Medicine (doesn’t work)

Early on, my doctoral supervisor returned a draft to me with a red line through an entire section, headed “Methodological considerations”. We didn’t discuss it, but I took him to mean: just do it, and cut out the huffing and puffing. In another institution I won’t name, I experienced the opposite, more usual approach. There is meant to be an Aristotelian inevitability to the marriage of theory, method and matter, rigorously demonstrated. The result is generally uncontroversial and pedestrian. Jim did give us his thoughts on creative method, though — a slightly different question. Some plan in outline, others write “generatively”, that is, they just start writing and knock it into shape as they go.

I have what should probably be called a journal, with its origins in the diary I kept as a young man. At some point I lost the sense that what I wrote about my own life was sufficiently honest or penetrating to be worth the trouble, but I have sporadically continued to write about things of the kind that also appear here. My only readers are accidental ones, but nonetheless, these thoughts are more lucidly expressed, and mean to be more engaging, than what I put down for my own eyes alone, which are losing their acuity. Certain preoccupations return, indeed, with roots in my own unremarkable life. An intellectual focus itself tends towards objectivity, or generality. If medicine “doesn’t work”, that isn’t a complaint about my own doctor.

But these posts are like light that catches one face of a crystal; they fall short of making up a whole. Recently I dipped into Leopardi’s notebook, the Zibaldone, meant for his own use alone, which is still quite discursive; and interesting for its detail. He believed, following Locke, that the mind’s capacity for talent is a unitary quality, no different in the mathematician or the poet; so one could with application become the other, and might just as well have turned out a musician. The key is the capacity to form habits. This may not be a fair account of his theory; but you don’t have to agree with it to delight in the fine observation and psychological persuasiveness of the examples he gives. Then on the next page, he is talking about Horace’s style, or the derivation of Italian dialect words.

What struck me is the examples are meant to support the theory, and yet they don’t have any power to unsettle it; it just sits on top, like a cut glass chandelier illuminating the furniture below. But Leopardi isn’t dogmatic, on the contrary, his mind sparkles with freshness and independence. This is both an example of my own theory, and perhaps of the dangers of theories. Our rational justifications for things such as social practices (slavery, democracy, witchcraft trials) just sit on top. It’s a commonplace that modern medicine works because of its sound empirical basis. We have thrown out leeches along with the four humours. Smoking, like masturbation, is bad for you (doctors used to recommend it, less than a century ago). I hardly need to spell it out.

The trouble is that I can’t. All this, put together into an argument, is not even original; though I dare say it puts me in company I wouldn’t gladly choose. All that remains is misanthropy: we are such stupid, cruel creatures. To put it another way, though hardly with more optimism: rationality may be rare to vanishing, but it is still our cardinal moral obligation.


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