behaviour – the chook house

November 25, 2014

Grey t-shirt and Jeans

Today I heard the tail end of Mark Zuckerberg saying he wore the same thing every day to cut down on his cognitive choices. Wearing a grey t-shirt and jeans on a daily basis gave him one less thing to think about. Rather than it limiting him, it freed him.

Some of us have more anxiety over clothes’ choices than others, but even if this gives you little stress, it can still be possible to imagine that ridding yourself of having to choose can be a good thing. A liberating thing. Sometimes this is why I would like to shave my head.

Just as the monastic life and a hairless head gives the monk more time to meditate.

I think about school uniforms and the way individuals still attempt to put their personal stamp on their dress style. The skirt shorter than allowed. The hat more bent and battered than supposed to be. The untucked shirt – a duck tail. Some of us strive to choose. But does it equate with making us more content?

Ridding yourself of choices, the program goes on, relieves stress. Even small decisions take mental energy. For this reason I am thankful to have never discovered make-up. I never have to decide on lip stick, eye shadow, powder.

I start to think about this concept for dogs. When we give anxious dogs cues to follow that result in predictable outcomes for their actions we take away some choice. This can be reassuring and decrease their stress. Modern behaviourists also like to give dogs choice. We like to give cues and signals as opposed to commands. But this is not to say that choices are easy for dogs. It does cause them stress. Especially if doing one thing ends in a result that they cannot predict. One time they jump on Johnny and everything is fine, the subsequent time they get yelled at. The next time Johnny is over there is stress around his visit. Should I jump on him or not? What will happen if I do? Perhaps I might nip him and see what happens then.

Watch the dog without direction. The one with too many choices. He is a bouncing jerking mess of mayhem. He is all over the shop – pawing, licking, barking, whining. He is seeking information as to what to do. But no one has taught him to be calm. No one has rewarded calmness in him. He is trying on lots of outfits. Red shirt, blue pants. Green top, corduroys. Loafers, no runners. Top hat, cap.

Make life simple and predictable for dogs to give them back some calmness. Give them some cognitive space. Let them be a grey t-shirt and jeans type.

October 2, 2013

Learning Theory and Facebook Likes

As I study veterinary behaviour and study how animals learn I see evidence of learning theory in action all the time.

Just take Facebook for example.

For a behaviour to continue it needs reinforcement. For users of Facebook this is what that little thumbs up “like” button is all about. Every time a photo or post receives a “like” you are spurred on to contribute more. To up the ante. To get more “likes.” People may think it is superficial or silly, but it follows the laws of behaviour. In essence you can’t help but be motivated by the positive reinforcement of the little thumbs up. When a behaviour is positively reinforced with a “like” the behaviour is encouraged and the learner even keener to see if they can get a repeat pat on the head. Compare this with a mean-spirited comment which acts as a “punisher.” (A punisher is anything that makes a behaviour less likely.) A churlish comment attacking your post might mean a retreat from the using of Facebook – a wounded learner. Think of the dog who doesn’t come when called if all it gets is a berating from its owner.

When we want animals (and children) to engage and learn we would do well to remember what is motivating. It is not inspiring to be told you are not working hard enough, or you could do better. It is motivating to hear the American phrase “Good Job”, or “Thatta boy.”

I wonder if Mark Zuckerberg knew much about Learning Theory (he did study psychology so probably yes is the answer) when he designed Facebook with its little “like” button, or whether it just came naturally to him to praise the efforts of his peers. Because the “like” button is a generous thing. Push it often. Don’t be surly about it. It doesn’t cost you. It makes the author of the post know the post was read and received with pleasure. It means they will post this way again. Just as the dog who has the best recall will return from across the oval for the snippet of liver treat. Those “like” buttons are powerful reinforcers.

But controversy exists over who really came up with the “like” button first and a Dutch company claims to be the inventors. Rembrandt Social Media has sued Facebook, asserting that the “like” button violates two patents granted to Joannes Jozef Everardus van Der Meer in 1998. But of course no one can own the idea of “liking.” It is what we humans do – we have opinions on things and we want to express them to one another. As a completely social animal it is no surprise that Facebook is such a success. People may bemoan the lack of real intimacy in today’s world but to me Facebook is a testament to the craving that people have to connect with one another.

