What modern doctor would dare speak to his
civilized
patients in this way?
Peter-Sloterdijk-Critique-of-Cynical-Reason
We also do not know exactly what sexual consequences the mysticism of the brotherhoods of the Free Spirit had.
(See Norman Cohn, Das Ringen um das Tausendjahrige Reich [Bern, 1961].
) Only when, in the merry tales of the late Middle Ages, women come to the conclusion that the soldier is not as good a lover as the clericus can we be sure that this assertion was supported by diligent obser- vation.
In the bourgeois age, the stage was set for sexual cynicism in a new form. The bourgeoisie did not make claims on cultural hegemony without at the same time setting up its own model of ideal love: marriage for love. Countless novels do their part in stamping the templates of bourgeois erotic idealism indelibly into the minds of the reading public, especially the female public. With this, a cultural languor of unknown extent sets in. For on the one side, the "bourgeois soul" wants to partake of the joys of love and is hungry to experience the adventurous, vitaliz- ing, fantastic, and even sensual-passionate power of love. But the other side, the bourgeois soul must take care that love remains strictly confined to marriage, that the "animal side" plays no role, and that even in the most extreme case, the bodily aspect can be regarded as an "expression" of the passion of the soul. This erotic lay idealism (it is not clerics who preach it) provokes sexual-cynical antitheses
THE CARDINAL CYNICISMS ? 261
in virtually epidemic dimensions. As in many other things, the bourgeois is, in sexual matters, an almost-realist who indeed risks taking a look at the real, with- out, however, forsaking his idealizations and value phantoms. His ideas are therefore continually undermined by realistic premonitions, and it is this tension that makes the bourgeois man particularly receptive to sexual-cynical jokes, to dirty keyhole realism and pornography. For the bourgeois, the crucial point is to "cherish his values" without forgetting how things happen "down there in real- ity. " Hence the cynical smile. One knows all about it. One knows the business. I too was in Arcadia. But this is not "our level. " We will not so easily be made to confuse above and below. Admittedly, the bourgeois does not unwillingly visit the brothel and convince himself there of the common denominator between whores and ladies, but reality remains divided, the differences are defended. It may well be the cultural strategy of bourgeois literature and art to conquer the public sphere with a depiction of private life, but simultaneously, a dividing wall is erected in the private sphere between idealized private life and animal private life. When the bourgeois knows himself to be protected by a curtain, then he is in his animality more cynical than kynical, more swine than dog. He knows how to distinguish the human from the all-too-human. He can, on the one side, cer- tainly confess "human weaknesses," but on the other, ideal side, he is resolute in preserving "composure"; to quote Bismarck; "politeness to the last rung of the gal- lows. " A definition of a lady has even been attempted according to whether she knows how to make the "right face" when a dirty joke (Herrenwitz) is told in her presence. The right face betrays that the person knows what it is about but also that she "stands above it. " To the cultivation of a lady belongs the tolerant-ironical note in dealing with inevitable male cynicism.
Through psychoanalysis, we have become used to connecting psychological enlightenment automatically with sexual enlightenment. In this there is something right and something wrong. The psychoanalytic attempt to overcome bourgeois semirealism in sexual matters and to develop it into a full realism appears to be right. However, the tendency of psychoanalysis to confuse the unconscious with the secretive is wrong. Of course, sexuality is an area in which this confusion al- most inevitably occurs. When psychoanalysis began to interpretatively explore the so-called unconscious, it entered in fact into that area that in bourgeois society was the secret topic par excellence. It took the self-experience and the self- suspicion of the bourgeois as animal seriously. It went on to neutralize the animal- sexual area and to bring it back into the sphere of nonsecret matters. For this rea- son, contemporary readers were able to sometimes ask themselves when studying psychoanalytic publications whether these should be assigned to the genus of science or to that of pornography. Two generations of analysts as well as patients have been plagued by the tendential confusion of the secretive with the uncon- scious. For the airing of sexual secrets in late-bourgeois culture as a whole has in no way led to the elimination of neurosis from society--because pathogenic
262 ? THE CARDINAL CYNICISMS
Michael Voltz (? ), Animal Magnetism. A serious preoccupation for thinkers and believing souls. "The suspicion bourgeois individuals have of themselves being animals creates the cultural framework for modern depth psychology. "
sexual secrets constitute only a tiny fraction of the individual as well as of the so-
27
cial unconscious.
Psychoanalysis is a historical hybrid. With its sexual-pathological foundation,
it looks into the past; with its conviction that the unconscious is produced, it looks into the future. In the manner of a cultural detective, it has turned the early- bourgeois suspicion into a certainty: The human being is based on the animal- This suspicion has been, at least since the eighteenth century, with people in bour- geois society, a society that, on the one hand, began with the final taming of the inner animal by reason, enlightenment, and morality, but which saw, as a by-
? THE CARDINAL CYNICISMS D 263
product of this taming, an ever-larger and threatening animal shadow emerge from below. Only the fully civilized, "deanimalized" bourgeois semirealist can have such a persistent and eerie self-suspicion of its interior and its lower parts. This self-suspicion of the bourgeois animal flares up in romantic literature--with all its gloomy, mysterious metaphors of the animal abyss leading inward and downward. The romantics know that two paths are open to the bourgeois, one in the bourgeois light, the other in the unbourgeois depths. The first marries, be- comes a respectable man, begets children and enjoys middle-class peace--but what does he know of life?
To the second sang and lied
The thousand voices in the ground Tempting sirens, and drew
Him into the wanton billows
Of the colorfully ringing chasm.
