Alasdair Gray's 2010 collaboration with Pringle of Scotland is not wholly comparable to Gorbachev's advert for Louis Vuitton. But it is odd. I like it, though.

It was terrible - in terms of the British Constitution if nothing else - when Prince Charles's letter-writing got the Qatari Royal Family to drop Richard Rogers' design for Chelsea Barracks. Our Prince's desire to protect the loyal citizenry from those modernists like Lord Rogers, with their monstrous carbuncles, was not just over-reaching personal preference. It was symptomatic of a folksy merrie-old-England philistinism that infects this country still. Even Cool Britannia did not get rid of it.

I am so pleased, then, that Dundee is building something outstanding with the new V&A by Kengo Kuma. (http://VandAatDundee.com/your-future/PDF/KengoKuma_full.pdf) And Aberdeen is planning something bold - we don't know what yet - in Union Terrace Gardens.

Fortunately, Charles doesn't own all of London. Rafael Viñoly, a favourite architect of mine, whom I have drawn a sketch of in pencil, has designed something bold for 20 Fenchurch St in the City.

Cognitive therapy, and the cognitive revolution in general, freed us from the limits of both psychoanalysis and behaviourism. Freud and Skinner each in their own way devalued the thought, which cognitivists think is ineluctable, revealing and valuable. However, it is not to devalue thoughts to say that they are not all equal qualitatively. It may be a brave step for a cognitivist to take, especially since is merely an untestable introspective observation.

Obviously, not all thoughts are created equal. Some are profound, coming at the expense of great psychic effort. Others are about dinner. The President of the United States' thoughts can influence war and peace; a hermit's may never influence another person directly. But even when dealing with the same issue, a person can have two dissonant thoughts without hearing the dissonance. Is that because one is "louder", or more valuable, or even more convenient? Not always, in my experience. Thoughts can feel different.

When an exam is coming, I know that I have it, but put off studying. In abstract: I have the thought of the impending exam, and the thought of the importance of studying, but fail to structure my activity around that second thought. It has value to me - I do not ignore it - but it fails to be an efficacious thought. Then, at some point, and without cue, I feel a great emotional desire and cognitive imperative to study. I already knew that I had an exam coming, but at that point I know it in a deeply affective way that structures my behaviour, not to mention holding my emotions and sympathetic nervous system in its thrall.

To me, that represents best my observation that thoughts exist in two ways: a superficial and purely cognitive way; and a deep, cognitive-affective way that structures other thought. I would call the former a superficial thought and the latter an embedded thought.

I have seen similar in my very limited exposure to patients with phobias, or even in patients who have insight into hallucinations. I wonder what literature addresses this phenomenon.

I know that it is a complex issue. I do not claim to have the final word on the riots in England with this cartoon. But what struck me most strongly was that the riots were ever so slightly oriented around the axis of Owning Stuff.

This quickly-done cartoon is in Indian ink, with watercolour tint.

The Wikipedia Lesson of Dr Nicolaes Tulp, ink on paper, which I drew with this in mind.

For many of us, Wikipedia acts as the "front page" for most ideas. We visit it first. It is perhaps understandable if Wikipedia starts to be referenced in academic texts, but that is in itself a very big step. As the affair I describe here shows, it is a perilous one, and it is not clear why one should do it instead of referring to original sources. On Twitter a few months ago, Anne Marie Cunningham mentioned an academic paper she had read, which referenced the theory of the Four Stages of Competence.This is a model of learning widely used in medical and business pedagogy, but the paper talked about a fifth stage of the theory, and referenced Wikipedia for this. Naturally, Dr Cunningham was quite surprised, and posted this here, here and here on Twitter. However, the Wikipedia article it referenced had no mention of the fifth stage at the time she accessed it. Because of this, a few of us on Twitter started looking a little further. Anne Marie Cunningham linked to Business Balls, which gives a long and detailed discussion of the theory.

We found that the mention of the fifth stage was there, but had been removed. We also found that the theory is often attributed to Abraham Maslow, but it seems that there is no citable material on the Internet to support this, and it is not in his main works in any case. However, there were some decent references linking the theory to Noel Burch, a former employee of a Gordon Training International, a human relations training organisation of San Diego County, California. I attributed the theory to Burch and the organisation on Wikipedia. After doing so, I had hoped to expand the Wikipedia article, and did slightly. But it is still a stub, and there was very little in the way of citable material on the Internet that I could use to support any more writing. The little material there was tended to mention that other authors besides Burch and GTI had added a fifth stage of some kind, so I added the section back in.

