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A NEW PHILOSOPHY OF MEDICINE: Between Darwin and Crusaders.

por Antonio Palomo-Lamarca

...dejadme volver a mi antigua libertad; dejadme que vaya a buscar la vida pasada, para que me resucite de esta muerte presente.
(...let me return to my former liberty; let me go in search of the life I left, and resurrect from this present death.)
"Sancho Panza" in Don Quixote by Cervantes.

The 39 steps

Since the dawn of times Mankind has always dreaded illness and suffering. Even animals, no matter in what shape or epoch, have always had the same problem as well: decay and suffering as a mortal impediment. Even so, as much mankind as animals attempt to make way across the immemorial times crawling intermittently to new structures and transformations. This process, primitive and essential to life, was called by Charles Darwin by the name of struggle for existence. In the midst of this struggle Medicine was born, and it was not a product of reasoning, much less of observation and experimentation as it is nowadays understood, but as an outcome from spirituality in order to conquer suffering and disease. In our language and system of beliefs, spirituality meant (then) abstraction and unreality. Medicine was not a product of observation of reality, but the effect of a different concept of perception and experience. What for us are spooks and mental images was then reality and true phenomenon. Disease, then, was not a conglomerate of signs and symptoms-such as it is understood in the modernity-yet a real entity whose force and command was much more superior and strong than that of humans. Since its nature was pernicious to humankind it was called daemonic, meaning an entity which can not be seen but felt.

Demons are the oldest fellows in the mythology of our specie. Each culture and each language has a name for them. In essence, they are feared and only felt. There are many demons, and each one has its own characteristics. Man, then, did not know how to think or reason in the way we do in the actuality. Man was a naked primate. It will take thousands of years for mankind to "think." Man was (and still is) an animal, one more of those surrounding him; his posturing and morphology made him totally different from the rest. Yet, as an animal he was, Man was able to feel and to make up from his feelings a complete new world-outside of the cruel one he inhabited. In this process, Man will take the dust and mud from his eyes to arrive to the cleaning-point where Philosophy was born, as the first and only science and the beginning of the rational knowledge. Thus, we have a reality-the same all over the centuries and eons-which is disease. On the other hand, we have the subject of Medicine which has not been the same since time pasts. Every culture has its own ways to understand life and suffering, it may be different but the problem of suffering is exactly the same. There is no bigger suffering than disease and decay-with death in the end. This demon, disease, has been a true companion since the beginning of the Universe under the spell of the first bacteria and virus. This demon has been a true companion to every single body in this planet, no matter structure, habits or geographical location. Disease is daemonic to irrational animals and to Man too. Nonetheless, Man has been the only one to stand up studying his environment and trying to understand life as is presented to his eyes. Currently we may look behind our back and smile at the futile or pedantic way our ancestors treated Medicine; yet we ought to remember at all given moments the process of thinking varies and goes topsy-turvy along the path of existence. What today is meaningful yesterday was a prank —and vice versa. This irregularity within the realm of ideas is the main characteristic of our specie: not only have we changed in structure and function but also in our thought as well. Each culture, as well as each historical moment, has its inner value and preciousness. No epoch is bigger than the other, and no culture is wittier than any other either. From the most minuscule virus to the most giant vertebrate we have all been born for the same common end; we are all related like the branches of a tree and its leaves, and these with the roots and these, equally, with the soil. As soon as Man looses his own perspective in the chain of life suffering and misunderstanding take place in his soul, mind, brain or whatsoever we please to say.

It is not my purpose to unveil the significance and avoidance of disease, but put into context what the medical arena has been elaborating since what I have called the dawn of times. There is a certain sense of evolution in the regime of ideas, that is to say, what to-day can be cured yesterday was fatal. This is ultimately true; yet it is my inclination to believe this kind of thinking has been oversimplified. If we wish to say tuberculosis is just a step to a simple process of treatment in any of our present hospitals while it was a lethal ailment and a hitch just a century ago; this might as well be totally ascertained but unfortunately that is not the kernel. The kernel is that nowadays we have successfully treated tuberculosis and scrofula, and syphilis is just a joke within the common cases of venereal diseases; on the other hand, not only have we not a cure for ailments such as AIDS or (...) but also we have successfully created new diseases whose etiology and treatment is in complete obscurity. Of course, we have been born and educated in the middle of this disarray and are totally accommodated to it without the least notice. But, the problem, the kernel, is still there and it will be for ever: new diseases come and go, and what to-day is mortal to-morrow will be healed. This process has nothing to do with the evolution of science, but much more in the opposite way it is a mirrored effect of the circumference of life—which radius is strictly drawn by us. We may succeed to-day in finally curing cancer (God' speed) but we ought to be diametrically sure the postern generations will face new and more lethal diseases. Paleo-anthropology has evidenced how Man has suffered different sort of diseases since the beginning of evolution, mostly parasites. Cancer was a companion too, but no one has found yet a single skeleton that died of AIDS 10,000 years ago; much less a Neanderthal with signs of stress or cholesterol. Hence, many of our common and current diseases have been out-there long ago; yet many others are just the product of de-volution and genetic changes typical of our modern eras.

