musingsonwomenshealth.com

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

It is in the ocean that the river will realize it is not disappearing but becoming the ocean


There are some things I just can’t prove: that I am in pain, for example, and that it ebbs and flows like waves on the ocean. How would anybody know for sure, unless they were inflicting it, that it is pain that I am feeling -not something else? Let’s face it, I am the only expert on my own pain… And if there is no obvious cause, it’s still something that only I know: it’s mine, not yours; only I am able to access my feelings.

This special way I know my pain and other experiences is called introspection. No one has access to my pains, thoughts, or feelings in the way that I do.[i] This access is also completely secure: although I could be wrong about other things, I can’t be wrong that I’m experiencing. Even in a dream, I am still experiencing something that exists for me. And it doesn’t require anything special like meditation or counselling to know what it is: ‘Pain is its own testimony. It lets me know.’

Still, despite skepticism as to whether or not to believe that I am in fact feeling pain, I think I would be willing to grant that I may not be describing it correctly, or convincing you that I am experiencing something. That’s one of the problems with words though, isn’t it? Pain is a word alright, but like taste, or maybe love, some things simply go beyond the power of words to convey the experience; it doesn’t mean that whatever I’m trying to describe does not exist for me. And, at any rate, it’s the pain that I’m feeling right now that is mine: it’s what I know so securely, so intimately.

Anyway, the knowledge I have of my own experiences is a completely different kind of knowledge from something I have read in a book and tell my friend; it is a different knowledge from what they know, or could know, about the pain I am feeling.

When I was younger -okay a lot younger and still in university- I was intrigued by the philosopher Bertrand Russell. As I recall it, he distinguished between ‘knowledge by description’ and ‘knowledge by acquaintance’. ‘We know things by description when we are aware of them as satisfying some concept or description… Knowledge by acquaintance, in contrast, doesn’t rely on any concepts or descriptions. It’s simply constituted by direct conscious awareness of things.’ – like pain. So, even if I wasn’t sure that what I was feeling was pain, I would still be acquainted with it and ‘for Russell, that acquaintance would count as knowledge… some knowledge is different – constituted simply by conscious awareness.’

‘It’s not the kind of knowledge that you gain from reading a textbook or listening to a lecture, nor is it the kind of knowledge that subjects report when they try to describe their experiences to others. It can’t be expressed in natural language – at least, not fully…  What it is is experiential knowledge, made up of your conscious awareness of things you experience, like colours, shapes, smells, tastes, feelings and, in your case, pain. It’s not propositional, or the kind of knowledge that is expressed with declarative sentences like ‘The sky is blue’ or ‘Paris is the capital of France.’ It’s just conscious awareness of things, the things you experience throughout your waking life. To put it differently, it’s not knowledge of truths like facts that you could learn from reading a textbook, it’s knowledge of things like the experience of pain… As long as you’re aware of your experiences, you have the knowledge.’

Two kids were screaming at each other across the aisle from me on a bus the other day; their voices were partially obscured by the rattling and groaning of the bus as it travelled over a poorly maintained section of city road, so I could only extract fragments of their exchange. I gathered that one of them had punched the other with her phone and was revelling in the response she had elicited.

One of them was really angry at being jabbed and I could tell from his face that the phone had hurt more than had been intended. “Why did you hit me like that, Laura?” he gasped, tears already beginning to drip down one cheek.

“Come on, Teddy,” Laura said, trying to mollify her friend. “I only hit you with my phone, eh?” She was smiling malevolently, though; it seemed clear that she had meant to hurt him. From across the aisle, it was hard to tell if it had been retaliatory, or just part of a playful boy-girl flirtation.

“You used the corner of your phone and my shoulder was already sore from the game yesterday…!”

“You baby! You’re faking it: you’re not in pain… And anyway, I wasn’t the one who tackled you in the game!”

“Doesn’t matter who tackled me; what matters is that you just hit me as hard as you could. And it wasn’t play-fighting…!”

Laurie stared at him, wondering if he was serious. “You’re faking it, Teddy. You’re not really in pain,” she added after thinking about it for a moment.

“How would you know if I’m in pain? I’m the one feeling it, not you!”

“And how would I know if you’re faking it…?”

Obviously a Bertrand Russellian moment: an example of ‘knowledge by acquaintance’ for sure, but I realized that neither of them would likely have been exposed to Russell in High School, and leaning across the aisle and telling them about his thoughts on the matter would hardly have been appropriate.

Some things are meant to be personal; some knowledge is unsharable, I suppose, so I sat back in my seat secure in the knowledge that someday when they were older and better read, it would be them sitting across the aisle from a grimacing old man and wondering if they should ask if he was alright -although even then, they would have to guess whether or not he was just kidding…

Sometimes, it’s better to forget that philosophers inhabit a different world from us…

[i] https://psyche.co/ideas/the-special-kind-of-knowledge-that-cant-be-put-into-words

gozzter

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