"Medical Materialism, Health, and the Pursuit of Happiness - reflections on healing and happiness" - a talk to the Student National Medical Association, Middle Tennessee State University December 3, 2013

1. Medical Materialism,
Health, and the Pursuit of
Happiness
Reflections on healing and livingSNMA/MTSU, Dec. 3, 2013
Phil.Oliver@mtsu.edu

2. My original working title for this talk was ―Happiness, Experience, and Medical
Materialism‖ - not as catchy, maybe, but ―experience‖ drops out only in name.
The title is now bent towards the Spring 2014 Honors Lecture Series on Health
and Happiness at the University Honors College. On Monday Feb.3 I’ll present a
more evolved version of this talk (3 pm, Honors Room 106). Thanks for your
assistance today, in helping me evolve!

3. PHIL 3345, BioethicsSpg 2014, TTh 1 pm
http://bioethjpo.blogspot.com

11. PHILOSOPHY 3345, Bioethics
Description. This course explores ethical issues arising from the practice of medical therapeutics
(conventional and “alternative”), from the development of new biomedical technologies, and more largely
from reflections on life’s meaning and prospects.
The course aims at clarifying relevant bioethical and medical issues and debates, representing various
perspectives in application to present and future human possibilities and concerns (for example: genetic
engineering and biochemical “enhancement,” longevity and life extension, end-of-life decisions, health
care access, nanotechnology, cloning, stem cell research, mood and performance-enhancing
pharmaceutical use, animal research, and reproductive technologies).

12. “Bio” means simply life, but questions
about life’s goals, about appropriate
means for attaining them, and about
the professions devoted to sustaining
life, give rise to the most complex and
enduring ethical problems.

13. The course compares many approaches to the urgent human preoccupation with life and its many
challenges (biological, environmental, social, technological) , in order to articulate the appropriate uses
of emerging technologies, therapies, pharmacological interventions etc., in ameliorating and possibly
altering the human condition.
Other objectives include exploring the future of life (human, nonhuman, and possibly post-human) and
reflecting constructively on what it can mean to be human in an age of rapidly advancing technologies
and bioengineering.
The course’s ultimate objective is to provide students with critical resources and tools they can apply in
making pivotal professional decisions and crucial life-choices.

14. Bioethics: The Basics by Campbell, Alastair V. (May 29, 2013) $13.77 Kindle Edition Auto-delivered wirelessly $21.95
$19.00 Paperback
Humanity Enhanced: Genetic Choice and the Challenge for Liberal Democracies (Basic Bioethics) Hardcover by Russell
Blackford (Author) Hardcover $27.00
Life at the Speed of Light: From the Double Helix to the Dawn of Digital Life by Venter, J. Craig (Oct 17, 2013) $10.99
Kindle Edition $26.95 $18.84 Hardcover
The Case against Perfection: Ethics in the Age of Genetic Engineering by Sandel, Michael J. (May 1, 2007) $9.99 Kindle
Edition Auto-delivered wirelessly $15.00 $13.96 Paperback
Enhancing Evolution: The Ethical Case for Making Better People Paperback $14.68 by John Harris Kindle$10.49
Limits to Medicine: Medical Nemesis, the Expropriation of Health Paperback $14 by Ivan Illich
The Immortal Life of Henrietta Lacks by Skloot, Rebecca (Jun 4, 2010) $8.99 Kindle Edition Whispersync for Voice-ready
$16.00 $9.78 Paperback

15. “In 2010, scientists led by J. Craig Venter became the first to
successfully create “synthetic life”—putting humankind at the
threshold of the most important and exciting phase of biological
research, one that will enable us to actually write the genetic code
for designing new species to help us adapt and evolve for longterm survival. The science of synthetic genomics will have a
profound impact on human existence, including chemical and
energy generation, health, clean water and food production,
environmental control, and possibly even our evolution.”
“In Life at the Speed of Light, Venter presents a fascinating and
authoritative study of this emerging field from the inside—
detailing its origins, current challenges and controversies, and
projected effects on our lives. This scientific frontier provides an
opportunity to ponder anew the age-old question “What is life?”
and examine what we really mean by “playing God.” Life at the
Speed of Light is a landmark work, written by a visionary at the
dawn of a new era of biological engineering.”

