illustration (attribution, if any possible, is at the end of the article)
Ignorance and the cessation of ignorance.
When someone tells you "it hurts", you don't know what they're really feeling; you don't know the intensity, the threshold of bearability, or traits associated to the sensation.
When you tell someone "it hurts", you know it doesn't really describe how it truly feels. Sensations are unfathomable. Your own brain needs to simplify the richness of the stimulus, prior to giving it to your consciousness. Thousands of perceptive cells might be involved, to end up being summarised in consciousness by "the light is too bright: it hurts my eyes." Your own consciousness doesn't access a rich description of pain. How could you communicate one?
When you realise that words cannot truly communicate the embodiment of pain, you see what Buddhism calls ignorance: no model captures reality, no word captures reality… There's always some bigger context not taken into account (arbitrarily considered irrelevant 'background'), there's always a level of granularity at which the description stops (arbitrarily considered irrelevant 'details')… And, as a result, how we conceive the world does not capture how things are. We always assume some part of reality to be irrelevant, which is to say we always make a summary which embeds a model of how reality 'functions'.
However, description of symptoms is very much what medicine is based on. Verbal description, or a visual description by a graph or a photo after some tests… so while models don't capture reality, models are very much parts of reality and they can operate, they can participate in the fabric of reality the next moment.
So 'ignorance' is not to say that models or words are pointless or useless.
One doesn't cease ignorance by rejecting knowledge. One doesn't cure an illness by not seeing a doctor…
But the expectations that a proposed cure 'should' work, or that medicine 'should' predict how things will evolve, are ignorant. You can see these expectations as meta-models (models on the application of other models), dangerous expectations because they switch your attention off.
The cessation of ignorance is in paying attention: this is not about rejecting the diagnostic or the application of 'conventional' truths, this is about seeing the conventional nature of these truths and knowing that the situation in front of us is not exactly the same. Scientific knowledge is based on controlled repeatability. Mathematics or philosophy are based on repeatability of the reasoning: rules of transitions and the acceptability of external contingent evidence (supportive observations, or counter-examples!). Reality is contingent, it does not tend to repeat (nor to absolutely avoid repeating) itself: it has no agenda, it simply follows its 'course'.
The cessation of ignorance is in paying attention: use models, but pay attention that a first idea of diagnostic might blind you about nuances that should be taken into account as they could change the diagnostic! Use the diagnostic, but follow up, keep monitoring, adjust, keep compassion alive!
Ignorance is in the belief of a "job well done" after a diagnostic (or the use of any model, any concept, any notion, even any perception!).
The cessation of ignorance is in continuing to pay attention, staying mindful, after the perception / interpretation. The cessation of ignorance is in seeing that nothing is definitive: the show goes on, a particular view may affect acts which in turn affect subsequent views.
Ignorance is in denial of counter-evidence; ignorance is in confirmation bias; ignorance is in blindness to the sheer diversity of reality…
The cessation of ignorance is in paying attention, which means here and now. "Here and now" is not an «'after' a diagnostic I made 'earlier' and 'somewhere'»: maybe 'earlier' is only a second ago, and 'somewhere' is the same room, but within this second, the patient moved or I moved, and I now can see things from another angle and maybe there is something to see that would change the diagnostic… The only way to see it is to pay attention, rather than assuming that nothing has changed.
It might seem very impractical to question everything, to "not know" everything, all the time: here and now! Or it might seem exhausting…
These are models too, i.e. ignorance.
How would being 'blind' and 'indolent' prove any more 'practical'?
Life is suffering, the root cause of suffering is ignorance.
So "don't know!" Pay attention, here and now!
Do not assume that paying attention the previous moment was enough. That's an ignorant model, and that's how we hit the wall regularly.
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(unattributed image downloaded from