First Concepts.
WOB is Optimal
The thing-in-itself is a patient
The reality for me is the patient and my task is to promote his
health. I am less concerned with truth as such, and regard philosophy
as a source for interesting and fruitful ideas for promoting health.
I favor statements that serve my treatment objective and ignore
the non relevant. Take for instance Kant’s “the thing in itself”
(Das Ding and Sich) whose nature we shall never grasp. For me the
thing-in-itself is the patient who suffers and needs help. We talk
and interact and I promote his health.
v. Biological interpretation
of synthetic a priori
The philosopher as a patient
When studying philosophy I imagine the philosopher who bases his arguments on his personal experience with his self, and the world. From the medical perspective some of his profound philosophical statements may be naive and even ridiculous, Like the “I think, therefore I am”. Some time after arriving at this conclusion, Descartes sank into a deep coma. I watch him lying helplessly in his bed and say to him. Your mind is shut off, and with it your entire philosophy, yet for me you still exist despite the fact that you ceased to think. You are fortunate that WOB keeps you alive. Soon you will wake up and my task will be accomplished.
Your cancer is different than mine
Modern medicine is overwhelmed by Descartes’ philosophy
and his reductionist view of reality (the patient). While in acute
conditions the Cartesian approach is extremely fruitful, and advanced
medicine to its great and amazing achievements, in chronic conditions
it fails, and even harms the
patient. The present medical dilemma is highlighted by the
exclamation of the patient with cancer: ”Your cancer is different
than mine!” You reduce my cancer to a set of (aberrant) genes,
and enzymes, while cancer is more than that. It is a new life which
cannot be reduced to atoms and molecules. Might phenomenology shed
a new light on cancer?
v. Iatrogenic medicine
WOB and mind
I distinguish between two entities WOB (Wisdom of the Body) and
mind. Two operational metaphors which together encompass the condition
of the organism. Every symptom or sign in the organism ought to
be expressed by these metaphors. Like diabetes which consists of
WOB-diabetes, and mind-diabetes. By mind-diabetes I mean how patient
and society conceive WOB-diabetes, and not only the psychological
aspects of the disease. Here are some other examples, WOB-cancer
and mind-cancer. WOB-schizophrenia and mind-schizophrenia, WOB-neurosis
and mind-neurosis, WOB-homosexuality and mind-homosexuality, WOB-thalassemia
and mind-thalassemia The condition of the organism is expressed
by a doublet (WOB, mind) which cannot be taken apart. WOB
without mind is meaningless and so is mind without WOB.
Evolution of the mind
The newborn is a pure WOB. You might prefer the notion that it
is controlled by WOB. However WOB is the controller and the
controlled. As the child grows WOB creates its mind. The patient
in coma is also a pure WOB since he is mindless. Actually WOB and
mind are two interacting processes that change from instant to instant.
WOB maintains life and mind serves as an interface between WOB
and the world. By itself WOB maintains life optimally, yet
is unable to get resources, which is the task of the mind.
WOB is and controls the zygote which has just left the ovary
and moves through the oviduct. Its resources last for a week
whereupon it embeds into the uterine mucosa which serves as WOB
interface with the external world. Soon will this interface
be replaced with the placenta. Following delivery, mother takes
up the interface role. As the child grows the WOB will create its
own mind which ultimately will console itself with “I think therefore
I am!.”
Mind is first of all an interface between WOB and the world,
whose task is to provide resources. Thus, the uterine mucosa, placenta
and the mother are phases in the evolution of mind. The same is
true also for the microbe whose WOB is supported by a mind-interface
between it and other microbes. Actually the microbe is a member
of a microbe organism (society), and does not exist by itself. .
WOB is optimal
WOB is extremely complex and composed of many
interacting processes. Its sole function is to maintain life optimally.
How this is accomplished is beyond our understanding and cannot
be understood by taking WOB apart. WOB functioning and its optimizing
capacity has to be taken for granted in the same way as we take
gravity. Without gravity Newton’s laws are unthinkable, and so
is medicine without WOB. Enter phenomenology!
Franz Brentano
Long before it received its name, phenomenology
blossomed in Brentano’s mind: 1. mental phenomena are the exclusive
object of inner perception, 2. they always appear as a unity, and
3. they are always intentionally directed towards an object.
The last is particularly relevant to WOB requirements. The mind
of the growing child is molded optimally by WOB. Its understanding
of the external world is “intentional”. For example, WOB maintains
our water balance, and since we continually lose water it signals
the mind with thirst, which means: “Get me some water”. This is
the medical interpretation of “intentionality” which is simpler
than its philosophical interpretation.
How do I dare to meddle in ontological issues which are obviously
beyond my understanding? Since I encounter in my daily practice
Brentano's of all kind which help me to imagine how Franz studied
his mind when he was thirsty. Yet intentionality has some philosophical
stumbling blocks. What about mental phenomena that are directed
towards non-existing objects such as Hamlet? How does Hamlet serve
WOB? For what purpose might WOB send a Hamlet signal to the mind,
and what does it require?