16. The Venter-like character in Generosity declares, in response
to critics who complain that his gene-patents are driven by a
selfish personal profit motive and cynical disregard for the wellbeing and future happiness of individuals:
―I agree; no patent should be allowed to prevent progress. The
only thing profit is good for is reinvesting in research. I want a
world where the one real source of wealth-- genetic possibility- is common knowledge and accessible to everyone.‖

17. All writing is re-rewriting, Stone &
Powers & Kurton keep saying. In the
past that’s always slowed us down and
made us think. But if we’re re-writing
not just words but genetic code, it may
speed us up and change us faster than
we can think about. That's the promise
and peril of genomics. Stopping the
world may not be an option, nor thinking
before we change.

18. As a pragmatist I feel somewhat dissed by
Powers’ characterization of the ‖witty
pragmatism‖ of the positive psychologist
who tells ―Oona’s‖ audience– much like
Oprah’s– about happiness. He might be
right, though, to advise keeping your
options open (―stay loose and keep
revising the plan‖). Is Powers right to
predict that pop media culture will be the
largest stage upon which our collective
future is to be written? Another scary
thought.

19. But ―all the world’s a stage‖ is scary, too,
and there's nothing new about that.
Yesterday's pop is today's classic rock.
We're an adaptive species, we're easily
sold on the new and sentimentally forgetful
of the old. What's new from the
genomicists and synthetic biologists?
"So medicine keeps getting more
complicated. I see the revenue potential
there, down the line. But you can't run a
business without products. What exactly
are you selling?‖

20. Is he telling us he's found
the happiness gene? No.
Yes. Maybe... maybe you
could market it that way…
Up@dawn

21. A lot of people wonder what happened to J. Craig Venter, the maverick biologist who a few years ago raced the
US government to sequence the human genetic code…
...he's in the midst of a scientific enterprise as ambitious as anything he's ever done. Leaving colleagues and
rivals to comb through the finished human code in search of individual genes, he has decided to sequence the
genome of Mother Earth…”
Wired 12.08: Craig Venter's Epic Voyage to Redefine the Origin of the Species

23. PHIL 3345, BioethicsSpg 2014, TTh 1 pm
http://bioethjpo.blogspot.com
Phil.Oliver@mtsu.edu

24. ―You are a mammal with extraordinary potential,
but we have to take care of you if you are going to
fulfill that potential.‖
-Jennifer Michael Hecht, ―The Triumph of Experience,‖ in The
Happiness Myth
Hecht's last words in Happiness Myth, in the chapter she calls “The Triumph of
Experience”: "there are other ways to see things."
Isn’t that precisely what good physicians and diagnosticians do? Look for other
ways to see things? And try to see things whole?

25. Experience triumphs over preconception, ideology, rigidity, misdiagnosis...
when we take it seriously, and don't attempt to reduce it to something smaller and
more conveniently compact.
In a medical context, doesn’t this means healers who treat entire persons, not just
bundled symptoms and physio-mental malfunctions?

26. There are plenty of high-profile humane and caring exemplars of this model of physician to
emulate and appreciate. Some of them have popped up at TED (Technology, Entertainment,
Design).
Abraham Verghese-Modern medicine is in danger of losing a powerful, old-fashioned tool: human touch. In the
strange new world where patients are merely data points, we should return to the traditional one-on-one physical exam.
Atul Gawande-Doctors are capable of extraordinary (and expensive) treatments, but they are losing their core focus:
actually treating people. We should take a step back and look at new ways to do medicine -- with fewer cowboys and more
pit crews.
Mark Hyman-functional medicine is the way of the future, and we can only improve medicine if we understand the
body's system, not just symptoms.

