmentation, polarization, and the pressure to choose between opposing positions. Complexity is flattened into either/or thinking, and nuanced challenges are reduced to simple solutions.

How do we make room for voices that appear irreconcilable but are all implicated in the same unfolding reality? Steffi explores practices that widen the field of attention, creating space for complexity, context, and relationship. Her work invites us to navigate a richly textured world where our conceptual maps remain in dialogue with the territory they seek to describe.

I care for four outdoor cats and they care for me.

They are family, and it brings me joy that they belong not only to this home but to the larger world. Beyond my walls they are woven into an ecology that includes raccoons, feral cats, birds of prey, and coyotes, and the strange mechanical creatures that move on two, three, and four wheels.

Life outdoors is not simply life with more risk. It is life in deeper relationship.

The ecology of a home is curated. The ecology beyond walls is not. It asks everyone within it - human and feline alike - to become attentive to a world that cannot be arranged around our preferences.

Outdoor cats cultivate that attentiveness. They draw me into the rhythms of weather, the movements of traffic, the migrations of birds, the hidden pathways of other animals and there’s. I have sometimes just followed them around so they can show me where they go. They make my surroundings feel inhabited rather than merely occupied.

This is a different practice altogether from the familiar idea of owning cats between four walls.

Domestication has always been a politics of boundaries. It narrows variables until they become manageable. It offers places where love can settle safely and where grief is less likely to arrive uninvited. Outdoor cats undo those boundaries. They open worlds.

The variables multiply. Love stretches across a wider terrain. Care becomes less about possession and more about participation. Emotion lives a little closer to uncertainty, and with that uncertainty comes a different kind of intimacy.

I am not arguing that one way is better than the other. Indoor and outdoor lives are not competing moral systems. They are different practices of relationship that happen to share the same name: tending to cats.

I wonder whether this distinction reaches far beyond our relationships with animals.

We domesticate many things. We tame ideas into ideologies, living traditions into institutions, and vibrant practices into systems of governance. We often mistake what is controlled for what is valuable simply because it appears predictable.

Healthcare offers one example. Sterilization has transformed medicine and saved countless lives. Yet we are also learning that indiscriminate suppression of microbial life can diminish the rich ecology upon which our immune systems depend. The more completely we seek to master a living system, the more we risk losing our conversation with it. Control and vitality are not always companions.

Perhaps this is true more broadly. Wherever we build walls to keep uncertainty out, we may also keep relationship out. And what we exclude does not disappear; it simply returns in forms we no longer know how to meet.

Living with outdoor cats has become a practice of remembering this.

They ask something different of me. They ask for patience instead of certainty, attention instead of surveillance, participation instead of control. Through them I become more attuned to the life unfolding beyond my four walls, to the beauty and precarity of a world that refuses to be fully domesticated.

There are still moments when I want to gather them in and build higher walls around them. But the wilder parts of me are slowly learning another way. They are learning to feel at home on the wider edge of life, where care is measured not by how completely we control what we love, but by how fully we accompany it as it moves through the world.

By that, I mean people who possess a particular way of seeing the trouble we find ourselves in. They notice what others overlook. They recognize the forces that pull us toward easy assumptions or comforting illusions, yet they work to resist that gravitational pull. Their concern is not simply with what appears to be real, but with what is real.

There is a richness to their perception that I find deeply illuminating. It awakens something in me; a persistent impulse to look more closely, to question more carefully, and to understand more honestly.

Over time, I have noticed that many trouble-finders are also deeply attuned to trouble itself. They carry a kind of vigilance, a steady watchfulness that is always scanning the horizon. In the blunt language of clinical psychology, we might call them anxious, although that language can easily overlook context and other nuances that a singular clinical frame can miss.

Yet the presence of anxiety in some trouble-finders is more than a restless desire for things to change. It functions as a kind of radar, remarkably sensitive to the earliest signs of trouble. It detects patterns, vulnerabilities, and fractures long before they become obvious.

The difficulty is that radar is not the same as discernment. A finely tuned detector can identify genuine danger, but it can also mistake shadows for substance. It can discover trouble where it exists and, just as easily, create trouble where none was waiting to be found.

In a world burdened by overlapping crises, the work of trouble-finding has never been more valuable. We need people who can see clearly what others would rather ignore.

But those who tend to trouble face a difficult responsibility. They must cultivate their ability to perceive what is wrong while also learning to temper the instinct that sees danger everywhere. They must care not only for the work of finding trouble, but for the habits of perception that can quietly manufacture it.

This is no easy task.

Trouble invites worry, and worry has a way of feeding itself, tightening into an anxious loop. Many healthcare professionals know this knot intimately, though it is hardly unique to the caring profession. It appears wherever people are called to notice what is fragile, vulnerable, or at risk. That includes those thinking and feeling spaces we may overlook in our anxious gaze.

