Category Archives: atheism

What Does It Mean to Be a Disembodied Mind?

Really, we should go to the source for a self-report.

We immediately confront a problem, then. Where do we look?

That is to say, if we are to establish communication with the disembodied mind, then we must somehow individuate it. It must be a candidate for intentional inexistence if we even hope to take heed of it.

Yet individuation is precisely the psychological consequence of embodiment.

Look at it from the other side. What if the disembodied mind wants to talk to us poor saps wallowing in bodies?

Mustn’t it make it make the subject-object distinction first? And if it does, hasn’t it wiped out any hope of qualitative distinction from the rest of the body-wallowers?

It is merely a prettier critter, after all.


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…for a moment that you have been selected to participate in a groundbreaking experiment.

Neurobiologists have discovered a single neuron in the reticular activating system (RAS) which appears to be responsible for consciousness. In a rat model, when they hit this little cell with a pulse from an electrode, the rat stops and stares blankly. It will carry out reflexive acts, and even complex learned responses to stimulus. But when the electrode is hot, the questing nose and shifting eyes are still.

You will be the first human subject to undergo stimulation of the single consciousness neuron in the RAS. Well, at least one of the first human subjects, because I will undergo the procedure with you.

In the lab, we each have a tiny hole drilled in our skulls and a micro-wire inserted into the target neuron in our brains. Then, under video-EEG monitoring, I flip the switch that turns on your electrode.

Your EEG changes, but nothing seems to happen to you. You continue to chat with me and when I inquire as to the your status, you assure me that you are quite conscious.

But then I switch the current off.

You look surprised, and ask me, “How long was I out?”

I don’t know what to make of your behavior. Were you out? Was someone else in? Does the magic neuron just make you forget yourself for a bit?

There is only one way to find out. I tell you to flip the switch on my electrode.

I come to in the middle of a conversation, and report to you that I must have been unconscious while my electrode was hot. Your report of my behavior mirrors my report of yours: no change until the power goes off, and then the surprised “wake up”.

I still have no answer regarding anyone’s consciousness during the time when the RAS neuron is activated, nor will I get one. I may be able to make some guesses, if I gather loads of video-EEG data, or see what happens when I try to teach you something while the neuron is being stimulated. That behavioral information, in the brainwaves and in speech, may typically correlate with the presence or absence of a conscious state (in our experience).

The correlates can tell me nothing of the actual presence or absence of conscious experience, however. Consciousness occurs within a subject and won’t be found in the intersubjective. That state of affairs does not make consciousness particularly hard or mysterious – we all know all about it every day. It does require a subject to have it though, and it is always consciousness ‘of’. It is just ours and ours alone.

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Balance Impaired


DSC00176Close-up, the little gully evoked a strong sense of deja vu. The angle suggested that one might almost be able to stand up and walk it. The rock looked like a crocodile’s skin – all knobs and chunks with few cracks or pockets – and the few voids in the surface had formed from the erosion of yellow clay inclusions. I had been in this situation before, in the Canadian Rockies, the Tetons, the Cascades. It meant sparse and dubious protection for insecure climbing, with an ugly fall looming throughout.

The fresh memory of yesterday’s Eureka foray reinforced my unease. Just going into the mining country in Colorado’s San Juan mountains is sobering.  The road winds through acres of avalanche terrain peppered with jumbles of gray boards and rusty iron marking the eternal resting places of generations of abandoned avarice. Eureka itself stands for self-consciousness of our bitter relationship with the range. Once a small,  hopeful mining community the town is now a single building. The lone, windowless watchtower bears a prominent sign with the name of the town, placed there, no doubt, by the same sort of joker who might strap a party hat on a skeleton.