(Fourth verse of J. v. Eichen- dorff s poem
Die zwei Gesellen [The two bachelors, 1818])
The second is the inner other, the still unchainable animal that risks the descent into its own secrets and the crevices of its soul--in the colorful chasms of animal lust. Only those who try to completely banish the animal element in themselves sense in themselves a growing danger, which should be handled carefully. A vari- ant of such carefulness is encountered in the psychoanalytic vocabulary that designates the area of the "repressed," dangerous, animal element with a true lion tamer's expression: the "unconscious. " Psychoanalysis has a bit of the air of a pseudomedical domesticating science about it--as if it were a matter of chaining the "unconscious" with the fetters of insight.
When Freud speaks of a "sexual chemistry" and treats orgasm as a discharge of tension, it is difficult not to think of men in a brothel who, in "making love," don't even take off their trousers because it is only a "discharge. " This too is a silencing, a disenchanting, an unjustified objectification and neutering of sexual- ity. It constitutes the unarbitrary counterpart to the equally unjustified and un- avoidable demonizing of the inner secret area whose expression we find, almost at the beginnings of bourgeois culture, in the romantics. They created the stage on which the demonology of "sexual unconsciousness" begins its play. The demon is nothing other than the inner animal. What the "unconscious" is in its essence was expressed more clearly by the romantic Eichendorff than by the neoromantic scientist Sigmund Freud: "But take care not to awake the wild animal in your breast, so that it (Es, id) does not suddenly break out and tear your Self apart" (Das Schloss Durande).
264 ? THE CARDINAL CYNICISMS
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The late-bourgeois cultural situation is markedly different from the nineteenth century, which found its expression in the psychologies of the unconscious. No contemporary still believes in or practices the separation of ideal and animal love. Thus a basic precondition for sexual-kynical attacks has been voided. A "wo/man" does not laugh at "dirty jokes" any more, nor does pornography have an aggressive bite. Today, both are completely backward. However, it would be naive to think that this means the game is over. Whenever kynicism has asserted itself, new cynics can be found who can, as usual, make a dirty business out of the no longer "dirty" truth. Pornographic shock is admittedly over once and for all, but the business of pornography is still flourishing. For a long time now there has not been in late-bourgeois pornography any spark of a personal reckoning with inhibitions, erotic idealisms, and sexual taboos. Rather, it consciously
? ? ? ? "Bourgeois pornography exposes the commodity aspect of sexuality. Out of principled indiscretion, it bursts the closed rooms, makes nakedness and venality into synonyms, and brings visual drugs onto the 'free market. " 'Brothelization of minds' as a relation of production? (See chapter 9, 'Exchange Cynicism'). "
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produces backward consciousness by citing, with a wink, taboos "as if," in order to break through them with a false gesture of enlightenment. The cynicism of our tit-and-thigh press consists not in exposing more or less pretty, naked women to the general view but in unrelentingly restoring superseded sexual relations and working with a high degree of consciousness toward artful stupefactions. For this reason the kynical, enlightening, realistic momentum today is to be found in some feminist groups that as a public protest smash the display windows of porno shops.
Late-bourgeois pornography serves in capitalist society as an initiation into the not-now structure of schizoid life, swindled out of its own time. It sells the origi- nal, given, and self-evident as a distant goal, as Utopian sexual stimulus. The beauty of the body, which in Platonism was recognized as a signpost for the soul to the highest enthusiastic experience of truth, in modern pornography serves to reinforce the lovelessness that in our world has the power to define what reality is.
Medical Cynicism
Doctors have two enemies: the dead and the healthy
Proverb
In every culture there are groups of people who, through their professional tasks, are led to develop various realisms in their dealings with dying or dead bodies: the soldier, the executioner, the priest. In medical practice, however, the most thorough realism of death is constructed--a consciousness of death that, techni- cally more intimate than any other, knows of the body's fragility and reveals the death-oriented course of our organism, no matter whether it is called health, sick- ness, or aging. Only the butcher possesses a comparable and similarly craftsman- like knowledge, anchored in routines, of the material side of our death. Medical materialism is able to intimidate even philosophical materialism. The corpse would be thus the properly qualified teacher of an integral materialism. To keep pace as a layperson with the medical realism of death, one would have to stock up on a large ration of sarcasm, black humor, and romantic mischievousness, and not shrink back from a philosophical view of the corpse. To expose oneself with open nerve endings to the impact of a postmortem--only that can provide the ex- perience of "naked" death. The anatomical gaze, "more cynical" than any other, knows a second nakedness of our body, when, on the surgeon's operating table, the exposed organs present themselves in an "ultimate" shameless nakedness. The corpse too has long known the titillation of putting on a show --exhibition of corpses, nudism of death, existential night plays in the Callotian manner. An ar- chaic desire to look, suffused by horror, is directed at the corpse, as earlier execu- tions demonstrate, as do public burnings, the mortuary romanticism of long ago, and the lying-in-state of political cadavers.
THE CARDINAL CYNICISMS ? 267
Part of today's crisis in medicine comes from the fact that, and the way that, it has surrendered its once functional connection with the priesthood and since then entered into a convoluted, ambivalent relationship with death. In the "struggle be- tween life and death," priests and doctors are now in opposing camps. Only the priest, without becoming cynical, can take the side of death with a kynically free perspective on reality because, in living religions and cosmologies, death is held to be the self-evident price for life and one phase in the grand designs with which the knowledge of priests once knew itself to be conspiratorially (etymologically: "breathing together") connected. Mortality in general must embarrass the priest
just as little as the individual fight against death in particular. In both, a facticity of a higher type is effective in which our will plays no part. For the doctor things are different. Doctors define themselves through having to take the side of life. All of medical idealism derives from this unconditional partiality; it is this idealism that even today, down to the most cynical twists, guides the absurd struggles of medicine for the life of moribund bodies, long since decayed. The doctor takes the side of the living body against the corpse. Because living bodies are the source of all power, the body's helper is a man (Mann) of power. To this extent, the helper himself becomes a kind of wielder of power, since he gains a share of the central authority of all hegemonic powers, the power over the life and death of others. Thus the doctor comes into a mediating position: on the one hand, an "absolute" supporter of life; on the other, a partaker in the power of hegemonic powers over life. Herewith, the stage is set for the appearance of medical cynicism. Sure, why shouldn't medical students bowl in the corridor of the anatomical institute with skulls? We were not particularly upset when our biology teacher brought a skele- ton into the classroom for demonstration purposes, let its jaw snap, and explained that it had been only a criminal anyway. I wish the whole of medical cynicism, like these examples, could be treated under the rubric of black humor. But because medicine for the most part participates in the exercise of power, and because power, in a philosophical respect, can be defined by its virtual lack of humor, there is nothing humorous about medicine and its cynical tendency.