Mind-Janus
Actually Hamlet is not a signal from WOB to mind. It originates
in our culture and is transmitted to WOB by the mind. The mind-interface
receives two kinds of signal, from WOB and from the outside
world. He may be likened to the Roman God Janus who guarded gates
and doorways, depicted with two faces looking in opposite directions.
Inwards mind listens to WOB, and outward it listens to culture and
transmits its norms to WOB.
A young healthy female is told that she got a minuscule breast tumor.
She then leaves the mammography lab only to face Death. Her actual
diagnosis is {WOB-cancer, Mind-cancer}. While WOB cancer is insignificant,
Mind-cancer may kill her. Before entering the mammography lab she
was healthy since WOB was silent. After being told, WOB is still
healthy, and the threat comes from the mind. Mind-cancer dominates
her condition. This is her Hamlet.
Before continuing let’s remember again the distinction between phenomenological research performed by professional philosophers and phenomenological interpretation by a physician.
Any phenomenological description proper is to be performed from a first person point of view, so as to ensure that the respective item is described exactly as is experienced, or intended, by the subject. Thus, the epoché has us focus on those aspects of our intentional acts and their contents that do not depend on the existence of a represented object out there in the extra-mental world. Bracketing is the attention of the mind to WOB signals. If one is hallucinating, there is really no object of perception. However, phenomenologically the experience one undergoes is exactly the same as if one were successfully perceiving an external object.
When treating a hallucinating patient, we ought to distinguish between WOB-hallucination and mind-hallucination.
Martin Heidegger
Heidegger’s Being and Time is a critique
of rationalism. He achieves this by way of a phenomenology of the
everyday. The everyday is that which is closest to us, yet traditionally
it is denigrated as an illusion which has to be reduced to its essence
in form of a theory. We must start with the everyday because
this is where we are, called in German Da-sein, or Being-there,
which is extremely complex. Dasein is immersed in a world which
is experienced as a significant whole.
In order to avoid confusing Da-sein with complexity unrelated to
our daily life, Heidegger focuses on Dasein in its most undifferentiated
state, that is it's everyday state. The phenomenology of Da-sein
attempts to understand the nature of Being.
Our understanding of the everyday is "non-theoretical"
and "atheoretical” Like our behavior whose nature defies any
scientific theory. Our understanding of Being is implicit in everything
we do. On the other hand rationalism abstracts from the richness
of everyday experience. Being is not conceptual and so cannot be
encompassed within a conceptual system. Instead our understanding
of Being is primarily a tacit dimension of our embodied being-in-the-world.
WOB and Dasein
Dasein has been shown thus far to be essentially "being-ahead-of-itself".
Phenomenologically Dasein is the totality of WOB-Mind. In other
words since mind is created by WOB, it is its integral part, like
other organs and processes in our body. Being-in-the-world means
that each WOB state is the most optimal solution of this Being-in-the-world,
and therefore it appears as if Dasein is "being-ahead-of-itself".
Eppur si muove!
This exclamation sums up Galileo’s heroic confrontation with the
Catholic church. Phenomenologically speaking his truth is utterly
irrelevant to that of Dasein. WOB operates and exists in
the Ptolemaic universe, where the sun rises and controls
our activities. Which is acknowledged even by medical reductionists
according to which our biology is controlled by circadian rhythms.
v. Eppur si muove!
Mind disease of Dasein
Dasein is "initially and for the most part" absorbed and
"taken in" by the world. Being-in-the-world leads Dasein
to misinterpret itself, for Dasein "gets its ontological
understanding of itself in the first instance from those entities
which it itself is not but which it encounters 'within' its
world, and from the Being which they possess". In the everyday,
Dasein "fails to hear itself" because of the deafening
"noise" of the "they".
When Dasein enters the mammography lab, it feels healthy. Then it
is told that it got breast cancer. Suddenly Dasein "fails to
hear itself" because of the deafening "noise" of
the "they" who proclaim its death, while in reality it
is still healthy since WOB did not complain. This deafening “noise”
of “they” initiates its mind-cancer.
Death
Heidegger noticed that death is not something we can experience.
There is really nothing at all to say about "our death itself."
What is important is not "death itself," but dying.
Indeed WOB is not aware of death, It maintains life, and
what we observe as dying are WOB solutions to maintain life.
Like in the patient in coma. To WOB death and dying are meaningless.
v. On death and dying
v. Death denial
Nevertheless Heidegger was preoccupied with death and dying. True,
death cannot be experienced but we are aware of the death of others.
Heidegger maintained that “My awareness that
I am going to die can give me the required perspective”. He
expresses this relation to the end of Dasein by the phrase "being
toward the end" (Sein zum Ende) or "being
toward death" (Sein zum Tode).
He obviously contradicts himself since death is outside of
any phenomenology. Why then did he create such poetic metaphors
like “being toward death”? Since Heidegger suffered from a mind
disease or mind-death inspired by the Lutheran church, which
he was unable to resist. Despite his ardent belief in phenomenology
he could not accept Nietzsche's "God is dead"..