What seems good about the Facebook “like” button is that there is no nasty alternate “dislike” button. You just say nothing if the content of a post doesn’t appeal. Just slide on past. Just as you ignore the barking dog or the dog that jumps on visitors. “Extinction” is the practice of ignoring a behaviour with the intention of it not receiving any positive feedback, it will eventually die away. What if your posts never received a Like? After many repeated check ups on your posts you would eventually tire of checking in. You would do so less often. Having no “likes” decreases the amount of time someone spends on Facebook and therefore acts as a negative punisher – absence of reward causes behaviour to decrease. Then one day you would wake up and you would not even recall your password. Facebook would have become a place of inconsequence for you.

And then there is the “share” button. This may be the most positively reinforcing button on Facebook. For a “share” denotes special love of a post. Not only do you “like”, but you “like” it enough to go that extra mile and “share” it on your page. When you ask a child to share there is a feeling of losing some of what they have and of having to divide it amongst a hoard of others. Sometimes just sharing with one is hard. Sharing leaves you with less of what you want. If there are eight people eating cake, how much do you get each? Many a mother has lamented the child who has trouble sharing their toys. Isn’t this a reason for play dates? Learning to share. But we all know the value of sharing as we grow up. There are share plates of food at restaurants which invite conviviality and conversation, there is sharing a bottle of wine, there is sharing the bed. And now in the age of the internet there is sharing information, ideas, images and, of course, words. As far as Facebook goes “sharing” is multiplying, not dividing. It is expanding and sending forth, propagating and spreading. I like to think of it as a “seeding” button. Wind and birds pick up kernels – taking them far and wide – the seeds are scattered, deposited in fertile soil and the germination begins.

September 3, 2013

Susan Friedman on Behaviour

I am forced to get off the comfy king sized bed – the urge to write overrides the laziness I feel when faced with the chore of getting on my wheelchair to go to my bag and dig out the moleskin notebook. I momentarily chide myself for not being forward-thinking enough before I got onto the bed in the first place. Being in a wheelchair teaches one the economy of transfers. But laziness and the desire to write are strong competitors, and the urge to put pen to paper wins, almost every time. This is how I know I am a writer. I do it compulsively. I don’t just want to think this stuff – I want to capture it for later when I want to recall the weekend. I want to revisit the Lego-like image of plane after plane taking off and landing across the water of Botany Bay – as I view them from my balcony window in the Novotel Sydney Brighton.

The planes are thunderously loud. They boom across the sky. At night it seems they are louder than during the day, as if the day-air somehow absorbs and blankets the sound. Chunky Sydney air – thick with moisture always – so different from Perth’s air – gauze thin. On a still Sydney night the jets crack the sky. Some dogs must hate this; living beneath the flight path. Others must habituate to the noise and become the seriously bomb-proof hounds.

Susan Friedman is an Applied Behaviourist and specialises in teaching people how to assess behaviour across all species. She has a penchant for work with captive birds. She has talked for two days solid. A true New Yorker, despite living and teaching these days in Utah. Some heavy reinforcement must have been declared, since she has turned a normally 8-week long course into a two-day seminar. “Strap yourselves in,” she tells us; peppers us with “Good Job”.

She is not speaking to the uninitiated in behaviour. It is an audience of veterinarians who are interested in behaviour or have done further study, of animal trainers, of zoological keepers and behaviour practitioners. I guess we could be considered a weird bunch; heavily analytical and deciphering. Even making her morning coffee with a new machine, Friedman, sees behaviour in everything she does.

And why wouldn’t you? It is one of those areas. The more you learn about how animals learn the more you see the world through a behaviourist’s eye. From a gnat to a blue whale – we all learn the same. Through motivation. Through being reinforced. Through wanting to move towards something or escape something else. The more we study behaviour across species the more we see the similarities, especially when it comes to learning and behaviour. There was a time, sadly not that long ago, when we concentrated on the difference between us and animals, even believing animals felt less pain than we do and hence operating on them without adequate pain relief following. That seems ludicrous now.

Susan Friedman has a simple message for all. Behaviour is what animals do – all of us – on Earth. To change behaviour is simpler than you think. What comes before the behaviour is called the antecedents – the environmental circumstances that the behaviour happens in. And what comes after the behaviour are the consequences of the behaviour itself. So, if a dog bites a hand, the bite is the behaviour, and the hand being near the dog is the antecedent and the consequence is that the hand goes away. To successfully change the behaviour we can work both with the antecedents and the consequences. We can change the way the dog thinks about an approaching hand by positively reinforcing the approach of the hand. Much behaviour can be managed by changing both the consequence and the antecedent before addressing the behaviour itself. Looking closely at the consequence of an animal’s behaviour can tell us what it was doing the behaviour for in the first place.

