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The Edifice of Pinkerism
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Submitted by Andrew McCarthy MD, Sep 16, 2007 04:32

You are right in one aspect in that I did not clarify my thoughts in a more detailed way. Dr. Drury in his treatise goes over this much better than I can. He spends most of the treatise going over why psychology must come to grips with the inexplicable. Dr Drury did not say that there is no science in psychology of any type. But he and Wittgenstein and many others including the famed Edith Hamilton defend quite vigorously why there are other methods of learning beyond simply a complete and absolute scientific approach. And we all know this in our day to day living. No mother just treats her child in a rational way unless you think caring and kindness are entirely a rational exercise to which I could never agree with. And anyone who treats patients finds out in a hurry that very little can be treated with just a purely scientific method.

You never come upon the same exact situation with the same exact patient and thus the practice of medicine or any type of healing art will never simply be a pure exercise in rationality. It is why medicine has been called an Art and a Science for eons. It has never had just the scientific approach as its only method of practice nor as its primary reason to be. As a neurologist I come up against the same emptiness that psychologists do. Even when I think I can concretely measure everything or define every variable I still can never know what it is like to be that patient in that situation. But how we want to call our fields entirely rational instead of simply being humbled by our inability to understand everything by some mechanistic process. And it is this humility that allows for empathy with humans under duress. And it is my opinion that we do ourselves and our patients a diservice when we think we can know what is going on entirely within their thoughts even if we have done every test imaginable. We just can't rationally define away their personhood as easily as we think we can. There are things that are always immeasurable in medicine and in science.

Take for example a young man who gets in an accident. We give him a Glasgow Coma Rating. We see his MRI. We give him a neurological exam. And we examine him with psychological methods when we he begins to come to. And we have a very rational as well as a very helpful method to treat this patient. Yet I still can never know much less control all the circumstances in that patient and in that situation. I cannot be the patient nor really know his situation or inner thoughts. Thus I cannot entirely know what he is going through. It is why we call medicine the practice of medicine in that it is always a humbling experience. This is what Keegan goes over in his book on WW I and why I use the comparison. Our rational plans whether in war or in a hospital are always going to have chaotic moments. And those moments are not just some kind of irrational behavior. It is human behavior and in some ways it will never be a measurable rational exercise.

It is this practice of medicine that makes me throw out all those who try to tell me that everything I do can be knowable, testable and verifiable. And it is why I think that the idea of a philosophical breakthrough via psychology or neurology is a dangerous thought to all of us. You all can decide on your own whether you believe in things that are immeasurable. I do believe in these things for I see them every day. I studied pi in school. It too is immeasurable and will always be thus. I learned the Heisenberg Principle where the idea of mass itself has uncertainty to it. Even every single solitary scientific experiment has elements that are immeasurable. What is always immeasurable is the instrument that does the examining. And the final instrument that does the perceiving is the human being. And that is something we will never figure out because it cannot be measured. And that is forever and ever under our current rational circumstances. It is just how it is and it is a very humbling thing. I have never ever had anyone on their death bed discuss their life in a purely rational way. Comme il faut...

So things do come down to a choice. Do you ignore everything

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