Perhaps this is why the backdrop to trouble is not certainty, but clarity.

Clarity does not deny the existence of trouble, nor does it become consumed by it. It sees what is there, not adding more nor subtracting less. It allows us to distinguish between what demands our attention and what merely demands our fear. The finest trouble-finders are not simply those who can see and sense distortion. They are those who can remain clear-eyed enough to know what is alive in the difference.

Not because it’s pleasant. Not because it’s fair. Not because you’d wish it on anyone. Just because, it makes sense.

A client arrives carrying sadness like an overpacked suitcase.
Makes sense.

An organization spends another year having the same strategic conversation with newer slides.
Makes sense.

You and your partner find yourselves arguing about money again despite sincerely promising to yourself the last time was the last time.
Makes sense.

A low hum of unease follows you from Monday into Friday with relief promised on Saturday and Sunday.
Makes sense.

A room full of thoughtful people can’t agree on what the future should be.
Makes sense.

It’s almost disappointing, really. We’d much rather discover that something has gone wrong.

Healthcare, like much of modern life, is remarkably efficient at turning situations into problems waiting for repair. By the time people first arrive in coaching or counselling, they’ve often rehearsed the diagnosis so thoroughly they can deliver it without notes. Occasionally they ask me how many sessions it will take to fix themselves. Time, it appears is another problem waiting to be solved.

We’ve become experts in the problem frame. We introduce ourselves through what’s not working. We market our suffering with remarkable clarity.

The trouble with a problem is that it immediately recruits a fixer. And once the fixer arrives, every conversation starts marching toward a solution, even when the terrain is trying to tell us something else.

So I find myself asking a different question: If this wasn’t a problem, what would it be?

The question feels strangely spacious.

Problems have a way of locking things up. They place bars around experiences and appoint us lifelong wardens. But what we imprison doesn’t disappear. It rattles the cage. It makes noise. It waits patiently until someone mistakes the rattling for another problem.

Perhaps what we call problems aren’t holding us captive. Perhaps they’re simply revealing the shape of the web we’re already caught in.

Anxiety in an anxiety-producing workplace isn’t evidence of failure. It’s a remarkably intelligent adaptation.

Endless arguments about money in a culture built on scarcity and demanding consumption may be less a communication problem than an honest conversation with the world we’ve inherited.

Impossible decisions in a world full of double binds are, inconveniently, exactly what we’d expect.

Makes sense.

We’re often less defeated by problems than by the entanglements that produce them. We rarely notice the webs we’re woven into because, from the inside, they look suspiciously like reality. Stranger still, we’ll defend those webs with surprising determination, even when they cradle our deepest fears.

Which is why “Makes sense” isn’t resignation. It’s an invitation.

Not to stop changing things, but to stop pretending that problems are our captors and we are their prisoners. Dressing yourself up in thick pinstripes is a sure fired way to create traps that your current world cannot escape.

Once something makes sense, we can become curious about the converging conditions that made it so. And curiosity has a much better change track record than fixing.

I’ve noticed something stranger still: I seem to be practicing it. And the more I practice, the less failure resembles the thing I once feared. It begins to look suspiciously like freedom.

What I have come to, for now, is this:

I am practicing failure. There is no failure.

People I coach often tell me while practicing new worlds: “It feels like two steps forward and one step back.” Others insist it’s “one step forward and two steps back”. Either way, I’m relieved to hear they’re dancing.

Failure has inherited a terrible reputation. Much of the story of “how to live” revolves around success as a moral imperative.

And yet, there is…

The project that collapses under its own ambition.

The ceramic bowl that softens into a puddle in the last few turns of the wheel.

The life that once fit so well and, one ordinary morning, no longer does.

The bonsai that dies; from a storm, from a fall, from a misstep.

Recently I spoke with a physician whose résumé could quiet almost any room. He told me, with complete sincerity, that everything he had devoted himself to, everything the world would call good work, had somehow left the world worse than he found it.

I didn’t argue. Instead, we found ourselves speaking about the practice of dying.

Which, if you stay with it long enough, becomes indistinguishable from the practice of living.

Perhaps this sounds cynical. Or perhaps it sounds like another polished version of “failure is how we learn.”

I mean neither.

I’m interested in the place where success and failure lose their names. The place where life simply keeps life-ing.

Somewhere along the way we learned to divide experience into success and failure, gain and loss, progress and regression, as though life itself were keeping score. It’s not.

The universe seems remarkably uninterested in the distinction.

Leaves do not fail when they fall.

Rivers do not succeed by reaching the sea.

Stars are not diminished because they burn out.

They simply complete the shape of what they are.

The Tao Te Ching offers this:

Therefore the Master

Acts without doing anything

And teaches without saying anything.