All power proceeds from the body, it was said earlier. How does this apply to medical power? There are three possible answers to this question.
1. Doctors' work is based on their alliance with the natural tendencies of life toward self-integration and the avoidance of pain. Two allies aid them in this: the will to live and artificial medical means. Physicians who know how to use both can regard themselves as competent helpers. Medical power is legitimated and confirmed in the effectiveness of vital suggestion (whatever that may mean) and in practical measures for treatment (medicaments, surgery, dietetics). Healthy societies will be recognized, above all, by the way in which they remunerate their helpers and integrate them into the social framework. One of the most profound ideas of traditional Chinese village medicine was the custom of paying the helper
268 ? THE CARDINAL CYNICISMS
as long as one was healthy, and of stopping payment when one became sick. This institution cleverly hindered the splitting of the power of the helper from the vital interest of the communities. For us it is especially significant that the Chinese ex- ample represents a folk medicine tradition. For it is this that, in medical matters, embodies what we called in the other domains of values the kynical impulse. Here the art of helping remains under the control of a communal consciousness that, for its part, commands the art of dealing with the helper's power. Above it, how- ever, stretches an old line of masters' medicine that always knew how to escape the control of remuneration from below. It always preferred payment in the case of sickness and thus created for itself a powerful lever for extortions. Of course, there is also a productive perspective in this. The freedom of medicine, where such freedom exists, is based not least of all on the economic autarky of the doc- tors, which they know how to protect through their demands for fees. (To this extent, there is a parallel between Greek medicine and Roman law, namely, the principle or private consultation and payment for each case, which is supported by the idea of a "contract for treatment. "
2. The will to live, an important agent in any healing, feels threatened by self- doubt in the case of "serious" illnesses. Where the tendency toward life grapples with that toward death, sick persons need an ally in whose unconditional pact with life they can believe. Patients thus project the self-healing powers of their bodies onto the doctor, who knows better how to stimulate and strengthen these powers than the patients alone, in their debility and anxiety, could do. In a crisis, patients who can believe in their own will to live, concentrated in the helper, have a deci- sive advantage over the person who is left alone and who thus wrestles simultane- ously with sickness and doubt. In this drama, sick persons who can trust place all of their own strength in the hands of the one who is helping them. Perhaps this way of looking at things sheds light on the quite amazing successes of old magical medicine, e. g. , shamanism. In the magic healing ritual, the shaman ex- tracts the "evil" from the sick body, perhaps in the form of a skillfully placed for- eign body -- a worm, a larva, a needle. In cases in which the ritual was successful, such extractions, often performed at the height of a crisis, formed the turning point at which the self-healing processes began to take over. (To a certain extent, the extractions were enactments of the inner dynamic drama. ) Up to the present day, doctors draw their magical status from such, and similar, mechanisms, inso- far as demoralization and cynical body technocracy are not readily apparent in them--which, by the way, is happening more and more. Wanting to completely take such magic functions away from doctors would mean to dump the prevailing system of medicine. That there are good grounds for such radical demands is a common topic in magazine articles. For the less credibly the pact with life and
the healing-magical motive is embodied by today's doctors, the stronger will be the incentive to reflect and to seek ways of self-help. Once they know how the
THE CARDINAL CYNICISMS D 269
Thomas Rowlandson, Lecture with Doctor Gall.
suggestive part of healing functions, then gradually the time becomes ripe for pa- tients to draw the outwardly directed projections of the will to live back into them- selves. A broad field of alternative help will open up here.
3. The power of physicians reached its apex through royal bodies. If the king fell ill, then for a time the physician ruled de facto over the "body of power. " The ability to cure princes raised the art of healing for the first time completely to the level of masters' medicine. The ruling medicine is thus the medicine of the rulers. Those who heal the powerful themselves become central bearers of power. In old theocracies and priest-controlled dominions, this connection was still direct by virtue of the personal unity of ruler and healer. Later, the healer was differen- tiated from the prince, and this precisely to the extent that the art of healing devel- oped into an art with a technical core of experience that could be distinguished from magical manipulation. The German word Arzt (doctor), according to Duden [the authoritative German-language reference books;-Trans. ], comes from the adoption of the Greek word for the ruling medico, arch-iatros -- the chief doctor.
? 270 D THE CARDINAL CYNICISMS
? Pitt and the king of Sweden consult Doctor Gall incognito.
This was the title of court physicians of ancient princes, first established for the Seleucids of Antioch. The word came to the Frankish Merovingians through Ro- man doctors. From the monarchs' courts, the title then went over to the physicians of spiritual and temporal dignitaries and became the general name for the profes- sion in Old High German times. Significant in this word migration is, above all, that the title "doctor" (Arzt) suppressed an older name for the healer, namely, lachi, which means roughly "the conjurer. " The change of words signifies a change in praxes: The quasi-rational masters' medicine began to suppress the magical folk medicine. The statement in Duden that Arzt was never really used by "the folk" can give cause for reflection. The word "doctor" (Doktor), however, has been in common use since the fifteenth century. The "doctor"-as the learned exorciser of sickness--to the present day is more likely to gain trust than the "ar- chiater," the masters' medico. There is, in fact, a kind of medicine that has always been recognized as a dubious shadow of power.