Having worked with delinquent children she sees the need for working ethically and changing behaviour by trying the least intrusive method first. This means we should not be reaching for shock collars when we deal with a barking dog as a first port of call. (I would say there is always another way.) Ethics demands we explore the least punitive measures first and so therefore, with our barking dog, as an example again, we should ask at what and when does the dog bark? Can we first manage the environment to stop the dog barking?

It was one of those conferences that sees you delving into the behaviour of your child and spouse and unpicking their behaviour in the behavioural assessment kind of way. And holding the mirror up too. Perhaps it is as simple as reinforcing the behaviour you want. She told the delightful story of a group of psychology students who successfully manipulated their professor to only teach from one corner of the lecture room. Whenever he moved towards that corner they became more attentive, listening and nodding, smiling as he spoke. When he moved away from that corner they looked down and uninterested, fiddled and feigned disinterest. By the end of the term he was indeed corralled exactly as they had planned – all with the use of positive and negative reinforcement.

A mantra she taught us to ask when looking at behaviour is, “What is the Function?” Use this when studying behaviour and you can see how useful it is. Perhaps when people believe they are unable to change a behaviour then it is because they are invested in the behaviour continuing unaltered.

She also talked to us to be wary of the investment in“story”. As behaviourists let us not get too caught up in how the behaviour developed in the first place. It is common for people to want to tell you stories of how a dog’s jealousy, anger or fear arose, but as behaviourists, we should concentrate more on teaching animals what to do and be less concerned on what NOT to BE. This too carries over to children who, for example, have been shown to do less well at school once a label; such as having a “learning disorder” is attached to them.

Most clients will want the tool to “stop” a behaviour that is causing them problems, when really they would be better served asking themselves what would they like the animal to do instead – and then teach it. It sounds simple and is – but this is not the same as easy – since people live in a “cultural fog” of misinformation regarding animal behaviour – from thinking animals should just do it because you have asked it of them, to believing that animals are incapable of learning anything at all.

At the end of the two days, as the organisers were getting ready to thank Susan for her talks, the fire alarm went off. Loud.Persistent. The conference could not continue over the siren. Intermittently a recorded voice came on and asked us to stay where we were and await further instructions. I thought of 9/11 and the people who died because they heeded that advice. I thought we should leave the building. Isn’t that what you do when a fire alarm goes off? After several minutes the alarms had been switched off and another announcement told us the source of the problem had been located. Susan was presented with a sculptured galah, which she sincerely claimed to love. A behaviourist till the end, she left us saying she hoped she wouldn’t be paired forever more with the piercing sound of a fire alarm. The lectures were over.

I ascended the building in the lift and could smell the smoke as I entered the sixth floor. I could see no smoke. In the corridor two heavily clad firemen stood by the entrance to the laundry. They had tracked the smoke to the laundry room where someone had set a meal aflame in the microwave. The perpetrator had fled with the burning meal and the smoke had made the alarms go off. Now there was just unmistakable taint of smoke and burnt food lingering.

I spoke to the firemen because. Because they are in yellow, with bulky suits and because they are firemen. FIREMEN. Since our own house fire, years ago, I have the conditioned response to firemen (the conditioned stimulus) of going weak at the knees and running off at the mouth. I hovered about them as they measured the smoke with their machinery. I asked them about the rule of not using a lift in a fire. They said I could use it. The lift was for them and me. They said the person who had set the meal on fire could be charged with a criminal offence if caught. I thought of the learning we had been doing moments before downstairs. Of how punishment is entrenched in the way we humans do stuff. Despite there being no injury or damage caused, the punishment inflicted could be severe. Deterrent enough to being caught. If the world could become the tiniest bit like the world offered up by Susan Friedman we could see more harmony between our species too.

August 23, 2013

Barbara Arrowsmith Young

It is a winter’s night, but not cold.

Barbara Arrowsmith Young tells us of her usual winter’s night in Canada where temperatures hover around minus forty. I wonder if she is speaking Fahrenheit or celsius. Either way it is nothing I can imagine.

But Perth people don’t really do winter or the rain.

The audience is mainly women between 40 and 50 in slacks. Like me. A queue has formed for a snappy white wine before the lecture begins. Not a skirt in sight. Trouser wearing women – practical types. Women who think they can change things – including their own and others’ brains. That’s the business they’re in. Mostly educators, psychologists. Probably mothers too.