Viruses and bacteria make way through the eras; genes, on the other hand, shape themselves trying to respond to the environment. The way we live and the way we respond to the demands of life have a special repercussion upon our genes. This is the first step in how new diseases and symptoms are born. In 1876 a physician called Benjamin W. Richardson published a book on tobacco[1], but the main stream of it was considering tobacco use as a potentiality to illness. Richardson touched this theme explaining how tobacco use had made way through nature and constituted a new disease placed in the lungs. Furthermore, Richardson talks about cancer in the lungs as a new disease produced by an overuse of tobacco. How could Galen, William Cullen or Laennec have treated lung cancer produced by tobacco when the use of tobacco was not well-spread if not inexistent? Contemporary Medicine has reacted in a favorable manner to these new diseases; new investigations have been made and new treatment and drugs have appeared. Unfortunately, healing is a word which has become taboo in the medical arena; actually, diseases are open and positively treated, but healing is still a word with too much heavy weight. Doctors do not want to look at these facts and they talk such as the politician talks about the future: with promises but a lot uncertainty. On the other hand, Medicine is not anymore what it was 100 years ago. The last 50 years have been so rapid and transformative that this field has become a total different terrain of what it was before. Medicine is not anymore an arena where reason and wit play an important role in the battlefield of observation. Medicine has turn out to be a highly technological ground wherein keen observation and rationality have painstakingly been substituted by technology. Doctors do not think anymore because they have computers and technology which do the job for them—this is not to say computers "think." MRIs, CT scanners and similar technologies have improved the way disease is treated and diagnosed, but it has painfully decreased wit and observation in the human mind. The doctor has become more of a servant of his own technological instruments than a master in commander. Thus, we have invariably crafted a new feudal system within the medical field where technology is the steadfast monarch. To this, we may add how treatment has also arrived to the point of being another servant in the scale of feudalism. Treatment is the servant of pharmacological corporations, which are the most interested of all in "healing" every illness. A doctor knows about something, but just about that-one "something." Treatment is not anymore provided by intelligence and cautious observation, but sold by pharmaceuticals sellers accompanied by an all-colorful nice booklet. Pharmacologists are doctors but not physicians, and they are the ones who investigate and design new drugs to be implemented and sold. A physician goes to work and immerse himself into the daily routine, using technological instruments and pamphlets to foster the new kind of Medicine we have created. New drugs are expectantly waited for by physicians who just prescribe them as they come by the hand of the pharmaceutical representative. On top of this, the physician does not really know the mechanism of the drug if not reading it from the booklet; and he knows nothing or just a minuteness about the physiology or anatomy of those diseases he treats—it was way too much information and it was back long ago in his pre-clinic years in med-school when he learned them by heart just to past the exams. Within this feudalistic system, the role of specialization and super-specialization has very well been delineated. Specialization has become a double-edged sword. It is hard to believe that Medicine has become not only a servant but also a hyper-specialized monde with a tremendous amount of sub-sections and fields. To-day it is difficult to find a doctor who knows anatomy or physiology enough as to understand the intrinsic process of disease. Anatomy and Physiology are now different fields from Clinical Medicine and they have their own researches, most of them being doctors but not physicians. Henceforth, it is very difficult to find anatomists or physiologists who actually know enough Medicine as to comprehend their own investigations. Research is not anymore a "related" field, but a highly-specialized ground whose mechanistic basis has gone bizarre. In this way, it is not difficult to find a doctor who studies tuberculosis and who actually has never seen a single patient with this disease—the most he has seen are bacilli under the light of his microscope; or doctors investigating Alzheimer disease who has never seen a patient with such a condition either. When I use the word "see" I don't mean to physically see, but to witness and deal with as an actual physician does. Nobody wishes to look at these facts because they are just politically incorrect. Yet, the reality is presently in front of us.

The practical-side of an old tool

The foundation of Medicine is observation and praxis. Without observing the facts a doctor is no more than a mere computer. In fact, we already have computer-programs which tell us much about symptoms and structures and internal mechanisms of illnesses. Observation is the beginning of science, but practice is its consolidation. This consolidation means intensification and strengthening of science's endeavors and aims. We do not learn just observing but practicing. Practice settles and reinforces that which we have already learnt. The main difference —amongst others— between Philosophy and Science takes place in the realm of praxis. What rotted Philosophy was not its lack of knowledge or perspective but its poor equilibrium in the practical edifice. It was an unfortunate decision to separate both terrains; but it was a vain and naïve purpose to foster Philosophy in the way all the centuries past-by philosophers did. Philosophy became across the centuries a field of theological matters and political enterprises; and science was just an ancillary baton in needed cases. With the upbringing of Christianity the error was even bolder. Christianity —which is the worse historical mistake of all times— undermined its values and aims with the help of a reign and a false god being carefully kept by an all-divine earthly monarch called Pope. No wonder how the Church promoted her biased assessments and made sure that everything out of their reach was properly emaciated from existence.

