musingsonwomenshealth.com

Reflections on 40 years as a doctor in Women's Health

Art thou not, fatal vision, sensible to feelings as to sight?


I feel fine today; I feel fine most days, but what does that actually mean? Who, or more probably what, is it that feels fine? The words of Virginia Woolf, in her essay On Being Ill haunt me at times like this: ‘All day, all night the body intervenes; blunts or sharpens, colours or discolours, turns to wax in the warmth of June, hardens to tallow in the murk of February. The creature within can only gaze through the pane – smudged or rosy.’

I am my body, after all. My I is not simply the resident, or the driver of the car. Woolf continues her assessment: ‘it cannot separate off from the body like the sheath of a knife or the pod of a pea for a single instant; it must go through the whole unending procession of changes, heat and cold, comfort and discomfort, hunger and satisfaction, health and illness.’

Perhaps it’s just me, but I sometimes have trouble combining the two (body and mind) into a single functioning entity; they each seem somehow different, even though I can’t deny they also affect each other. And yet in moments of pain, they undeniably fuse into one.

Still, ask me where I am, and in all probability I would locate me somewhere behind my eyes -Woolf’s creature gazing through the pane -smudged or rosy. It’s where I sit, manning the controls, blissfully watching the world outside and ignoring the body when I am well -not too happy so as to be unduly influenced by my heart rate, or the taste of dessert, but not so unwell as to be inconvenienced by heartburn, or sore muscles from a fall. Indeed, when I actually think about the unit I am, it is exciting, and I have to wonder where the separation lies: why should I feel in any way distinct from the body that is also me? Or do I?

I suppose that when I think of sensations like smell, taste, sound, and vision, their receptors are all in my head where I live. So far so good; but touch isn’t. Nor, for that matter, are my interoceptive senses like the place I feel my stomach grumble, or my bladder aching. And yet they are still me -perhaps not the control center, the thinking, conscious part of me, but inseparable nonetheless. Stranger and stranger… almost like two Magisteria, or maybe two overlapping components of a Venn diagram: different from each other, and yet… and yet not.

Perhaps it’s the Great Summation which accompanies the final act that draws the wonder from me like the mists that hang like laundry over mountains, but I am fascinated by the why of them both: why does one part seem conscious -the noun- and the other more adjectival. More descriptive -the colour description of the me?

I was drawn to an essay by Lauri Nummenmaa, a psychologist at the University of Turku in Finland. https://aeon.co/ideas/it-is-not-all-in-your-head-sometimes-its-in-your-legs

‘Everything we sense in our external and internal worlds has a distinct subjective quality… It is puzzling, however, how these external and internal pieces of information are organised into inner, subjective states.’ But, ‘Why did the feelings crawl into our consciousness in the first place?  The neurologist Antonio Damasio at the University of Southern California has proposed that emotion-related inputs from the body to the brain could have generated the first traces of consciousness in our early ancestors… The development of awareness of body-related harms might have ultimately paved the road for the emergence of more advanced forms of conscious thought and processes, such as language, thinking and reasoning.’ 

And, ‘Similarly, as our bodies signal our internal states to us, they also often communicate our internal states to others too… Such capability to promote social cohesion by exchanging emotions and other mental states has likely yielded significant evolutionary advantages already to our ancestors, and it could even be argued that a purely private consciousness would be of limited use.’ I have to say that the solipsist in me never thought of that.

Even more interesting, perhaps, is the famous Rubber Hand Illusion I discovered in another article. For this illusion, you see a rubber hand being stroked at the same time as your own hand (which you can’t see) and experience the rubber hand as your own. So, do you somehow acquire another body part which is ‘you’ much like your own leg or finger? Where do ‘you’ stop? As the article pointed out, ‘this induced change in conscious body ownership results also in nonconscious changes in the physiological regulation of the self’: interoception. The body and brain are engaged in a sort of feedback loop, with homeostasis regulating the body, but allostasis anticipating what might be required to achieve the regulation: hunger signalling the need to eat, for example.

But, doesn’t allostasis suggest that, in a way, the real controller in the mind/body complex, is the body? After all, as Damasio, pointed out, Life likely began before nervous systems (brains) were even in the picture. Presumably, only later when there needed to be some way of better anticipating the needs of the still-primitive organism rather than mere chance environmental encounters, did nervous systems develop for allostasis… It’s an interesting thought that the I is a byproduct, as it were. Would the body, on its own have any sense of, well, itself? Could it? Would chance encounters of bacteria with other unknown but similar organisms in the wild have any significance to either one of them? Does individual identity, in other words, require a nervous system? For that matter, does the very ownership of genes, constitute an identity in itself -one that doesn’t require a nervous system?

You can see what the Great Summation does to someone with a stack of years on the shelves. Where it leads…

So, if my personal me is necessarily linked to my internal bodily states (they are as much me as my mind’s I), is what I am unavoidably joined to in the outside world also a type of me? Like Shakespeare’s Juliet talking about the ‘rose by any other name’ still being a rose? After all, what’s in a name?

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gozzter

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