Their cancer is different than mine
The Polyp-Cancer sequence illustrates “their” reductionistic cancer
progression. Cancer starts with an aberration of the cell genome,
called a mutation which transforms a normal cell into a malignant.
The aberrant cell multiplies and creates a tumor. The entire cell
population continues to mutate acquiring gene mutations which make
the tumor more and more aggressive. Additional aberrations enable
it to spread all over the body and finally killing it.
v. Their cancer is different than mine
Yet cancer is more than that. It is a sophisticated Dasein.
From its very beginning tumor and WOB maintain a balance.
The disease progresses either because the tumor becomes more aggressive
or because WOB weakens. This balance is the essence of cancer
as well as of any disease. This is what Dasein is about. It maintains
a balance. Treatment may thus be directed either to weaken the tumor
or to strengthen Dasein. Medicine ignores this balance. It equates
cancer with the growing tumor and reduces Dasein to aberrant genes
residing in the genome which it calls the Book of Life.
Emmanuel Lévinas
Dasein’s unconscious
Any symptom in the human or a concept related to it is a doublet.
In our case, the unconscious is {Mind-unconscious, WOB–unconscious}.
Freud and Jung deal with mind-unconscious simply because the patient
in coma who is mindless, is not bothered neither by the Oedipus
complex, nor by a Jung archetype. The Id are WOB messages to
the mind, which were Freud’s main concern. These WOB demands
which opposed the cultural norm initiated a conflict which Freud
tried to resolve.
Jung’s archetypes are rooted somewhat deeper
than the Id. They are manifestations of instinctive behavioral
patterns of live forms which mold the WOB. They operate also
in the patient in coma, yet Jung ignored their contribution to the
patient’s health
Freud was a reductionist anxious to establish psychoanalysis as
a science. Jung was attracted by mysticism, and the irrational
yet did not attempt to harness them during therapy. Yet Dasein is
more than that. Prior to usurpation, to ontology, to theoria, to
intentionality, Lévinas finds the embodied human.
v. Religion and mind disease
v. WOB and Theology
The Other
The Other is another person in its infinite totality. When the self
encounters another person it attempts to absorb the alterity of
what it encounters in to the self’s horizon.
In its consciousness the other will appear as something foreign,
a disequilibrium, beyond principle and volition. Nevertheless the
self attempts to absorb it. The Other presents himself as a
face which hides his unknowable nature, nevertheless it is grasped
by the self, otherwise it could not broaden its horizon.
When Lévinas was born his Dasein was a mindless WOB. After crying
briefly the baby encountered its first Other which had the Face
of a mother. For the coming days, mother served as its mind substitute.
As the child grew up it absorbed the alterity of its mother and
gradually broadened his mind’s horizon. Communication between
mother’s Dasein and the baby was instinctive and non verbal. Baby
and mother are equipped with instincts like, imitation and empathy,
which enabled the baby to grasp
the Other.
This primordial experience matured later into the philosophical
concept of the Other, However we are interested here mainly in
its medical implication. With time the baby met additional Others,
who inspired it to stand, walk and talk. Since birth, the self
has absorbed everything it has encountered into the self. Compare
this phenomenological description of the growing child with that
of Freud who reduced the contribution of the Other to four stages
of sexual differentiation.
v. Shamanism
The self is born out of ethical response to the other
When captive in a Nazi camp, Lévinas came to the conclusion about
his responsibility to the Other. The ethical demand that emerges
from an encounter with the other takes on fuller meaning when contextualized
in Lévinas’s understanding of the face of the other as the
trace of God’s face.
v. Medicine without ethics
v. Two codes of ethics in medicine
The absolute Other
The unknown, according to Lévinas, is God or the absolute other that is always outside the grasp of the self. The face of the other points to the face of the absolute other. The face of the other acts like an ideatum to the face of the absolute other. God is part of unknowable aspect of the unknown. This God does not judge human behavior rather the judgment of morality becomes the responsibility of the self in the presence of the other.
There are other timeless and infinite deities, e.g., the Brahman, Spinoza’s God which is the natural world and has no personality. According to the kabbalah, the Infinite “bracketed” itself (epoché )(Tsimtsum) and then created the world. Lévinas’ God is different. He does not rule and judge, which seems like a view of an atheist. Was the observant Jew Lévinas an atheist?” Or perhaps Lévinas founded a new post-modern religion which was the consequence of Nietzsche’s “God is dead”. What matters to me is that Lévinas’ God does not cause mind-diseases.
References
Epstein Daniel, Near and Far. Ministry of Defence press. Israel, 2005
Heidegger, Martin. Being and Time translated by John Macquarrie and
Edward Robinson Oxford: Blackwell, 1962
Husserl
Levinas Emmanuel, Totality and Infinity translated by Alphomso Lingis.
Duquesne University Press Pittsburgh Pa. 1969