The Dynamic Reference

By adding it back in, did I not make the academic paper more valid? It is an intriguing thought, and one that belongs to the wiki age, but perhaps to no age before it. Obviously, any reference is only to the Wikipedia page as it was at the time it was read. That is why we put dates of access. But that is not how Wikipedia is used: it is constantly changing, and only the most responsible and oddest of people would trawl through past edits, and regard them as wholly valid, while discounting the current and presumably most evolved version of the page.

The academic paper was certainly lacking when following its references lead to a dead end, so in a sense, I did improve that paper, while of course being nothing to do with it. If people keep referencing Wikipedia, it therefore raises a mildly thrilling prospect in academia. The community could improve an article written by someone, just by improving the quality of the material it cites.

Cite Uncite

Not long afterwards, though, I found that a Wikipedian, Gti123, had removed the reference to the fifth stage again. I looked at Gti123's edit history, and found that they had only edited articles about Gordon Training International, or Dr Thomas Gordon, its founder. I posted a message to the user talk page explaining why I felt the fifth stage should stay, which was because I felt it had encyclopaedic value. The section on the fifth stage has since remained. Recently, on Gti123's talk page, the user said that, as I suspected, they were from Gordon Training International, and that the account was operated by Linda Adams, President and CEO, whose late husband is Thomas Gordon. I can see from her website that she is a well-trained social scientist who, along with her daughter, continues her husband's work with dedication.

It is clear that Ms Adams was performing a good service by trying to increase the amount and accuracy of information online. Of course, she knows more about GTI and its learning model that anyone else does, and is to be lauded for trying to make that information public. Indeed, she mentioned that she had been in touch with the late Noel Burch by email on this particular matter.

Certainly, though, I had a wider idea of what is germane to an encyclopaedia article. I see it as a place to include any knowledge that is relevant to the topic, as long as it is referenced to clear, verifiable, external sources, and its inclusion is in proportion to the rest of the article. The article on Karl Popper's theory of falsifiability, for example, does not just expound Popper's doctrine. It discusses it, mentions its development by others, puts it is its historical context, and explains critisisms of it. That is what makes it an encylcopaedia article, with a neutral point of view: it can widen the focus, and live up to the etymology of "encyclopaedia".

Once a theory is published - once it is "out" - its author has the right that it be attributed to them. I am glad that this theory is now attributed to Noel Burch and Gordon Training International. But they lose some ownership of it: they will find it discussed, developed, refined or abused. That is the nature of the community of ideas. There is going to be all the more wrangling over the narrative that structures and defines an idea in the wiki age, since it is in fact the current edit of the Wikipedia article that is the "front page" for the subject for many people.

Futher Information

In the famous Rembrandt painting, An Anatomy Lesson of Dr Nicolaes Tulp, we see the essence of medical education: the students are learning from the open textbook, the open cadaver, and Dr Tulp himself. The book relies on its author, the book relies on the real facts of the anatomy, the student relies on the book and the teacher, and the teacher relies on everything. Everything is reflexive, but everything is stable. 

To move away from Gordon Training International, whose motives were unquestionably good, this affair raises a disquieting notion. Of course, any paper could be totally deracinated by having the material it references removed from wikis. That is what happened briefly to the academic paper. It was done unwittingly. But if the material an academic paper references is labile, then something more sinister could happen that its simply disappearing. A reference could be subtly modified, or subtly brought into line, so that the paper's contention loses its validity in degree or in part. I do not think that this is a reason to stop using collaborative sources in science, because it is an ineluctable fact that Wikipedia is, for many people, the "front page" for any idea. But it is a reason for caution and vigilance. And for perhaps referencing original texts.

Incidentally, it also shows that the Four Stage Theory has a surprising lack of academic hinterland for something that is used so often. I've emailed GTI, and will update you with a reply.

I have not been drawing for a couple of weeks because of my exams. It frustrates me when I cannot draw. I once heard someone say that all children draw, but only some strange adults refuse to give up the habit.

