Experiencing Illness (Its Uncanny Liminality)
Perhaps the most pressing impingement on the will to life as lived is the experience of illness. Health, as Hans-Georg Gadamer aptly put it, is an enigma. We are unsure of exactly what it is without due recourse to understanding its absence. As if it were a singularly focused sense of the social, wherein we only feel the weight of society as a set of rubrics, roles and rules when we resist its presence or openly rebel against it, similarly, illness speaks to us in irruptive tones, interrupting the generally unthought experience of health. Illness, no matter how slight, is always something of a shock. ‘I felt fine, just a moment ago’, we might tell ourselves. ‘What could possibly have gone wrong in that time?’ of course, we are told that many illnesses have incubation periods, genetic markers might manifest themselves over a brief and sudden period, or injury might have resulted from being at the wrong place at the wrong time, or through a freak accident, or yet a calculated risk gone awry. Our health, the most precious thing we can be said to ‘possess’ – the love of another is a gift and not a possession, for instance – is, in one sense, constantly at risk of being lost.
And it is not that illness is ever-present for most of us. If so, we would have no true experience of what it means to be healthy at all. Sickness and health would be subjectively interchangeable. No, it is rather the sometimes-stark contrast between them that allows us the perspective to compare and contrast such seemingly opposing states. Illness confronts us in the manner of all things irruptive. The visionary was confronted by his vision, the saint by her mission, the pilgrim by the end-times, and the artist by their muse. In all such cases, there is a ‘reality to the unseen’, which William James specifically states is a hallmark of religious experience, also irruptive when radically present, though much less so when presented through institutional lenses. This generally invisible yet real plenum, the space from which uncanny things emanate is by its character unidirectional. We, for instance, at least in our mortal and fragile form, cannot transgress its boundaries, oblique and occluded as they are when made contiguous with the everyday world. To do so would be risking all, as if we had deliberately made ourselves sick, or if we had attempted suicide.
The irreal sphere speaks to us, but it hears us not. We too might close our ears to its glossolalia, turn our eyes from its hieroglyphics. But what we cannot do is control it from without. This at least, from the tradition that claims such a realm even exists at all. It is medicine that makes the first attempt to open up the irreal in the name of rationality and through the use of empiricising methods. The mystery of ill-health itself was to be solved, even if specific conditions remained unresolved. What medicine does is to reframe illness as a departure from a set of experienced conditions that betray their ‘normal’ state through their functional status. That the doctor often begins his hermeneutic by asking ‘How do you feel? Where is the pain? What kind of pain is it? How strong?’ and so on, betrays both its kindred nature with the investigation of any mystery, including the criminal type at perhaps one end of the spectrum – after all, the criminal role is merely a socially defined career that itself is ‘ill’ and Abnormative – and cosmology at the other; what is the nature of the universe, how did it come to be? The diagnostic criteria are themselves arranged on a spectrum of their own, gradually departing from the cut and dried as we experience the shift from physical ailments to those deemed ‘mental’. If we can say that the mechanics of proprioceptive function seem to take on their own uncanny presence – functioning in health ‘normally’ and yet also somehow miraculously – they thus exude a certain tacit charisma, as if they are the resonance of Being in creation. On the other hand, mental illness is both the truer mystery due to its ability to fraudulently present itself as if it were a kind of charismatic presence, but also and at once due to the fact that while charm can be faked, as anyone who has been on a first date can attest, authentic charisma cannot. The emotionally compromised can maintain their charm, at least for certain hours of the day, but physical illness is simply, and at best, unpleasant.
For modern physical medicine, the discursive dues have been paid. Even if the root cause remains unknown, this idiopathy is never an epistemological problem. One always can identify the effects and perhaps also treat them. ‘Managing one’s illness’, from addiction to diabetes to pancreatic breakdown and a host of others, has become a commonplace phrase in daily life. It may be diet, it may be drugs, exercise or even meditation, but such management clearly takes the place of any outright cure. It is of interest, from the perspective of witnessing the shift from illness being sourced wholly within the irreal no matter its material effects to it being itself fully material and empirical, that illness management can claim to have the only remaining pedigree that harks back to traditional diagnostics. That is, the shaman, in countering the sorcerer, tells the victim that she must ‘live with the curse’ as there is no cure for it. But there are countermeasures, which must taken even daily, that ameliorate the curse’s effects or indeed force it into dormancy, as if in remission. For in traditional cosmology, there is no such thing as an accident; nothing occurs by chance alone.