Yesterday was our second consecutive day at the ice climbs in the valley above the ghost town. The day before, we had been denied access to the longest climb in the area by an SAR exercise. Yesterday, we encountered a line of four parties on the same route, and we decided to trudge a bit further past the routes at the valley’s entrance. Around the bend and not far above, we found a lovely pillar of ice baking in the sun. The air temperature was cold however, and the ice looked to be in good shape from the ground, so we went for it.

My partner took the lead and ran the two pitches together. It went well until the very top. There he found the last few feet melted out and he could not get to the fixed anchor. Worse, in a fit of hubris, neither of us had thought to have him take the kit for building ice anchors. He put in two ice screws at his high point and I lowered him back to an intermediate ledge. He set up a belay and I set off to retrieve the ice screws and build an anchor in the ice to get us back down to the base.

Looking up at the situation, I knew that I should not risk falling. He had placed the two screws at the anchor properly. They had already held his weight on the lower. But the stainless steel tubes were basking. Many times, I had raced the process now at work on the anchor, placing another screw on a sunny climb before the last one heated up enough to melt loose. I arrived at the anchor and placed a back-up screw. Out of curiosity, I jiggled the anchor screws. They rattled in their holes, and by the time finished the rappel anchor, I could lift the screws free with two fingers.


By the time we got back down, the crowds had migrated our way. We had another objective in mind for the afternoon, but our hopes were squashed on the road, for we found a fellow standing at the head of the approach trail just staring across the valley as if he were reconsidering something. He informed us that he had ridden a slab avalanche for a few meters down the slope below our goal.  My partner had his wife and young son waiting back in Ouray anyhow.


There had been angst around bringing the child, who was their first. He was a nidus of concern in some familiar ways. He was 18 months old and did not want to eat or sleep regularly. He clearly understood everything said to him, but his only bit of expressive language was the word “No”. Each morning, he spent a non-stop hour on Rube-Goldberg action. Cups went into other cups, packets of jelly were transferred from person to person and then into the cups, and then back to their original owner. All of this chaos worried his parents. It seemed so overwhelming that one could hardly imagine any organized behavior arising from it.

Unless you had seen it before. I had. I distinctly recalled worrying about how I could possibly teach my first child to speak. I had no training, and no idea where to begin. Nevertheless, the kid started to talk. He had inherited the talent for it. From an adult perspective, it looked like a miracle, because adults liked to think that they had, each and every one, invented the world – or at worst discovered it. That way, the adult felt more competent, and the world seemed more solid.

From the child’s standpoint, he was building a constellation from the inside out. He had his experiences – what he might come to call ‘sense impressions’ should he grow into a particularly deluded adult – and he had the dots and lines to mark and tie together those experiences, inherited in his nucleic acids, language, and culture. The dots and lines were powerful tools. They would allow him to develop at heady pace, mapping out massive territories, like language, on the fly.

His ancestral mechanisms  assembled his star chart in a blur, and if he was at all self-conscious in his adulthood, he would spend a lot of time figuring out how he got there, and what kind of picture he had made with all those dots and lines overlying the bright spots of his experience. It would be daunting and he might be tempted to throw his hands up and just call the dots and lines the truth, to give the mathematical, linguistic and philosophical accretions on experience an undeserved solidity, while relegating the experience itself to a dirtier, incomplete status.

My partner’s son would have an antidote in that case. He would learn to climb, and that would at least open the blinds on the relationship between the picture of the stars and the stars themselves. He would still have to look, but most people didn’t even get that chance.


Perched in the little gully, I saw the true landscape.

I was not motivated. I felt the burden of all those extraneous considerations which populated the slope with angels and demons instead of little edges and blotches of ice. I climbed back down and handed the sharp end over to my partner. He was motivated, and managed to lead the pitch despite some misgivings about the security of the climbing. I followed without slips or fumbles. It was sketchy, no question. We looked at the next pitch, but decided against it. It would be there when the stars aligned favorably, or even better, when no one was thinking about the pattern of stars at their back.

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The One Brute Fact

Even naming a brute fact, a Brute Fact, is the beginning of a mistake, but it can’t be helped.

