The mechanistic worldview which prevailed in twentieth century medical research and practice is being challenged on many fronts. Quantum physics has demonstrated the nonlocal reality in which limitations of space and time do not apply. It has also pointed to subtle correlations between the probabilistic "quantum reality" and our conscious perception of our actualized physical world. Further, many studies have now demonstrated that conscious intentionality can have measurable influence on healthcare outcomes. [ 2,3,4 ]

In an earlier communication [ 5 ], I used the term nuocontinuum to designate the nonlocal multidimensional continuum of which the spacetime continuum is a part, and to underscore the need for wholistic integration of reductive science. The "paradox" of conscious intentionality compels us to continue to look carefully into that realm of the quantum reality, to seek a better framework (even if necessarily speculative) for description and discussion of healthcare experience.

As Penrose has noted [ 6 ], any satisfactory theory of consciousness must ultimately connect up with a theory of reality. Yet a consensus theory of reality seems still to be elusive. Various physicist-authors have suggested that the sought-for theory is likely to be simple but decidedly unconventional. Lee Smolin [7 ] suggests that the answer likely will also require a new understanding of time, must account for extraordinary organic complexity, and unify quantum theory and relativity theory. However, it must also unify physics with psyche, since both domains relate to nonlocal reality [ 5,8 ].

Seemingly the most promising line of research for a unification of quantum theory and gravity is that of string theory (and its companion M-theory). [ 9 ] There is a high degree of consistency in mathematical operations describing fundamental physical units ("strings") at the Planck limit of physical size, 10^-35 meters, well beyond the current reach of experimental confirmation. However, the theory does not clarify the nature of time, and the complexity of its mathematics puts it out of the reach of an ordinary intuitive understanding of cosmos. Even if (when) confirmed, string theory will require some sort of metaphorical interpretation, if it is to become a "working theory" in healthcare practice.

The present exploratory essay outlines a tentative view of reality which seeks to relate the problems of dimensionality, time, "eternity" (nonlocality), quantum probability, and gravity. Clarifying these relationships, even metaphorically, should help better define the reality-context in which consciousness studies and our healing actions must take place.

The findings of quantum physics are "weird" only with respect to mechanistic theory, and only to the extent that their implications have not been accepted. The ideas presented here are based on further questions about the nature of (1) nonlocal reality; (2) the speed limit of light; (3) dimensionality; and (4) time/duration.

(1) Nonlocal reality: "Local" reality is the familiar spacetime world of classical physics, with its speed limit for signals and diminution of force over distance. Though phenomena are local, quantum physics says that reality is nonlocal. Reality is a "seamless whole" [ 10 ], as established in experiments affirming Bell's Theorem. Further, according to the dominant interpretation, the law of conservation of energy applies everywhere in the universe. From that, we may infer that the nonlocal domain must provide (or be) a steady-state reserve of energy available for the creation of mass (E=mc²), and for translation into local actions of all types. But what is the relationship between local and nonlocal domains?

(2) The cosmic speed limit: Presumably an illuminated cosmos without a speed limit would be perceived as a blinding glare, and time would be a meaningless concept. There could be no distinction between local phenomena and nonlocal reality. We take the speed of light as a given, as a defining parameter of this cosmos. But by what "mechanism" does cosmos, based in nonlocal reality, establish a speed limit? What is the limiting factor?

(3) Dimensionality: The definition of physical dimension seems to be slippery. We ordinarily think that there are three discrete dimensions of space, and time yet another dimension, all operating as a continuum. In this discussion, dimension is simply a permission to move or to have an effect, i.e. a degree of freedom; but the "licensing scheme" confers cumulative privileges: With a two-dimensional license one may be stationary (zero-D), move along a line (1-D), and on a plane (2-D). With three-dimensional privileges one may move anywhere, spatially speaking (3-D), but requiring time to do so; thus, local reality is four-dimensional. Also, string theory and its variations treat forces and symmetries as dimensional, thus requiring that cosmos be a "hyperspace" [ 11 ] of at least eleven dimensions.

Yet our degrees of freedom are also constrained by prior events. We may not move in ways or make combinations of things for which the history of cosmos has not prepared a potential. For example, at the macro level, it is premature for me to book a flight to Mars, but each increment in space technology helps prepare the way for someone to do so, someday. Each increment in the organic complexity of cosmos increases its degrees of freedom, and like dimensionality ordinarily construed, does so cumulatively and exponentially. Should we not then consider whether the evolution of dimensionality itself is a basic feature of cosmic evolution?

