Mastery’s Shadow

Wilfred M. McClay on Modern Medicine & the Human Soul

The modern world prides itself on its freedom from the past’s unreflective orthodoxies. But of course it has accumulated quite an impressive stock of its own. None is more settled than our unquestioned belief in the rightness and efficacy of using modern science and medicine to prolong human life—so long, of course, as the life in question is deemed to be of the requisite “quality.”

A Settled Matter

One could almost hear the machinery of this sturdy piece of orthodoxy clanking into place during the recent debate over federal funding for embryonic stem-cell research. Only let an accredited research scientist stand before us and float the proposition that a procedure, however morally troubling, might hold some promise for the cure of diabetes, cancer, Parkinson’s disease, dementia, herpes, or the common cold, and the matter is settled. The American public wants it.

They are only too happy to roll over and give the man in the lab coat whatever he wants, especially if it is no skin off their own blastocysts. The thought that such scientists, like other human beings, might have a limited perspective on the matter, and might occasionally act in self-interest, seems never to occur to our famously skeptical journalists.

There is, of course, real force behind the scientists’ appeals. No one who suffers from an incurable condition, or has seen a loved one suffer and die from one, can be immune to them. It is in our nature to cherish life. Even those of us who are convinced that a better existence awaits us beyond the grave nevertheless cling to earthly existence. Those who hold no such belief, or hold it only tenuously, are sure to cling to life all the more intensely. And it is an undeniable fact that remarkable medical breakthroughs occur all the time, so the hope for cures cannot be dismissed as a vain one.

Nor does it help matters that we live in an era in which shameless appeals to sentimentality and emotionalism have become the principal means by which public opinion is molded. And yet it would be cruel, even inhuman, not to be at least slightly moved by the pleas of celebrity sufferers such as Christopher Reeve and Michael J. Fox. There go I—so we think to ourselves—or someone I know, or might have known. Who could be so heartless as to deny them hope?

Let it be stipulated, then, that modern medicine’s achievements have been remarkable and promise to become even more so in the years to come. Yet it takes no prophetic genius to see that medicine can have no cure for the unintended moral and spiritual consequences its progress will surely engender. In the wake of the stem-cell controversy, much thought is being given to the moral trade-offs between the promise of medical progress and the multifaceted cannibalization and degradation of existing life. This is surely the bioethical question of the hour.

But consider for a moment a different concern, one that even the most implacable opponents of embryonic stem-cell research did not express. Let us suppose that even the cannibalization issues can be solved—that, for example, stem cells can be extracted from adults, placental tissues, umbilical cords, and such, without recourse to the destruction of embryos—and that all other related issues can be satisfactorily resolved.

Would the progress of modern medicine be thereby rendered entirely unproblematic? Might it not rather be the case that the very meaning of suffering and death, and their place in the economy of the human soul, are in the process of being cancelled, in ways that may be hugely consequential to us?

I am not suggesting that we all should want to rush back to a world without anesthesia. And I have no idea what it would mean to be an “enemy of the future,” unless one first posits that the future is foreordained. No, I am merely pointing to an inescapable irony at work in the progress of modern medicine, and to the fact that the high cost of medical care may be the least of the prices we are going to be paying for it.

The Conversation

What recently presented the issue to me in especially compelling form was an old friend’s death from cancer. He was a very intelligent and convinced atheist, who had over the years been coming, little by little, to take the claims of Christianity more and more seriously and to entertain the thought that all the things he valued in life might well be meaningless without the support of some transcendental ground. He had watched my own development as a Christian with wary curiosity, and notwithstanding his deep-seated aversion to “Christers,” our friendship seemed to deepen with passing years.

I thought it likely that someday we would have a serious conversation about it all. I believed he would listen to me, and I wanted to be ready for his questions when the time came. When he was diagnosed with the cancer, and it was clear that he might not have long to live, I thought “the conversation” would be coming soon, and so consciously began to prepare for it. I visited him repeatedly in his last days, each time hoping that this would turn out to be the moment when we would talk about God. But we never did. I gently sought openings, was gently rebuffed, and that was that.