Before I open my eyes, I am groping toward a mood. Some say that my mood will be nonintentional – that it will not be about something.

I disagree.

My mood will not have content, but it will stand in relation to something, in this case my unawareness at first, and then my time and place, and then where I left off before sleep. This ‘standing in relation’ – orientation in it’s most basic sense – is everything.

It is the bone of intention – the ‘aboutness’ itself, rather than the analysis of an intentional relation. It comes with consciousness and is not really distinguishable from consciousness. Logic (and its mathematical adjunct) models it, by permission.

Immediately, it yields identity and explanatory reduction. Further out, it leads to categories and theories. All this is natural to us, and renders meaningless terms like ‘supernatural’ and ‘separate mental substance’.

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Curse You Peter Higgs

“Mass was so simple before you. Mass was just a property. Actually it was just a property of having another property: inertia. Inertia was so simple, though. It was just the property of resisting changes in motion.

Of course, we all know what ‘resisting’ means. And, we all know what motion is: d/t. If anyone must ask what distance and time are…well, there is little hope for someone so dim. At least, there is little hope for such a dimwit in physics. Hah! It looks like someone needs a metaphysician!”

The line of thought is a big hit with dualists. Actually, it is the best thing about mind/body dualism, and is why it’s good to have mind/body dualists around. Without them, physicalism grows too complacent.

The physicalist can be forgiven. It seems so obvious what we mean when we say that something is physical. But what does that mean? Is it simply anything that’s the proper business of physics? Is physics itself the proper business of physics?

The question of what makes something physical is actually difficult, even within physics. Take the Higgs field. It is not a ‘thing’; it is not even a ‘property’ of a ‘thing’. It is a property of space. It is a phenomenon which physics considers, but it is really weird, from the perspective of the old extended/unextended divide which Descartes proposed.

Yet we are prepared to accept the Higgs field as something physical, along with apples and atoms. That’s because we have been prepared to accept the physicality of the Higgs field by accepting  the physicality of things like d and t in the Newtonian scheme, as physical. Time and distance are not any less weird – they are strangely malleable, for instance – but they are more easily recognizable as our own phenomena. We experience time and distance, and we are comfortable with the idea that physics is a phenomenology of time and distance.

If we have drilled down to the notion of physics as phenomenology, and understand phenomena as our experience, then the remaining question is: What is our experience? I am not sure there is an all-encompassing answer to that question. Yet I think we can say a few things around the question which are instructive as to the notion of physicality.

At base, our experience is identity, and identity is interdependence. If I am watching an egg roll off the counter and hit the floor, I am the one watching that egg. The rolling egg, among other things, is making me, me. The memories of eggs, dependent upon the shape, color, texture and historical context of my current experience, shape my thoughts and expectations regarding the egg, just as the color, shape and texture of the egg depend upon the impression that the kitchen light delivers to my eyes after it bounces off the rolling egg. That is what the notion of supervenience is getting at: identity is fixed by spatial and temporal history.

And such a thing cannot be ‘transcendent’. It comes with the here and now; (physical) existence has a tense. ‘Tenseless’ existence is a product of reflection and not what we directly experience. Transcendence, in other words, occurs in the storybook, not in the story (else we would never read a story twice).

The trouble with this whole picture is that it looks like a truism. If physicality consists of an interdependent identity which avoids transcendence, then what is left? Ghosts are live possibilities; so are Higgs fields. Of course, that is the point of physicalism. When we look at our experience in total, physicality seems to exhaust all the explanatory possibilities, or at least the ones we could hope to know.



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That Moment


Every climber starts out believing in their own invulnerability. Death and injury happen to other people, because they are fools, suckers, or just don’t have the luck, like you do. Believing oneself impervious comes in very handy, especially during the formative years. In that era, every risk and critical action is still new.


