The Existential Crisis in Medicine: Le Regard, Körper, and Leiben
Ian Barclay, Graduate Student, Yale University; and Benjamin R. Doolittle, MD, MDiv, FAAP, FACP, Professor, Internal Medicine & Pediatrics, Yale University School of Medicine, Program Director, Combined Internal Medicine & Pediatrics Residency Program Medical Director, Yale Medicine-Pediatrics Practice
Sartre’s concept of le regard — the gaze — captures a fundamental structuring principle of interpersonal dynamics, one that extends into the doctor-patient relationship and not for the better: The Sartrean gaze overly objectifies patients; the patient is seeking the restoration of leiben (life), but leiben is incompatible with le regard’s objectification. The widespread intellectual milieu of körper —metaphysical materialism — exacerbates the problems of the gaze insofar as it casts human beings as fundamentally physical objects, with subjectivity — or mind — relegated to either a lower, derivative metaphysical level (reductive materialism) or having no ultimate reality at all (eliminative materialism). In order for le regard to be subverted that milieu must be subverted, and mind must attain metaphysical primacy. Careful considerations in the philosophy of mind reveal how readily such a subversion is obtained; the case for mind’s immateriality is vastly stronger than the case for its materiality, rendering immateriality of mind the metaphysical default at minimum. This immediately attaches prima facie plausibility to the notion of the human soul, since mind’s immateriality constitutes prima facie support for its immortality. With the vindication of mind comes a healthy mystery regarding its nature, a mystery embodied in questions like, “What is the mind? How can something so radically different from the rest of the natural world nevertheless bubble out of it? Is it plausible therefore to suppose mind instead has a divine origin, seeing as an infinite, capital-m Mind resting at the helm of reality would crisply account for the origin of all finite, lowercase-m minds populating the cosmos? Is mind spirit?” Within that healthy mystery reside opportunities for greater humility in doctor-patient interactions. Mind’s primacy also engenders primacy of subjectivity and human stories, leaving the physician primed to exert a benevolent gaze — le regard bienveillant – upon the patient in full honesty. To bolster the gaze of benevolence, speculative notions can be sensibly attached to it, such as all human beings, sick or healthy, being equal before God, and every human being’s possession of a deep, unalterable dignity via having been created in the image of God.