My friend works in Mindfulness. She is well in-touch with her mind and its capabilities. She knows she needs a lot of sleep. She tells me how working with people to develop mindfulness “deepens their keel in the water.” What a steadying, comforting image. Indeed for most minds it is a rough sea out there, but what a difference a solid keel makes.

Barbara tells us her own story first. As a child she had such severe learning disabilities that she was a danger to herself. Despite so many issues she managed to learn through sheer determination and persistence. It helped that her mother was an educator and her father a creative inventor. But it was not till adulthood when she discovered the work of a physician, who had studied a patient who had had a bullet lodged in his brain, that she uncovered the source of her problems. Seeing the similarities between her own cognitive fog and that of the damaged man, she was able to locate her disability and pin-point it to the angular gyrus in the cerebral cortex. She then devised exercises to teach herself the things she could not do. She worked at the exercises, which were always slightly above her level of skill, till she mastered them and then she made them harder. She changed her brain, at a time when medicine really didn’t believe it was possible to do so.

It is accepted today that the brain is changeable. Neuroplasticity is studied and yet in schools we don’t give children the cognitive exercises that would help them to change their brains. Instead if a child is poor at hand writing we give them permission to type. She didn’t really go in-depth as to the specific exercises she has developed to help the various disorders of learning, but gave examples of how countless people have changed their brain’s functioning through the use of exercises in the areas that they have trouble with. She said people needed to lose the supports they had developed to cope with the learning disorder and approach it head on.

Again I thought of dogs.

Dogs too can change their brains. And we can be their teachers. I have a sense that changing a dog’s brain may be simpler than changing your child’s, especially since asking your child to join you in some cognitive exercises might be harder than you think. At least with a dog there is always food rewards. Just like people, dogs have the ability to learn new things. Everybody needs the right environment to learn. Dogs and children need not to be anxious, not ill, not in pain, not sleep deprived and not chronically stressed. The old adage “you can’t teach a dog new tricks” may not be true after all.

Think of the dog-reactive dog that flies into a rage every time it sees another dog. To improve behaviour it must practice being calm in front of other dogs. It is best to work just below threshold with dogs like this. We don’t want it to tip over into non-thinking dog. Brain-switched-off dog. One that is just shouting – go away, go away. But it must see other dogs to learn the new way. Neurons need to make new connections, instead of flying down the well-worn path of reactivity. I think of the laminex table and its marbled pattern – why now it resembles dendrites. A filigree of filamentous nerve endings reaching out for connections. A finger can trace the path to get from one point to the other, but the route can change. So too the destination. Left isolated, apart from other dogs, our Cujo will never improve its dog reactivity. Leaving maths alone won’t make your arithmetic better. Buying a piano and leaving it idle will not turn you into a pianist.

She described the feeling of living with a learning disorder as walking through life with a heavy pack of rocks on your back. But when people changed their brains they were released of their heavy loads. Previously difficult tasks became easy and free of stress. A stressed brain cannot relearn. At any age change was possible. For all species.

Like a dance. The neurons that fire together, wire together, and the more they fire together the stronger the connections between those neurons become. I guess this is the basis of learning. We can all do it. Change our brains to become peaceful, calm and plastic.

May 31, 2013

Doggy Dementia

Just the other day I euthanised a pooch whose owner described him as having doggy dementia. She came in with him clutched to her. He was a sixteen-year-old little white fluffy who spent his days wandering the house, soiling himself and the floor, refusing to let anyone rid his coat of the tangled matts and deteriorating into a bundle of anxious quivering. She didn’t care that he stunk. She did care that he was in pain. If she could have admitted him to a nursing home for dogs maybe she would have. Maybe not. Recently she had had to go away and she’d left him with her sister. He’d not slept for three days.

Now I am reading Rebecca Mead’s absorbing article in The New Yorker about the advanced-dementia care at Beatitudes and I can’t help but think of the little white fluffy. Dogs get dementia too.

The director of education and research, Tena Alonzo, at the unusual and forward-thinking nursing home says, “All behaviour is communication.” With dogs it is even more so, since we never have a verbal language in common to begin with. We cannot ask them how they feel. To be a vet you must watch and listen. To know dogs is to observe and interpret their body language. To understand the demented human, body language needs to be read too. Alonzo gets the staff to practice interpreting non-verbal queues on each other, by having another staff member instruct them in a foreign language. She also gets the staff to brush one another’s teeth and to spoon feed each other – this is how you come to understand what it feels like to be the resident. The dedicated take to wearing adult diapers – to get a real sense of what life might be like for a dementia sufferer.