The other ‘O.S’ route, North Ridge of the Grand Teton

You will take big run-outs whether you plan on it or not. You will make potentially fatal mistakes along the way. If you think nothing bad will happen to you, then you will march on past those moments of critical danger and learn the game. Of course, other outcomes are possible. Some people get the chop during the formative era. Some get bored with their apparently inevitable success and abandon the sport.

For everyone who sticks with it, there comes a moment when the belief in one’s invulnerability gets wiped away. For me, it was watching people die, and nearly being killed by the falling bodies. After that, there was no wishing my way back to the last age, where it couldn’t happen to me, no matter how convenient such a wishful belief may have been.

We can’t pick and choose what we believe in the end. No matter what, those moments come to spoil the utility of our delusions. Yet after the disappointment fades, you begin to understand: what you do after those moments is what really matters.



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A Quick Defense of Fideism

First, consider the alternative: natural theology. It is a failure on two levels. On a technical basis, all the arguments which constitute natural theology rest upon a claim that God can be known in the same way that we know any subject of our experience. No matter how clever the argument, the basic  premise saddles a natural deity with some very limiting baggage – like an appointment book of times and places where the deity must be, with the associated activities and relationships. And, if the deity is the sort of fellow who can have an appointment book, then It is not the sort of fellow who can have all the limitless characteristics(?) which make a deity interesting.

Which leads to the level two problem: the arguments of natural theology lead to a deity who is completely uninteresting. Let’s say that someone came up with a cosmological argument which made sense, for instance. God is left with some familiar questions. It can’t tell anything about the source of Its motive by examining It’s creative act. It can’t say why It woke on our day #1 with the thought of creation in Its mind, any more than I can say why I looked at the ceiling fan when I opened my eyes this morning*. We are left with a God who is a guy. It’s a very powerful guy, but one who is in the same metaphysical boat as we are.

Two arguments are typically advanced to remedy the above situation. Let’s call them the Springboard argument and the Aspect argument. In the Springboard, we creep to the edge of an explanatory plank (think Aquinas’ contingency argument) and then launch to a conclusion by inference. For instance, the conclusion that, because we can’t abide an infinite regress of contingent causes, there must be a non-contingent cause at the source of causation.

In the Aspect argument, we are told that we may discover aspects of the deity by analysis of our experience, but that we should not expect to see Its whole structure due to our own limitations, though that structure is implied in the aspects.

The trouble is, neither of these arguments offer any explanation of what is in their remainders – the unexplained parts. In the Springboard, the remainders are things like an explanation of non-contingent causality. In the Aspect, the remainders are relations between things like intentionality and aseity or omnipresence. In other words, there is no account, in either the Springboard or the Aspect arguments, of the things lost in the guy-God conclusions of natural theology.

Implications are fine, but in the end, we need to be able to say what is implied, or we have gotten nowhere. Both the Springboard and the Aspect fail to give such an account, and we can see in their shared mode of failure, that they are actually the same argument. To understand an aspect of something which is unlimited and fully extant, is to understand nothing about “it”. To leap into an inexplicable conclusion, is to leap into the void.

But we are faced with voids no matter which way we turn. There are situations where we can’t climb out of our own skins (to borrow a phrase from Dr. Blackburn) to look into our own motives or the intelligibility of our experience. In those cases, no beliefs are possible, but assertions are as good as a shrug and a shake of the head.

So, if you feel that there must be something rather than nothing, nothing is stopping you. There.

*I can give a reductive explanation for what motivated me to look at the ceiling fan, but then I must explain my motive for reducing and explaining, and so on and so on…the motives seem to come first.

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He Baked a Cake with Duty in It

Duties never truly conflict. Unless they are truly categorical. But if they are not categorical, are they truly duties? 

You know what, I gotta take a walk. Forget all that stuff I said before.

– Immanuel Kant (astral form) as related to me, 0300 June 8, 2018


Every act is a political act.