27. ―We have to take care of you…” Hecht, a poet and historian as well as a
philosopher, whose latest book is about suicide (another issue in bioethics,
whether ―assisted‖ or self-executed), was not speaking as a physician.
But it is a physician’s credo, and one which implies a physician’s vital interest in
the whole person who is his/her patient - an interest in that person’s health,
happiness, experience, and future.
I know you all intend to be humane, holistic, whole-person physicians and
healthcare professionals. You may already have identified some role-models, in
that regard…

29. Why do some people mistake wives for hats? Must have
something to do with personhood.
Oliver Sacks has an "abiding preference for the
organic, the human, the humane." Robin Williams
may have been a good casting call, then, since
humanity is nothing if not crazy and sometimes
manic.
Like the notorious metaphysical pessimist Arthur Schopenhauer, he's a
musicophiliac and a fount of epigrammatic wisdom. Unlike Schopenhauer, he's a
nice man. He'd never push an old lady down the stairs, or inform a patient that the
world is without point or purpose.

30. Music can lift us out of depression or move us to tears - it is a remedy, a tonic, orange
juice for the ear. But for many of my neurological patients, music is even more - it can
provide access, even when no medication can, to movement, to speech, to life. For
them, music is not a luxury, but a necessity.
If a man has lost a leg or an eye, he knows he has lost a leg or an eye; but if he has lost
a self—himself—he cannot know it, because he is no longer there to know it.
Language, that most human invention, can enable what, in principle, should not be
possible. It can allow all of us, even the congenitally blind, to see with another
person’s eyes.

31. “In examining disease, we gain wisdom about anatomy and physiology and biology.
In examining the person with disease, we gain wisdom about life.”
Sacks the person, as revealed in a charming “desktop diary” interview in which he
declared “my theme is survival,” is “grounded” by his stuff.

32. What Hallucination Reveals
About Our Minds Neurologist and author Oliver
Sacks brings our attention to
Charles Bonnett syndrome — when
visually or aurally impaired people
experience lucid hallucinations. He
describes the experiences of his
patients in heartwarming detail and
walks us through the biology of this
under-reported phenomenon.
(Recorded at TED2009, in Long Beach,
California. Duration: 18:48)

33. On Thanksgiving Day my wife’s elderly Aunt posed a philosophical-neurological
question some might be tempted to dismiss. She’d been hearing voices, in chorus.
Who or what were they?
Oliver Sacks would not be dismissive. He’d take Aunt Tom’s reported experience
seriously. He’d wonder if it wasn’t possibly an instance of Bonnet Syndrome.
He’d be a great role model in this respect, for physicians and neurologists. And
for philosophers?

34. “Good bye + God bless you!
Keep your health, your
splendid health! It's better
than all the 'truths' under the
firmament. Ever thy W. J."
William James to F. C. S.
Schiller, 8 August 1910
shortly before his death.

35. Though the ULTIMATE state of the universe may be its
extinction, there is nothing in physics to interfere with the
hypothesis that the PENULTIMATE state might be a happy
and virtuous consciousness...

36. In short, the last
expiring pulsation of
the universe's life
might be...
"I am so happy and
perfect that I can
stand it no longer.”
WJ to Henry Adams, 1910

37. William James (1842-1910) was
America’s greatest psychologist and
philosopher, one of our greatest
writers, founding “Pragmatist,” an
ardent advocate of everyone’s right to
pursue happiness, and - by the way - a
Harvard M.D.

40. 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 organtones 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. [Lecture I]

41. Taking experience seriously in every context involves humility,
compassion, receptivity, and openness. It doesn't claim to know more
than can be known in advance,of one's own or another's experience of
life. It doesn't automatically "discredit states of mind for which we
have antipathy." Unlike Medical materialism, it's multiply-perceptive
and non-reductive. It's like Emerson's self-reliant "thousand-eyed
present" and Thoreau's miracle of vision through another's eyes.