There is nothing more sad and pathetic than a creed which is expired; and that is what precisely Philosophy and Christianity are: expired ideals. Philosophy was a closer, if not the same thing, friend of Science. When Christianity was born and institutionalized the main bishops and the Pope took care of extirpating any scientific approach to life, since Jesus was supposed to come soon to redeem everybody —this is an aspect that even to-day is fostered in mainstream United States, which I will comment on later. Besides the thwarted concept of faith that the Christian fathers concocted, we have another attempt to Christianize the Pagan thought; and for that, what a bigger product of Paganism than Philosophy? Christianity thought of Paganism as a defiant of God and especially of the Church. To destroy Paganism was a goal back then, but it had to be done step by step and along the centuries: it was a long and tedious process. Since the very moment Democritus defined the concept of atom to the point where atomism is taken seriously and incorporated again in science as an important point, 2,000 years will have passed by. This was not performed due to the lack of wit or evolution in the human mind, but on the contrary, it was purposively decided by Christianity. It was Christianity who decided what and what not should be studied and how it ought to be studied. Any theory or way of thinking could easily be considered as "pagan," and atomism was not out of their reach. If we needed to thank someone for the delay of 2,000 years of progress in Science it would be fundamentalist-Christianity. The biggest and cruelest barbarities in the history of ideas have been stated by Christian thinkers —especially the fundamentalist-ones. This is not meant to be an opinion, but a fact which could be earnestly proved[2]. How many philosophers and scientist have been put to the stake just because of their ideas? It hurts our mouth just to mention again the case of Galileo Galilei. The violation fundamentalist-Christianity has committed across the seas of centuries is so heavy it can hardly be weighed. The lack of consideration, the prohibitions, the tortures, the crimes, the robberies, and the humongous amount of concocted lies Christianity has perpetrated and still does are so vastly gigantic that our measure system could just not amount. Once again, this must not be said because this is the queen-mother of all political-incorrectness.


Perception is a quote which is difficult to redact, that is, it is different in every person and it varies from culture to culture and epoch to epoch. The eye adapts itself to the environment and relies on light and colour. Furthermore, perception is a tool which is totally different in lower animals. In our species, perception is internally connected with our thinking. The way we perceive objects makes a special print upon our brain, and this is translated into the language of ideas and impressions. Rationality did not appear just out of the blue in the scale of evolution, but as product of changes in the system of eye-vision in the human being. This is why we do still call thinking by the name of perception. To perceive is just a step away from thought; in fact, the dividing line is so dim it is almost impossible to split it. As soon as we see something immediately we post a thought in our brain, and if the case is given, we utter it into the form of sentences by the voice of language. For this reason, when I say perception has changed across the rows of history I mean to say that our way of thinking has abruptly undergone transformations. Just let us think about how we think at the age of 30 versus how we used to think at the age of 15. We have decided to call this maturation of ideas, but that is not the pertinent detail. The truth is that our perception (thought) has changed due to our instability; we change ideas as we change clothes. With this in mind, let us say each century has been given the cordial gift of seeing things into a determinate mold, and this mold has been, likewise, changed in the next generation and so forth. That is also applicable to different cultures; what is a taboo in our society is a virtue in our neighbor. This is already an old anthropological chanting which is of no avail to repeat. On the other hand, and for the sake of our own prejudices, we have decided to call such a fact by the name of "cultural relativism." Having said this, we can easily grasp how Medicine has also varied the way things are perceived; yet the charge of this is even more electrifying. Medicine has not only changed the way she thinks about the facts, but her way of thinking has invariably been motivated by an anatomical and physiological adaptation of the human eye and ear to the new environment.

The XVII century witnessed the birth of the microscope[3] [4] which gave the opportunity to perceive the world in a different way; in fact, it was a new world what was perceived. The XIX century appreciated the appearance of the first stethoscope which gave a complete new entry to the way of diagnosing. Even though, this might seem superfluous, I must state perception, as much as visual system as process of thought, has played a fundamental role in the edifice of Medicine. What Anthropology has called "primitive man," is just a academic and snobbish way to explain how man possesses a typical way of enhancing his perceptual system, and this method was incorporated into a religious and cult system within the tribal organization. I am talking about the use of hallucinogens and the use of music and fasting in order to see what the ancient man considered as the other world. To us the other world is a world of bacteria, viruses, cells and molecules; to them it was a world of spirits. To us it can be seen with the use of a microscope or a MRI-depending on the range of vision; to them, it could only be seen opening the eye of the soul by means of what they called "magical plants." Some tribes used music as a means to achieve ecstasy; other tribes used fasting and many others used hallucinogenic plants. It is very interesting to underline how this way to perceiving the world, the other world, was interlaid in Medicine and Religion. The other world had the answer to their tribal origins and to their ailments and sufferings. Anthropology has used the misleading term "shamanism" to name it. There is not such a thing as "shamanism." Shamanism is Medicine, but practiced in a different way, epoch and culture —and of course, without technology. The fact than in many tribes the physician and the priest are one and the same person does not endorse the name of "shamanism." Some other tribes have shamans and priests as two very well differentiated persons.