-Cain, to whoever would listen.

A baker in Colorado claims to have managed the feat. He said that the totally gay-free contents of his cake fulfilled his obligation to show love for the Baby Jesus. Because, as everybody knows, the Baby Jesus don’t like the gays. Wait. Strike that. The Baby Jesus loves everybody, so he just don’t like the gayness.

Anyway, this baker loved the Baby Jesus. He refused to bake any cake with any gayness in it, and in doing so, baked into each cake his duty to abide by the wishes of the Baby Jesus.

Some might ask how the baker’s achievement were possible. Cakes are made of flour, sugar, mixing and heat. You will never find respect for the Baby Jesus between the crumbs or under the frosting. But that assessment is not fair.

The folks who ask to see the duty in the cake (God bless their simple hearts) are the same ones who, when told that green experiences reside in the brain, ask to open up a skull to see the green inside. They like to hold the notion of supervenience  upside down, because it seems easier to grasp that way.

But it isn’t so much that neurons and photons and retinal pigments add up to green; the point is that green experiences break down in certain, common ways. Admittedly, the difference is a little tricky to apprehend. It has eluded smarter folks than the poor bastards delving for green things in a pile of brains. Mistakes about the difference have led some very smart people to propose that we can get rid of green, and everything else. Instead of saying “green”, we can just hold up a balance sheet with all the retinal pigments, neurons and photons on it. But then we’ll need a balance sheet for the neurons, photons and retinal pigments, and so on and so on. You can’t get away without primarily localizing things somehow, and you always end up reaching for the balance sheet labeled “green” when you want to indicate “green”, and then you  might as well just say “green” in the first place.

The same mistake about supervenience gives rise to the notion of emergence. Emergence is the balance-sheet scheme for those who just can’t let go of Aristotle (and a very uncharitable reading of Aristotle at that). The only thing on the balance sheet, in the emergent case, is something like a metaphysical time-share: property theoretically without exclusive ownership, but available for occupancy by a variety of occupants in turn. For green, the pigments, neurons and photons tally up to a certain critical point and then begin acting with ‘greenity’, which subsequently begins to explain everything else directly related to green. In the case of the cake, flour, sugar, water, heat, and so on tally up to a certain point and suddenly – cakeity. Ask the obvious question – where does the cakeity or the greenity begin – and the whole thing unravels, just like the more detailed balance-sheet scheme. You circle back to simply saying ‘cake’ and ‘green’, and ‘cake’ and ‘green’ then break down in certain, common ways. Each cake and each green perception has its own, unique identity, without a homogenizing property reaching down to bring it into the categorical fold.

Now we can get around to duty in the cake. Not only will we fail to find specks of duty among the crumbs, but we can’t expect it to pop out of the baking process, or even to be the sum of baking, Bible verses, and love of the Baby Jesus. That’s OK, though. So far, duty fares no worse than green, or cake itself. But it is worse for duty, because duty does not break down in any reliable way. It doesn’t even break down in any definitive way.

The baker baked a cake without any gayness in it, because he loved the Baby Jesus. He told the world, but he would have felt that he was true to the Baby Jesus, even if the baker himself was the only one who knew that there was no gayness in the cake. So then, the duty can’t break down to any relationship between ideas or even attitudes. Maybe it breaks down to just the baker’s attitude toward the Baby Jesus. But then you don’t have an account of the compelling part of the perceived duty, especially regarding gay-free cake.

Loving the Baby Jesus is just loving the Baby Jesus. In itself, the attitude does not contain any obligation. You can’t break down moral obligations (or any other moral “properties”) to a supervenience base. Therefore, we also lack reliable generalizations regarding moral obligations and moral representations.

You can’t even make a cakeity (emergent) case for duties, because duties don’t arguably emerge at some compositionally determined phase. Duties can pop up anywhere along the way, from turning on the lights in the bakery to accepting money for the cake.