Things arise and she lets them come;

things disappear and she lets them go.

She has but doesn’t possess,

acts but doesn’t expect.

When her work is done, she forgets it.

That is why it last forever.

You will not last forever. Nothing you make will last forever.

What saves you today may burden you tomorrow. What burdens you today may one day save you.

You were made for obsolescence. Not by accident. By design.

Why should that frighten us? Why does it feel, instead, like the first honest breath?

A fish cannot escape water by swimming harder. You cannot outrun failure by trying harder.

Trying is another current.

Failure is another name for living.

And because life never finishes, neither does the practice.

What lasts forever has no regard for succeeding or failing.

That is the grace of being fully alive. That is the grace of being built to end.

A little while back, I came across a post by Nora Bateson about a Quebec music duo called Angine de Poitrine. It took a friend living in Sweden to draw my attention to something beautiful growing in my own backyard. I have been listening ever since, including while mowing my lawn in circles rather than straight lines.

This relatively unknown Quebec duo has since become a major musical sensation, drawing more than 100,000 people to an outdoor performance at the Montreal Jazz Festival. The year before, they played to a modest crowd of roughly 2,000. Their rise in public visibility appears to have been accelerated by an online video of a live performance recorded at a radio station. Don’t skip the comments section — it’s at least half the experience.

This is not an attempt to explain their popularity. Anyone who claims to know precisely why they have become so successful is likely underestimating how complex phenomena unfold. Their emergence is thick as a thicket: there is no silver bullet, no single causal thread to tug upon. Reductionist explanations will no doubt be offered, but they are unlikely to catch all that matters in their net.

Instead, I want to talk about worlds that polka dot; the signature pattern of the duo, who claim to be from another planet.

Polka dots are hardly new. The internet tells us that polka-dot patterns emerged as a nineteenth-century fashion trend. But who knows when the first circle was drawn by hand, or the first constellation of dots began to gather meaning.

For a music duo with such a quirky and fresh style, the choice of polka dots as the defining texture of their world seems curious. Polka dots are not especially alien, and their rhythm is almost conventionally monochromatic. I have no idea why they chose to cover their world in them, and anything I say would be speculation. What fascinates me more is why the pattern holds our attention so carefully, so completely.

People often describe the world visible in my Zoom background — otherwise known as my office — as monochromatic. That seems fair enough. It has its own simple, alternating rhythm. It is not polka-dotted, but it does carry a more predictable cadence, a steadier beat.

In the documentary Shangri-La, we are given a glimpse into the studio world of Rick Rubin, the renowned music producer whose work frequently circles back to the creative act itself. His studio environment, while eccentric in some respects, is remarkably stripped back: meticulously maintained, carefully ordered, and free from distracting aesthetics. It feels closer to a Zen monastery than a recording studio. Between clients, he repaints it white and dusts every knob, crook, and corner until the room itself seems to exhale.

Recognizable patterns, like polka dots, and creative acts often seem to arrive together, coherence and difference riffing beautifully with one another. The foreign flavor of Angine de Poitrine is wed to the cadence of black and white. To be alien, it would appear, requires a distinctly on-and-off rhythm.

It is tempting to think of difference and sameness as pulling against one another from opposite ends of reality, each the gravitational opposite of the other. And yet, reality seems to suggest otherwise.

A melody needs rhythm. A conversation needs turn-taking. A forest needs seasons. Even improvisation leans against some kind of structure, however lightly held. Pure sameness suffocates; pure difference dissolves into noise. Creation seems to happen in the shimmering interval between the two.

Perhaps this is why polka dots work so well. They are not merely decoration, but cadence made visible: repetition with room for surprise. Every dot is familiar, yet no landscape made of dots is ever encountered all at once.

This feels close to what Nora calls Warm Data: the understanding that meaning lives not in isolated pieces but in the relationships between them. A species cannot be understood apart from its ecosystem, a child apart from family and culture, a song apart from the room, the audience, the season, the moment in which it arrives. The interesting information is often found in the patterns that connect, the dots holding each other in place.

Maybe this is why attempts to explain Angine de Poitrine’s emergence feel so unsatisfying. The question is not which dot caused the phenomenon, but how so many dots came to matter together. A ruse. A radio session. A festival crowd. Quebec. Algorithms and AI. Longing for the alien and the novel. Humor. Timing. A friend in Sweden pointing back toward home. The story is thick with polka-dotted relations.

The lawn mower circles. The studio walls are painted white again. A crowd of two thousand becomes a crowd of one hundred thousand. Somewhere between coherence and difference, something begins to sing.

Worlds, it seems, do not spread by erasing difference or by celebrating novelty for its own sake. They spread when they find a pattern that others can enter without needing to become the same.

Perhaps that is what polka dots are: not decoration, but invitation. A way for many lives, histories, and contexts to remain distinct while still participating in the same rhythm.

