Sunday, June 8, 2014

Rational Medicine and Dehumanized Healing

Say you get sick or injured. You make your way to the emergency room or doctor's office and you get seen by a doctor who prescribes the appropriate drugs, procedure, or therapy, and in a few weeks the problem goes away. This, presumably, would be considered the ideal experience, the most that any patient could ask for--and yet, there is an aspect of degradation to the patient that is invisible and a sense of alienation that accompanies him or her even upon full recovery from illness.

The experience of getting medical help within an industrialized system completely disregards arguably the most important aspect of healing--love. By this, I mean simply an emotional investment by the caretakers in the patient as a whole person beyond just the diagnosed condition, the way a parent, sibling, or child would naturally be emotionally invested in a person and would wish for his or her total well-being and happiness. This emotional investment is decidedly not the same thing as compassion, empathy, or decent bedside manner. Those things are entirely allowed and in fact encouraged, in the face of the current epidemic of apathy on the part of overworked and overstretched medical professionals, by hospitals and medical associations. However, all medical professionals have it drilled into them in their ethics classes and, subsequently, by the threat of lawsuits, that it is unacceptable to take a personal interest in a patient's health lest judgment become compromised. Thus, medical professionals must walk a sometimes ambiguous line and negotiate the tension between being too invested and too callous. The conventional thinking seems to be that love for the patient has no place in medicine--indeed, that it is superfluous, distracting, dangerous, and altogether undesirable. This "ethic" has come to inform mainstream thought in industrialized societies such that healing from illness and injury is considered purely a physical matter, and neither disease nor convalescence has anything to do with emotion. Even psychological disorders such as depression or bipolar disorder have by now been ultimately attributed to structural or chemical flaws in the brain and nervous system. By extension, the physician's feelings about the patient are not what bring about a cure, but merely the prosaic chemical properties of the drug compound or the physical reality of the scalpel incision. The efficacy of a drug is not influenced in the slightest by the emotions of the physician or the faceless factory workers who manufacture the drug in vast, uniform quantities.

It must be emphasized that this penchant to cast disease as a purely physical and physiological phenomenon is extremely novel in evolutionary time. Prior to this, caring for the sick and injured in one's community was always a natural extension of love. Just as important as the physical components of a treatment in such a community is the healer's intention, much as it makes all the difference for a child to be comforted in sickness by her mother rather than by a stranger. In times of vulnerability, humans don't just seek a cure for their individual selves--injuries and disease, like virtually all occurrences in primitive societies, are opportunities for members of a group to foster stronger interpersonal bonds, the currency of pre-industrial life. I believe that a person in pain or distress first and foremost seeks comfort in the form of moral support from familiar faces. It's commonly enough observed in young children that a substantial amount of their crying after a supposed injury is really just an attempt to garner the attention, sympathy, and reassurance of parents and other caretakers. After the perfunctory kiss on the boo-boo (an American custom, for international readers), the child magically feels better, without any additional physical treatment (although kissing kids' injuries might turn out to provide greater and farther reaching benefits than the practice has been customarily given credit for). Contrast this scenario with one in which the crying child is rushed to an unfamiliar hospital room where, in lieu of any familiar caretakers, she has her wound expertly cleaned and bandaged by an unfamiliar nurse or, perhaps in the near future, a robot. Contrary to the first scenario, this one involves addressing only the physical, "real" aspect of the injury. I would wager that the child would find the second scenario significantly less edifying than the first. Now, the question is: are adults, at base, any different from children in their desire for attention and comfort from loved ones? The answer, I think, is no, though, for many lamentable reasons related to civilized life, adults are no longer permitted to either crave or satisfy these basic human needs, and instead are expected to act as though all an illness requires is the impersonal administration of a rational treatment by a qualified specialist whom they may or may not have ever met before. Furthermore, this treatment is provided not out of sympathy, love, or even altruism, but in exchange for payment. As with another venerable profession, money cannot buy love, only a physical sham thereof. In this sense, physicians and prostitutes are simply different and imperfect substitutes for an erstwhile common and plentiful bond that we no longer adequately satisfy, for both healing and sleeping with another person will elicit feelings of attachment in that person that, purely out of professional necessity, neither the doctor nor the whore is ultimately able to reciprocate. With his or her need for love reduced to business arrangements with impersonal surrogates, the modern seeker of true healing will increasingly find only degradation and dehumanization in the face of the advancing erosion of a human-scale existence.


  1. Ziqian,

    This is a really good frame for how the western or mind body dualism dictates the medical industry.
    Please keep up the writing!


    1. Chris,

      Thanks for reading and commenting. I think it's obvious that modern medicine's primary concern is to support civilization's needs, and only seeks to treat illness insofar as this contributes to this goal and can never act in opposition to it, for it depends on civilization for its very high-tech existence. Going back to the chicken farm example, the chickens are fed antibiotics so they don't get sick, but its hard to imagine that the chickens would feel grateful that they get to enjoy their brief lives free of infection inside their shed. If healing isn't about love, explicitly isn't allowed to be about love, then what, really, is it about? Profit, and keeping the machine running with ample fodder, no?

    2. Yes, I totally agree, and your chicken farm analogy works well to mirror domesticated humans propped up on medicine and other technologies. Affording them a lifeless life. On the other side of the drug spectrum, I've recently been going through some health problems and have relied on them to make it through in a relatively comfortable way, though if modern medicine hadn't been available I would currently be in severe pain and my quality of life would be so poor as I might even prefer death. So while realizing the underlying goals of the medicine machine, I'm at times grateful for it, and of course leaving this gap between idea and practice. What do you think personally about abandoning modern medicine?

    3. Thanks for the thoughtful question. I really prefer the example of the chicken factory because it seems to be a near-perfect metaphor for domesticated life. I think the example is instructive with regards to your experience, as well. My intended response to your question, which I find to be a very important one but one that for some reason doesn't quite get satisfyingly answered too often, wound up being too long to post here as a reply to your comment, so I've posted it as a separate blog entry titled "Response to Chris's Comment, July 16, 2014". Please take a look and thanks again for reading!