An academic psychiatrist, writing about people and the world from a materialist and phenomenological perspective.
Why we'll never agree about abortion in America
People living together within a milieu will eventually come to understand the world in more or less the same way -- the universality of human feelings and the basic mechanics of belief formation promote ideological homogeneity on such things as the importance of the right to self-determination, the dangers of abuse and prejudice, the reprehensibility of sadism anywhere outside of the bedroom of consenting adults, and the morality of a well-developed empathic capability. As a front-line physician my observation has been that if they live long enough, all persons happen upon a time when they awaken to the sensibility of enduring maxims, going on to hear everything with a new ear. On their deathbeds, the evolutionary biologist and the priest find that they agree on all substantive things, though they may use different language to describe them. Often we disagree only in a very technical way that amounts to nothing -- we agree that 'heaven' is the reward for a moral life, but you posit heaven at a time after death, while I imagine it here on Earth; at the level of linguistic idea construction, the differences in the way we state the belief don't amount to a change in the way we behave socially, though you may do something different with your time on Sundays. As beings who absorb data from everyday-life, we inevitably arrive at agreement on much that matters, our behavior agrees. And for our behavior to agree, so must our unconscious learning.
The Long-view of History
The physician describes the patient in his private notes: Twenty-five year old male sex worker, arrived by ambulance, in the custody of police and emergency medical services status post intentional heroin overdose, per report. Pale, attired in blue paper scrubs furnished by the hospital. Denies current complaints. Musculature well-developed, hirsute. Black stubble, but scalp shaved. Well-healed longitudinal scar, one-inch, with loss of follicles over the right anterior mandible. Respirations non-labored, ambulates unassisted. The oral mucosa is moist, skin is not overly dry, and there are no active lesions on the face or trunk. Normo-cephalic without apparent trauma or signs of previous head injury. The mouth is full, jaw enviably square. Prominent vascularity in the extremities, track marks can be seen only unilaterally. Single visible tattoo between the scapulae, stated there is another over the pubis, showed to staff without request. "Helen". Piercings of the areolae with steel bars. Dysphoric-appearing, hypervigilant, but non-irritable, acquiesces to staff and other patients. Physically convalescing, has taken extended periods of sleep. Now attending to hygiene. Eating and toileting without difficulty. Denies abdominal pain or symptoms of withdrawal, mildly diaphoretic and tremulous at times. No obvious hallucinosis. There have been no paranoid or grandiose or morbid thoughts expressed to undersigned or nurse. Fluently masks guardedness, distrust. No self-injurious behavior or violence since admission. Has expressed in passing gratitude for unsuccessful suicide attempt. No expressed suicidal or homicidal ideation. Urine drug screen positive for fentanyl and cocaine, blood alcohol level 100 milligrams per deciliter on admission. Mildly elevated transaminases and macrocytic anemia. Vital signs within normal limits. Initial impressions: under-privileged, twenty-five-year-old male recovering from acute alcohol and opioid overdose, in mild withdrawal. Passively refusing care through denial of complaints. Appears at once older and younger than stated age, as if aged all at once then not at all; piercing blue eyes over an effortlessly masculine build. The world was generous to him with ways and gestures that are the objects of painful longing for other men, but which prove toxic in excess. Excess of attention from both sexes in youth, who would have found him desirable, and “hunted” him, deepening deficits in socialization and promoting promiscuity as form of intimacy. Suspect repeated occupational trauma, hypersensitivity to abandonment. Suspect altered empathic sensorium, with resultant functional impairment. Suspect limited experience of authenticity and altruism, relationships exclusively transactional or deeply co-dependent, expects and is comfortable with boundary crossings and anti-sociality. Maladjusted as a consequence of childhood physical, emotional, and likely sexual abuse. Prognosis limited by education and milieu, although there is normal intellectual functioning and general physical health, and hence theoretical potential for rehabilitation with total novelty—
One-hundred thousand welcomes (caed mile falte) to the dissolution of the self
For five years, the balmy, palm-clad street had been coastal perfection, a grove to hide in while the war of the country's third largest hospital raged in the center of the city. For five years the air danced vivaciously across the skin and one had a sense of fullness emanating from the earth itself, as if power and vitality entered the body through bottoms of the feet. One half-mile from the Atlantic. One could reach the Bahamas by canoe. How mad would a man have to be to willingly leave paradise, and grow old on the arid, stepped plains of the Texan llano estacado, unless he had once known that place as home?
The first time it happened was on the anniversary of Fiona's death, five years previously, in his intern year of residency. He had moved to Miami to train as a psychiatrist, and in a moment of fragility, he purchased some pot from the gentlemen who delivered a chaise into his first floor condo.
A quiet thunder on the arid plains, as Artur eviscerates atmosphere with hot aluminum. The summer puncture leaves behind a gasping tunnel, hunger of air for air, parted on the frame of an old Ford Ranger, dented mass that careens over and down the dry hills of North-Central Texas. Westward, the world transitions from verdant green and piney canopies to yellow waves of grass fractured by bare red rock, like a scalp split open under the weight of a hammer. The truck’s radio is exultant, loud with 90’s rock, but the cacophony of turbulent trails sheered by open windows and a dangling arm is louder. Smoke falls out the nose and mouth of Artur, tobacco warmth, alert asphyxia, ancient chemical mood, a fire upon the universe of thought; and in the breath of distant solar flares his left arm corrupts in midday, until it becomes red and boiled, then pained, peeled, dark. The proof of this moment will be a peculiar half-sided tan, patina human-gold.
c. 2222 CE
The lecturer in the cortical projection appeared to stand in front of the half-lit walls of standard reality in a 90th-floor condominium of the eldest tower in Manhattan. The scholar shifted his weight from one leg to another, as he engaged in ceremonious elocution, pausing occasionally to stare at a lectern where he rested his palm, or turning away from the audience to produce a little cough.