Analysis

Postmodern Medicine

A special seminar section on postmodernism (PM) in a medical journal may require an explanation. Several papers in this issue tackle the proposal that the recent acceptance of the sometimes absurd, often pseudoscientific aspects of alternative medicine (AM) is due to a changed “paradigm” in thinking about what is so and what is not so. A system of relativity of truth, of fact, and of existence itself has been presented to and indoctrinated into two generations of university students and professionals. The system is called postmodernism. Students educated for the past four decades have now become our reporters and editors, producers, lawyers, judges and legislators, academicians and writers, and heads of major granting agencies. These professionals occupy positions in medical schools as well as in the social sciences of most major universities.

We present several essays from nursing, medicine, and sociology to define and describe postmodernism in common language with a minimum of esoteric philosophy and a maximum of applicability. We acknowledge the many interested scientists and academic philosophers who could have written on PM. Some have authored articles and books. A collection of essays can be read in Flight from Science and Reason by Paul Gross and Norman Levitt.1

I first heard of PM at a 1989 San Francisco conference on propaganda. I attended because of an interest in language used in the selling of quackery. The speakers’ references to PM at the time escaped my understanding, and the matter receded into other interests, but one message was that language helps create perceived reality. It was not until the publication of Paul Gross and Norman Levitt’s 1994 skeptical inquiry, Higher Superstition2, the matter invited more attention.

Higher Superstition is an indictment of the literary and philosophical PM worldview that there is no rational basis for perceiving the existence of an objective universe or reality. PM’s casuistry includes the concepts that all views of a subject may be of equal value, reality is relative to the observer, and reality is molded by cultural and social influences.

PM originated in literary critique. Literature consists of both explicit texts and subtexts. An author may have intended one subtext, but according to PM, others may be discernible through one’s own personal orientation. Such analysis has been extended to mathematics and the hard sciences, which are conceived as “narratives” and which were molded by mainly white, European males. Thus, sciences are open to discussion, dissection, and reconstruction using literary methods and literary terms.

Another principle is the surprising notion that language can actually re-create reality. This principle has been captured by AM advocates to change public perception of pseudoscience medicine. Consider the following comments from a leading AM journal:

  • “The terms holistic and alternative were coined with specific stipulative meanings.”
  • “Changes in definition can be of great political importance because their evolution serves to shape development of applicable laws.”
  • “If alternative medicine . . . is to receive fair consideration, it must have access to the language-making process within the powerful institutions of society.”

Such commentary straddles the border between PM’s unrealistic claims to change reality and the very real effects of public relations, advertising, and propaganda on public opinion. Whichever the case, this surprisingly frank admission from leading AM theoreticians opens an eye into the techniques used by AM in redefining itself for public acceptance.

Some PM adherents engage in wordplay and punning, leading to the ludicrous. A case was made by Laçan for considering the square root of –1 (an imaginary) as equivalent to the male sex organ. Igaray made a case for E=mc2 as having a sexual meaning; the speed of light was defined as a “favored” speed (described by a European male) with not enough attention to “other speeds that are vitally necessary to us.”3

Postmodernism is an outgrowth of cultural relativism—a concept nurtured in sociology and social anthropology in the early twentieth century. Cultures and subcultures are described value-free and need not be held to the same standard, allowing for analysis free of cultural biases. Applied to medical systems, each system performs services required by the specific culture’s needs—and those are not always those of “Western” standards (cure of diseases, increased longevity, etc.). For instance, a medical system may, through ritual, serve to assure the society’s cohesiveness. Thus, cultural relativism opened the doors for an “open mind” toward differing concepts of medicine. But problems occur when one tries to place such a system on an equal footing with scientific biomedicine in a technologically advanced society.

If science and rationality could be reduced to and be defined in literary terms, literary analysis would become a tool for reinterpreting and actually recreating reality. Thus literary critique, through PM’s declaration, supercedes science—even physics and mathematics—on the academic pyramid. The PM movement has also been called the Academic Left because of its somewhat revolutionary and socially leveling attitude, but a number of advocates have had strong right-wing ties, even to the Nazi party in World War II Germany (Martin Heidegger) and France and Belgium (Paul De Man).

The social sciences—especially sociology, social anthropology, and political science—have attached to PM and are linked together in an assault on scientific method now known as the “culture wars” or the “academic wars.” Battle lines have been drawn. Some mainline journals taken over by postmodernists do not accept manuscripts from critics or those expressing a logical positivist view (the view of those who perceive an objective outside reality subject to scientific description—like most of you reading this). Special journals have been created to assure publication on both sides. Academic promotions may depend on whether the applicant and department head are on the same side.

The problem with medicine’s being able to deal with AM has been that PM is the hidden agenda of the movement. PM contributions to “alternative” ideology have been successfully occult. As a mode of thought and of viewing medicine and health, it can be recognized only by certain cues. Among these are the misuse of language and the “open-minded” attitude toward absurd propositions. Medical scientists have been slow to recognize AM’s co-opting of postmodernism’s language distortion and language invention for recreating medical reality. They construct their own reality through their altered views, describing it by inventing new meanings to words along the way. (The comment “It depends what the meaning of ‘is’ is” would be a source of serious discussion in PM literature.)

PM philosopher Bruno Latour reoriented history around personally sculpted knowledge and altered language. He doubted that Pharaoh Ramses II could have died of tuberculosis because Robert Koch had not discovered the tubercle bacillus until 1882. “Before Koch, the bacillus has no real existence.”4 It is not a long journey from such ideation—that of a consciousness that constructs reality—to familiar AM logos such as “we create our own reality,” and on to concepts of personal “healing energy” and “subtle energy” (energy not measurable or even detectable).