What a tribal physician sees under the effect of a hallucinogen? This question goes undermined by a trick. We can answer from our own perspective or answer it from theirs. We can see both answers and suit ourselves with the most apposite to our personal agenda. In any case the choice is ours. A scientist in our culture would say they are just under the potent effect of a very strong chemical agent which floating in the blood and crossing the frontiers of the brain will customarily produce hallucinations, which in the end are just but a result of a distorted and drugged imagination. This is wholly accurate and certain, but it is also a product of our system of beliefs within the realm of our culture. If we went all the way and consider the tribal perspective, we shall contemplate a very unlike answer. To them it is not a "hallucination," actually they don't even know what a hallucination is. To them there is a world next to us which can only be seen tearing apart the veil of appearances. I do not wish to enter into disquisitions and analyses of anthropological demand, but it is my point to enforce the reality that every culture has a manner to perceive things and that the same culture will find sooner or later a way to enhance this perception system. It may look bizarre or utterly strange to us, but as much those as ourselves want the very same thing: to perceive that which can not be seen. Our culture has also very successfully developed a mythology. We do not wish to call it under such a languid name because it is not convenient, but the thing is that we also have named entities which can not be seen but just measured or inducted. Atoms, protons, electrons, genes, etc, are just models drawn to understand the other world, and they have not physically been seen yet. We have learnt to believe and foster the creed that they actually exist and are out-there; yet the reality is that they are as much a product of our imagination as the tribal hallucinations. This is nothing to be ashamed of, but on the contrary to be proud. Imagination, as Kant already desalted, plays a very important function in the construction of science. Imagination has also undergone the trepid travels of evolution. The Homeric imagination is not anymore working. Our imagination nowadays has been shaped by televisions and movies; we can not imagine anymore a book if we don't actually see it in a screen.

Our western culture is a very complicated and intriguing one. It has suffered the changes and spoils of instability, and this instability is the main factor in the human nature. Science has envisaged a path to control and mold her way of perceiving. This is just magnificent, but it has its own price to pay as well. A sculptor has a piece of stone, a big and devoid of any form piece of rock and from there he looks at us and says: "I see a horse inside." We may look and look and the harder we try the worse it gets: we just see a deformed and gigantic piece of stone. To prove his point the sculptor takes a chisel and commences chipping here and there. Finally, and under the surprise of our eyes we see that he has actually sculpted a horse. It was a horse but we couldn't see it. The truth is that it was not a horse; the truth is that it was exactly what the artist wanted it to be. It could very well have been a bird, or a ship or even a naked athlete. Science works exactly in the same way: chiseling theories. Now the question, the tricky question is: what is right and what is not? What is real and what is not? My position is that every question like these has just a particular answer in a particular culture, and those universalistic answers are just naïve. Personally, I do believe in Science, but I am also very conscious of the fact that what to-day is accepted to-morrow will be defeated. DNA is supposed to be an idol within the biological arena, but it will come the day when DNA will be just one more mistake in the staircase of Science. To avoid this fact is to fall into bigotry.

Science is the history of mistakes and successes, and the history of revolutions. The metaphor of chiseling might be considered a little bit over the top, but it is not directed as an attack or a radical point but much more as a call of our attention that things are very entangled and hidden. A scientist must be aware in all moment that there is nothing proved till it is either seen or measured, and that measurement is not perception but conception. Conception is the actuality of a concept, and a concept is a construction nevertheless. Science must be strictly built on facts, and facts are those which can be seen. A true scientist must be conscious of this fact always, and must be also aware of the reality that theories are only theories until they are proven either false or true; and that this falsehood or truthfulness could be revoked by next generations. If a scientist is not able or capable of accepting these issues then he is converting Science into a religion, a cult where beliefs in "possibilities" are the only choice. Science is not a religion and there is no room for faith in Science. Science must not and can not be a religion, and faith is just an unwelcome spook in the realm of scientific approach. Faith is what stopped Science from evolving during 1,500 years!

Unveiling the curtain.

The history of Medicine is the history of the despairing search for the enhancement of the human senses. If the microscope was invented in this way, and later on the stethoscope, we have also a high degree of usefulness in the way the last decade of the XIX century saw the upbringing of the X-Rays. Discovered by chance in 1895 by the German physicist and engineer Wilhelm Röntgen, the X-Rays were beautifully adapted into the reign of Medicine for the sake of diagnosis. Certainly, it was a great discovery, verily, the best in the past two centuries. Medicine was once again blest by the improvement of the human senses: to see that which is occult. What really concerns me is not so much how these discoveries appear, and how or in what manner theories and experiments are performed; what actually concerns me is the chiseling of Science. How a theory which, in principle, has been enunciated as a possible fact is in the end a true-fact? Could be possible that, as Kant already suggested, the human being has a very strong power in his will and is able to shape the reality making things to happen? It is distressing to think this and almost insane; contrarily, we must so. Let us just remind ourselves, one more time, that the Ptolemaic theory of the universe and the Copernican theory are just one and the same, but in mathematical terms it is easy to adapt everything in Copernican formulas. In the end, it seems that Copernicus was right, but was he really right or we made him be? This is a mystery in the history of Science; a mystery which is nearly impossible to unravel. On the other hand, it might be feasible that it appears to us in that way, but actually it is simpler than it seems. What it is, it is and there shouldn't be any roundabouts. This makes things very simple, but experience shows that Nature and Reality are not so simple. How scientific facts are molded into new forms and how these being theories become realities is not easy to decipher. A stone thrown into the river will definitely sink —no matter what Kant might say. The will is the will and we all agree in this, but reality is too tough to be bent. If this could be done, how could it be is a total mystery if not a foolishness. When a theory dies always a new one is born, and the latter always try to debunk the previous one. This is a vicious loop that goes and will go for ever. Indeed, Science needs theories and hypothesis. Without hypothesis Science wouldn't be born; and without theories Science would die a premature death. Yet, in order to mature, Science needs experimentation and sharp observation; without these Science would berth into the port of Religion. Many of these issues have already been discussed by the philosophers of science; people like Thomas S. Kuhn argued how science gets shaped and how theories are enunciated and substituted for new ones. When a theory is accepted is automatically transformed into what Kuhn calls a "paradigm." The history of Science is to Kuhn a history of paradigms. This is completely refreshing and indeed, realistic. In essence, what Kuhn says and claims is true, and any serious scientist would think so too. Yet, that is not the case either. In a more rationalistic and scholastic way we encounter the philosophy of science of Karl R. Popper, who analyzes the ups and downs of Science; and whose theory of falsification of theories was a success in the philosophical and positivistic world. Opposite to these views, and relenting a much more anarchist and radical view is that of Paul K. Feyrabend. Each of them got a nice and pertinent point about the scientific doing of theories and experimentation. Each of them said something quite interesting and useful. After all, that is not the point yet. Many of the issues they address and the things they say about those issues are just gratuitous, that is, they need to be said but not discussed in 500 pages. Philosophers of science have converted demagogy into an academic art, and have fathomed all kinds of language-tricks to make their points. Still that's not the point.