The inevitable response to the above observation is an argument from incredulity which refers to the holocaust or infanticide. You can always say that it is morally wrong to throw a baby on the campfire, bake a gay cake, or exterminate a certain group of people, but such statements are always after the fact and are supported by historical fixation of the facts in the acrylic of moral terminology.

After all, moral arguments have been made in favor of all the above activities. And, the moral advocates have not differed with moral opponents of those actions on the factual contents of the actions; they have merely assigned different moral properties to the things and events which can, like a cake or a fire, be said to have a supervenience base, and about which effective theories are possible. In other words, moral ‘properties’ are merely attitudinal ephemera, pinned to the facts of the matter, whatever the matter may be.




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Breaking Trail

For the umpteenth time, my snowshoe breaks through the crust and dives into hopeless depth hoar. The continental snowpack nibbles away at one’s soul with a false promise in every step. The crust feels solid when one’s foot first rests upon it. It even holds as weight shifts from back foot to front foot. But, it can sense when the full weight of body and pack has shifted, and then it collapses.

The slog would be bad enough were it a grueling monotony of breakthrough after breakthrough, but it is worse that that. Because sometimes, the crust gives you a few steps on top, and just when you relax, then it lets you fall through into the great vat of cornstarch beneath. What’s still worse about my current situation is that I am following a trail. Minus the snow, it would be easy walking.

If I persist, I will soon get a little psychological boost, as my course turns off the cut trail and into untracked forest. Though it really isn’t any harder or easier than wallowing above the Summer trail, breaking off the established path onto the section that only I know, feels like progress and is an antidote to the demoralizing snow conditions.

I used to do the walk to high camp with a map and compass. I no longer need those. The rocks, trees, sequences of slopes and their conformations chart a more accurate course in my memory. These days, I can get to my destination despite the snow cover because the trail isn’t really on the ground; it is in my mind. Or, so it would seem,

One might say that the trail presupposes or lies in the potential of, my mind and memory. For a trail to be, the possibility of a trail must have been. But the trail is not made of possibilities. It is made of my memories of trees, slopes, rocks, and all the other landmarks on the way. It is made of my senses of time, space and distance, which are properties of the phenomena which constitute thought and memory. My memory, and its possibilities, are dependent upon its contents. And so it is with memory in general; it is defined by having extant referents.

In other words, my memory is nothing without memories, and all the possibilities of memory lie in its contents, including its metaphysical possibilities, which lie in its having contents. When I recall looking down the trail in this moment, I trace a path through the space and time of my memory, just as I did when I stood in the snow on the day I recall. And I do so on background – all the historical infrastructure which orients my current experience and dictates its aspectual shape.

My recollection at the keyboard can’t get going without the background, yet the background can’t be background except in relation to current experience, which links it all together. The possibility of a trail inheres in legs, eyes, slopes and trees. Memory resides in its defining contents. The contents of my memory rely upon where and when I am now.

Some folks get frustrated with all this interdependence and would retreat to the simple certainty of a hierarchy. I can understand the appeal of a world where there is a separate mental substance, an uncaused cause, memory as an independent faculty among other independent faculties, and a trail waiting beneath the snow to accommodate our walk without the hard work of trail breaking.

But that means a world where there may be memory which doesn’t necessarily remember anything, a mind which doesn’t necessarily think about anything,  an agent which does not experience the changes it makes, and destinations which don’t belong to anybody – a world which is not possible.



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Cult of the Range-Fed Turtles

When my best childhood friend grew up, he decided to become an archaeologist. During his graduate training, he was in charge of  a dig in the Mississippi river valley which unearthed an odd structure. In the midst of the native people’s dwellings, was found a circular enclosure made of closely spaced wooden posts and containing a large pile of turtle shells. The undergraduates were eager to speculate about the purpose of the structure, but my friend cautioned them against it.