Medical kynicism begins at that moment when the helper, as supporter of life, uses his knowledge of the body and of death frivolously and realistically against the delusions of sick people and the powerful. Often the doctor is dealing not with a fateful suffering but with the consequences of unawareness, carelessness, ar- rogance, idiocy with the body, "stupidity," or an unhealthy life-style. Against evil of this kind, the kynical medico's intimacy with death can serve him as a useful weapon. This is portrayed nowhere more spendidly than in Johann Peter Hebel's Der geheilte Patient (The healed patient). A clever doctor had given advice to a
THE CARDINAL CYNICISMS ? 271
rich, overstuffed citizen of Amsterdam that, in its kynical coarseness, left nothing to be desired. Because rich people have to endure diseases "that, God be praised, the poor man does not know of," this doctor thought up a particular form of ther- apy: "Wait, I soon will have cured you. " So he wrote the patient the following exemplary letter:
Good friend, you are in bad shape, but you can still be helped, if you want to follow. You have a nasty animal in your belly, a dragon with seven mouths. I have to speak with the dragon myself, and you must come to me. But you are not to drive or to ride a pony; come instead on the shoemaker's mare, otherwise you will shake the dragon and it will bite off your intestines, seven intestines, completely ruined in one stroke. Second, you're not to eat more than twice daily, a plate full of vegetables; at lunch you can have a bratwurst with it, at night an egg, and in the morning a cup of bouillon with chives sprinkled on top. What you eat in excess of this will only make the dragon larger, so that it will squash your liver, and the tailor won't have to measure you any more but the carpenter will. This is my advice, and if you don't follow it, you will not hear the cuckoo sing next spring. Do what you like. " (Johann Peter Hebel, Das Schatzkastlein des Rheinischen Hausfreundes, 2nd ed. [Munich, 1979], p. 153).
What modern doctor would dare speak to his civilized patients in this way? And how many patients are put into the situation of having to admit on the day of a consultation, "I could not have picked a more inopportune time to become healthy than now, when I'm supposed to go to the doctor. If only my ears would ring or I would bleed someplace. " And what doctor today, when he asks the pa- tient what is wrong; gets an answer like, "Doctor, God be praised, there's nothing wrong with me, and if you are as healthy as I am, then I'd be glad. " The extent to which Hebel's sarcastic story closely follows a folk-medicine way of thinking is revealed also by its conclusion, which says that the rich stranger "lived 87 years, 4 months, 10 days, as healthy as a fish in water, and every New Year sent the doctor 20 doubloons as a greeting. " The sick/ee has become the New Year's greeting of a healthy person. Could there be a better indication of that "other help- ing" in which the healers are rewarded for doing their bit so that their fellow hu- man beings do not get sick in the first place?
To today's popular realism, in spite of science, in spite of research, in spite of grand surgery, doctors appear only as questionable supporters of life, and one sees all too often how easily they can change over to the side of sickness. For a long time it has been a distinguishing feature of masters' medicine that it is in- terested more in the sicknesses than in the sick person. It is inclined to establish itself smugly in a universe of pathology and therapy. Medicine's clinical way of living increasingly robs doctors of an orientation toward health and destroys the roots of healer consciousness in a life-affirming realism that would really rather
272 ? THE CARDINAL CYNICISMS
? George Grosz, The Faith Healers or the K. V. Machines, 1916-17. ((C)S. P. A. D. E. M. , Paris/V. A. G. A. , New York, 1987. )
have nothing at all to do with medicine. Doctors like the one in Hebel's story be- long to a dying species --doctors who show the candidate for sickness how su- perfluous medicine is for people who suffer not from a disease but from the inabil- ity to be healthy. It used to be said that the best doctors were often those who wanted to be something else, such as a musician, writer, captain, pastor, philoso- pher, or vagabond. It was still understood that those who know everything about sicknesses do not necessarily know anything about the medical art. The inclina- tion "to help willingly" is as human and joyful as it is joyless and suspect when the helping bears some relation to evils that arise from self-destructive tendencies in civilization. A doctor will be all too easily pushed into the camp of masters' cynicism when, like the great Doctor Hiob Praetorius of Curt Goetz, he is no longer allowed to oppose self-destructive "stupidities" that frequently underlie the "sick raw material. " The more sicknesses are produced by the political relations in civilization, indeed even by medicine itself, the more medical praxis in our so- ciety is caught up in the twists and turns of a higher cynicism that knows that it itself furthers with the right hand the evil for whose cure it takes in money with the left. If doctors, as learned supporters of life, really saw their task in hindering
THE CARDINAL CYNICISMS ? 273
sicknesses at their source, instead of accommodating themselves to them parasiti- cally (and, in effect, helpingly), they would have to open up for candid discussion again and again their relation to and use of power. Today a medicine that radically insisted on its pact with the will to life would have to become the scientific core of a general theory of survival. It would have to formulate a political dietetics that decisively intervenes in the social relations of labor and life. However, in general, medicine lurches ahead in a cynical shortsightedness and interprets its pact with the will to live in such a dubious way that only from case to case could one specify the position in the kynical-cynical spectrum to which it relates. Is it the kynicism of simplicity, as practiced by the good parson Kneipp? Is it the cyni- cism of complicatedness as started recently by Professor Barnard with his heart transplants? Is it the kynicism of a medical resistance that refuses to collaborate with self-destructive institutions and mentalities? Is it the cynicism of a medical collaboration that gives the causes a free hand in order to profit from the effects? A kynicism of the simple life or a cynicism of the comfortable death? A kynicism that healingly pits the threatening certainties of death against unawareness, self- destruction, and ignorance? Or a cynicism that collaborates with the repression of death, which is constitutive for the system in overmilitarized and overstuffed societies.