Science is not perfect; everybody who takes seriously his/her scientific job knows that. Science makes mistakes and dissent from theories along the path of history; equally, anybody who takes his/her scientific job seriously will understand that too. It is my belief that the academic world did not need the help of people like the above mentioned in order to conform the fact that Science is not a perfect field and that what to-day rules to-morrow will suck...We need to be extremely aware of the power of language and demagogy; and how philosophers of science have used this power to their own advantage. Of course, I am touching again the borders of political-incorrectness. (But, this article is an article about political-incorrectness.) Every time we take a plane, or a ship, or we enjoy the benefits of a open-heart surgery should we think on the fact that these scientific progresses have not been made thanks to people like Popper or Kuhn; but to people who being totally conscious of the pitfalls of Science have indeed continue in the task of redeeming their own human fellows by means of hard work and progress. This progress has been made thanks to people like Darwin, Galileo, Newton, Einstein, Bichat, and long etc, and not to fundamentalist-Christianity and its lack of concern for the human wellness. Of course, progress also has its expensive price —nobody denies that. The interesting thing about the Vienna Circle, to which Popper belonged, is that most of their members were scientists. Persons like Feigl, Carnap or Neurath came from a scientific background where Philosophy, per se, was more of an accident than anything else. Now, my point is this: why a person like Kuhn, with a scientific background, studying Physics would shift to Philosophy trying to analyze the mistakes and problems of that field he did chose to study? That Science is not perfect and is replete of pitfalls is already known and accepted by intelligent and responsible scientists; but is it necessary to spend the rest of one's life bitching about it? Psychologically, I have always seen this as an act of vengeance against the field one studied and felt disappointed with. This act of disillusionment can be dual: either one studied a field being compelled by ones' own parents or one chose wrongfully. In any case, there is the persistence of vengeance. I can recall meeting a bioethics professor in Minnesota, who being a Medical doctor not only did not practice his profession but on top of that was radically disgusted by having gone to med-school. I asked why and evading my sharp-question he said: "Philosophy is more fun." Why a person would take the care and heavy work of going through chemical and physical formulas and difficult mathematical reasoning to end in a department of Philosophy trying to prove that scientific theories must be axiomatic and consistent? Only a fool gets a ticket for a Shakespeare play and ends in a rock-concert. Some decisions are made intelligently and some others are just an act of revenge. The best way to see the ignorance and superfluity of Philosophy of science is looking at it from a medical point of view. Can any imagine a professor of Philosophy of science being admitted in an ER unit for heart failure and trying to convince his specialist physician that some of the scientific theories he is following are just inconsistent and mostly sure in next generation will be depleted? It is just ridiculous, right? It just does not happen because we only see the reality of life in front of Death and Illness. When we cross that line we see everything else devoid of false veils and non-senses. "Give me my pills and please operate my chest —says the philosopher of science— and the hell with Kuhn and Feyrabend! Who needs them anyways in the operating room?" This is what I call the art of achieving.

We only achieve certain truths after being compelled to jump across the ravine of suffering. There is nowadays an epidemic of searching for redemption, and this pathetic search has found a nostalgic movement in the new age visionaries that preach new medicaments and treatments. Everyone is interested in herbs and infusions, in acupuncture and moxibustion. The depressed person who is just fed-up with side effects runs half choleric and half disappointed to the Chinese doctor looking for a new panacea. In the end everybody ends in the same hospital being treated by the same kind of medicine: Western. We just don't want to see this because we live what I also call the Pinocchio Syndrome, that is, we lie to ourselves for-ever and ever and always evade fulfilling our duties as living beings. Aye, Medicine is full of problems; I did not claim it to be rounded. Aye, Medicine is a field wherein one can find from nice and competent professionals to the most despicable snake-oil seller; I do not deny that either. But, I deny that anybody with a cyclic psychosis or a schizophrenia will be cured taking a Chinese herbal tea. The futility of life can only be seen once we have made it futile, and once we are already in the realm of illness and/or death. Thomas of Aquinas, priest and philosopher, died saying to his assistants as a piece of advice to not write too much in life as he did, because he wrote too much and many of those things are just not relevant. He saw this fact in his death-bed: do we need to wait till that moment to see the reality of life we have been called for in our times? The world we are building with our prejudices and hatred is the world we will be bequeathing to our children; and the world they will construct will be passed on to their own children as well —this is a fact of existence. The sooner we learn to accept this, the sooner and better we will be released from suffering. Yes! My doctor is an idiot too; but this is not an article about my or your doctor. This is an article about Medicine, about how Medicine has been molded and framed since the beginning of the Western culture to the present —picking up the most interesting physicians in my view. In any given case, neither my doctor nor yours will be in the pages of the history of Medicine for his intellectual feats. People like him do not make Medicine, and Medicine will never ever get wounded because of people like him. Medicine is too excellent and divine to be affected by men or women like those.