Alonzo says, “When you have dementia, we can’t change the way you think, but we can change the way you feel.” This might be true for dogs in distress too. We could always do with a little more empathy.

She describes how a black square of carpet at the entrance to the lift might stop a demented patient entering, since people with dementia have been shown to be unwilling to step onto such a black space, imagining it to be a hole. Reading this I thought – how like the cattle grid at the farm gate. Perhaps as we slide into dementia we are becoming more akin to animals. When Alonzo talks about her own old age – she says, “when I have dementia” knowing that cognitive decline comes to nearly all of us. Most of us will go there.

She says, “one of the things that create comfort for people who have trouble thinking is space. If you are too blocked in you feel frightened.” Think again of the animal that cage guards. Lunging and growling at anyone coming near, but as soon as the gate is opened and freedom is sensed, the animal can be handled.

When a patient can’t seemed to be helped with pain killers and distractions Alonzo says, “we’re going to try chocolate.” Hershey’s Kisses are a mainstay at the nursing home, because “it’s hard to feel very bad when there’s something tasty in your mouth.” We manipulate the behaviour of dogs with food rewards and lures too. Trainers and vets have long used the momentary pleasure of food to minimise distress. Keep feeding as nails are trimmed. Offer a popsicle coated in peanut butter to be licked while a coat is brushed. We can change a dog’s perception of something it is frightened of by repeated pairings of a food reward with the thing that is the dog’s monster. All the puppies I see for vaccination are injected, mostly without ever feeling the needle, as long as they are distracted by some tasty dog treat. As patients slip into deeper dementia it is as if the primitive structures of the brain take over. There is pleasure and pain. There is fear and anger. There is flight and fight. These core parts of the brain are similar across all animals so that in the end, when we are old and have lost our cognitive function, we are not so different from a frightened dog. Or horse, or cow. We may no longer be able to operate on a high intellectual level, but we still feel. Emotion lives on, sometimes stronger, unchecked, unleashed. Patients are described as “resisting care” when really they are like the dogs who are objecting to being restrained for grooming – they just want the man-handling to stop. In the nursing home the supply of pleasurable food helps avoid conflicts and makes people feel good, just as the only thing that could quell the white fluffy’s pacing was roast chicken from the corner store.

I think about how vets have learnt a lot from paediatric dentists. Today in the dentist’s there is no fear. It doesn’t even smell the same. Fuzzy green toys hang from the lights. Toys are handed out after the clean is done. The child’s dentist is so very different from what he was like when we were little. No white coat. Now they know how to distract and comfort rather than force and bully. The nursing home is changing too. It is no longer acceptable to bomb patients with antipsychotics (developed for schizophrenia) just to make them easier to handle for staff. Rather than becoming obtunded on Haloperidol, something as simple as Panadol may be all the patient needs to feel less pain and become more cooperative. It is better to lower the bed, so there is less harm in falling, than restrain people to their mattress. People need to maintain dignity, just as animals need to feel calm. It’s all about the kind of handling. You can take them gently by the hand and lead them or you can put a collar on them and pull. Which one do you do?

Just as humans are afflicted with dementia, our pets also suffer from cognitive decline. They seem to do the same things as our human relatives do. They mix day and night. Sundowning for dogs.They wander the corridors and holler for someone to help them. They don’t know where home is. They stand in corners. They forget who their relations are. They hear non-existent noises and bark at them. They are in pain.

Seeing others. Feeling like others. When we work well, at whatever we do, isn’t it because we recognise the emotion the other is feeling? Be it animal, be it human. We aren’t as different from other animals as some humans would like to think. Connectedness. When we strive to understand what another is feeling we make great steps to knowing ourselves.

April 24, 2013

Mad Mother

In my attempt to not embarrass him, I keep my cool.

There are stairs at the entrance to the sign-in area for the GATE visual arts testing all-day workshop. Deliver me from evil. This is not supposed to be a test of a parent’s resolve, or a parent’s coolness under pressure. We have already waited as a herd of uninformed, uninstructed parents with our stressed and unenthusiastic eleven-year olds – asked to do a whole day of testing during the holidays to get into an arts program at the public school of their choosing. Everyone would rather be somewhere else (like still in bed) as opposed to at this seventies High school that resembles more a detention centre than a place of learning.

