One sunny day over the summer, as I was waiting for my items to be checked out at the supermarket, I struck up a seemingly open, friendly conversation with the cashier. When the subject veered to college and I mentioned my fields of study however, he perplexedly cut me off and shot back, “wait, why?” Unfortunately, this dismal response is one I’m all too familiar with.
Indeed, whenever I’m asked what I’m studying in college, and I spiritedly say I’m a Philosophy-cum-Neuroscience major, I’m met with disproportionately more puzzled looks than neutral or enthusiastic ones. I’ve reluctantly learned to accept these reactions before I explain the disciplines’ subtle similarities, as they seem to be an inevitable part of life, but I can’t help but wonder—why is it that my decidedly scientific-humanistic approach to medicine isn’t a more cherished path of study?
After all, in our increasingly interconnected and integrated world, the global environment is no longer an isolated one—because of both the rapid pace of communication developments and the quickening adaptive nature of technological complexity, the human population is willfully forced into a new cross-model thinking pattern, involving cultural, academic, social, and political spheres. In this maelstrom of novel ideas, it’s hardly a surprise that innovative disciplines such as “biomedical engineering”, “cultural anthropology”, “bioethics”, “psycholinguistics”, and “bioinformatics” have emerged by the handfuls, promising to create new methods to heal, control, and maintain our world.
As demonstrated by the overwhelming success of these fields, it’s clear that when disparate subjects are combined in a counter-rational fashion, the resulting force of will ignites a grand revolution in society, both in the way of thinking and in the way of doing. Indeed, when properly harnessed, this raw power has the capacity to take entire teachings and turn them on their heads, transforming the very foundations on which they were constructed. How? It’s simple. The dichotomies between the two that had once seemed so stubborn vanish, yielding space for potential innovations beyond the realms to which they had previously been assigned.
Consider, for instance, the merging of ecology and economics—termed “ecological economics”, this blossoming field provides a pragmatic answer to questions about the limits of sustainability as defined by the Malthusian dilemma. Combining economics, brimming with statistical dryness, and ecology, craving the utmost devotion to nature, enables us to come to terms with the importance of nature and its constraints in modern society. While traditional economists hardly regard nature a limiting force in the growth of the market, and traditional ecologists are so taken up by their purist respect for nature that they fail to see it as a means of production, ecological economists have the trained ability to set aside these biases, to arrive at a cohesive understanding of both economical and environmental conflicts. Indeed, these complex problems seem less insurmountable when taken in tandem with each other, in the context of nature’s contribution to the manmade economy.
Thus, when supported by such innovative formulae, even the most objective fields can take on a role of learned subjectivity, allowing for a level of understanding unmatched by any other methodology. As a result, reasoning becomes nearly intuitive, and previously unconsidered solutions can be examined. Furthermore, by blurring the lines between two fields and consolidating them into one, we render the familiar unfamiliar, granting us the added benefit of eliminating the stereotypes that may have plagued them in their past. Therefore, the novel manners of thinking that stem from the collaborative nature between any combinations of disciplines should not be taken lightly—in fact, they may just be the impetus needed to give new life to hackneyed areas of interest.
It’s apparent that medicine, especially, is an inherently interdisciplinary field that is only enhanced by the conscious introduction of the humanities, including literature, music, art, and yes, philosophy. After all, both the practice and theory of medicine are crucially harnessed to the underlying basis of the human condition, a concept the humanities are exclusively equipped to illuminate and manage. Identifying with Russian literature, for instance, allows us to grasp the depth of humility Humbert felt upon confronting the moral consequences of his horrifying, pedophiliac desires. It allows us to comprehend the fevered guilt and hellish turmoil in Raskolnikov’s mind after brutally murdering his half-sister, even while subtle nuances of the semantics may have been lost in the Russian-to-English translation.