“We can’t be sure of its use,” he said”, and we can’t just guess based on what we might use an enclosure like that for today. We can’t just assume they were running a turtle ranch here. Why would they do that with a river full of turtles just a quarter-mile away? We have to put it in context of the surrounding village and the environment of the time, look for other examples and see if there are any modern structural analogs. Then we can make a guess, but it will still just be a guess.”

The next day the professor in charge of the dig came around on a rare site visit to see how things were proceeding. The students were eager to show him the mysterious ring of posts with its pile of shells.

Upon seeing their find, the professor remarked without hesitation, “Huh, must have been a turtle pen,” and promptly resumed his walking tour of the dig.

I don’t know if archaeology has an excuse for this kind of thinking, but medicine does:

Life is short. The art is long. Experience is difficult.

– Hippocrates

We can be forgiven for resorting to teleological assumptions now and again in medicine. With limited time and incomplete information, we must sometimes act on hypotheses which attribute function to structure and purpose to processes. Lucky for us, there’s plenty of slop in the system, so even if we’re wrong at the start, we usually get a second chance. We are trying to get away from teleology, though. “Evidence based medicine” and “scientific medicine” are the names that we have given that effort.

We are trying to get away from teleology because we have been burned by it. We thought that the body made pus to fight off bacterial infections, so for years, when we saw people with respiratory illness cough up phlegm with pus in it, we gave them antibacterial medications. We were wrong, not just about the purpose of pus, but in attributing a purpose to pus. Again, it was an understandable mistake, given the long history of debate regarding the merits of pus. Was it a good sign, or a bad one? Should we encourage or discourage its formation? It turns out we shouldn’t have been focusing on the pus at all, but on    the outcome of our purposeful intervention in the underlying process that produces the pus.

Purposeful results and final causes apply prospectively to human endeavors alone, and even there it’s often difficult to tell whether, when our actions are associated with the desired result, the outcome is due to our actions or simply due to fortuitous circumstances. Applied retrospectively or to processes and structures beyond our control, teleology is a sure mistake.

When we assign an endpoint to a process, we presume causation and correlation must be proven. Humans are notoriously bad at that. In systems which we can’t duplicate or control, we can always tell a causal story (I’m looking at you evolutionary psychology, intelligent design, cosmological fine tuning). But those stories are just interesting rationalizations, sharing the merits of a fairy tale in that they reveal more about us than the subject matter. Our fairy tales are harmless when they are about the universe, the origin of life, turtle ranches or anything else beyond our control. When we tell teleological stories about processes we do seek to influence (and can) we court tragedy.

The practice of bleeding was based on one such tale: the story of homeostasis. We still tell it today, but we tell it as metaphor instead of fact. The story is based on the simple observation that, when a person becomes ill, they go through a series of changes in their physical state which ultimately ends in either the restoration of their previous state, or death. Having observed other systems, the Greeks thought that the process of illness looked like a disequilibrium. Having observed associated changes in fluids which emanated from the body, they attributed the disequilibrium to an imbalance in those fluids. We can hardly blame them for the limits of their observations. We can’t fault their hypothesis. However, we can fault their method.

They didn’t just postulate an imbalance in the humors as a cause of illness, they presumed a balance of the humors as a state the body sought. The difference in these two points of view is subtle, but crucial. If  the balance of fluids is seen as descriptive  then restoring health by balancing the fluids remains a working hypothesis. It admits that other factors may determine the observed equilibrium. It leaves open the possibility that the observed flux of humors is a secondary phenomenon. Most important, it leaves physiologic equilibrium as a simple description, instead of presuming that it is a purpose with causal powers.

Given a description and a working hypothesis, physicians would look at their efforts to balance a patient’s humors with a critical eye. As a teleological assumption, with equilibrium as a “final cause” under Aristotle’s system, the idea creates an entirely different viewpoint. With  humoral balance rooted in the body’s design, variances in expected observations must be due to inadequate methods or incomplete knowledge of the humors. For this version of the “balancing the humors” hypothesis, failure is not an option.