They have an arts program here too, but amongst the grey shoddy brick and the moth-eaten grass, I feel distinctly unartistic.

We follow the mistaken directions of a janitor in a fluoro vest. By luck we find a ramp that allows us access to the sign-in area where the two women are perplexed we had issues. A pin-striped suited man says he wasn’t informed someone would be attending in a wheelchair. I am a parent, I say. I need to drop my child off and pick him up. I presumed the school would be accessible. It is a government school, is it not? In the year 2013. As a community we are interested in equal opportunity and access, aren’t we? Isn’t it your job to check things are equal for all? I am speaking to people who have never encountered a problem with stairs. It never crossed their minds. Legs like racehorses. And when I suggest maybe some better signage for the other souls who stood about with us wondering where to go, she says, yes we had the same issue last year. I feel Jasper at my side willing me to shut up.

I don’t want to shut up. I want to tell pin-stripes how it is. Blonde bob too. I have the urge to push my point. To be understood. Be in my seat for a moment, looking up at you from the height of a ten-year old, and feel my rage, my frustration, my sadness, my awkwardness. Jealousy. In the end my voice a quiver. Just to get my son to the test.

He is there now. Breathe. And I am in the State Library that I still call the Alexander library – where around tables bunches of students work in groups of four or five. Through thinking doors. Entering a vacuum. Ahh books. Students are plugged into music, others have their phones by them to keep an eye on their social networks. During their short interludes of study they are silent, but mostly time is spent idly chatting, files open, pens down. Denim-clad legs all a jiggle. From the mezzanine level there is the shrill cry of toddlers and babies. Libraries are not silent spaces anymore and it seems nobody expects them to be. A dirty homeless man makes use of the nice surrounds and finds himself a comfy chair to settle down in. He carries on a conversation to himself.

I am in the medical section – pouring over neurology texts trying to make sense of the limbic system and the brain. I draw it, as best I can. I wish for coloured pencils like the ones Jasper might be using. I remember anatomy and the feared neuroanatomy lectures. How is it that something as squidgey as jelly, as unctuous as mucous, be so complex? I read about the primitive brain. The one we share with other mammals. A rat in a cage. A red light flashes and then the rat receives a shock through the floor. Next time the red light flashes the rat anticipates the shock and so now simply the appearance of the flash results in fear from the rat. You know how when you smell the antiseptic in a doctor’s surgery? This is how I feel about the sight of stairs when my child needs to be at the top of them and we are at the bottom. It is primitive. It is amygdala-based. It sets physiological events rolling and I have to rein them in with the cognitive powers from my higher brain. In the end we are all just brain chemistry.

I head out on the street to find lunch. I am not hungry, just conditioned to seek food at this time. If I were Graham I might wait till I had an appetite and it was the inconvenient time of three o’clock. The bain-maries would be empty or else diseased. I eat half the sandwich and leave the rest beneath the paper napkin. I should have asked them to remove the cheese. I’m not really fond of seeded mustard. I go back to the library past some book shops. I am drawn inside to their smell. I pick them up, finger the covers, read their opening lines, think about purchasing because I love the way that word follows that one, the perfect sentence, but think of my house and the way it risks being subsumed by tomes.

On the incline heading back to the library a woman wants to push me. She offers help. I decline it. She says, “it looks hard – the pushing.” It is. Shrug. But. I can do it. We hang on, at least I do, to the things we can do. Having her push me would be worse than she realizes. A stranger on the handles of my chair, her breath behind me. Like looking at a flight of steps. Only Jasper, and Graham, take the handles of the chair and push on an ascent. They sense the need. There is no call for them to ask, for me to accept. To some a marathon is the street. The pole vault a six inch kerb. A steep driveway is my Alpe d’Huez. I shuffle to the front of the chair to get an inch taller to reach a neurology text from the top shelf. I could ask some one. Instead I stretch. How long my arms have become.

Two girls sit opposite each other – grilling the other on the epidermis. Do you know what a mast cell does? She takes her red plastic sandals off – they are jellybeans like the ones we wanted in the seventies. Her feet could be sweaty. She folds her legs beneath her on the chair. Her heels in her buttocks. Her brain makes them do it. Her spinal cord too. Effortless beauty. I watch them. Leg envy. Maybe we don’t need to know all the fancy stuff, she says. Who cares that mast cells release histamine? Somehow I think she will need to know. Next question. Name the two stages of wound healing? To think there are only two.