Thursday, October 4, 2007

A Sick Philosopher is Incurable

Today, I left my office having put in a decent day's work at school, and started heading home to do some more work--the kind that can be done at a computer. But on my way, I remembered that my wife said she'd be hanging out at a local coffee shop, so I took the long detour. I didn't even get a drink. Just stopped to smile and make sure she was feeling good.

From the coffee shop, then, I walked to the parking garage where my car was parked on the sixth floor. Between the coffee shop and the garage, I started feeling pretty good, so I decided to climb all six floors rather than take the elevator. On my way up the stairs, feeling good and not thinking about anything in particular, I started singing to myself, "Don't bring me down," by (I had to look this up) Electric Light Orchestra. I sang whichever words I knew, and hummed the rest. I opened my car door, started it up, and the radio was blasting: "You got me runnin goin out of my mind / You got me thinkin that I'm wastin my time / Don't bring me down... no no no no no..."


As a follow up to my previous post, and in particular to my comments on psychiatry and metaphysics, I re-read chapter 16 from Herman Melville's The Confidence-Man. If you have any interest in this topic, I really urge you to spend ten minutes reading the chapter. I first read the book five or six years ago, and it seemed to be about naivety or gullibility or susceptibility. It seemed to be about how "con-men" can take advantage of us if we aren't on guard with skepticism.

I have a different view of the book now. These days, I tend to think that Melville meant to dramatize the difficulties of "keeping the faith," or, staying "confident" -- what I recognized at an earlier time in my life as naivety. With these two different ways of reading the story in mind, consider (if you can't read the whole chapter) the following dialogue between a "sick" (read: depressed) man and a peculiar kind of healer:

The herb-doctor took a sealed paper box from his surtout pocket, and holding it towards him, said solemnly, "Turn not away. This may be the last time of health's asking. Work upon yourself; invoke confidence, though from ashes; rouse it; for your life, rouse it, and invoke it, I say."

The other trembled, was silent; and then, a little commanding himself, asked the ingredients of the medicine.


"What herbs ? And the nature of them ? And the reason for giving them ?"

"It cannot be made known."

"Then I will none of you."

Sedately observant of the juiceless, joyless form before him, the herb-doctor was mute a moment, then said: -- "I give up."


"You are sick, and a philosopher."

"No, no; -- not the last."

"But, to demand the ingredient, with the reason for giving, is the mark of a philosopher; just as the consequence is the penalty of a fool. A sick philosopher is incurable."


"Because he has no confidence."

"How does that make him incurable?"

"Because either he spurns his powder, or, if he take it, it proves a blank cartridge, though the same given to a rustic in like extremity, would act like a charm. I am no materialist; but the mind so acts upon the body, that if the one have no confidence, neither has the other."

Again, the sick man appeared not unmoved. He seemed to be thinking what in candid truth could be said to all this. At length, "You talk of confidence. How comes it that when brought low himself, the herb-doctor, who was most confident to prescribe in other cases, proves least confident to prescribe in his own; having small confidence in himself for himself?"

"But he has confidence in the brother he calls in. And that he does so, is no reproach to him, since he knows that when the body is prostrated, the mind is not erect. Yes, in this hour the herb-doctor does distrust himself, but not his art."

The sick man's knowledge did not warrant him to gainsay this. But he seemed not grieved at it; glad to be confuted in a way tending towards his wish.

"Then you give me hope ?" his sunken eye turned up.

"Hope is proportioned to confidence. How much confidence you give me, so much hope do I give you."

So I suppose the big question I want to pose is whether or not this "herb-doctor" is a huckster or something else. And if it's utterly clear to you that he is a huckster/con-man, don't feel bad. I've read him that way before -- in fact, I think that would be most people's reading.

But what if there is something to the idea that placebo effect is majorly significant? What if what we really want is for a person with authority (in cases like these, we Westerners turn to "doctors" or "psychiatrists"; elsewhere it would be the village shaman) to tell us to take a pill or drink something, and for that authority figure to tell us it will be okay.

Especially with psychological sickness, I am inclined to believe this is almost possible: that if you are "a rustic" (caution: there are more rustics who think they aren't rustics than rustics who know they are rustics!) you will go to your doctor, describe your symptoms and trust (have confidence!) that what he prescribes will fix you. If, on the other hand, you happen to be a philosopher, you will demand to know how and why what he gives you will fix you... and if you be this latter, your chances for recovery or improvement are minimal.

Well, nobody considers himself or herself a bumpkin or a rustic -- and yet just how much faith do we put into our little pills? Into our health foods? Into other prescriptions? Shall we call this faith "confidence," or "naivety?" What if (drumroll, please!).... what if it is only the confidence, not the pill, that does the fixing? (play dramatic thunder peal)


That would be an utterly confusing and difficult thing to know. At first. But then one day you'd be walking along humming a song in your head and you'd get into your car and the song (an unlikely song, certainly!) would be playing on the radio... and you'd wonder if it might have been your confidence that triggered the whole thing. You'll wonder if you had just the pill you were looking for all along.

The wonderful thing about the Melvillian dialogue and about life in America in 2007 is that these pills give us such an undemanding opportunity to engage our faith. In this view, this herb-doctor and our contemporary psychiatrists are huge assets. When no pep-talk and no binging or purging can cure us of our mind sickness, these authority figures cannot promise us anything, but they can extend their hands with a smile and a pill, they can look confident themselves, and they give us every opportunity to demonstrate our faith. All we have to do is unscrew a child-proof cap twice a day.

See also. Question: is a mustard seed bigger or smaller than my cholesterol pills?


Monica said...

I think the placebo effect is majorly significant. Sometimes I think I have already taken my sleeping pill, and so I go to sleep because I believe I took it.

I am very discouraged, however, when you say: "If, on the other hand, you happen to be a philosopher, you will demand to know how and why what he gives you will fix you... and if you be this latter, your chances for recovery or improvement are minimal."

I do this every time I see my therapist or psychiatrist. I interrogate her, and then I leave in disgust, because I imagine that I know more than her.

Casey said...

Monica, what do you think of rituals? Don't they work the same way, perhaps better, than pills? If the shaman says kill a goat and mix its blood with its milk bury its corpse outside the village, then your demons will leave you... isn't that what the "herb-doctor" or psychiatrist does? How absurd it would be to inquire into "why." (Of course, I would do the same as you... Ah!, a whole generation of Good-Will-Huntings, aren't we?)

I wonder just how long those clean-rituals of the Old Testament worked to clean consciences? Evidently many of the catholic rituals still "work."

Casey said...

And by the way, don't be discouraged -- just have a mustard seed of faith! ;)