Title of the paper:
"Herba non verba: Probing the foundations of Medicine"
Abstract: I propose to contest Thomas Szasz’s classification of therapies (Journal Humanistic Psychology, 1998, 38, 2:8-20), which distinguishes between the talking cure (verba) of Psychoanalysis and the physical healing methods of conventional Medicine (herba) and Psychiatry (verba and herba). Beginning by re-visiting the Humanist’s chants of Sorrow and Consolation, or Cuidar e Sospirar, and the very actual figure of R.L. Stevenson’s homo duplex, I recall the Hippocratic ethos and its triangular canon: the patient, the disease and the physician. As against the dictate of the letter (“l’écriture”, the “guidelines”) I will show, following Balint, that the clinician is a pharmakon, stressing the aporias of medicine as an ancient “science of the individual” and showing the diverse plots of the Art. Then, I will comment on an autobiographical narrative of a patient suffering from fibromyalgia and will explore a few aspects of the phenomenology of pain and first person authority in Medicine. In consonance with this I’ll comment briefly on two of the principal barriers to communication laid out by Rita Charon in Narrative Medicine: the context of the illness and the emotions revealed by severe disease. In this way, I try to demonstrate that though Szasz might not be absolutely accurate in his description of “Hippocratic” Medicine, his points become increasingly cogent when considering the stark reality of medical practices, under the pressure of current technology, ideology and management. Finally, recognizing that much clinical “material” and many choices are opaque, non-verbal, latent, I will conclude by defending the need for the grafting of Narrative-based Medicine (NBM) and Evidence-based Medicine (EBM) into Clinical Reflexive Medicine. Accordingly, I will show the epistemic principles of the clinical encounter (Zaner): they are foreclosed foundations that make system and they have the ability to illuminate and resolve the ambiguities of alterity (partial and castrating narratives), of inter-subjectivity (predator-prey relationships), of morals (Jekyll-Hyde temptations), and of science (imperfect metrics and dogmatism, barely considered here).
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