A warm-data world seems, fittingly enough, polka-dotted.

Together we wandered through questions of creativity and constraint, the inheritances of modernity, the patterns that hold systems in place, and the forms of difference that open new conditions for emergence. We explored the assumptions that stabilize healthcare while simultaneously narrowing the range of ways we might attend to care, relationship, and the living world.

Jason and Iain’s work through Emergent Futures Lab has cultivated a rich practice around creativity as a mode of participation in the making of worlds. Their community, Worldmakers, offers an invitation to keep difference alive, not as an abstract ideal, but as a practice that can be carried into the everyday textures of our lives and work.

Jason and Iain are among a remarkable group of guides who will be joining us for Listening for Tomorrow, a gathering starting later this year dedicated to sensing into the futures already seeking expression through the present.

For listeners who want to explore further:

• Emergent Futures Lab

• Listening for Tomorrow participant wait list

Recently I was with a group talking about the challenges unfolding across our work and lives.

One person described rebuilding their website from the ground up — new structure, new orientation, new language. They sent it to friends and colleagues who knew their work well and asked for feedback.

Most of what came back was criticism. What puzzled her wasn’t the criticism itself. It was the absence of delight. Why did no one write back to say: This is exciting. This feels alive. This sounds like you becoming more than yourself. Why no love?

Having grown up in an anxious home, I know the anxious mind well. Years spent in the atmosphere of a vigilant nervous system make its logic feel familiar. The anxious mind is a strange companion: comforting and exhausting in equal measure. There is reassurance in believing that someone is always on watch. The anxious mind patrols the perimeter endlessly scanning for danger, contradiction, embarrassment, rejection, exposure. It notices what doesn’t fit. It anticipates what could go wrong. It edits reality before reality can wound you. It protects through criticism. Like an overbearing partner, it loves through control.

I suspect many of the people offering feedback were acting from exactly this place. They were not trying to diminish her work. They were trying to protect her from misunderstandings, mistakes, or humiliations that novelty can invite. The anxious mind makes excellent guardians and poor explorers. Its genius is pattern recognition. Its weakness is possibility. The very habits that keep us safe inside familiar territory become liabilities when we step into the unknown.

When she asked, “What do you think?”, many people heard something closer to: “Using the categories you already have for me, tell me whether this fits in my world as you know it.” And the mind dutifully complied. It gathered everything it knew about who she had been, combined it with its instinct to protect, and produced a torrent of reasons to retreat toward familiarity. This may have been one of those moments when feedback from outsiders would have been more valuable than feedback from insiders. People untouched by the old map are often better at seeing the new territory.

Each of us lives inside a world with its own rhythm and logic. We mistake that world for reality itself. The anxious mind is one of its custodians, preserving the known, defending its boundaries, guarding its assumptions. Sometimes that protection feels like warmth. Sometimes it feels like suffocation.

To invite novelty into a life requires noticing the anxious mind without surrendering authority to it. It means loosening the conviction that everything unfamiliar must first be controlled, managed, or measured against what came before.

The practices that have helped me most are simple, though not easy:

Learning to observe the movements of the anxious mind, disclosing its tendencies, and deliberately practicing worlds larger than the one is used to protecting.

Perhaps maturity is not learning to silence the anxious mind but learning to place it in the passenger seat. It can point out the potholes and weather ahead. It can remind us where we have been hurt before. But it cannot be allowed to choose the destination. The anxious mind is a gifted guardian. It was never meant to be the cartographer of possibility.

This fall we hope to gather people from across Canada to explore a difficult question:

How do we invite a different future for healthcare?

A more beautiful future, perhaps. Though beauty has many dialects.

We have called this gathering Listening for Tomorrow.

Tomorrow is easy to understand. Listening is more elusive.

We often imagine listening as receiving information. But listening may be closer to excavation.

Every conversation is a landscape with visible features and buried rivers. Words sit on the surface.

Underneath lie assumptions, fears, loyalties, incentives, memories, absences and possibilities that shape what can be spoken and what remains trapped underground.

Listening is the practice of digging carefully enough to discover what the conversation itself does not yet know it is carrying.

What futures are buried beneath our current stories of healthcare?

What possibilities have been paved over by urgency, efficiency, and habit?

What forms of care exist in the margins because our institutions have forgotten how to recognize them?

The challenge of creating new futures is rarely a failure of imagination.

More often it is a failure of attention. We cannot build what we cannot perceive. Listening, then, becomes an act of uncovering.

Not merely decoding what is said, but refining the instrument that does the hearing. Because every instrument hears a different world and the symphony of a better tomorrow will be orchestrated together.

If the possibility of a more beautiful future for healthcare wakes you up, consider joining our participant wait list (scroll to the bottom of the page).