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J R Soc Med. 2005 May; 98(5): 244–246.
PMCID: PMC1129053

A farewell to the flesh?

Since, as the saying goes, ‘those who live by the crystal ball end up by eating ground glass’, I am not going to predict how things will be in 2055 and have my 108th birthday spoilt with a mocking recitation of my erroneous forecasts.

Instead, dear reader in 2055, I want to reflect on some general trends in human life and wonder whether or not you will have solved a problem connected with something rather extraordinary that has happened over the last 10 000 years, and particularly the last century, in the more prosperous parts of the world. I am referring to the diminishing part played by immediate bodily experience—physical sensation—in human life. While medicine has recently contributed to this trend, we need to look far beyond medicine truly to understand it.

Aristotle famously noted that human perception ‘consists in receiving the form of sensible objects without their matter’.1 This is most clearly evident in visual perception—where we get to know of an object without literally bumping into it. In human vision, the intuition of an object as something of which one is aware, but from which one is disconnected, is fully developed. There is more to vision than meets the eye. Not only do I see an object; I also see that I see it; and see that I see it from a certain angle. What is more, I am aware of the object as other than myself—as existing in itself independently of my sense experience, and as having intrinsic properties and causal relations.

This sense of objects existing in themselves is the key to the distance between animal sentience and human knowledge and lies at the root of practical investigation and science. (The story that follows here is spelt out in pitiless detail in my Handkind trilogy.2) It is not available to any other creature—not even our closest primate kin,3,4 for whom proximate senses such as smell and touch have at least as great a significance as vision—and constitutes the first step towards a disconnected, abstract awareness that we call ‘knowledge’ or ‘information’. Human vision, giving form without content, prefigures a trend in which humans deal primarily with the abstract form of what is around them and eventually interact with abstractions.

The sense of objects existing out there, with intrinsic properties and causal relations, inspired purpose-made tools and the secondary tools needed to make them—the most basic example of mediated interactions with the material world. Tools, which implicitly acknowledge the otherness of the material world, its existence beyond our senses, and our selves, also retroact upon the tool user, underlining their nature as embodied subjects (to use the term employed by the French philosopher Maurice Merleau-Ponty to characterize the human condition) rather than as mere sentient organisms. Since tools are both material instruments and general signs—abstract markers of human intention, need and agency—tool-use (and tool-sharing) fostered a progressive collectivization of individual awareness whose most striking manifestation is human language. (This was not quick. The pebble chopper appeared about 2.8 million years ago and language about 100 000 years ago.) Over the last few thousand years, language has been increasingly deposited in writing and other forms of inscription.

Writing allows information to be stored outside of the human body. This is a crucial step in the transition from a sensation based human life to an information based one, for it completes the separation of the form of objects (in this case their general meaning) from their matter. What is more, the quantity of sense experience in reading compared with information gained through it (think of the written word ‘world’) is minute.

Abstraction now permeates every aspect of our lives, which are increasingly regulated by, and take the form of, exchanges of spoken and written sentences and a variety of other verbal, iconic and numerical signs. Not only has the struggle for survival been transformed into cooperative labour, labour itself has also been transformed. Grubbing in the dirt, which gave place to hunting and gathering, and then to nurturing and harvesting crops in the recalcitrant soil and tending equally recalcitrant beasts, has now been replaced largely by gadget-using. Work, at least in advanced countries, is often in consequence minimally physical: machines require less and less of our hands. The ordeal of effort, which was at first replaced by the ordeal of precision, is now, with the advent of sophisticated industrial technology, often reduced to undemanding repetitive activity. The difference between manual labourers who use their bodies to handle matter and white-collar professionals who use their minds to handle information has also been eroded. Information handling (in which our hands are in fact little involved) becomes the common medium of all work—and indeed of leisure and of everyday life in peace and war. What is more, thanks to the efficiency of the multitude of artifacts that surround us, we are less exposed to cold and heat, to hunger and thirst, to unchosen darkness and unwanted light, to the predations of the animal kingdom.

Human interactions with the natural world and each other are increasingly technology-mediated exchanges of symbols. Shoving and pushing and dragging, body-on-body rutting, fist-on-face fighting, grooming and other direct physical activity occupy a waning portion of waking life which is mainly occupied with handling documents, pressing keyboards, checking invoices, looking after tills, chattering, phoning, messaging, reading, or listening to or watching the electronically transmitted thoughts and behaviour of remote strangers. Most of our contacts with nature and other humans, in short, are virtually discarnate.

It is important not to exaggerate how far these trends have gone. We are not yet so liberated from our bodies that we float in a medium of mediations, a soup of signs. First of all, ‘we’ is severely circumscribed. Outside of enclaves of affluence there is unrelieved misery, where life is no more comfortable or safe than it was in the stone age. Disease, poverty, war, and oppression and persecution by bosses, bullies, and unaccountable governments headed up by blood-boltered kleptocrats, make sure that a significant portion of the human race still suffers Adam's curse to the full. Many living on the surface of the earth would welcome the ‘problem’ that I want to discuss with you. Secondly, even in the more comfortable parts of the world our experience is not entirely given over to abstraction. Mishaps great and small—a stubbed toe, toothache, a fractured neck of femur following a fall, a blocked or perforated bowel—remind us of the incompleteness of our discarnation. These are the unwilled equivalents of the arias of physical pleasure (walks in nature, sunbathing, lovemaking) and physical ordeals (extreme sports) we requisition to season the flavourless recitative of words and other endless intermediaries which link our abstract situations with our abstract purposes.