Because doctors must protect their hearts from the many hardships of the profession, popular reason has always granted them a bit of cynical coarseness that it would never have tolerated in others. The people recognized its real allies in those who possessed enough heart to hide it behind black humor and coarse manners. Medical jokes --more cynical than any other kind --always had an ac- cepting audience of laypeople who, on the basis of the strong cynicism of their helpers, could convince themselves of the latters' good intentions. Icy coldness surrounds the medicine that no longer knows any jokes and has completely con- gealed into the exercise of its own and delegated power. There is a medicine that is nothing other than archiatry--the realm of chief doctors. As was the case for all battered masters' mentalities striving for disinhibition, the hour for this medi- cal cynicism arrived when fascism came to power. The latter created the scenario in which all those unperpetrated brutalities could emerge with which repressively civilized society is laden. Just as there was an older, camouflaged, cynical com- munity of interests between the execution of punishment (which left a trail of corpses behind it) and scientific anatomy (which is notoriously hungry for corpses), so there was a community of interests between medical masters' cyni- cism and Fascist racism that at last allowed it to satisfy its hunger for corpses on its own. Those who have the nerve should read the protocols of the Nuremberg trials in which the crimes of German medical fascism against humanity were heard. I do not choose this expression lightly; the phrase "medical fascism" does not come from a critical whim but encapsulates a phenomenon as pregnantly as possible. What was swept to power in medicine at camps and universities between
274 ? THE CARDINAL CYNICISMS
1933 and 1945 reveals not the accidental straying of individual doctors to Nazi ideology but rather an old, masters' medical tendency, which was encouraged by fascism to reveal itself; this tendency had always found that there were too many people whose treatment was not "really" worth the trouble and who were just good enough to become experimental objects. Alexander Mitscherlich wrote on this.
Of course, one can do a simple calculation. Of about 90,000 doctors active in Germany at that time, around 350 committed medical crimes. That is still a considerable number, especially when one thinks of the enormity of the crimes. But in relation to the entire medical profession, it was still only a fraction, about one in three hundred . . . every third hundredth doctor a criminal? That was a proportion that never before could have been found in the German medical profession. Why now? (Medizin ohne Menschlichkeit, Dokumente des Niirnberger Arz- teprozesses, ed. A. Mitscherlich and F. Mielke [Frankfurt, 1962], p. 13)
Mitscherlich shows that behind the criminal leaders stood a large medical ap- paratus that had already step by step advanced to a considerable extent the trans- formation of patients into human raw material. The criminal doctors "only" had to take one more cynical leap in the direction in which they were already headed. What today goes on quietly without being seriously disturbed by anyone--torture research, genetic and prosthetic research, military-biological and war- pharmacology research --already has within it everything that will provide the tools for the medical fascism of tomorrow. The horrifying living experiments and notorious collections of skeletons in Nazi medicine will be "nothing by compari- son. " "Nothing by comparison": That is cynical one-upmanship, yet it simply ar- ticulates a tendency of reality. In the area of cleverly thought out cruelty, the twenty-first century has already begun.
What will help against the masters' helping profession of today and tomorrow? Several answers are conceivable.
First, from a society with the will to live and from its philosophy--to the extent that it captures the will to live of its time in concepts--must come an offensive that rehabilitates the idea of the "good doctor" and brings a "helping at the source" into battle against the universal, diffuse cynicism of modern medicine. What good help and what a real healer are, medicine by itself has never been able to define. A social order like ours furthers almost by necessity a medicine that, in turn, tends to further the system of sicknesses and of making people sick rather than life in good health.
Second, only self-help helps against masters' helpers. The only defense against false or questionable help is to have no need for it. Moreover, for a long time now we have been able to observe how capitalist masters' medicine attempts to
THE CARDINAL CYNICISMS ? 275
bring self-help traditions in folk medicine under its domination--after centuries of defamation and rivalry--by absorbing them as part of orthodox medical rea- son. ("It's been scientifically proven: There really is something in some herbs! ") The interest of the institutionalized medical profession works with all possible means toward a state of affairs in which everything corporeal will be totally medicalized--from occupational medicine, sport medicine, sexual medicine, digestive medicine, nutritional medicine, fitness medicine, accident medicine, criminal medicine, and war medicine to the medicines covering the competency to supervise healthy and unhealthy breathing, walking, standing, learning and newspaper reading, to say nothing of pregnancy, birth, dying, and other caprioles of human corporeality. The "health" system is heading toward a state of affairs in which the masters' medical control of the somatic dimension will become totalitarian. A point can be imagined at which private bodily competencies will be expropriated completely. In the end, one will have to attend urological classes to learn how to piss correctly. The central question in the current medical-cynical process is whether "orthodox medicine" will be able to destroy the lay helper movements that have arisen for numerous cultural reasons (self-actualization, the women's movement, ecology, rural communes, new religions, etc. ). This ques- tion runs parallel to the question of the intramedical chances of "political" tenden- cies in professional medicine: psychosomatic internal medicine, occupational medicine, gynecology, psychiatry, and so on. These are the professional medical disciplines that, for logical reasons concerning their occupations, should know best that everything they do runs the risk of harming more than helping, as long as another direction for helping--coming from life, freedom, and conscious- ness--is not pursued.
Third, in the last instance, only the conscious embodying of our fragility, our being sick, our mortality, can help against the medical splitting off of responsibil- ity for our own bodily existence. I do not have to say how difficult that is, for the fear, when it becomes great, makes us all the more inclined to repress our responsibility for the life and death of our own body or to delegate it to doctors, not considering that even the most perfect conservation medicine, in the end, hands back to us the entire responsibility and unsharable pain in our most helpless moment. Those who recognize that the circle of alienation and flight must always finally close in one's own death must also be aware that it would be better to re- verse toward life rather than anesthetization, toward risk rather than security, to- ward embodiment rather than splitting.
Religious Cynicism
And what will you do with the grail when you have found it?
