Medicine in the Machine

I was recently in the emergency room with the family of a parishioner who had had an unexpected medical emergency. After waiting a while for the results of the procedure a man abruptly appeared clad in the iconic medical digs. This was obviously the person we were anxiously looking to hear from. Before we received the eagerly anticipated news, I was given the once over. For, of course, I was clad in cassock and cross. Our eyes were not to meet again.

What happened in the next two and half minutes is something to which I have become accustomed. Rapid fire details poured forth. We were informed of the details of the procedure, in all of its grainy and Latinate specificity. After this dictation we were assured that the patient was recovering and doing well. And then there was silence. The family was already overwhelmed but this was just too much. We were asked if we understood and one of the family members meekly said, “Yes.” To any ear the uncertainty and emotion were palpable. With this affirmation the doctor disappeared as abruptly as he appeared. Murmur among the family arose, “What just happened? Was I meant to understand that he is ok?”

Now we all joke about the bedside manner of doctors. I once heard a joke that there really is no difference between a doctor and a plumber. It is just that the plumber works with pipes and doctors work with our bodies. But there is some truth to this joke. It exposes the truth of much of modern medicine.

Modern medicine is deeply intertwined with the broader quiltwork we all refer to as “modernity”. René Descartes, broadly considered the father of modern philosophy, took the skepticism of Michel de Montaigne and moved the conversation away from the humanities, fields like history and poetry, towards the abstract, decontextualized fields like geometry and epistemology.1 Skepticism was to be answered by sure and confident knowledge. Mathematics will become the language of modernity. Straight lines, calculated outcomes, and nevermind the messiness of humanity and reality. Descartes began a seismic shift for human knowledge and our understanding of the world. In medical terms we see this when we contemplate how we used to die and how we die now. We move from the rich and multilayered human existence where one died at home surrounded by family and the bosom of the Church and begin moving towards the cold and sterilized modern hospital where we surround ourselves with machines.

We come to die among machines because modern medicine thinks of patients as machines.

This shift is even evident in Descartes’ philosophy. Dr. Sholom Glouberman, a philosopher and advocate for medical patients, points out that Descartes actually understood the human body to be a machine. When something is wrong then some part in the body is broken. According to Dr. Glouberman, and chronicled by Russel Shorto’s Descartes’ Bones, the drive behind Descartes’ philosophy was the “preservation of health” and “because the body was a mechanism that lent itself to mechanical proof, he hoped to devise “a system of medicine which is founded on infallible demonstrations.””2 Descartes sought the certainty and the objectivity of mathematics and applied to to our bodies. The messy and organic whole that we are, soul included, are now to be subjected to the cold, analytic, and abstract purity of mathematics. Thus we are transformed into machines.

We die as machines because we are machines.

This is what we encountered that evening in the ER. It is not necessarily the fault of the doctor, he was just following protocol and had been trained to approach problems as technical or mechanical failures. But the jokes or complaints about doctors’ bedside manner has its roots in the entire modern approach to medicine.

Think about the way most modern medicine is practiced. Or at least what has been my experience. For the sake of efficiency and profit most medical encounters are fast paced and laser focused on the particular symptoms one is having. The goal is typically the eradication of pain. And to that end, because of pharmaceuticals, we have on hand an easy list of drugs to be prescribed. While this can be a good thing, there is the serious challenge of holistic care which requires an entirely different approach. No wonder we are in the midst of an antibiotic resistance crisis from the overprescription of antibiotics. I once had my blood drawn and a certain judgment made about my thyroid. Was exercise or a change of diet encouraged? No, I was just given a prescription.

I know there are whole programs, continuing education courses, and an expressed desire for medicine to be practiced differently. But overall medicine is generally practiced as a technical process rather than an art. Humans are just more complex machines and we must simply fix the particular part or make the particular irritation go away and that is the extent of care. To be clear I am not trying to denigrate those in modern medicine, but trying to peel back some of the layers of our assumptions and practices so as to look to better ways for us to care for our bodies and souls.

The various challenges of modern technology echoes through the problem of modern medicine. How can we die well as humans if we believe we are machines? How can we even attend to our souls if we are so deeply trained to approach ourselves as machines?

This is at the core of why priests were unable to minister to the dying during the height of COVID-19 last year. We as a culture are so thoroughly ingrained with a mechanistic and materialist philosophy we cannot imagine the need for someone to be confessed and communed before they pass from this life. Lawyers, liabilities, epidemiologists, and every other professional opinion and scientific opinion weigh far more heavily than the fate of a soul. This is the reason why one theologian calls medical doctors the new priests of a new religion. What is this religion? Modern medicine’s ability to save and keep us alive, possibly even for forever. Couple this mechanistic belief with our fear of death and there you have a new clerisy.

We are not machines and we should not be treated as such. Not just for the sake of our physical bodies but more especially for our souls. How can we die well if we die as machines? We are so deeply enmeshed in what Paul Kingsnorth calls “the Machine” that we cannot imagine anything to be possibly different.3

Thankfully I was able to bring the true antidote to death to my parishioner after a successful operation. We thank God for the many fruits of modern medicine but we should remain vigilant against the encroaching tentacles of the Machine into every corner of our lives.

May God grant us to graciously accept the limits of death, the prayerful bosom of the Church, and the courage and imagination to begin to disentangle ourselves from the Machine.

  1. Chronicled for us by Stephen Toulmin in his Cosmopolis: The Hidden Agenda of Modernity.
  2. Quotations and a nice summary is found at Dr. Glouberman’s post Descartes and modern medicine.
  3. Kingsnorth sketches what he means by the “Machine” when he points to the modern “intersection of money power, state power and increasingly coercive and manipulative technologies – [which] constitutes an ongoing war against roots and against limits. Its momentum is always forward, and it will not stop until it has conquered and transformed the world.“