Which brings me (and not before time, you may be thinking) to medicine. The passage from sentience to useful knowledge took longest in relation to our own bodies. Not surprisingly, the body, which we look out of, is the last object to be caught by our gaze; the last, that is to say, to be objectified. This primary cause of the delay in discovering our bodies—that we are them to a great extent—has been compounded by secondary causes: myths, supersititions, groundless but fiercely defended theories, rooted in intuitions about the place of humans in the wider scheme of the universe, and their relationship to one another. Theories of disease were developed ahead of any objective observation. At first they drew upon theological notions of guilt and shame and later upon ill-thought-out conceptions of the natural world of which the human body was a part. In short, transcendental and then humoral accounts of illness got in the way of a scientific medicine rooted in unprejudiced observation.

In the last 400 years—and especially in the century just past—that has changed. Biological and clinical science, driven by a perpetual willingness to question received ideas and, by a ‘disenchanted’ view that sees the body as just another natural object and as subject to the laws of the material world, has given us an extraordinarily potent therapeutic armamentarium. As a consequence, the return of the repressed body, in the form of a flood of sensations associated with disease, is itself being repressed. Even the sensations of illness are being assimilated to a boundless sea of discourses and there addressed. We are progressing, it seems, towards driving out the last vestiges of natural sentience, of prehumanity, from the human body.

This is far from complete. Treatments are often unsatisfactory; and many are still as brutally and unredeemably carnal as the illnesses themselves. No-one vomiting after chemotherapy or recovering from a sternotomy feels the need to be rescued from discarnation. Even so, we cannot deny that medical care, which has hitherto participated rather fully in the primordial sensations of the illnesses it aims to correct, has made huge progress in humanization. Medicine, surgery and hands-on care are closer to the everyday life of abstract discourses than they were.

Which brings me to the heart of the matter. Let me make three assumptions for the next 50 years and then pose my question.

The first is that medicine will become more successful at preventing, postponing, treating and palliating disease. The result of this will be a modest increase in life span but a very significant increase in health span, so that the proportion of our life in which our bodies are transparent with wellbeing, and we are free to be quasi-discarnate, will also increase.5 The second is that medical treatments, even surgery, will become less brutal. The incision with a knife, for example, will be consigned to that barbaric past in which we were more concerned with saving lives and dealing with savage pain than with customer services. And doctors, interacting with their patients through knowledge-bearing instrumentation, will touch their patients even less: hands-on care will be hands-off. In sum, we shall have marginalized the inhumanity of the human body to the very end of life. Even our ending, better managed, will be metaphysical rather than physical; or, at least, human rather than animal. The third is that those enclaves of comfort currently occupied by the affluent will grow, as a result of a widespread understanding as to where our self-interest lies. Avoiding devastation by a universal and perpetual war fuelled by the nuclear-armed anger of the wretched of the earth will have become a real priority. If these presuppositions have proved to be true, then the journey I have described, towards a discarnate human life, may by the time you read this be close to arrival.

And this may make the situation I have described into a pressing problem. Having been eased of the burdens of which we were first apprised, when we woke out of animal sentience into human knowledge, we may seem to be threatened with ‘an unbearable lightness of being’ (to steal, and misuse, the title of Milan Kundera's wonderful book), passing through our lives like a dream, without touching the sides, without ever being fully there. Insulated from raw sensation, we may find we have lost ‘those counsellors’ that as Jacques said in As You Like It ‘feelingly persuade me what I am’;6 or, indeed, that I am.

I fear that this attenuation of our bodily self-presence and the protopathic joys and woes of the body may already be accounting for some of the unhappy social trends we observe in 2005. How otherwise are we to explain: rising levels of reported depression, despite progress in the conquest of those immemorial sources of unhappiness, nature-made pain and privation and man-made tyranny; more frantic consumption of consumables, far beyond the point at which they answer a need or are capable of even being enjoyed; increasing resort to the paradis artificiels of drugs and loveless sexual activity; and the increasing dissatisfaction with, and breakdown of, longstanding relationships within and outside of the family?

This, then, is the question that I would like you to address. In parallel with the progress you will undoubtedly have made in postponing and humanizing death and banishing the terrible antimeanings (pain, nausea, malaise, paralysis, etc.) that arise out of the dysfunctioning human body, will you have made progress in dealing with the ‘lightness’ of human being that becomes apparent as we are increasingly sealed off from nature, and from the unmediated joys, as well as the horrors, of sensory experience; as consciousness is transformed into an ever-more complex, ever greyer, hubbub of information? Or will you leave this to the artists and philosophers? And what will they have to offer?

Answers to these questions would make my 108th birthday one to remember.

References

1. Aristotle. De Anima, Book 2 424 (a).18 -24
2. Tallis R. The Hand. A Philosophical Inquiry into Human Being (2003);I Am. A Philosophical Inquiry into First-Person Being (2004);The Knowing Animal. A Philosophical Inquiry into Knowledge and Truth (2005). All published by Edinburgh University Press.
3. Wolpert L. Causal beliefs and the origins of technology. Phil Trans R Soc Lond A 2003. ;361:1709 -19 [PubMed]
4. Povinelli D. Folk Physics for Apes. The Chimpanzee's Theory of How the World Works. Oxford: Oxford University Press,2003
5. Tallis R. Meagre increments: the supposed failure of success. In: Hippocratic Oaths: Medicine and its Discontents. London: Atlantic, 2004 [PubMed]
6. Shakespeare W. As You Like It, Act II, Scene I.

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press