Benjamin Disraeli
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. . . even grinning is mixed in with it, like that of the skull it- self: because the fact that long-planning human beings depart like cattle is also somehow funny.
Ernst Bloch, Das Prinzip Hojfnung (p. 1299)
Suddenly, someone leaves the visible and continuous world common to all and ceases to share existence with us. His breathing has stopped, his movements have ceased. At first, death manifests itself negatively; something is extinguished and passes over into stillness. A little later, this cessation shows also its positive side, the body becomes cold, starts to putrefy, rot. The skeleton then steps forth as the part that resists decomposition longer than the other parts. It takes over the representation of what remains of us in materia, hence the skeleton as death im- ago. The framework of bones symbolizes the end that all who live already carry within themselves. Everyone of us is our own friend Mr. D. , the bony forerun- ning of one's own departure.
From the perspective of this side of death, the only one usually observable, the idea imposes itself on living persons that an invisible force is at work in ani- mated bodies that allows them to breathe, jump about, and remain form-coherent, whereas this invisible something must have departed from the dead, so that they grow stiff and decay. The invisible something stimulates breathing, movement, feeling, alertness, and the maintenance of the body's form --it is the epitome of intensity and energy. Its activity creates, although not visibly or in a way that can be isolated, the most real reality. This invisible force has many names: soul, spirit, breath, ancestors, fire, form, God, life.
Experience teaches that animals like us are born and die, that plants germinate and pass away, and that they too, in their own way, participate in the rhythm of death and life, form constitution and form dissolution. Without doubt, the human "soul" is surrounded by a cosmos of animal and plant life and by mysterious energy subjects that are active behind day and night, storm and calm sky, heat and cold. In nothing does this being surrounded suggest a "domination" of hu- mankind over nature and the environment. Rather, the naked biped appears as a being that is tolerated and endured by the whole, insofar as it controls the inter- actions with the bringers of bounty and danger from the animal and plant world.
Life and death, coming and going, they are initially natural constants, pulsat- ing beats in a rhythm in which what is pregiven outweighs what is added later. In the course of civilization, however, the relation between submission and ac- tion, suffering and doing has shifted --also with regard to the experience of death. What appeared to be an aspect of natural pulsations becomes in more developed societies a more and more profound and more and more embittered struggle be- tween life and death. Death is then no longer so much an event that nothing can influence, but is itself something that our violence and caprice bring about. Its primary image is no longer the unavoidable coming to an end, nor the peaceful
THE CARDINAL CYNICISMS ? 277
self-exhaustion or the quiet and unresisted burning down of life's flame, butacon- tested, horrifying happening imbued with premonitions of violence and murder. The more people think of death as being murdered rather than as being peacefuly extinguished, the more violently must the flood of the fear of death swel up in higher and more violent civilizations. For this reason, the historical states and empires, wherever we look, are religious states and empires. They constitute so- cial worlds in which the fear of a violent death is a realistic one. We al have a thousand images of violence before our eyes: surprise attacks, massacres, rapes, public executions, wars, scenes of torture, in which human beings develop them- selves into diabolical fiends in order to extract a maximum of agony from the death of others. In addition, class societies suppress the vital energies of subjects and slaves through physical and symbolic violence in such a way that shadowy hollows of unlived life unfailingly open up in bodies, where wishing, fantasizing, the yearning for the divined otherness of a full life begin to brood. This unlived life combines its Utopian energies with the fears of annihilation that are distiled in the individual in violent societies from infancy onward. Only out of this combi- nation comes the absolute defiance of death in civilized human beings, a defiance that seemingly cannot be dissolved by anything. This is the answer to the pro- foundly terrifying experience of civilization. Our being in society comprises al- most a priori the threat that we will not be allowed to realize the vitality with which we were born. Every socialized life lives with the premonition that its ener- gies, time, willing, and wishing will not be at an end when the death knell rings, Life builds residues-an immense, burning Not Yet that needs more time and fu- ture than is granted to the individual. Life dreams beyond itself and dies ful of defiance. For this reason, the history of higher civilizations vibrates with count- less and boundless Not Yet screams-with a million-voiced No to a death that is not the expiration of the dying embers of life but a violent suffocation of a flame that in any case did not burn as brightly as it could have done in a vital fredom. Since that time, devitalized life in class and military societies ponders its compensations-whether in further lives, as supposed by Hindu consciousness, or in heavenly existence as promised by Christianity and Islam - for the thwarted dreams of their believers. Religion is not primarily the opiate of the people but the reminder that there is more life in us than this life lives. The function of faith is an achievement of devitalized bodies that cannot be completely robbed of the memory that in them much deeper sources of vitality, strength, pleasure, and of the enigma and intoxication of being-there must lie hidden than can be sen in everyday life.
This gives religions their ambiguous role in societies: They can be used to legitimate and double (verdoppelri) oppression (see the Enlightenment's critique of religion in chapter 3, the section entitled "Critique of Religious Illusion"). They can, however, also liberate individuals to a greater power of resistance and creativity by helping them to overcome fear. Thus, depending on circumstances,
278 ? THE CARDINAL CYNICISMS
religion can be both an instrument of domination and the core of resistance against domination; a medium of repression and a medium of emancipation; an instrument of devitalization and a precept of revitalization.