And God protests

The most stupid question is not that one which is made and impossible to answer, like for instance: What is God? What is Science? What is life? And so forth. The most stupid question is the one which is posited out-side and responded in the next 200 pages. There we have "the whole nine yards." Philosophy is the craft-master in these sorts of things. Personally, it is of no consequence to me what Science might be and what God might or might not be. Kant taught me that making questions which are not liable to be answered is just thoughtless; and also he taught me that writing down 600 pages trying to answer a question which can be answered in three paragraphs is even more foolish —the latter he did in his Critique of Pure Reason which is a book that can be abridged in 3 or 5 pages. Said this let us move to the next summit.

I am going to make the mistake (once again) to wonder: what is Science. Yet, I shan't make the error to answer it not even in 4 pages. Allow me to ask something else: What is Surgery? What is Medicine? Nobody uses a whole book in order to explain those; on the other hand, it is a customary acceptance to present a paper in an international congress where we are trying to explain what Science might be. I will say that Science has the seeds of rationality, the trunk of consensus and the branches of specializations. The seeds need be watered in order to flourish and sprout. The trunk will be as high and robust as the potency of its seeds has permitted it. The branches will prosper if the roots —before seeds— are properly fed. Finally, we shall have the fruits, which all depend in the way we treated the tree. As a metaphor it can be interpreted in many ways, but the essence is far too simple. A tree dies and another one will substitute him; and the life and resurrection of the same entity foster the generation of the next one. This is a cyclic process that goes for ever. Still, we may ask what Science is, but the answer, as beauty, will universally be in the eyes of the beholder. The nature of Science is curiosity and human-wellness. The most humble curiosity is that of a scientist. A scientist is like a child, a human being who looks for answers, and trying to disassemble the red-truck than Santa brought this Christmas so he could see what is inside.

One of the main problems I see inside of Philosophy of Science is the way it has interrelated issues which are not akin to each other. For instance, the concept of mathematical truth and the concept of truth applicable to a field like Medicine are two distinct aspects of reality. Alfred Tarski (1901-1983) is responsible for starting this new line of research, which was imported to every single scientific arena. One more trepid question is following the Pilate's tradition: go ahead and wonder what truth is. Alfred Tarski tried not only to answer it but also to write it down and give it a universal form which could be used in every scientific field. In neo-positivistic terms truth is that which conforms to reality. The typical example was that the snow is white only and only if it was white —too much to call it a life's career and an achievement! Do you really need a Philosophy Doctor degree to reach onto those premises? Upon this, thousands of pages were exaggeratedly filled with examples and demagogic explanations about how logic, mathematics and science should be one and the same thing. Tarski[5] called his enterprise by the name of semantic concept of truth —something which we won't ever know if Pilate would have obeyed. The closer mathematical logic and philosophy of "science" gets to real Science, the bigger the waste of time for Science is.

Our Philosophy of Science professor was pretty sick, and was interned in ER, after a day under supervision he underwent open-heart surgery. A week after being treated with strong pain killers and cardiac drugs, he started to walk a little. This is the truth, and there is implicit my concept of truth: the truth is that he was dying a week ago, and now he is alive and kicking again. The truth is that he couldn't even walk or properly breathe a week ago and now he could go to the bathroom by himself and is breathing just fine. His wife came to visit him and asked him: "Do you want me to bring anything to read?" To what he answered: "No really, but I have a request for you." "And what is it, honey?" And the professor said: "Please burn all my philosophy of science books!"

There is no need to overt a problem indefinitely; and this is done very well by philosophers of science. They not only wonder about impertinent problems but also answer them in the most impertinent and boring manner. As I just above stated I do not believe a surgeon or a physician would really need the readings of Popper or Tarski in order to achieve his/her goal. A Biology investigator wouldn't really need them either. Once again, DNA theories, engineering advances, medical technology and so forth did not need at all the invaluable help of Popper, Tarski, Carnap or Hanson. Philosophers of Science want to unveil and combat scientific theories with another theory: their theory of truth. What kind of a game is this? It is real that DNA is a theory, but it is real also that their concept of truth is a theory as well. Has it to be more respectable just because they invented a mathematical language full of religious symbols to prove their point?

Now, the next and most rotten core is still to come: religion and fanaticism.

Epilogue: The Strange Case of Prof. Darwin and Mr. United States

I clearly remember it was a cloudy day. Rainy —to be exact. I was 24 years old then, naïve and full of expectations. I had just arrived to New York, in one of those typical newyorkian days. I had been told that their education and background was the fittest, and therefore the best. Great disappointment overcame me when I found nothing was farthest from reality. This country sells an image —false— and expects the rest of the world to buy it; and of course, they have the best machine to fabric myths: Hollywood. They have their own interpretation of facts, their own view on the rest of the world, their own concept on Vietnam and their "heroes," and their own making of what was the Roman Empire. Film has become a national consciousness —and a very dangerous one. Yet, that's beside the point. I intend to describe how I encountered one of the most ridiculous problems a person might mention by the end of twentieth century and the beginning of the twenty-first. I mean to say: evolutionism and the ideas of Charles Darwin.

