How Did Iain Kerr and Jason Frasca Meet?

Iain Kerr and Jason Frasca met at the entrepreneurship center at Montclair State University, where Jason joined the faculty in 2014 and Iain was already consulting. In spring 2015 the founding director, Dennis, told Jason they were hiring Iain and that Jason would love him because he was building a boat by hand. Iain started full time that fall, and the two have shared the 3D printing lab ever since. Iain describes what made the partnership work: neither of us wanted to change the other. When one of us throws out a proposal, the other takes it as a move that shapes the conversation, and by the end of the day the original proposal has turned into something else. Mark calls this a working example of keeping difference alive. Even the phrase splits between us: Jason says "keep your difference alive," and Iain says "keep difference alive."

Why Start From Difference?

Starting from difference matters because much Western thought assumes an essence or kernel behind everything, while life is ongoing differentiation. Creativity, in this view, is difference differing. That starting point carries an aesthetic, an ethic, and a curiosity: the story is unfinished, what happens next has to be made together, and everything has agency. Jason adds that our definition of creativity, the production of something new through change in kind, already makes difference central, and that honoring difference means suspending judgments of good and bad. A sameness worldview measures everything against something fixed and given, and so cannot come to terms with a creative reality.

What Happens When Healthcare Measures Everything Against a Baseline?

When healthcare measures everything against a baseline, it begins from one model and translates every other way of being healthy into that model. A feast becomes endorphins and metabolic rates, and the meaning it holds in another world disappears. The model colonizes everything because it cannot see itself as a historical construction. Jason adds that a baseline also erases history, as if everyone arrived at the same starting point. Iain connects this to what Heidegger called standing reserve: to be alive becomes having caloric, hormonal, and attentional resources to balance and spend, and a forest becomes carbon sequestration or pulp. Mark notes that resource metaphors are dominant in healthcare, offered as both the problem and the solution.

Why Do Cultures Flatten Difference?

The pull to flatten difference feels universal because we are inside it, but we read it as a historical question about modernity and the practices that grew from European spheres of influence since the 1700s. Anthropologist Marshall Sahlins contrasts immanent cultures, where mountains and thunderstorms hold power within this world, with transcendental cosmologies that place something more perfect outside it, which gives a culture a fixed center. Whatever we already do feels easy, and what others do looks complicated, while they see us the same way. Jason adds that people do feel a pull to be like other people. The good news is that new practices can be invented.

Is Stability the Opposite of Change?

Stability is an achievement that takes as much creative effort as change. Seen from a difference perspective, patterns self-organize and then have to work to keep themselves going. Jason compares it to maintaining a house while wind, rain, snow, and temperature break it down. Homeostasis is a metastability: a system has several stable states, and crisis is often one of them. A traffic light keeps working when accidents happen, and ambulances, courts, and insurers are part of the system. In mental health practice, this means the individual is an emergent outcome of their relations. Depression can be an affordance of an alienating world, so care involves helping people create and join new assemblages. Iain also warns about a hyper-individualistic logic of self-maximization, where people blame themselves for failing to be all they can be.

How Do You Listen for Tomorrow?

Listening for tomorrow starts with disclosing the tendencies we listen through: norms, resource thinking, and the logic of the maximizing individual. Without that, everything new we hear gets pulled back into existing trajectories. Listening is a skill a group develops with effort and the right ecology, and it works as an experiment and an adventure: you set aside current achievements without calling them wrong. Jason adds the histories of other healthcare practices, some denied or eradicated, as a source of possibility, and notes that healthcare holds real achievements, like treating infections, alongside what it has lost. Iain suggests the plural: listening for tomorrows means listening for different pasts and presents too. You bracket judgment so other things can emerge, then return to good and bad with new perspective. Basic hygiene is an astonishing achievement, and an experiment might ask what health looks like when the body is treated as an ecosystem whose microbes we support.

Listen to the Full Episode

Hear the full conversation on the Uncharted Podcast from People Before Patients.