The Me of Science

This is going to sound trite, but have you ever wondered about your role in Science? Really. I mean that of your consciousness in apprehending and interpreting that which is measured: the ‘Me’-ness which separates each of us from whatever we’re doing -or, rather, which joins us to it: joins us to the other?

I don’t mean to sound Cartesian here; I don’t want to get into mind-body stuff, and yet it comes down to whether or not we believe that the Mind is reducible to a bundle of interconnected neurons, or something more, doesn’t it? An emergent phenomenon -a synergism- or merely a synthesis: an entity wholly explainable in terms of its constituents.

Where, in other words, do I come in? And if I don’t, is there any proof -apart from my saying so- that I even exist?

Of course, why should I even care? I mean, cogito ergo sum, eh? I know I exist, and so I can investigate anything I want, acting in my own right as a valid agent. Science and I can look into any box and measure its contents… except, perhaps, reality itself -I can assume no God’s-eye view of that. I cannot absent myself from that box while I measure it -I am immersed in it. The box, really, is all there is.

I have to say, I was re-seduced into this type of thinking by a very perceptive essay in Aeon written as a collaboration between Adam Frank, professor of astrophysics at the University of Rochester in New York, Marcelo Gleiser, a theoretical physicist at Dartmouth College in New Hampshire, and Evan Thompson, professor of philosophy at the University of British Columbia. https://aeon.co/essays/the-blind-spot-of-science-is-the-neglect-of-lived-experience

‘In our urge for knowledge and control, we’ve created a vision of science as a series of discoveries about how reality is in itself, a God’s-eye view of nature. Such an approach not only distorts the truth, but creates a false sense of distance between ourselves and the world. That divide arises from what we call the Blind Spot, which science itself cannot see. In the Blind Spot sits experience: the sheer presence and immediacy of lived perception.’

So, ‘Elementary particles, moments in time, genes, the brain – all these things are assumed to be fundamentally real. By contrast, experience, awareness and consciousness are taken to be secondary.’ And yet, ‘We never encounter physical reality outside of our observations of it… [and] these tests never give us nature as it is in itself, outside our ways of seeing and acting on things. Experience is just as fundamental to scientific knowledge as the physical reality it reveals… The point is that physical science doesn’t include an account of experience; but we know that experience exists, so the claim that the only things that exist are what physical science tells us is false.’ Or maybe misleading.

‘Husserl, the German thinker who founded the philosophical movement of phenomenology, argued that lived experience is the source of science. It’s absurd, in principle, to think that science can step outside it.’ And Alfred North Whitehead, who taught at Harvard University in the 1920ies, ‘argued that science relies on a faith in the order of nature that can’t be justified by logic. That faith rests directly on our immediate experience… he argued that what we call ‘reality’ is made up of evolving processes that are equally physical and experiential.’ You’ve gotta love this stuff.

Anyway, I suppose the importance of all this palaver is to point out that ‘When we look at the objects of scientific knowledge, we don’t tend to see the experiences that underpin them. We do not see how experience makes their presence to us possible.’ However, let’s face it, without an observer -a measurer- the results are unacknowledged. Science is not science, if we are not there to do it and record it.

The whole subject is reminiscent of the discussions I remember from my university days when we would sit around for hours in a pub exploring our growing awareness of the world.
“I don’t know how you could say that,” somebody at the table -Brian, usually- would exclaim, throwing his arms up. “Science is about objects! It’s not at all comparable to religion…”

“And why is that?” someone else -usually Jonathan- would answer. “It just deals with reality a little differently, that’s all.”

“A little differently?” The arms again. “Religion is completely subjective! You can’t prove anything…”

“And does Science prove anything -or is it just the scientist who looks at the instruments who proves it? Somebody has to read the data. Experience them…” This was always Jonathan’s argument, I remember.

Brian was a little more excitable, and he would roll his eyes at the slightest provocation as disdain dripped unchecked from the rest of his face. “Come on, Jonathan! You don’t experience science in the same way as religion. You do science!”

“How do you read an instrument, or interpret a result without experiencing it, Brian? There has to be someone who looks at the measurement.”

Brian would always shake his head in disgust when Jonathan disagreed with him. “But the measurement was not created by the scientist, it was made by the machine, or whatever -and that’s about as objective as you can ever get.”

A little smile would always creep onto Jonathan’s face at this point. “Well, who designed the machine? Who built it for the purpose…?”