Maybe, in the end, he just didn’t want to have “the conversation.” Not that he was especially reticent in speaking about death. On the contrary. But perhaps it would have seemed too much a confession of weakness to him to allow the mere fact that he was dying to be the cause of his reopening a lifetime’s settled opinions. In any event, there was another reason why he would not have “the conversation” with me. And that was because he was too preoccupied with other matters—in particular, with an exhaustive search for a possible cure for his affliction.

All over the country and the world, there are countless clinical trials going on, drugs being tested, therapies being experimented with, miracle cures being explored and touted. It is a full-time job just to research them all and sort through the conflicting claims to decide which one to try, and then to get oneself admitted for participation. He was understandably preoccupied with this search each time I saw him, and remained so until very near the end. As it was, he died in his bed at a prestigious hospital, of an infection contracted there while awaiting his treatment for the cancer. A particularly hard irony.

Thankfully, he died in the presence of his wonderful family. And at the end he spoke to them of an inner serenity, once all the pondering and choosing was past. That thought is some comfort to me. One wants to hope for the best, particularly of one’s friends. God alone knows for sure what transactions take place in a man’s final moments. Still, I was left wondering whether he had really even had time to come to terms with his death. And if he hadn’t, didn’t “the miracle of modern medicine” have something to do with it?

Here is an instance in which the very possibility of a cure—a possibility that, to repeat, was entirely reasonable to hope for and that it would have been unthinkable not to pursue—may have robbed his death of its full meaning and distracted him from a frank consideration of his ultimate condition. How different would it have been had he been faced with the inevitability of his death some days and weeks before, as a terminal barrier looming before him like an insurmountable mountain? Would he have been led to give more serious thought to it all? Might we even have had “the conversation”?

The Shadow Side

The problem has already been with us for a long time. It is a variation on the theme that Aldous Huxley famously sounded. It is the shadow side of our growing mastery of the physical terms of our existence, a shadow that grows in ominous symbiosis with the mastery. Aleksandr Solzhenitsyn limned it memorably in his famous 1978 Harvard Commencement Address (a document whose greatness is even more evident today), when he pointed to the “weakening of human personality in the West.”

One sees the same thing in a more banal, but for that very reason more sobering, phenomenon reported in the Chronicle of Higher Education. Two Vermont psychologists relate therein that “a steadily growing number of students who are struggling with depression, anxiety, sleep disorders, and other problems visit campus health-care services . . . for the sole purpose of refilling prescriptions . . . [They] tell us they are not interested in working toward an understanding of their lives [but] ask only that their regimens of psychotropic medications—antidepressants, Ritalin, tranquilizers, and others—be continued or adjusted.”

Unfortunately, one sees it too in the psychologists’ less-than-resounding arguments against such behavior (e.g., that the use of such drugs might interfere with “late-adolescent development” and might be mixed inappropriately with alcohol) and their openly self-interested arguments for “greater attention to the intrapsychic world” (which of course means we need to spend more money to hire more people like them). The pill-popping kids may be misguided, but they are right to sense that there is not much of substance behind the psychotherapeutic curtain.

Indeed, what these kids are doing increasingly mimics the modus operandi of the adult world. We now can comfortably forestall and evade confronting the cosmic questions until the very last moment, if then. Evasion, rather than belief or unbelief, is the eschatological watchword of our day. (“I’m not afraid to die,” said postmodernity’s windsock, Woody Allen, “I just don’t want to be there when it happens.”)

But this task of evasion will become more complex in the years to come. How will we make sense of death if it comes to be viewed as something with no intrinsic meaning, but chiefly as a piece of bad luck, a matter of bad timing—the misfortune, for example, of contracting the disease before the march of inevitable medical progress has caught up with it? Or worse yet, how can we ever be reconciled to death when it becomes understood as something almost entirely accidental, and largely preventable?

There will be surprisingly little room for joy or exuberance or adventure in such a world. It will be a tightly wound world, permeated with bitterness and anxiety and mutual suspicion, in which human life will be at one and the same time deeply devalued and fiercely guarded. With growing mastery comes growing responsibility—and the need to assign accountability. In a world without God and without contingency there will always be someone or something at the bottom of everything bad that happens.

The moral economy of a controlled world will demand that a villain be produced. Someone must be to blame. It will always be the twitch of the surgeon’s hand or the slip of the obstetrician’s forceps (or a slip-up by the managers of some future human hatchery), rather than the will of God or the finger of fate, or simply the imperfections of a fallen world, that explains deformity or death. Paranoia will flourish, and so will the trial lawyers, who may even become for a time the high priests of such a civilization—at least until they themselves become objects of litigious ire.

