Wednesday, March 20, 2019

Is Pain a Sensation or an Emotion? and Medical Materialism etc.

The essay on the psychology of pain I mentioned in class yesterday:
We could learn a thing or two from the ancient Greeks’ understanding of suffering.
The United States uses a third of the world’s opioids but a fifth of Americans still say they suffer from chronic pain. The only demonstrable effect of two decades of widespread prescription of opioids has been catastrophic harm. With more than 47,000 Americans dying of opioid overdoses in 2017 and hundreds of thousands more addicted to them, it was recently reported that, for the first time, Americans were more likely to die of opioids than of car accidents.

This has forced many to take a step back and ponder the very nature of pain, to understand how best to alleviate it.

The ancient Greeks considered pain a passion — an emotion rather than a sensation like touch or smell. During the Dark Ages in Europe, pain was seen as a punishment for sins, a spiritual and emotional experience alleviated through prayers rather than prescriptions.

In the 19th century, the secularization of Western society led to the secularization of pain. It was no longer a passion to be endured but a sensation to be quashed... (continues)
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A fascinating podcast conversation about the ethics of addiction with Sally Satel and Sam Harris. Sally Satel, M.D., is a practicing psychiatrist and lecturer at Yale, author of PC, M.D.: How Political Correctness Is Corrupting Medicine; When Altruism Isn’t Enough: The Case for Compensating Organ Donors; One Nation Under Therapy; and Brainwashed: The Seductive Appeal of Mindless Neuroscience...
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And, William James on "medical materialism":

We are surely all familiar in a general way with this method of discrediting states of mind for which we have an antipathy. We all use it to some degree in criticising persons whose states of mind we regard as overstrained. But when other people criticise our own more exalted soul-flights by calling them “nothing but” expressions of our organic disposition, we feel outraged and hurt, for we know that, whatever be our organism's peculiarities, our mental states have their substantive value as revelations of the living truth; and we wish that all this medical materialism could be made to hold its tongue.

Medical materialism seems indeed a good appellation for the too simple-minded system of thought which we are considering. Medical materialism finishes up Saint Paul by calling his vision on the road to Damascus a discharging lesion of the occipital cortex, he being an epileptic. It snuffs out Saint Teresa as an hysteric, Saint Francis of Assisi as an hereditary degenerate. George Fox's discontent with the shams of his age, and his pining for spiritual veracity, it treats as a symptom of a disordered colon. Carlyle's organ-tones of misery it accounts for by a gastro-duodenal catarrh. All such mental over-tensions, it says, are, when you come to the bottom of the matter, mere affairs of diathesis (auto-intoxications most probably), due to the perverted action of various glands which physiology will yet discover.

And medical materialism then thinks that the spiritual authority of all such personages is successfully undermined.2

Let us ourselves look at the matter in the largest possible way. Modern psychology, finding definite psycho-physical connections to hold good, assumes as a convenient hypothesis that the dependence of mental states upon bodily conditions must be thorough-going and complete. If we adopt the assumption, then of course what medical materialism insists on must be true in a general way, if not in every detail: Saint Paul certainly had once an epileptoid, if not an epileptic seizure; George Fox was an hereditary degenerate; Carlyle was undoubtedly auto-intoxicated by some organ or other, no matter which,—and [pg 014]the rest. But now, I ask you, how can such an existential account of facts of mental history decide in one way or another upon their spiritual significance? According to the general postulate of psychology just referred to, there is not a single one of our states of mind, high or low, healthy or morbid, that has not some organic process as its condition. Scientific theories are organically conditioned just as much as religious emotions are; and if we only knew the facts intimately enough, we should doubtless see “the liver” determining the dicta of the sturdy atheist as decisively as it does those of the Methodist under conviction anxious about his soul. When it alters in one way the blood that percolates it, we get the methodist, when in another way, we get the atheist form of mind. So of all our raptures and our drynesses, our longings and pantings, our questions and beliefs. They are equally organically founded, be they of religious or of non-religious content.

To plead the organic causation of a religious state of mind, then, in refutation of its claim to possess superior spiritual value, is quite illogical and arbitrary, unless one have already worked out in advance some psycho-physical theory connecting spiritual values in general with determinate sorts of physiological change. Otherwise none of our thoughts and feelings, not even our scientific doctrines, not even our dis-beliefs, could retain any value as revelations of the truth, for every one of them without exception flows from the state of their possessor's body at the time.

It is needless to say that medical materialism draws in point of fact no such sweeping skeptical conclusion. It is sure, just as every simple man is sure, that some states of mind are inwardly superior to others, and reveal to us more truth, and in this it simply makes use of an ordinary spiritual judgment. It has no physiological theory of the production of these its favorite states, by which it may accredit them; and its attempt to discredit the states which it dislikes, by vaguely associating them with nerves and liver, and connecting them with names connoting bodily affliction, is altogether illogical and inconsistent. VRE



Josiah's text:



The obligation of physicians to relieve human suffering stretches back into antiquity. But what exactly is suffering? One patient with metastatic cancer of the stomach, from which he knew he would shortly die, said he was not suffering.Another, someone who had been operated on for a minor problem--in little pain and not seemingly distressed--said that even coming into the hospital had been a source of suffering. With such varied responses to the problem of suffering, inevitable questions arise. Is it the doctor's responsibility to treat the disease or the patient? And what is the relationship between suffering and the goals of medicine?

According to Dr. Eric Cassell, these are crucial questions, but unfortunately, have remained only queries void of adequate solutions. It is time for the sick person, Cassell believes, to be not merely an important concern for physicians but the central focus of medicine. With this in mind, Cassell argues for an understanding of what changes should be made in order to successfully treat the sick while alleviating suffering, and how to actually go about making these changes with methods and training techniques firmly rooted in the doctor's relationship with the patient. He uses many stories and anecdotes to demonstrate that there can be no diagnosis, search for the cause of the person's disease, prognostication, or treatment without consideration of the individual sick person. Cassell goes on to explain what needs to be known about a person, as well as the importance of recognizing the dual standing of doctors both as physician and person.

Making an eloquent case for seeing the symptoms within the context of the patient's whole life and person, Cassell injects a critical element of humanism into what has become a largely technical discipline.  g'r
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Broken-heart syndrome. Poets and politicians have long known that hearts and minds are linked. Now neuroscientists and cardiologists have shown again, in a study published this month in The European Heart Journal, that the connection is more than metaphorical. It turns out that those afflicted by a rare, serious condition known as “broken-heart syndrome” have brains that work differently from those of healthy people, suggesting that what happens in the head can hurt the heart...

Weekly health news quiz...
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1 comment:

  1. Lilly AlegriaMarch 21, 2019 at 3:23 PM

    Heart Broken syndrome:

    I would like to share my experience with this, around 2 years ago I experienced a separation to a highly toxic person. Although relief and sadness came in waves my body reacted in ways that surprised me. For about a month or two, I experienced extreme lack of appetite (I could go days without eating) and because of this fast weight loss, insomnia, and a sort of numbness. I remember feeling very frustrated because it’s not like I was purposefully not eating or neglecting my sleep, I simply couldn’t. When I was finally feeling more myself, I felt as if I was able to deal with stress and failure in a more rational matter, in fact stress was more a motivator than anything else. I thought it was interesting reading the article and seeing that scientist weren’t sure if brains who dealt with this were going to be predisposed to deal with stress poorly after this. I sure hope that isn’t the case.

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