The speculations of psycho-neuro-immunology add plausibility to the concept of consciousness as a “healing” force, and of the mind as a healing tool. The distant healing of Edgar Cayce and present-day psychic healers join intercessory prayer to become knit into a conceptual whole—a “changed paradigm” of healing. Although the logical connections are missing, those minds hungering for spiritual expression and “meaning” become open to and satisfied by such displays of vagary. Thus the necessity for the critiques of intercessory prayer also included in this issue.

Gullibility is an indicator of the PM disorder in current medical and academic worlds. In 1996 Alan Sokal, professor of physics at New York University, created a literary scandal by submitting a masquerade PM paper on physics to Social Text, a leading PM journal. He used PM jargon to disguise absurd and contradictory comments about physics. The article was titled “Transgressing the boundaries: Toward a transformative hermeneutics of quantum gravity.” Such language sends one scurrying to dictionaries, which may be of little help because of PM-changed definitions or recently invented words. Sokal used this distorted language and jargon to describe absurd concepts: “. . . the pi of Euclid and the G of Newton, formerly thought to be universal, are now perceived in their ineluctable historicity; and the putative observer becomes fatally decentered, disconnected from any epistemic link to a space-time point that can no longer be defined by geometry alone.”4

The PM style was so convincing that the editors bought the hoax and published the article without comment. When Sokal exposed the hoax in another periodical, the Social Text editors felt betrayed and discounted the importance of their actions. Those actions parallelled those of the Anthropology Department at UCLA when it was hoaxed into granting Carlos Castaneda a PhD on the basis of fictitious field work. The Castaneda affair, dating from the late 1960s through the 1990s, is perhaps the greatest literary hoax of the twentieth century. PM open-mindedness, gullibility, and lack of critical thinking were responsible for it, as recorded by Richard DeMille in the last issue of this journal.5 Castaneda parlayed his fiction into a fortune from several best-selling novels marketed as nonfiction. Other major players in cultural anthropology circles were taken in, and excused Castaneda’s behavior, lauding it as good social insight.

PM describes a topsy-turvy, inside-out world in which knowledge is relative and logically derived opinions are biases; relativism gives equal weight to both rational and absurd conclusions; and language distortion (propaganda) reverses meanings. Use of the words such as “quackery,” “false,” and “irrational,” is not only “out,” but the user is branded as biased and is assumed to have rejected the claim without having evaluated it. Even if he has evaluated the claim, the evaluation is considered prima facie prejudiced.

Other footprints of PM are phrases such as, “When looked at in this way … ,” “from the point of view of … ,” and “according to the patient’s worldview. . . .” Such phrases create an immediate bullet-proof construction that protects an absurd proposition against critique.

Some of journalism’s principles and ethics express relativism and PM. Reporters give equal space and weight to the advocate of the absurd and to the rational critic: “We present both sides and let the reader decide.” Book reviewers modify tones and hide critique behind circumspect language. A confessed murderer is described as “alleged” before formal conviction, and a false claim is “unsubstantiated” or just “unconventional.” Normal reactions are restrained by a straitjacket of niceness. PM/relativism conception joins propaganda, with the press as witting and willing vector of the union.

PM orientation is the basis for acceptance of AM and medical pseudoscience among some segments of medical school faculties. It is difficult to conceive how homeopathy could be a legitimate subject for medical school courses without cultural relativism as a basic operating system for faculty thinking process. PM is the code in which the language of modern “alternative” medical thinking is written. As such it is buried from view, “invisible” to the user, incomprehensible to most observers—and therefore the observer’s fault for not understanding it. Advocates have worked hard to make the system user-friendly. What just twenty years ago would have been called merely foolish gullibility appears now as open-minded tolerance.

A previous article described several examples of disordered PM thinking.6 Sociologists were unable to distinguish between “Laetrile” as a medical and financial stock swindle wrought by convicted criminals (including members of the Mafia) on one hand, and medical science’s valid, biochemical, pharmacological, and clinical principles on the other. Learned opinions were branded “biases.”

Relativists have no current difficulties accepting roles for chiropractic, acupuncture, and homeopathy. The former two are excused with rationalizations such as not having enough data or lack of fair hearing because of institutional or cultural bias. As for homeopathy, “it shouldn’t be rejected just because we do not know how it works” (always assuming of course, that it really works). In all cases, evaluation by scientific method, plausibility, or plain common sense can be rationalized away using postmodernist conceptions. No information can ever be strong enough on which to base a “real” opinion.


REFERENCES

  1. Gross P, Levitt N, Lewis MW. Flight from Science and Reason. Baltimore, MD: Johns Hopkins University Press; 1997.
  2. Gross P, Levitt N. Higher Superstition. Baltimore, MD: Johns Hopkins University Press; 1994.
  3. Igaray L. Sujet de la science, sujet sexue? In: Sens et place des conoissances dans la societe. Paris: Centre National de Recherche; 1987: 110. Quoted in Bricmont J. Exposing the Emperor’s New Clothes. Free Inquiry. 1998; 18(4): 23–26.
  4. Bricmont J. Exposing the Emperor’s New Clothes.
  5. DeMille R. How I learned not to believe Carlos Castaneda. Sci Rev Alt Med. 1999; 3(2): 11–13.
  6. Sampson W. The braid of the “AM” movement. Sci Rev Alt Med. 1998; 2(2): 4–11.