I didn't know anything about fundamentalist-Christianity; and the only shreds of it I had found it was just by reading the old debates of the Church and the Inquisition —back almost four hundreds years ago. Now, to my surprise, I had drawn myself into a country whose national-consciousness was exactly the same as Europe had during the Dark Ages: a mind of bigotry and fatal judgments with its ascribed consequences. I got acquainted with what is called "the Bible Belt," which is in fact, half of the country. It grossly includes all the Midwest of the United States, although some people strive just to reduce it to four of five states: nothing farther from reality. The main factor in the Bible Belt is its fundamentalist-Christianity, which is led by fanatic sectors like the Baptist and Methodist sects, that are always behind any moral debate from abortion to stem-cell research and further on to euthanasia and homosexuality. They decide what is to be or not to be accepted as morally "good," according of course, to their own interpretation of the Bible. But, the champion issue of all the moral discussions has ever been since long ago the debate around evolution and the figure of Charles Darwin —who is treated as a "despicable sinner."

The state of Kansas, and their championing Baptists, Protestants and Methodists are behind all possible effort to ban Darwin from schools, and demand to be prohibited even at the university level. Many people see it as too much, and they just cling to the fact that evolutionism should not be taught at schools. Since their sectarian beliefs are spread all over the country, and even the Senate have an enormous amount of senators who are militant in the lines of extreme-hardcore-Christianity, the issue has always been dwelling in a land of deception and bigotry. For these people, fanatic-Christians, the general ambience is very simple, as a matter of fact, is exactly the very same ambience we experienced in Europe during the times of the Crusades: the enemy of God is the Muslim. Without any generalizations, for the American-fundamentalist-Christian there're only two kinds of people: Christians and terrorists. The term "heretic" has historically been substituted by the decanted verbum "terrorist." It is exactly the same proportion Pope Urban II stated when he described the world of the enemies of God as belonging to the Church, and then he decided to spare the souls of the sinners asking them to kill as many Jews and Muslims as they could because, anyways, they were enemies of Christ. In one of the public speeches done by the President George W. Bush, he bluntly declared: "either you're with me, or you're with the terrorists." Once again, "Urban II mentality" comes back from the dead.

This type of thinking is mainly fostered within the Republican Party, where fanatic-Christianity has an important stratum. Therein we find from Baptists and Methodists to Puritans and extremists Protestants —the Catholic Church has turned in United States to be a sort of conservative democratic sector. Still, Christianity, in one way or the other, does its damage. In a sarcastic way, we might as well say, they believe "God is white and speaks English." Yet, and not sarcastic though, they believe themselves to be the "soldiers of Christ," and they believe Christ is not only the "only one" reality but also the true "god." Curiously enough, this important sectarian line of fanatic-Christianity believes the Bible can not be interpreted and it shouldn't be; on top of that, and to make it even worse, they think it as a "manual of instructions" to follow, and in where one could find all the answers to our searches, and all the solutions to our problems. Even though they do not believe in Bible interpretation, that is, what in Catholicism is called exegesis; they do interpret the Bible in their own terms. If for the Jehovah Witnesses a blood transfusion must be abhorred, because they believe God forbids it, the Baptists believe God forbids dancing, or going to the cinema, or listening to modern music, or believing in evolutionism and Darwin, and according to their own pastors or ministers, they believe the world not only to have been created by a "omniscient rational being," but also to be just around 5,500 years old! In their mind, all the archeological findings plus all the paleontological skeletons must be considered with extreme caution. Their pastors, which are the main poison in the sect, foster the insane idea that the dinosaurs and the first men lived altogether, and that they were extinguished when Noah couldn't put them inside of his ark. The carbon-14 test, used in archeology and science, means to them nothing; and they always have the Devil at hand to make their point that we're all being deceived by Lucifer. They have their own schools and universities where they diffuse their insanities indoctrinating kids and youths in their sectarian-totalitarism and fanatic-Christianity.

Funny as it may appear, these schools are not even accredited by the government and yet, they do exist and are legally accepted. Universities like Bob Jones[6], in South Carolina, foster extremist views on Christianity, believing (among other madness) that interracial marriage shouldn't be allowed or that they have a mission to fulfill on earth, and that this mission has been given to them by God. Even mental illnesses are supposed to be just a product of sin, which can only be cured by asking for forgiveness to God; they are even against the use of anti-depressants or any other kind of "brain drug." So, what in Europe might qualify for paranoia or treatable schizophrenia, in Unites States is just something common, normal and, worse yet, accepted. I read one a declaration by an old alumni from Bob Jones, that the School of Nursing totally forbids the use of psychotropic drugs in depression or mania, and that when a person has a mental illness is because God —who supposedly has always a purpose— is punishing him/her because of his/her sins. Fanatic-Christians with interest in psychotherapy always recommend prayer as the only medium to be rid of any mental dis-ease.