(4) Time and duration: Time measurement in the local domain is relativistic; we might refer to that as Einsteinian time, or "E-time." But, according to one's state of consciousness, perception of time passing does not necessarily correspond to E-time. Indeed, it is strikingly variable. Whitehead [ 12 ] referred to reality in terms of discrete "actual occasions" or "actual entities," each of which "experiences" how its world is qualified by other actual entities. The extension of these occasions of experience would represent a psychological time (all experience being psychological, even when unconscious). Let us designate that as "W-time," which some cultures (predominantly Eastern) have construed as cyclic, and others (predominantly Western), as linear. [ 13 ]

Time's arrow for both E-time and W-time is reversible. But time's arrow for cosmos points one way, so some new conception of time (or new relativization of time) must be forthcoming. Bergson theorized that duration (durée, connoting especially continuity) is the key feature of "creative evolution" [ 14 ], which carries its own forward impetus, or élan vital. Whitehead [ 12 ] dealt with time/duration as the "extensive continuum" of the actual entities, both authors emphasizing that being is process of becoming. Is it possible to conceptualize a one-way cosmic time which is consistent both with relativistic E-time and with quantum duality and uncertainty?

Imagine a "protocosmos" consisting of nonlocal Energy, which contrives to express, by the simplest possible rules, its potential for the type of physicality we know in our own experience. Such a physical cosmos could be "programmed" to operate by these three rules. For that universe as a whole:

(P.1) The life of the cosmos is a series of discrete states;
(P.2) Each new state is summed into the probabilities which govern the next state; and
(P.3) Each new state confers a new degree of freedom (dimension).

Hilbert space is an infinitely dimensioned mathematical structure [ 15 ]. Running the above program by discrete increments (P.1) creates a growing Hilbert space, but one in which each new dimensional state enfolds its predecessor (P.2), yielding an "implicate order" (cf. Bohm [ 16 ] and Bohm and Hiley [ 17 ]). That would mean that the momentum and all other historical characteristics of any quantum object would be represented in the multi-dimensionality of the current state of cosmos. The smallest interval imaginable in current physical theory is the Planck time, a natural unit defined by the speed of light, but it is unimaginably infinitesimal: 10^-43 seconds. Let us construe the extension of the discrete dimensional states into a series (P.1) as the "ticking" of the "Planck clock."

Such a ticking could represent a synchronization pulse between nonlocality and locality, but cosmos offers no external reference against which such a mechanism could yield a timing. Even though the "P-clock" is not really a clock, the pulsing of nonlocality would represent the critical interaction between the nuocontinuum (the realm of the quantum world's potentia) and the physical actuality realized through quantum-level process.

Each Planck time "tick" (P.1) (one can hardly avoid calling it a "plick") would re-seed the probability wave function (the Schrödinger equation) to determine the distribution of the whole-cosmos Energy for each momentary (re)creation of mass (P-3). A "sum over histories" [ 18 ] would be inherent in that process.

There would also be a speed limit for physical objects (photons), since nothing may move faster than the P-clock, each plick being 10^-43 sec (Planck time). Timing (E-time) becomes apparent only as motion is tracked within spacetime, from plick to plick. A speed limit of light is inherent in that process. The Planck interval would be the fundamental parameter, from which all other physical parameters derive.

In such a pulsed-nonlocality cosmos, physicality (locality) exists only during each plick. The interval between the plicks, being nonlocal, would be undefinable and imperceptible.

The state expressed (P.2) at each dimensional increment would include the characteristics of all interference waves at all harmonics among all clusters of quantum objects. Since the probability wave function of local-level interactions would be renormalized to nonlocality (zero point field) at each plick, cosmos would in effect be the observer who reduces its own wave function. This is consistent with Zurek's work [ 19 ] on quantum decoherence by the environment.

The probability would become extremely high that an atom would continue in existence as an element of the same type, or if it were an unstable element, would decay in a probabilistic way. For an object consisting of many atoms/molecules, the probabilities that it would tend to retain its present state of motion would be so high as to give rise to a "law" of inertia.