I do not know why we give it up. Plenty of us write our thoughts down in a diary, but never sketch shapes. But drawing makes me happy, and I like to do it as much as I like to write words. Maybe we stop because of the inadequacy of the result. None of us, though, have the draughtsmanship of Leonardo: that does not make it useless to us, since by that thinking, only our finest novelists should pick up a pen to write even a shopping list.

I stopped drawing between when I was 15 and when I was 19. I do not know why. I don't even know why I started again, I just felt the urge to, and have never stopped for more than a few days. My drawing has improved only a little since I started again. I do not think it will ever improve greatly, but I enjoy doing it, and think that more people should make it a part of their lives.

This is a drawing of my flatmate James's feet. He is wearing trainers, sitting in the living room in Rosefield Street, Dundee. There are dirty glasses and a side table in the drawing. There is always something to draw.

I am completely entranced by Steve Reich's work. It is so satisfying to recognise a structure, and to hear it played out, and that it what Reich gives us. His kind of music has often been called passionless, and unhuman, but I cannot agree.

In Different Trains, I always feel a quick thrill during the sublime moments when the recorded words are repeated by the strings. There is a quick variation on the melody of the human voice - that particular human voice in the recording - and the train chuffs along. It is so masterful: he has such a command of sound.

And there is little in music to rival the anticipation and excitement when I know a change is about to come in the rhythmic structure in Drumming, not to mention the satisfaction when the rhythmic structure does change. When I get involved in the music, it feels unique: I start counting the beats without thinking of numbers, and the changes come as instincts rather than planned-out events. It is deeply emotional music. 

This is a pencil drawing of Steve Reich in the dark at a piano, not at the drums or the tape deck. The photograph is from decades ago. He is blending into the darkness. That is how I feel when listening to some of his music: that feeling of porousness, of the music going right through me.

I was interested to read a debate on Twitter today, started by @welsh_gas_doc, discussing the major gaps in medical undergraduate education. Some argued that basic science was missing, or that their course was too heavy on it but did not show its clinical relevance. Of course, it is difficult to know what skills a doctor should have, especially once they take on additional non-clinical roles, as is the norm at senior levels. Some training in non-clinical areas related to medicine already occurs in undergraduate and post-graduate medical education. Indeed, @welsh_gas_doc mentioned that management was now part of the course for Fellowship of the Royal College of Anaesthetists.

This is not new, because basic science is not strictly clinically-relevant all of the time. But there is a new professionalisation. For a decade, the MRC has been running the National Clinician Scientist Award Scheme, which is a prestigious scheme to fund research by top-rate scientists who also are clinicians, recognising that having a cadre of people who work as clinicians and as scientists is a boon to both fields. Of course, most doctors do (or have done) some audit or research work at some point, and the clinical academic is a common sight in any hospital or GP surgery. But in the past decades, things have been greatly formalised and, for want of a better word, professionalised. There are now distinct clinical academic career pathways. There are even academic foundation programmes, so that the most junior medical staff - none of whom will have passed membership exams - can now be involved in clinical or clinically-relevant research.

But it is not just basic science that can influence healthcare outcomes, and perhaps we should build cadres of clinicians with well-defined post-graduate training in other non-clinical areas. The clinician-educator, for example, is now a distinct breed, with many opting to do clinical fellowships in medical education.

Infection control teams have input into hospital design, and there are some doctors-turned-architect, like the American George Tingwald. But could there be future professional training in design for some clinicians, so that they can make informed input into design that encourages safe medical practice? Or future professional training in management for those whose interests lie that way? Policemen and army officers being promoted to command roles go on courses to train them in management, so why not make a cadre of clinician-managers, whose training in management theory and background in clinical work would both be of benefit. Perhaps we should not rely on a small number of doctors to get themselves MBAs or pick up management on the job, but instead recognise their value and train them for it.

Above, in Indian ink with watercolour tint, is a quickly-done illustration of the clinician-lawyer, who strikes fear into many hearts.

It's a parochial thing, but Alasdair Gray is my favourite author. Or perhaps it's not just parochial - not just a Glasgow boy idolising what Anthony Burgess called "the greatest Scottish author since Sir Walter Scott". Like most people, I came to Gray by reading Lanark, his syncretic novel that, by its hodge-podge of different themes and thoughts, attains the coherence of a symphony. But I have come to love his artwork, his poems, and his other prose.

This is a quote of his, put in Indian ink, tinted with watercolour.