Nothing truly is altered by the upshifting of both magic and sorcery – the one patrolling the sunny side of the existential street, the other skulking along the shady side – into the sole purview of a god. If such a deity is given to evaluation, it issues forth its own curses and blessings, and only time will tell which is which in the end. The sourcing of the irruptive in the irreal, giving it is uncanny force and perhaps also a kind of soteriological suasion, is unchanged. It is only with the advent of medicine that illness is both brought down to earth but at once denuded of its earthy roots. Even so, such knowledge is clearly also a work in progress; everything about the subjective volatility of mental illness underscores the incomplete character of medical discourse. More than this, its own history, especially that of psychopathology itself, lends credence to the belief that applied science may have its limitations, if not in principle its limits, when confronted with a state which rests part of its status in premodern metaphysics. Like ultimate questions which only religion presumes to answer – indeed, it must do so if it is to be worth our consideration at all – mental illness proffers to the doctor a kind of abject faith, if only in itself.
Though the medical specialist is also human and thus also can suffer ill-health, medical discourse is an objectivating space deliberately set over against the irreal, just as is modern evolutionary cosmology a bastion against creation ex nihilo. Not that the discourses of anti-transcendental metaphysics can answer to ultimate cosmogonical questions. In this, the absence of understanding precisely what health is, in its essence, is made choate only by being able to tell what it is not. Sanity thus is best framed as a practiced knowing of social customs and the presentation of self in daily living-on. Any other definition risks sliding sideways from this normative practice and becomes immediately subjective or, at the very least, introduces a ‘subjectionable’ element by having to undertake the interrogative journey of ascertaining how the patient ‘feels’ about her emotions and thoughts. The person who suffers from illness of any kind is subjected to it simply by retaining their status as a subject. I feel my illness in a manner no one else can, and so it goes for everyone else. Even the dislocation between pain receptors and pain processors in the brain is not enough to resolve this subjection of the subject to illness. Yes, some persons appear more ‘stoic’ than others, another factor amongst a myriad that the doctor must try to take into account. Some patients ‘present’ well, other badly. Some presentations little resemble clinical data, while in other cases, the data speak to relatively good health though the patient still feels badly. In a word, illness is the most salient way by which we identify health.
One early deontological departure from the traditional sensibility that illness and therefore also mortality are functions of either evil acts or primeval fates comes to us from the Greek physician Alkmaion, who stated that humans are in fact mortal because ‘they have not learned to connect the beginning and the end’ in the way that the rest of nature has been evolved to do. I am not a perennial being, and even though my being is completed in mine ownmost death, this completion differs utterly from that which is completed by beginning once again, over and over. Insofar as the experience of illness is like a rehearsal for dying, its theatrical power emanating from a representation of both the uncanny and the charismatic in the guise of a journey from the healthy place of magic to the unhealthy space of sorcery, it alerts us to the fragility of our shared human lot. But illness is no mere metaphor, a point to which Sontag as emphatically has alerted us. However irreal it may feel, its reality rests in the material change in function and variance that often can even be measured, sometimes indirectly but always with a sense that illness’ sources, however obscure some of them may yet be to medicine, cannot be taken literally as either curse or cure.
Thus, the experience of illness is as much something that distracts us from pursuing the most objective course while at once offering a very personal glimpse into the very ontology of health, its history and its discursive career. For mental illness, this glance may become a manner of life, though never a way of living. For in being forced into the darker reaches of mortal being, we should not think to rest there let alone remain. Illness is the lesser sibling of anxiety, which rests within us as part of our Dasein. Even so, illness as experienced allows us to more gently understand that dying has its own ethic, and that the disconnect between our origins and our ends is not so fatal to absolve us of willing a return to an enigmatic health. Only through accomplishing this return do we then also glimpse the wider miracle of nature’s self-connected being, that which our consciousness cannot so far grasp in any other manner.
G. V. Loewen is the author of 56 books in ethics, education, health, social theory and aesthetics, as well as fiction. He was professor of the interdisciplinary human sciences for over two decades.