For a complex system, especially a life system, the P-clock rules would result in a growing (large scale) probability of expressing some new degree of freedom (P.3) as a new characteristic. We could think of that as an "impetus" (élan) which could be expressible as a probabilistic state vector. The inherent probabilities also favor its returning (smaller scale) toward its stable historical condition (P.2) after perturbation. There would always be tension between emergence and equilibrium (physiological homeostasis), as we observe.

Something similar would be seen at the cosmological level, in the tension between expansion and gravity. From our "local" perspective, the relationship between gravity and spacetime is now construed as topological: Space is a physical matrix deformed (curved) by mass [ 20 ], yielding gravity effects. That fosters a search for a contrary expansive force preventing cosmic collapse.

The pulsed-nonlocality idea offers the possibility of a probabilistic view in which expansion of the universe is analogous to emergence, and gravity analogous to homeostasis as described above. In the momentary renormalization and (re)creation of all states of matter (with cumulatively higher probabilities), new degrees of freedom (P.3) could increasingly and most easily be expressed as further elaboration of whatever (of quantum scale, 10^-17 meter, or subquantum scale) is found to constitute the matrix of space [ 7, 9 ], resulting in further separation of galaxies.

Gravity is the observed effect of accelerated motion (Einstein's equivalence principle), as seen within spacetime. In the pulsed-nonlocality model, a particle in motion (or a large cluster of particles) is recreated across a "quantum gap" at each plick. The probabilities (P.2) governing its new position have a component derived from its historical momentum, but also a component representing the resultant of the interference wave patterns of all harmonics (including any which may exist at subquantum wavelengths) between any two mass objects. (These are presumed from the wave aspect of the wave/particle duality.) The intensity of such interference patterns would be proportional to mass. These characteristics will also be conserved by the process (P.2), as though the two objects were attracted.

If we presume also that the state actualized at the next plick represents the best fit of probabilities computed nonlocally across the cosmos (the "world equation"), the observer in spacetime will see motion (relative to his own state of motion), not as uniform, but as deflected as though by a force which was in tension with the vector of expansion. The gravity-vector would predominate in dense regions of space, while the expansion-vector would dominate in low-density regions. (Note Penrose's reminder [ 20, p 65 ] that the nonlocal state vectors express, not simple probabilities, but complex numbers.)

Such a schema, taken as a theory of the current cosmos, would be rather startling. Cosmos would be "neorealist" in the sense that it is "really there" even in the absence of a human or other sentient observer to collapse the (probability) wave function. But human consciousness, expressing its own degrees of freedom in various ways, would be one aspect of the state of cosmos being integrated at each plick. It would thus be interactive with cosmos with a potential to affect nonlocally, in subtle but unconventional ways, the probabilities governing local states.

It has been proposed that consciousness is achieved by quantum-level interactions within the brain, through the neuronal microtubules [ 15, 21, 22 ], or through boson condensates in brain water [23, 24 ]. The new view offers the possibility of understanding consciousness as a diffuse sensing by quantum mind of cosmic integration within nonlocality, providing a screen on which local content is projected by processes generated at ordinary neurological scale. In any case, the P-time idea would have a number of interesting implications for consciousness studies, as well as medical practice and other fields.

When ideas leap too far ahead of current evidence, the standard response is "naked speculation." This proposal is more in the line of a naked intuition, which would be even harder to prove than string theory. After all, it will be difficult to describe it mathematically, for mathematics abhors infinities. (Quantum theory even discards them, through the process of renormalization.) Nor would it be easy to derive testable predictions from it. It seems that the idea must stand or fall entirely on the results of testing by thought experiment.

Though such an idea may be valuable only as metaphor, it is intriguing that it provides an intuitive resolution of the two-slit paradox (in which an interference pattern appears on a film plate, as though there were two beams of light, even if only single photons are projected) : Given stable conditions (e.g. this experimental situation) in which two paths remain equally probable, the succession of plicks would actualize pulses of energy in each of them, resulting in the observed interference pattern.

The pulsed-nonlocality idea highlights critical reality issues in the search for an understanding of consciousness, including medical experience. One might also hope that discussing such ideas will help science-based medical practice reestablish a relationship with its ground of being, however we name it or construe it in our many cultural traditions. Doing so requires extending our frame of reference beyond the local domain. The pulsed-nonlocality idea offers a new view of the richness of the ground of being in the nonlocal mix of energy and potentia in the nuocontinuum, interactive with the physical and psychic states of being in each moment. There's a great deal of poetry in such a concept, but poetry itself is another level of consciousness.

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