Learning to poignantly feel each of these sentiments—the familiar and the strange, the gruesome and the pleasant, the homely and the refined, the keen and the reluctant, the antiquated and the modern, the loved and the despised—as literature allows us to do, is invaluable. As Thoreau once questioned, “could a greater miracle take place than for us to look through each other’s eyes for an instant?” The written word enables us to not only resolutely answer this for ourselves, but also teaches us how to tolerate ambiguity and reminds us to be open-minded. It is this degree of empathy that is noticeably absent in the physician repertoire, but so crucially needed. Indeed, the essential implications of such a capability cannot be overstated, especially in the physician-patient relationship. Arriving at an absolute understanding of a patient’s complaints, harbouring no prejudgments or misconceptions, ensures that physicians will be able to offer the highest quality of care. This is the salient point: with nothing lost in translation, with the patient and the physician reaching the apex of communication together, clinical care becomes not a means to an end, but a means of experiencing and understanding.
Literature does more than just teach us empathy, however. It urges us to feel the string connecting our internal world to the external world, and encourages us to see our fates as part and parcel of others’ fates. It teems with laws of morality and of justice, one after another, in a seemingly endless loop of discovery. It shows us that just as the physician has a responsibility to her patient, so does the artist to her reader, the salesman to his customer, the president to his cabinet. While the particularities of the roles may differ, each of these relations has a single commonality: the obligation to remain genuine, maintain consistency, and practice fair judgment—in other words, to shun all that that seeks to corrupt the purity of trust. In this way then, language can take its rightful place in the family of morals—after all, morality (and moral responsibility) is grounded in the compassion and empathy of literature, not in the reason and objectivity of science. Thus, literature, in its greatest form, also presents us with grandiose questions of ethics, passing the proverbial torch to philosophy.
As the philosopher Tertullian presciently noted in the first century AD, “Medicine is the sister of philosophy.” Ignoring the conflict of interest inherent in this claim, I believe this message holds more truth today than it ever has in the past. In our contemporary society, medicine, philosophy, literature, and economics have all melded together in a theoretical fraternal brotherhood, yearning for something to offer significance to, for a question to shed light on. After all, if the collective knowledge gained in the past two thousand years is to have a purpose beyond merely existing, it must be to affect and comprehend the human condition—to invigorate the intellectual essence of the lost human soul. To this end, philosophy and its many domains can play a crucial role in transcending the limitations humanity has unconsciously set for itself.
For example, the age-old philosophical case of Determinism vs. Free Will lends a thrilling perspective to medicine, similarly characterized by its own underlying developmental dilemma: Nature vs. Nurture. While the former is defined by its generality, and the latter ties in aspects of heredity and the environment, their possible transmutability is reason enough for personal crisis. Indeed, we experience an intractable tension here—while we believe we are the agents of our own will and select our courses of actions freely, this view is jarringly inconsistent with our scientific belief that we live in a universe controlled by determinable laws of nature. If the universe has been laid out as an immutable roadmap, wholly indifferent to our desires and needs, then how can we justify taking responsibility for our presence in it—and if we are not responsible for our actions, if we are not responsible for our aggressive tendencies or slow metabolism, then who or what is?
To put the matter in cruder terms, the aforementioned philosophical debate vs. biological debate can be summed up as the universal lottery vs. the genetic lottery, in which the lottery cards are the irrevocable cards we are dealt in life. However, even after acknowledging that the universe and hereditability are unchanging constants, we can still choose not to be limited by our will or our inability to act—we can consciously make a choice to legitimize and adopt the influences we feel strongly pulled to, and ignore the others. After all, who among us hasn’t tried to bend the natural order to his or her will? While the alcoholic’s progeny might have a genetic predisposition to abuse alcohol, for instance, he can still make the purposive decision to evade the “fate” that’s been written for him. That is, the core, organizing principle of these seemingly dissimilar disciplines is one and the same: the innately human propensity to seek fundamental answers to our existence and survival, while ensuring our domestic growth and power.