The first case of religious Kynicism in the Judeo-Christian tradition has no one less than the original father, Moses, in the role of kynical rebel. He committed the first blasphemy of grand dimensions when, on his return from Mount Sinai, he smashed the tablets; "they were tables of stone, written on by the finger of God" (Exodus 31:18). "And the tables were the work of God, and the writing was the writing of God, graven upon the tables" (32:16). Moses, who, with the divine laws under his arm, came down from the mountain and found his people dancing around the Golden Calf, set an example for the religious kynic's behavior with respect to the sacred: He smashed everything that was not spirit but letter, not God but idol, not the living but its representation. It is emphasized that he did this in anger and that it was a holy anger that gave him the right and the necessary impertinence to lay violent hands on God's personal handwriting. That needs to be understood. Namely, immediately after he had shattered the tablets, so the bib- lical account says, Moses seized the Golden Calf, melted it in the fire, "ground it to powder, and scattered it upon the water, and made the children of Israel drink
of it" (32:20). Later, Moses had to chisel new tablets so that God could inscribe them a second time. He also received from God the commandment: "Thou shalt make no graven images. " Moses' kynical blasphemy came from the knowledge that people are inclined to worship fetishes and to indulge in the idolization of objects. But nothing material can be so holy that it may not be smashed as soon as it becomes apparent that the representations of the sacred have begun to over- shadow the spirit of the religion. In this regard it can happen that no distinction is made between the stone tablets of the dear Lord and the Golden Calf. If it is a representation, or idol, then smite it. That is the spiritual-kynical core of the commandment to make no image of "God. " Image and text can fulfill their func- tions only as long as it is not forgotten that both are material forms and that the "truth," as a material-immaterial structure, must always be written and read anew, that is, materialized and, at the same time, immaterialized anew --which means that every materialization will be shattered whenever it begins to force it-
28
All primary blasphemies are borne by the kynical impulse to not let oneself be made a fool of by any idol. Those who "know" something of the gods know the great rage of Moses and the kynical lightness in dealing with representations of the divine. Religious persons, in contrast to pious persons, are no buffoons of the superego; it knows the laws, and religious persons know that it knows the laws, and they let them speak and they obey them too when it seems appropriate- This distinguishes the primary blasphemy of mystics, the religious, and the kyni- cally alive, from the secondary blasphemies that arise from resentment, uncon-
self into the foreground.
THE CARDINAL CYNICISMS ? 279
? Max Ernst, The Virgin Disciplines the Christ Child 1926. ((C)S. P. A. D. E. M. , Paris/V. A. G. A. , New York, 1987. )
scious compulsions for vices and an unfree desire to drag down whatever is elevated.
The first cynicism of the religious type likewise is found in the Old Testament. Significantly, it is contained in the story of the first murder in human history --in the story of Cain and Abel. Adam and Eve had two sons among their children. Cain, the firstborn, was a farmer, and Abel, the second, was a shepherd. One day both brought sacrifices to the Lord, Cain from the fruit of his fields and Abel from the youngest of his herd. The Lord, however, welcomed only Abel's offering and
280 ? THE CARDINAL CYNICISMS
cast scorn upon Cain's. "And Cain was very wroth and his countenance became distorted . . . Cain talked with Abel his brother: And it came to pass, when they were in the field, that Cain rose up against Abel his brother, and slew him. And the Lord said unto Cain, Where is Abel thy brother? " (Genesis 4:5-9). With this question, the stage for religious cynicism is set. The art of dissimulation, spo- ken of here for the first time, is directly connected with the cynical turning of a
29
violent consciousness against the other.
said, it would have to be cynical -- for, in truth, he does not intend to tell the truth. The communication with the questioner is distorted from the start. Cain could, if he felt he had nothing to lose, answer his God: "Don't be so hypocritical, you know as well as I do where Abel is, for I have killed him with my own hands, and you not only looked on calmly, but even gave me occasion to do it. " Cain's real answer, in its brevity, still has enough cynical bite: "I know not: Am I my brother's keeper? " (Genesis 4:9). An all-knowing and infinitely just God, as Cain's testy retort suggests, should be able to refrain from such prickings of con- science. What kind of God is it who treats people unequally and at the very least provokes them to crime, but then, with pretended innocence, asks questions about what has happened?
In the bourgeois age, the stage was set for sexual cynicism in a new form. The bourgeoisie did not make claims on cultural hegemony without at the same time setting up its own model of ideal love: marriage for love. Countless novels do their part in stamping the templates of bourgeois erotic idealism indelibly into the minds of the reading public, especially the female public. With this, a cultural languor of unknown extent sets in. For on the one side, the "bourgeois soul" wants to partake of the joys of love and is hungry to experience the adventurous, vitaliz- ing, fantastic, and even sensual-passionate power of love. But the other side, the bourgeois soul must take care that love remains strictly confined to marriage, that the "animal side" plays no role, and that even in the most extreme case, the bodily aspect can be regarded as an "expression" of the passion of the soul. This erotic lay idealism (it is not clerics who preach it) provokes sexual-cynical antitheses
THE CARDINAL CYNICISMS ? 261
in virtually epidemic dimensions. As in many other things, the bourgeois is, in sexual matters, an almost-realist who indeed risks taking a look at the real, with- out, however, forsaking his idealizations and value phantoms. His ideas are therefore continually undermined by realistic premonitions, and it is this tension that makes the bourgeois man particularly receptive to sexual-cynical jokes, to dirty keyhole realism and pornography. For the bourgeois, the crucial point is to "cherish his values" without forgetting how things happen "down there in real- ity. " Hence the cynical smile. One knows all about it. One knows the business. I too was in Arcadia. But this is not "our level. " We will not so easily be made to confuse above and below. Admittedly, the bourgeois does not unwillingly visit the brothel and convince himself there of the common denominator between whores and ladies, but reality remains divided, the differences are defended. It may well be the cultural strategy of bourgeois literature and art to conquer the public sphere with a depiction of private life, but simultaneously, a dividing wall is erected in the private sphere between idealized private life and animal private life. When the bourgeois knows himself to be protected by a curtain, then he is in his animality more cynical than kynical, more swine than dog. He knows how to distinguish the human from the all-too-human. He can, on the one side, cer- tainly confess "human weaknesses," but on the other, ideal side, he is resolute in preserving "composure"; to quote Bismarck; "politeness to the last rung of the gal- lows. " A definition of a lady has even been attempted according to whether she knows how to make the "right face" when a dirty joke (Herrenwitz) is told in her presence. The right face betrays that the person knows what it is about but also that she "stands above it. " To the cultivation of a lady belongs the tolerant-ironical note in dealing with inevitable male cynicism.