Only Ourselves to Blame

But much of the burden of blame will devolve upon ourselves, since in being set free to choose so much about our lives, we will almost certainly find ourselves more and more anxious about, and dissatisfied with, the choices we make. It need hardly be pointed out that the expansion of choice does not always make for the expansion of happiness. Everyone knows the sense of inexplicable relief that comes when a hard decision is taken out of one’s hands by the flow of events. That relief will become rarer. Everyone knows the aching hollowness of “buyer’s regret.” That ache will become more familiar. It will all be our own fault.

The more our lives are prolonged, and the more death becomes seen as an avoidable evil whose precise moment should be “chosen,” rather than an inherent feature of human life, the more we will come to live imprisoned by a compulsive and narcissistic dread of all risk, since the possible consequences of such risk—the gulf between life and death, which will yawn before us like a chasm between eternity and extinction—will be too vast, too horrible, and too fully avoidable to be contemplated. The price of living life to the fullest will be deemed too high.

The typical man of the medical-miracle future will not be an Übermensch. He will be more like an obsessive-compulsive hand-washer who lives in constant dread of other people’s germs. He might even choose to wait out the next century in the form of a frozen embryo, in anticipation of the day when the final triumph of science has been secured, and a grand and immortal entrance into life could be assured. (Assuming, of course, that he is foolish enough to believe that his “potential” life would not have long since been cannibalized by the march of progress.)

That such a world would drain human life of the very possibility of dignity and vigor is not hard to imagine. Just as the treatment of the soul as a mere congeries of manipulable psychological states renders inner life meaningless, so the infinite extension of life will render life infinitely trivial. “Death is the mother of beauty,” intoned the great post-Christian poet Wallace Stevens, “hence from her, /Alone, shall come fulfillment to our dreams / And our desires.”

Such words must sound strange, even pathological, to the modern ear. And yet everyone who has ever read the Iliad knows that the gods of Homer’s epic are rendered less admirable, less noble, and less beautiful than the human warriors, precisely because these gods cannot die, cannot suffer, and therefore cannot live lives of consequence. All they can do is meddle in the lives of mortals, who have to play the game of life for keeps.

Only a Prelude

Death also is the indispensable prelude to newness of life, which is why the water of Christian baptism carries both meanings—death to old self, risen life in Christ. Without death, there is no new birth. Death is the profoundest way we know of symbolizing our need not only to put off the old self, but to be constrained and molded by a power greater than ourselves, a power in whose service is found the only enduring joy we can have as human beings.

The crass psychological models that dominate our era’s self-conception emphasize autonomy, independence, control, and—of course—choice. But these are illusions to which we cling, no more real in the end than the fantastical women’s bodies one sees in slick skin magazines. Illusory not only because they represent unachievable goals. Illusory because they represent unworthy goals. We will become miserable and hopeless beyond our wildest dreams once we become the masters of our fate and captains of our souls—familiar words penned by W. E. Henley, a suicide, and most recently given public utterance by Timothy McVeigh, a mass murderer.

The real beauty of human character is something different. It is something like the beauty of weathered wood, a beauty grained and deepened by its graceful and dignified incorporation of the elements within which it exists. Our dignity exists not only in our drive for mastery (and that is surely a part of it) but also in our acceptance of the limits on our will—in how we come to terms with our defeats, our failures, our decay, and our yielded territory, and nevertheless trudge ahead to a destination we could never have chosen at the outset, because we could never have had the wit to imagine it.

That is the deeper meaning of the famed “school of hard knocks.” It is a school in which much is left to chance, but is also the school in which God operates most powerfully, and surprisingly. It is the arena in which our lives are transformed. It is the only real school of the soul there ever was, or ever will be.

The article quoted appeared in the August 3, 2001 issue of the Chronicle of Higher Education.

Wilfred M. McClay holds the SunTrust Chair of Humanities at the University of Tennessee at Chattanooga, and is the author of The Masterless: Self and Society in Modern America (North Carolina) and A Student?s Guide to U.S. History (ISI Books). He is a member of the Presbyterian Church, U.S.A.