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The Heart of Complexity

The Dynamics of Healthy Living Systems

Ary Goldberger, M.D.

Linearity vs. Nonlinearity
  • We perceive the world as very linear... but it's really very nonlinear. Nonlinearity is the rule, not the exception.

  • Characteristics of linearity:
    1. Proportionality - Output and input are related by a straight line on a linear graph. (Turning a knob proportionally changes output.)
    2. Superposition: Global behavior equals sum of the parts

  • But nonlinear systems violate those two principles.
    • Output is not proportional to input. Abrupt changes, chaos, fractal organization, etc
    • Superposition is not applicable; components interact

  • So is your world linear or nonlinear? If it's linear, things add up; high predictability. If it's nonlinear, the whole does not equal the sum of parts (emergent properties; small changes may have huge effects; low predictability.)

  • Chaos: Just one part of nonlinear dynamics. Refers to complicated behavior from very simple systems. Very simple equations create complex outputs. It's doubly counterintuitive: simple systems generate random behavior (which blew much of traditional western science); buried inside randomness is hidden order - chaos makes patterns, which are fractals or the Mandlebrot set.

 

Fractals
  • A fractal is a tree-like object composed of subunits that resemble the larger scale structure. This internal look-alike property is known as self-similarity or scale invariance. Much of what we find pleasing in nature is fractal. Turbulence is one of the most complicated subjects in physics, but it turns out it is fractal. Mountain ranges are also fractal. Some quilt designs are fractal - self-similarity at many scales.
  • A coastline is fractal. But the more small scale detail you pick up, the longer the line is. The smaller the ruler, the longer the line! It's a paradox.
  • " An anatomy book is an atlas of fractals!"
  • Fractals aren't just physical objects in space. They are processes in time, too. (E.g., heart beats, classical music, etc.)
  • The Fractal heartbeat:
    • Healthy heart rate fluctuates in a manner consistent with fractal processs. If you look at closer scale, it is wrinkly and irregular.
    • Disease is associated with breakdown of fractal structure, loss of complexity.
  • The nonlinear mapping of Bach concertos and a healthy heartbeat are almost identical. Perhaps the root of musical genius is the ability to recognize biological patterns. It is the complexity of the human spirit, which is physiological.
  • Shakespeare recognized this when he wrote: "Ecstasy! My pulse, as yours, doth temperately keep time, and makes as healthful music
Health and Nonlinear Dynamics
  • Why is it healthy to be chaotic/fractal?
    • It leads to a large repertoire of responses.
    • It gives the capability to cope in an unpredictable environment.
    • Our system can't be too organized, but it can't be too random either. A fractal structure is a nice in-between point.

  • Concept of Decomplexification of Disease is where the output of systems becomes more regular. The loss of variability creates breakdown. Disorder is actually healthy!

 

The Final Big Questions
  • How can we restore fractal chaotic-like complexity to individuals?
  • How can we restore this same property to organizations?
  • Does your organization chart look like a tree, with nested hierarchies, or do you basically have a bunch of middle managers talking to themselves?
  • How efficiently does information percolate throughout system?
  • How varied is the repertoire of the organization?
  • Markers of Healthy Organization
    • Fractality (tree-like complexity)
    • Feedback (parts of system talk to each other in nonlinear interactions)
    • Ferment (systems are not at equilibrium)
Question and Answer
Q:

"I'm a manager of quality. My job is to decrease unpredictability. My fear is that we are overdoing it. Should we be increasing fractals?"

Ary:

"There is a paradox, because we do have to do things in a linear way. There will be a certain amount of homogeneity... but there does need to be fractal underpinning. If you overregulate, you lose creativity. Ask yourself, is this physiologic? Does the human body do this?"

 

Q:

"We have compressed all of our communications according to technical limitations - faxes, e-mail, etc. I wonder if we are over-compressing our communications."

Ary:

"Yes. There's a new stress where we get to work and have 60 e-mails. That's not physiological. How can we turn that back and get a physiological time frame?"

 

Q:

"One of the things we do clinically is restore partial variability but not complete."

Ary:

"There is no recognition of what health is. It's just seen as homeostasis. So with no definition, how do we treat people? How can we see how whole system is fluctuating? There is hidden information. Some of the greatest disasters in therapy have been in linear thinking. Extra heartbeats after a heart attack were thought to be bad... but when they tried to stop them, it was killing patients. The most effective treatment for heart attack is to lower the contractive heartbeat of the heart, which prevents it from becoming stronger. Very counterintuitive, but it works."

 

Q:

"In my practice, I noticed that if I got patients who were older out of bed and try to restore balance, they got better. Hospital people thought I was out of my mind. We are dividing people's bodies up into parts. What we do is put people in bed, minimize their variability and try to control them, getting them on our schedule. That's part of the problem with delirium in older people, I think. I'm rethinking what aging and health is, but it's politically incorrect. "

Ary:

"Aging does involve a loss of complexity. And what we do further kills what variability there is. I agree that things like exercise, music, dance therapy can further increase complexity. But drugs are bad. We're asking if there's an arc of complexity in life, where you peak at some age, and begin losing as you get older? Is there a way to prevent the decline? It's an exciting challenge."

 

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