“Give me a break, eh? Once it’s built, it’s an object!”

“But the experiment -the question- which the object is built to answer, is subjectively constructed, is it not? And the results have to be formulated into a conclusion, don’t they? Accepted, or rejected, the results have to pass their way through a mind. Through consciousness… They have to be experienced!”

“And what is doing the experiencing? It’s just your brain -a physical, an objective, thing.” Then Brian would smile and sit back in his seat with his beer to deliver the coup de grace. “The brain is not a ‘who’ but a ‘what’ isn’t it?”

But Jonathan would like this part of the argument, I remember -it always took this turn. “If that which interprets data is an objective ‘what’, and if that which it is experiencing is also a ‘what’, then everything is a ‘what’ -Religion included; it’s doing the same thing… sort of like Science, eh?”

The arguments, fuelled no doubt by the effects of alcohol on inquiring minds, would go on in increasing complexity and implausibility until the pub closed, and we would all wake up the next morning with hangovers -but still friends, willing to take each other on again at the next opportunity. In a way, it makes me wonder what those authors of the Aeon essay were going on about with their questions about what role subjectivity and experience has in dealing with the world -its role as the Blind Spot. My friends and I -subjects all- don’t experience it as anything like a problem -not really. We see it simply as friendship. And that is the foundation for everything isn’t it…?

 

 

 

The Wisdom of Experience

Sometimes, I feel like a fake. I suppose the ability to see oneself from various angles is a gift of age, but I rather enjoyed myself more when I was sure of who I was –or at least didn’t trouble myself with the question. And yet, to dig for the core is to taste the apple on the way.

It was easy to be a doctor when, primed with knowledge, experience was something displayed in a shop window, not something I wore. It was an outfit I didn’t need -an extravagance, really: a luxury you only donned when the facts you’d learned were threadbare and outdated. It was a costume of authority, a camouflage for waning certitude: Moira.

And yet as I plough through the years as steadily as a man walking through waist-high water, I have come to realize that experience is more than subterfuge, more than mere artifice; it is Age. Nothing less. And following in its wake is all the jetsam tossed overboard to lighten the journey, all the flotsam through which we, as sentient beings, must wade in order to progress. A dirty passage protected only by the hull of maturity. But enough metaphor.

All of this somewhat depressing prologue is to introduce an incident that occurred a few years ago when I was teaching a medical student in my office. Stephanie was very good, really –very perceptive and knowledgeable- and she carried herself like someone who had already graduated. It was not hard to integrate her into the chaotic machinations of my busy office.

We were seeing a woman sent to me from a well-respected family doctor who sometimes attracted patients with very dissimilar world-views. She had come to see me for a second opinion about the management of her menopausal symptoms. Or rather, she had been sent to see me by the GP when she refused to accept the treatment offered by the first specialist.

A very well-dressed woman with neatly brushed hair, she sat across the desk from me looking quite confident. She smiled at Stephanie, and then straightened her shoulders and stared at me defiantly. “My doctor wanted me to see you about the menopause…”

I smiled and waited, pen poised to write down her complaints so I could address them later, but she sat back in her chair, obviously finished, and stared at the calendar hanging on the wall behind me. “So, are you having any problems?” I asked after a rather awkward silence.

She shook her head and shrugged. “Am I supposed to?”

I glanced at Stephanie, who was sitting on the edge of her seat, fascinated at the exchange. “No…” I said, looking at the referral letter that just said ‘MENOPAUSE!’ in giant capital letters followed by an even bigger exclamation mark. “But I rather thought your doctor must have had some reason to send you to see me.”

The woman smiled –at least, I suppose that’s what she wanted me to think, but actually it was a smirk. “I’m managing my menopause very well, doctor…” It was a challenge: a dare to be contradicted.

“So… there are at least some symptoms you’re feeling a need to manage.” I said this carefully, not wanting to provoke her.

She immediately straightened in her chair and her eyes hardened. “Why would you say that?”

My turn to shrug. “Well, is there anything I can do for you, then?” I kept the smile on my face.

She took a deep breath to contain her obvious irritation. “My doctor thinks I should be taking hormones… And so did that other doctor she sent me to.”

I started to write in her chart –it often helps patients to think they are saying something important. “Why is that?” A simple question; no sense confusing her.