42. "It seems to be a rule of wisdom never to rely on
your memory alone, but to bring the past for your
judgment into the thousand-eyed present, and live
ever in a new day."
-An Essay on Self-reliance

43. ―Could a greater miracle ever take place than
to look for an hour through another’s eyes… ?‖
-HDT

44. When someone identifies one of his own experiences as
transcendent, he is making a much stronger statement about its
vivacity and impressiveness for him than if he were simply to say
that he had had a vision, an intuition, or a powerful feeling
that might for all he now knows have been just a bit of
synthetically or chemically induced mental weather signifying
nothing. "I had a transcendent experience but . . . I might have
just been hallucinating" or "my norepinephrine and serotonin
levels were spiking" or "my medication was kicking in" would be
very strange things to say in reflective response to one's own
transcendent experience, even if accurate at an isolated level of
neurophysiology. The personal quality of our specific experiences
is rarely so isolated from our "real" world that we are prepared
to dismiss them out of hand.

45. It makes even less sense to cash out a transcendent attitude
or habitually high default level of happiness in terms of causal
factors sharply removed from the form of a person's actual
experience of life. Such a translation of personl experience into
the generalized form of an explanation might not be literally
false, yet it might be inappropriate, harmful to someone's ends,
or incompatible with our happiness. Pragmatists and their foes
argue incessantly about the relevance of such considerations, the
former insisting that nothing could be more relevant. For a
Jamesian, taking experience seriously involves the rejection of
single-level description in favor of a multiplicity of selfreckoning. (Continues in Springs)

46. Beyond Therapy: Biotechnology and the Pursuit of Happiness
...perhaps the most promising route to real happiness is to live a fully engaged
life, as teachers and parents, soldiers and statesmen, doctors and volunteers-in
short, to follow the vocations of life that involve not the self alone, but the ties
that bind and that ultimately give the individual's identity its true shape. To be
sure, there are many people whose deep psychic distress precludes meeting
obligations and forming close relationships, and for whom the proper use of
mood-brighteners is the blessed gift that can restore to them the chance for a full
and flourishing life. But there is also a danger that such drugs, suitably improved
and refined, may one day offer us peace of mind not only without side effects but
also without exertion or interest in human attachments-a peace of mind that
might rival friends, family, and country for our deepest devotion...

47. What will you have done to your newborn when you
have installed into the nucleus of every one of her
billions of cells a purchased code that will pump out
proteins designed to change her? You will have robbed
her of the last possible chance for creating context—
meaning—for her life. Say she finds herself, at the age
of sixteen, unaccountably happy. Is it her being happy—
finding, perhaps, the boy she will first love—or is it the
corporate product inserted within her when she was a
small nest of cells, an artificial chromosome now causing
her body to produce more serotonin? Don't think she
won't wonder: at sixteen a sensitive soul questions
everything. But perhaps you've "increased her
intelligence"—and perhaps that's why she is questioning
so hard. She won't be sure if even the questions are
hers.
Bill McKibben

48. "Ever not quite!"—this seems to wring the very last panting word out
of rationalistic philosophy's mouth. It is fit to be pluralism's heraldic
device. There is no complete generalization, no total point of view, no
all-pervasive unity, but everywhere some residual resistance to
verbalization, formulation, discursification, some genius of reality that
escapes from the pressure of the logical finger, that says "hands off,"
and claims its privacy, and means to be left to its own life.

49. In every moment of immediate experience is somewhat
absolutely original and novel... Let my last word, then, speaking
in the name of intellectual philosophy, be [this]: "There is no
conclusion. What has concluded, that we might conclude in
regard to it? There are no fortunes to be told, and there is no
advice to be given—Farewell!" -A Pluralist Mystic

50. There is no conclusion, no final word on how to be happy and
healthy. On how to be. Experience triumphs not when it gets the last
and final word, but when we open ourselves to the practical and
personal wisdom of its next instructive deliverance. Tomorrow and
tomorrow and tomorrow, the mind must walk its path. Life is a
highway. This is no less true of the humane physician than of any of
us. An experienced medical practitioner has not yet seen it all.
So… nothing has concluded, but I conclude my modest remarks
with a hearty Thank you! for inviting me today, and a humble
request that you beware medical materialism and remember to take
your patients’ experience seriously.