Now, the ancient Greeks may have weathered this kind of assumption better than their heirs. They loved to fight with each other. In the face of inconsistent outcomes from humor-balancing interventions, they were likely to call Aristotle and Hippocrates idiots or just ignore the under-girding theory of causes altogether in favor of their own pet theory. Definitive statements naturally took a healthy beating in the Greeks’ intellectual environment. The Romans, and the Europeans who came after them, were much more pious.

As a result, no one questioned the teleological assumption, out of reverence for its sources, and the vital fluids persisted in medical thought owing largely to the idea of homeostasis by design. No matter how apparent the flaws in our understanding of the blood, bile and phlegm, they were somehow attached to the homeostatic goal of the body. As long as physicians saw that equilibrium as the body’s goal, they could reconcile any discrepant observations with the over-arching story and persist in practices such as bleeding. It fell to investigators outside of the medical profession to discover the secondary nature of the humors. Only then did the practices aimed at balancing the fluids truly begin to fade.

But long after bleeding and the balance of fluids fell by the wayside, the tale of homeostatic purpose continued to plague medical science. Physicians continued to view physiology as directed toward an end. For example  the heart was seen not to pump blood, but to be a pump. Therefore, medical students were instructed to never administer medications called beta-blockers to patients with heart failure.

Beta-blockers stick to proteins in the membranes of  heart cells called beta receptors, which normally bind adrenaline. Via the beta receptor proteins, adrenaline stimulates the heart to pump faster and with more force. In heart failure, the heart can’t contract forcefully or fast enough to keep up with the volume of blood returning to it from the veins. If the heart is a purpose-built pump, beta blockers should be anathema in the setting of heart failure. But in reality, when given to stabilized heart failure patients, beta blockers reduce long-term mortality by about one-third.

We don’t yet know exactly how these medicines achieve such a feat. We do know why they are not inevitably detrimental in heart failure. It is because the heart pumps, but it is not a purpose-built pump. The heart is instead a group of cells which inhabits a specialized niche in a system of many cells all with complimentary and competing characteristics, existing in a state of equilibrium which, in deference to tradition, we call homeostasis.

Our physiology doesn’t try to maintain homeostasis any more than erosion tries to form a natural arch. The arch forms (rather than crumbling like the sides of a stream-bed) because it is geometrically stable given the geology. The arch persists because it is geometrically stable, and so we frequently see natural arches where the climate and geology allow. Nobody marvels at this, speculating about a conspiracy between sandstone and weather patterns. Then again, few people have an emotional stake in natural arches. The same is true of our physiology, minus the low stakes. There is no overall homeostasis sensor or hormone in the body. There is no homeostasis conspiracy.

So, we have abandoned the notion of purpose in physiology, and that simple maneuver has allowed us to discover things like the survival benefit which beta blockers produce in heart failure. This move is the principle behind the randomized, controlled clinical trial. All along, it wasn’t ignorance holding us back, but the project of rationalizing our knowledge to traditionally understood, teleological models.

Of course, the questions driving evidence based medicine don’t start from nowhere. Scientific medicine asks questions based on the results of previous investigations and hypotheses derived from basic science discoveries regarding the components of physiology and their relationships. Some of these hypotheses are even most easily stated in terms of purpose. But those statements are now understood as metaphor, rather than bare fact.

Beyond the fecundity of this change in method, the move away from teleology finally brings some redemption for poor Hippocrates. Rather than using it as an excuse, we can understand his aphorism, “Life is short. The art is long. Experience is difficult “, properly again – as an admonition about method. Be skeptical. Remember that your viewpoint is limited. Watch out for overarching narratives. Good advice, and not just for medicine, but for all those turtle-ranch theorists out there (I’m looking at you intelligent design, cosmological fine tuning, evolutionary psychology…).

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