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The Integrated Life — Personal philosophy written from the bedside. Short essays building one idea at a time, by a surgeon who works inside the organ that makes us who we are.

I spend my working life inside the human brain. Not metaphorically. There is no more physical, more materialist trade than mine, and over the years it has carried me to a conclusion it had no business reaching.

I'm a neurointerventional surgeon. I treat strokes, aneurysms, and the other things that go wrong in the blood vessels of the head: opening the ones that clot, sealing the ones that bleed, often by threading a catheter up into the brain while the patient lies awake on the ta

ble. Few people spend as many hours as I do with their hands, by way of fine tubing, inside the living organ of thought.

You'd expect that to leave me certain the mind is nothing but the meat. For years I assumed it would. The job did something stranger. The closer I got to the machinery, the more plainly one thing refused to appear in it, however good the picture became: the fact that someone is home. I could see everything measurable about a person and never the person. Once you’ve seen the absence, you can’t stop seeing it.

So I did what surgeons aren't really supposed to do. I wrote a philosophy.

It's called Integrative Realism, and it's laid out in full in a two-volume book, What We Are. It's built from exactly two ideas: that reality has both an outer, measurable face and an inner, experienced one, and you cannot peel them apart; and that everything complex, including us, is assembled from simpler things by degrees, with no magic switched on anywhere along the way. From those two starting points the system works outward through consciousness, time, the self, free will, ethics, beauty, justice, meaning, and death. The books make the whole case, and test it against the strongest objections I could find.

These essays are something else. They're that system taken apart and handed over one piece at a time.

Each one starts where I start, usually at the bedside, sometimes at the kitchen table, and follows a single idea as far as it will go in a few pages. You don't need the books to read them, and you don't need to read them in order, though they'll add up if you do. What I'm after is this: that any curious person, with no training in philosophy, can follow every step and decide for themselves whether I'm right.

I'll be plain about the places I'm unsure. I'd rather lose you with something true than keep you with something that only sounds true. That's the one promise I can make and mean.

They'll arrive about once a month at first, and more often as the work builds. The first essay starts where I do — at the table, with the best machine I've ever used and the gap it can't close.

If a piece lands, or doesn't, tell me. I read every response, and they genuinely steer what comes next.

I'm glad you're here.

— Michael