The best is still to come; the very founder of Bob Jones University, besides being a fundamentalist-Christian was a member of the Ku Klux Klan of Alabama, and a staunch defender of Christ. Bob Jones University is one of the main shelters for fanatic-Christians, where they get brain-washed over and over, and where they received an education that in any other part of the world would be labeled as mere craze. Evolution is not taught, and when they touch the theme is to offer their own sectarian views; the Biology department is only interested in teaching to their pupils the wonders of God and His creation, again: creation. Tennessee Williams is banned, because he is considered to be a bad writer and also a danger for the youth. Likewise, other colleges around the country promote the same type of thinking, colleges that, of course, are not even accredited, and if they were their accreditation is coming from "a national association of Christian colleges."

With this little introduction, my intention is not to criticize the fanaticism of Christianity but giving a context to the real problem to be treated here: evolution. Once it's understood the above stated, it shall be easier to see why and how evolutionism has been taken under such extremist consideration in the Unites States.

Let us start saying that Darwin was not a fool. His theories and views have been proved right, and Science has literally advanced quite a bit thanks to his evolutionary postulates. Since the very first day Darwin announced his theories, London and its surroundings burned in desperation and laugh. The Protestant sector was quite adamant in its theological conceptions; and no matter what Science might bring, the question of creation was meant to be untouched. Yet, the worse fate for Darwinism was still to come. What happened in England during the XIX century regarding the Darwinian ideas was sheer joke in comparison with the destiny Darwin had to face in the United States of America. By the nineteen-hundreds Darwin had been already put in a better rung in the steps of Science. Still yet, by the nineteen-twenties Darwin had become part of Molecular Biology and altogether with the genetic theories he had achieved an important role in the scientific arenas. As I write this paper, in the year of 2005, Darwin is still rejected in the United States of America with the same voracity (or even worse) that he was despised in the second half of the nineteenth century. As funny as it might sounds, the North-American Senate still wastes its time in talking about Darwinian issues and their position in front of churches and creeds. If Christ must be accepted, they think, he must be accepted as only is stated in their Bible —which is a painful and obsolete translation, in most cases the King James Version. In this absurd manner, and by people whose education is not only fanatic but also very deficient, Darwin is lapidated and put to the stake day by day.

The very sick-and-fanatic-sector of society that sees "creation" as the only answer to everything and that condemns Darwin and Evolutionary theories goes to the very doctor whose education, background and medical advances are indebted on most part to the evolutionary theories of molecular biology. This proves, once again, that their bigotry and hypocrisy are at the same level: quite high. They have hardly read Darwin, and those who have done it, they have just seen in him whatever absurdities they were determined to see before they even open the first page. The same blinded-bigot who is against Evolution and the evolutionary theories may suffer of a disease which is being treated thanks to molecular advances in biology —advances, allow me to say, that were only fostered and achieved by means of an evolutionary view on Life. Radiation therapy, advances in Surgery, progress in Pharmacology, etc...wouldn't have happened if Darwin hadn't proposed that life did not happen at all in the literal way the Bible states. We may add to it that, thanks to Christianity Science has experienced a span-delay of 1,600 years to the point that men like Galileo or Darwin stood-up and risked their own live and reputation for the well-being of their human fellows.

Fanatics have an answer for every possible question; they are like the psychiatric patient who states that he's Napoleon and one tries to convince him he's mistaken. Not one single shred is left alone, and the literature of people defending creationism against evolution is quite impressive. Of course, another different story is if their concoctions can or can not be supported —which by all means they can not. Trying to prove creation is as futile as trying to prove Santa Claus actually exists. Yet, fanatics have a magic word for this: faith. Unfortunately, not only they ignore the real meaning of faith but also, on top, they fabricate their own understanding of it; what an original concept was quite complicated and attached to the mystery-religions of antiquity, they have converted into a sort of robotic-view. Thus, the fanatics have literally confused faith by stupidity, so the more stupid they become the more faithful they feel. There is not such thing as "faith" in the way they conceive it. Faith means not to believe, yet to see. We can't understand or even believe that which we are unable to see. To fabricate a ghost-concept in-between is sheer-paranoia. Seeing is believing. To see is to feel something, to apperceive it. And, in this relationship between object and perceiver the eyes play a fundamental role but not essential. There is a way to see even higher than the eyes. Now, the real question is if what you see-feel is real or just a product of your imagination. Faith in Christianity and in fanaticism is a brute-product from the imagination. To believe that God created the world in seven days and made man out of mud is not faith, it is clearly stupidity. And so, the more stupid the person becomes and more devoid of will the more he/she believes it. The Bible is not a manual of instructions, and much less a book of recipes wherein is stated the way God worked-out this peach-pie called World. It is just a book, a sacred book from the thousands we might find around the world and in every culture.



1. Diseases of Modern Life. New York: 1876.

2. Let us not forget that as I write this there still are schools and states in the US where Darwin and evolution can just not be taught for being considerate as a rebellious and pagan thinker. The curse is still on.

3. In 1665 was published Micrographia by Robert Hooke (1635-1703).

4. René Laennec (1781-1826) is credited for the invention of the stethoscope. In 1819 Lannec published his book De l'auscultation mediate.

5. Alfred Tarski: "The Semantic Conception of Truth and The Foundations of Semantics." Philosophy and Phenomenological Research 4 (1944).

6. For Bob Jones University pathological way of thinking see this link

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