Silence, and then a prolonged blink. “I told her I wasn’t sleeping and was becoming irritable at work.” She pinned me to the wall with a sudden glare and then, just as suddenly, relaxed the intensity. A little grin crept onto her lips, but she erased it almost before it flowered. “And I mentioned I was having the occasional hot flush.” Her face hardened. “Why do we always medicalize things and make them into illnesses?”

She was silent for a moment and I put down my pen. She looked at my now dormant chart, for a moment.

“I do not want hormones, doctor,” she said shaking her head angrily. “I’ve solved the issues myself.” And she crossed her arms across her chest as if to ward off any criticism.

I picked up the pen again and her expression softened a little.

“Ginger and lemon juice three times a day…” she said and then stared at me: the dare again.

“It helps?” An innocent question I thought.

“Of course it helps!” Her arms tightened across her chest. “You don’t always need hormones, doctor.”

I tried to keep smiling and sat back in my chair. “I certainly agree with that, Sandra. Sometimes we pathologize things unnecessarily.”

The change in her body language was dramatic and she unfolded her arms and loosened her shoulders. “So you think it’s okay to continue with my lemon and ginger?”

I nodded and wrote something in her chart. “As long as it’s doing the job, why not?” I started to put the pen down and she noticed.

“There’s a lot of stuff in there that you haven’t filled in yet,” she said with an increasing grin on her face and stared at the almost blank history sheet in the chart. “You can ask me some questions –I won’t bite.”

I proceeded with the usual consultation and then looked up at her. She was beaming.

“You’re the first doctor who actually listened to me…” she said, clearly surprised. “Still think I’m okay with the juice?”

I smiled at her -my face was beginning to ache with the effort. “It won’t hurt, “ I said, and sensing she was satisfied with the interview I got up from my chair to open the door for her. “But just let me know if you need to discuss some other options, eh?”

As soon as she was out of the room, Stephanie rolled her eyes; she was obviously troubled.

“So what do you think, Stephanie?”

She took a deep breath and looked at me. “She needs hormones…”

I sat down and waited for her to explain. “I mean, she was obviously describing estrogen withdrawal symptoms: hot flushes, night sweats, sleep disturbance… And did you see how irritable she was? Classic menopausal stuff.”

I smiled patiently. Stephanie was young and enthusiastic. Full of knowledge. “So what would you have done if she’d walked into your office?”

She thought about it for a moment; that she didn’t want to offend me was obvious in her face. “Well… First I would have taken a detailed history like you…” She politely ignored the order in which I had proceeded. “And then I would have told her about how estrogen –and progesterone, I guess, because she still has a uterus- would help alleviate her symptoms.” She looked at me, whether for approval or permission to deviate from my approach I couldn’t tell.

“And if she told you she didn’t want to take hormones? That she felt they were too dangerous, or maybe she didn’t believe she needed them..?”

Stephanie didn’t even blink. “I would have been more insistent…”

“And if she still didn’t agree?”

That stumped her for a moment. “Well… uhmm, maybe I would have sent her to a specialist for another opinion.”

“To validate your opinion, you mean?” I said it lightly and with a grin to defuse the tension I could feel increasing in Stephanie. “She already saw another specialist, who validated her GP’s view… Now what? Give up on her?”

Stephanie stared at me, but it was clear she didn’t have an answer.

“Look,” I started, gently, carefully, so as not to appear to contradict what we both knew to be true: many menopausal symptoms are related to hormonal changes and many of the symptoms do disappear when you prescribe hormones. “Why was she sent to me?”

Stephanie rolled her eyes again –an annoying habit she was prone to use at the slightest provocation. “To treat her menopause…”

“Didn’t she tell us at the very beginning that she was already managing her menopause?”

“Yes, but…”

“Yes, but not the way you would like?”

I could see that Stephanie was becoming exasperated. “But surely you could see that she wasn’t. I mean, she was obviously really irritable and…”

“Wouldn’t you be irritable if nobody listened to your opinion?”

Stephanie’s left eyebrow suddenly took over half her forehead –another trait I had noticed during her time in the office. “But there’s no data on ginger and lemon juice. No studies…”

“She seems to think it’s helping her.”

“Yes, but that’s just a placebo effect. It’s going to wear off…”

I broadened my smile. “And when it does –if it does- who will she decide to talk to about it? The doctors who were unwilling to accept her approach, or the one who admitted she had the right to try another way?”

I’m not sure I convinced young Stephanie, and I’m certain that she’ll succeed in whatever field of Medicine she chooses. But I do hope that she learns that the paths we need to follow are not always straight and that even detours usually end up where we want…