Photograph Source: Pepa Barril – CC BY 2.0
In Dostoevsky’s Demons, liberal academic Stepan Trofimovich says before dying: “I’ve been lying all my life. Even when I was telling the truth …. The worst of it is that I believe myself when I lie. The most difficult thing in life is to live and not lie.”
It’s because lies are behaviour. Dostoevsky’s characters “eat” ideas. They don’t believe them, but more important, they don’t know they don’t believe them. Some beliefs are tacit, presupposed, not acknowledged, just lived.
This aspect of thinking is known in Cuba. It is why its independence traditions, centuries-long, are so interesting, philosophically, although it’s largely unrecognized. In 1999 in Caracus, Fidel Castro said, “They discovered smart weapons. We discovered something more important: people think and feel.”
It is not trivial. It has to do with lies that are lived and how to know them.
José de la Luz y Caballero, in early 19th century Cuba, taught philosophy because of a lie: slavery. Progressives accepted it. They couldn’t imagine life without slavery. Luz taught philosophy so privileged youth could know injustice when injustice is identity: lived lies.
José Martí, later, identified another lie. He built a revolution around it, not just the lie, but how to know it: a revolution in thinking. He said the South didn’t need to look North to live well. That lie is lived still. We can’t imagine life without a dominating North.
Both Luz and Martí taught that “people think and feel”. It’s about reciprocity. A new book on the US medical system identifies just such thinking, known to science, but hard to practise. Reciprocity involves experiencing – that is, feeling – relations between people, and becoming motivated, even humanized.
Anyone seriously ill (in Canada too), knows medicine is not about care. Soul of Care, by Harvard psychiatrist, Arthur Kleinman, explains why.[1] The failure is systemic. He cites an educator at a major medical school, who feels like a “hypocrite” teaching about care. She knows doctors don’t have time to listen and aren’t supported to try.
Medicine is about “cost, efficiency, management talk”. Survival “depends on cutting corners, spending as little time as you can get away with in human interactions that can be emotionally and morally taxing.”
As Kleinman tells his personal story, of caring for his beloved wife, Joan, he offers a different view. Caregiving is not a moral obligation; it is existential. At its heart is reciprocity, the ““invisible glue that holds societies together”. In caregiving, one finds within oneself “a tender mercy and a need to act on it”. Caregiving, Kleinman argues, made him more human
Reciprocity offers solutions not identifiable previously. It matters for science, for truth. But the capacity must be cultivated. “Being present” means submitting intellectual judgment, on occasion, to experience of feelings. One can’t just decide to do it without preparation. Yet such training is not happening. It’s not likely to. It contradicts “politically useful fictions” like the “self-made man”.
Kleinman says medicine needs help from sociology and “even philosophy”. But the myth of the self-made man is taught in philosophy. It’s called philosophical liberalism, providing ideas of identity, rationality and autonomy assumed in social sciences. It denies person-making reciprocity.
Marx taught such reciprocity – the kind that recognizes receiving back, cause and effect, giving. So did Lenin, the Buddha, and Christian philosophers, Thomas Merton, Jean Vanier and Ivan Illich. We don’t teach these philosophers. We barely recognize them.
Caregiving is so alien to medical practise that Kleinman’s “modest proposal” is to omit it from the curriculum altogether. Nonetheless, health institutions claim to care about care. Kleinman’s colleague says: “We can’t even tell ourselves lies we can believe in”.
But they can. Whole societies can. I was reminded of this reading Hippie Woman Wild, a recent book on hippie communes of the 70s.[2] Having lived in such communes most of that decade, I spent subsequent decades figuring out lies: How to explain to students. Those communes weren’t about love and peace. They couldn’t be. You can’t love when you’re self-absorbed and morally superior. It doesn’t work.
We didn’t know that we didn’t believe in love, or even know what it is. When Dostoevsky’s characters begin redemption, they fall, or are thrown, to the earth and “water it with tears”. Raskolnikov, after confessing, berates himself for “submitting”. But he:
could not understand that even then, when he was standing over the river, he may have sensed a profound lie in himself and in his convictions. He did not understand that this sense might herald a future break in his life, his future resurrection, his future new vision of life.
He must wait for “something completely different” to work itself out. Waiting, submission, is not the “self-made man”. The “self-made man” seizes control of their destiny.
That’s what autonomy means, supposedly. Che Guevara saw the myth as an iron cage, blocking truth. If you believe it, there are no lies, not about you. Truth is whatever you want it to be. It’s easy but limiting – humanly so.
Some understand Cuba’s famous medical internationalism as a mere moral achievement. They undervalue it. Being “good” doesn’t motivate sacrifice. Reciprocity does. It energizes, compels.
It beats “smart weapons” because it’s about truth. Che Guevara told medical students in 1960: “If we all use the new weapon of solidarity [i.e. reciprocity] then the only thing left for us is to know the daily stretch of the road and to take it. … [and we] will gain from individual experience.” He meant capacities direction. Reciprocity means giving but also receiving back, humanly.
José Engenieros, brilliant Argentinean psychiatrist, early 20th century, dedicated himself to educational reform across the continent. Philosophical liberalism, grounding medical education, had convinced Latin Americans, with its false freedoms, to support imperialism in World War 1.
It convinces North Americans to “follow dreams” just because we have them. It makes it hard to live and not lie.
Notes.
1. Penguin Random House, 2019. Review forthcoming at https://www.nyjournalofbooks.com/ ↑
2. Hippie Woman Wild (Wyatt-MacKenzie, 2019). See review https://www.nyjournalofbooks.com/ ↑