Many such examples abound in the history of medicine, and while a careful study of these “big ideas” is beyond the scope of this post, suffice it to say many exist, and many more have yet to be discovered and accounted for. To touch (very) briefly on these, consider the roles of reductionism and judgment in the art of medicine and the art of philosophy.
In the philosophy of science, reductionism is the belief that many of the obscure questions of science can be resolved by reconsidering them through the lenses of physics, the fundamental science. It’s the idea that the degree of complexity of a system is only as great as that of its parts, and when broken down into those basic entities, the system is less formidable and easily tamed. In medicine, hospital practitioners have been known to practice a reductionist approach—instead of considering the patient as a holistic being, they zero in on the malfunctioning heart or the malignant tumour. The goal is simply to divide and conquer, no more and no less. While the success of this mechanical oversimplification is indubitable, it still begs the question—how can hospitals do even better? How can they decrease mortality rates, how can they enhance patient care? We don’t yet have answers to these, but I believe stepping away from a reductionist approach and moving into a holistic one is a place to start.
In political philosophy, judgment—or the power of judgment—is the term given to the capacity to recognize and develop wise solutions, even in the face of ignorance and complexity. It’s the capability to successfully apply previously learned knowledge to novel problems. Moral judgment, its resoundingly ethical face, on the other hand, is a descriptor given to the theoretical situations of judgment: it considers the criteria of “good” and “bad” relative to some predetermined standard, and factors it into the final judgment decision. In medicine, it’s undeniable that moral judgment has forged its own place—from controversies as varied as euthanasia to stem cell research, ethical implications are unavoidable aspects of the field. However, I believe the power of judgment is also as crucial a skill for physicians, and will only continue to grow in importance. In the modern-day operating room, clinical judgment might be mainly seen as the experiential knowledge of what tools to use. After all, the current era of generalized rules in medicine is hardly conducive to much else, offering no room for judgment calls or additional assessments. But, in combination with a holistic approach, physicians would be able to apply this same judgment to elucidate the uncertainties of diseases and identify the patterns of subjective variabilities—age, ethnicity, stress levels, etc.—between patients, ultimately increasing the overall quality of care.
The parallels between the study of philosophy and the study of medicine allow for such intriguing breakthroughs that it’s almost a surprise they aren’t more carefully considered. Indeed, philosophy—in the form of ethics, metaphysics, ontology, and epistemology—has so essential a stake in the art of medicine that it is imperative to give it the credit it deserves and allow it to flourish, especially in our changing global culture. It has the unique capacity to redefine the scope of medicine, while simultaneously illuminating the specificities of the raw “public good” medicine professes to provide. It is this clarity that is invaluably vital in this uncertain climate of knowledge and cultural transformations. In these modern times, especially, the medicine-philosophy pairing allows us to reflect on the humanistic side of medicine, which has lost its footing since the advent of for-profit healthcare companies. Accepting a philosophical analysis of the human state of being carries with it the promise of recreating the purity of medicine—including the methods, concepts, practices, theories exclusive to its existence as a practice and profession. Indeed, the crafty, whimsical Germans have just the word for this: Geisteswissenschaft, or the spirit of science and knowledge as methods of understanding.
These examinations bring me to my final point. Though neuroscience is already an assuredly interdisciplinary study, melding perspectives from chemistry, psychology, anthropology, biology, linguistics, and engineering, the importance of its further union with philosophy—often known as cognitive science—cannot be overstated. Indeed, it is this union that is rightly positioned to give new meaning to our comprehension of the totality of existence. After all, we are self-reflective, self-aware beings accustomed to being fulfilled by the promise of self-justification and through the vision of self-direction. We perpetually renew our energy in our unyielding pursuit for the origin of consciousness, the elusive theory that yields life. We are psychologically enlivened by the rational prospect of integrating our scientific and humanistic knowledge for even a single drop of progress, on either a personal or global scale—and it is this rooted, innate human desire that is targeted not only by medicine, but also by the neuroscience and philosophy duo.