“I am the wisest man alive, for I know one thing, and that is that I know nothing” - Socrates

This week, I’ve been struck down by some lurgy - a fruity cough, fever and the rest, which has laid me out for a few days. Between bedsheets, I’ve been catching up on a pile of BMJs (British Medical Journal). Something caught my eye in the 4th May edition—a piece on page 144 on psilocybin.

The Best Teachers

The article brought back memories of a man I met fifteen years ago when I was a GP trainee. It reminded me of how much we know and don’t know in medicine. He came in to tell me something revelatory—six months before, he’d experimented with magic mushrooms for the first time, had a trip, and that, ever since, he’d had a sustained lift in his lifelong depression that was quite remarkable.

He asked, “Is this normal? Has this ever happened to anyone else?” I replied that I hadn’t ever heard of such a thing. I was glad he felt better, but I couldn’t explain it. I remember this patient so clearly, and I find myself thinking of him often, especially with the growing interest in psychedelic therapy for mental health today.

My GP trainer always said that our patients are our best teachers, and it’s true. Since patients rarely present in textbook fashion, we have all to learn from their complete individuality and unique stories, something we could never hope to learn from theory.

How Do I Kn🤯w?

This pondering of what I know, what I believe I know, what I don’t know, and what none of us know had me thinking about a recent debate with colleagues about how we determine what is true and reliable

—how do we know what we know?

If we consider health and well-being, whom should we listen to and trust right now? Doctors? Then which ones? Or wellness influencers, the media, naturopaths, family members, or yoga teachers?

Dr Florian Ruths, Psychiatrist and head of the Maudsley mindfulness service in South London, says that there are three ways we gain understanding, knowledge and truth, and it’s a nice way of looking at things:

• Eminence-based: I trust what others say because of their reputation and credentials.
• Existential/Experiential: It works for me based on my own direct experience.
• Evidence-based: It is supported by statistically significant empirical evidence.

Doctors are still among the most trusted people in our society. I suppose it’s because they rely on evidence which advertises a degree of certainty whilst developing a bit of eminence in their field. We have confidence that they will steer clear of overclaiming and avoid giving advice based on bias and belief of one.

But this has limitations. Just because we don’t have evidence doesn’t necessarily mean something doesn’t work—perhaps we haven’t examined it to the standards that we require.

And if evidence is the only measure of reliable truth, should this invalidate an individual’s experience, however unorthodox or unmeasured, like that of the man who told me of his mushroom trip years ago?

Experiments on One

Yoga is one area where I can freely explore existential knowledge more than the evidential without judgment or consequence, just for myself. At its heart, yoga is a profoundly personal exploration —a practice whose outcomes need no validation from external jurisdiction. Being fully invested and alert to whatever happens is enough, where there isn’t a right or wrong, only experience.

Though yoga, too, is a great portal of learning and is based on the eminent guidance of others who have gone before, our firsthand experience is something no scripture or teacher can implant. Direct experience goes beyond theory and embeds the truths of our own discoveries, whether that’s an awareness of our big toe or a spiritual encounter in meditation (or with a psychedelic, for that matter).

Yoga teaches you to try out what is known, tested and beloved. But the mat space and time are places of experimentation, empowering the inner teacher to choose for oneself. Truths are made and broken, and both confusion and enlightenment are honoured.

Existential knowledge is underrated if you ask me.

Not Knowing

Coming back to the memory of the psilocybin patient and the recent BMJ article - I’m struck again by how much we know and do not know. How desperately, in this age of information and easy expertise, we require nay demand certainty.

So, I diligently save up my BMJ so I’m up to date on everything I could and should possibly know. I also try furiously to mine my inner wisdom by diligently practising introspection through yoga.

Yogis sometimes describe themselves as seekers; perhaps this expresses a yearning to find truths, whatever they may be. If I am indeed a seeker, I might have expected feelings of uncertainty to unnerve me. Paradoxically, however, I seem to have chosen a medical speciality where not knowing is practically the job description: GPs, aka masters of uncertainty.

Even weirder still, having stepped on the yogic path in the hope of discovery and self-discovery, it’s through this particular existential process that I have come to one conclusion (in my experiments on one) - the truth and beauty of not knowing.

Does this mean I’m getting wiser? Coming to terms with the fact that I know nothing about anything at all? I don’t know what it means, but I do know...

It’s liberating.

Let’s practise.