ascertain the extent to which a patient is already a refugee from specialists. I have seen so many circular referrals to one sub-specialist after another where a general practitioner has been engaged not so much in a washing of hands but rather in the fashion of a desultory ringmaster. Diagnoses and interventions of a specialist, whether physical, pharmaceutical or psychological, are as likely to be over-described but poorly defined. Of course the therapist must always be aware of the challenges when treading close to the edge of her or his field, and be on guard against vanity masquerading as power of discernment. The courage shown by an individual patient or practitioner is usually greater than an institution but, against that, a committee is less likely to exhibit foolhardiness. Specialisation is in some ways equivalent to scale on a map, or to the detail revealed by the size of magnification on a microscopic slide. Moving over an ecosystem, you can concentrate on one element or its subdivision. The unit under discussion then has a name and a gradation: the cabbage on which the caterpillar grazes and the other grazers in the open field and the distinction with its borders and other natural lines that describe the landscape. One can move from meadow to stream, from wood to hillside and notice the distinct changes and the different experiences these changes engender, having changed the scale but without altering a sense of the whole.
Of course there are edges to things and events: the words limbs and limbic attest to their position at the hinge of some other structure, but the whole point about the interconnected matrices described in previous sections is that no line can be drawn between them except temporarily for the artificial purposes of exposition. The greatest biodiversity occurs at boundaries.
However convenient it may be to think of the body as a discrete object, an entity, it is more appropriate to think of it as an ecosystem, sterile only in parts. Even self–embodied elements in the blood, such as white blood cell populations, respond in part to the outside world as it presents to ducts in the skin and mucous membranes of our exposed digestive and respiratory organs. Nor is sterility the point as the mucous halo surrounding the ovum as it waits to be fertilised negotiates with the sperm to choose the next incumbent of the attendant womb. When the body is considered to be a collection of ecosystems, with organisational compartments that are fully porous, the introduction of complex material from a plant, which is what happens every day with food, would seem to an unbiased mind an obvious source of primary medication that will easily move in and between the matrices.
Essentialism
Even though I have used the word “essential” several times so far, I have used it to mean absolutely necessary to a process or an entity. I use the word “entity” because it is crucial to our survival that we recognise things, living and non-living, as discrete objects that we will have to negotiate: not bump into, trip over, be eaten or ostracised by. At the human scale, objects and beings are separate, and it would be pedantic to speak otherwise. “The world is so full of a number of things, I'm sure we should all be as happy as kings” wrote Robert Louis Stephenson, half ironically. Our world of things is so obvious and commonsensical that daily life does not stop to question it in the way that philosophers must. Their search for the reality “behind” appearances is one that consumes not just philosophers but which we delegate to them, to scientists and to the tenets of religious and other beliefs.
At the scale of deep time, Darwin's Theory of Natural Selection shows us that all beings emerge from previous forms. These slow transformations disabuse us of the previously held Platonic notion that everything that has being exists in its essential form on the plane of the ideal, a kind of ever–present afterlife. Plato deepened the division of realist and idealist with which Christians, including Darwin, have since had to contend. Darwin is the great example of observation being the handmaid of good science, philosophy, art, medicine and living. His observations were made in conjunction with the astonishing laterality of the discoveries in animal, vegetable and mineral forms catalogued by Louis Agassiz (1807–1873) and other adventurers like Alexander von Humboldt (1769–1859), Baron Cuvier (1769–1832) whose five forenames I'll not bother to list, and the extraordinary family of botanists, naturalists and philosophers led by Karl Schimper (1803–1867).
It is perhaps worth also reminding ourselves that misogyny and sexism, racism and supremacist ideas are all examples of Essentialism. In this context, all these kinds are, as Adam Phillips puts it, mystery–mongering.47
Essential can of course mean necessary to, for example, petrol (essence in French) is essential for an internal combustion engine to operate, and when lawyers stipulate in contracts that “time is of the essence”, you can see how easily one slips into essentialist mode in the Aristotelian sense of something being necessary to being called that thing, in contrast to the Platonic idealisation of the essence of a thing. Lemon oil without any limonene is unlikely to be recognised by the nose but “essential oil” was an unfortunate choice. Intuition founded on the physical leads one easily towards analysis and discovery, but this materialism does not at all exclude transcendence. Let's not have more false distinctions.
Soil
Soil is both generator of and receptor to life, a matrix with a permissive, enabling role. Contemporary conservation in these latter days of assault on Gaia tends to focus on species and habitats but, and the following point was brilliantly illustrated by Timothy Walker,48 the most durable repository of terrestrial life is as much the soil as the species that inhabit it. Soil is a macrosystem that generates microsystems: a matrix of air and moisture creates an almost infinite web of small scale enclosures.
The human terrain—the inner landscape—is analogous to the soil in that it expresses the web of material relationships that permit life to manage itself and thrive, but the limitation with this metaphor is that the soil itself is a product of natural forces and is almost the glue that binds together species of all realms. In this relational sense, terroir as viniculturists call it, might be a better analogy for terrain. Certainly, plants create and need soil not only to thrive but to maintain the other members of the consociation of their niche and of the larger associations in the ecosystem they inhabit.
As plants evaginate their structures to extend outwards into sunlight and air, and animals invaginate them to protect their metabolic processes from too much oxygen and ultraviolet, the congruence of the metaphor holds if we consider the biome of our intestines to be our soil on which our inner landscape subsists. My notion of the matrices could simply be stated as internal ecology.
Recently, a patient asked me for help with recurring cholecystitis associated, as you would expect, with gallstones. Her naturopath had asked her to test her thyroid function in case it was involved in her associated fatigue. Well, of course thyroid function would be involved just as the condition of any soil and the stresses experienced by its plants will be affected by recent rainfall and wind compared with the average. Measurements of transient conditions may confirm your expectations but offer little if any aetiological insight. As Dr Duraffourd has pointed out, a blood test shows how much thyroxine is in the blood but does not tell you how the terrain maintained those norms, nor where the costs were sustained. A terrain, like a soil, is the result of a web of dynamic relationships that change as the day, the month, the season wears on.
Gaia's children: fauns and fauna
Biotic factors as much as climate create the soil, which creates in turn the conditions for most land plants and terrestrial animals to survive and prosper. The larger the fauna, the more they impose upon Gaia. The greatest imposition is the built environment because it is not very quickly recycled and resorbed into the ecosystem, liberating its trapped but unusually degraded resources. Leaving aside bees and beavers, the special human capacity for technology and our use of metaphor create marks on the landscape that are lines of distinction, not those made by pathways. Trade routes followed geographical imperatives until the recent human past.
If the concept of the Interconnected Matrices49 is accepted, human behaviour emerges from and reformulates the matrices upon which our life is built: it declares simply that axiomatically, life cannot be disconnected from its origins in space and time at any scale or any level of analysis. There may come a point, however, when the invention (though it emerges from the matrices of human life) has become detached from it with a life of its own, or at