Through psychoanalysis, we have become used to connecting psychological enlightenment automatically with sexual enlightenment. In this there is something right and something wrong. The psychoanalytic attempt to overcome bourgeois semirealism in sexual matters and to develop it into a full realism appears to be right. However, the tendency of psychoanalysis to confuse the unconscious with the secretive is wrong. Of course, sexuality is an area in which this confusion al- most inevitably occurs. When psychoanalysis began to interpretatively explore the so-called unconscious, it entered in fact into that area that in bourgeois society was the secret topic par excellence. It took the self-experience and the self- suspicion of the bourgeois as animal seriously. It went on to neutralize the animal- sexual area and to bring it back into the sphere of nonsecret matters. For this rea- son, contemporary readers were able to sometimes ask themselves when studying psychoanalytic publications whether these should be assigned to the genus of science or to that of pornography. Two generations of analysts as well as patients have been plagued by the tendential confusion of the secretive with the uncon- scious. For the airing of sexual secrets in late-bourgeois culture as a whole has in no way led to the elimination of neurosis from society--because pathogenic
262 ? THE CARDINAL CYNICISMS
Michael Voltz (? ), Animal Magnetism. A serious preoccupation for thinkers and believing souls. "The suspicion bourgeois individuals have of themselves being animals creates the cultural framework for modern depth psychology. "
sexual secrets constitute only a tiny fraction of the individual as well as of the so-
27
cial unconscious.
Psychoanalysis is a historical hybrid. With its sexual-pathological foundation,
it looks into the past; with its conviction that the unconscious is produced, it looks into the future. In the manner of a cultural detective, it has turned the early- bourgeois suspicion into a certainty: The human being is based on the animal- This suspicion has been, at least since the eighteenth century, with people in bour- geois society, a society that, on the one hand, began with the final taming of the inner animal by reason, enlightenment, and morality, but which saw, as a by-
? THE CARDINAL CYNICISMS D 263
product of this taming, an ever-larger and threatening animal shadow emerge from below. Only the fully civilized, "deanimalized" bourgeois semirealist can have such a persistent and eerie self-suspicion of its interior and its lower parts. This self-suspicion of the bourgeois animal flares up in romantic literature--with all its gloomy, mysterious metaphors of the animal abyss leading inward and downward. The romantics know that two paths are open to the bourgeois, one in the bourgeois light, the other in the unbourgeois depths. The first marries, be- comes a respectable man, begets children and enjoys middle-class peace--but what does he know of life?
To the second sang and lied
The thousand voices in the ground Tempting sirens, and drew
Him into the wanton billows
Of the colorfully ringing chasm.
(Fourth verse of J. v. Eichen- dorff s poem
Die zwei Gesellen [The two bachelors, 1818])
The second is the inner other, the still unchainable animal that risks the descent into its own secrets and the crevices of its soul--in the colorful chasms of animal lust. Only those who try to completely banish the animal element in themselves sense in themselves a growing danger, which should be handled carefully. A vari- ant of such carefulness is encountered in the psychoanalytic vocabulary that designates the area of the "repressed," dangerous, animal element with a true lion tamer's expression: the "unconscious. " Psychoanalysis has a bit of the air of a pseudomedical domesticating science about it--as if it were a matter of chaining the "unconscious" with the fetters of insight.
When Freud speaks of a "sexual chemistry" and treats orgasm as a discharge of tension, it is difficult not to think of men in a brothel who, in "making love," don't even take off their trousers because it is only a "discharge. " This too is a silencing, a disenchanting, an unjustified objectification and neutering of sexual- ity. It constitutes the unarbitrary counterpart to the equally unjustified and un- avoidable demonizing of the inner secret area whose expression we find, almost at the beginnings of bourgeois culture, in the romantics. They created the stage on which the demonology of "sexual unconsciousness" begins its play. The demon is nothing other than the inner animal. What the "unconscious" is in its essence was expressed more clearly by the romantic Eichendorff than by the neoromantic scientist Sigmund Freud: "But take care not to awake the wild animal in your breast, so that it (Es, id) does not suddenly break out and tear your Self apart" (Das Schloss Durande).
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The late-bourgeois cultural situation is markedly different from the nineteenth century, which found its expression in the psychologies of the unconscious. No contemporary still believes in or practices the separation of ideal and animal love. Thus a basic precondition for sexual-kynical attacks has been voided. A "wo/man" does not laugh at "dirty jokes" any more, nor does pornography have an aggressive bite. Today, both are completely backward. However, it would be naive to think that this means the game is over. Whenever kynicism has asserted itself, new cynics can be found who can, as usual, make a dirty business out of the no longer "dirty" truth. Pornographic shock is admittedly over once and for all, but the business of pornography is still flourishing. For a long time now there has not been in late-bourgeois pornography any spark of a personal reckoning with inhibitions, erotic idealisms, and sexual taboos. Rather, it consciously
? ? ? ? "Bourgeois pornography exposes the commodity aspect of sexuality. Out of principled indiscretion, it bursts the closed rooms, makes nakedness and venality into synonyms, and brings visual drugs onto the 'free market. " 'Brothelization of minds' as a relation of production? (See chapter 9, 'Exchange Cynicism'). "
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266 ? THE CARDINAL CYNICISMS
produces backward consciousness by citing, with a wink, taboos "as if," in order to break through them with a false gesture of enlightenment. The cynicism of our tit-and-thigh press consists not in exposing more or less pretty, naked women to the general view but in unrelentingly restoring superseded sexual relations and working with a high degree of consciousness toward artful stupefactions. For this reason the kynical, enlightening, realistic momentum today is to be found in some feminist groups that as a public protest smash the display windows of porno shops.
Late-bourgeois pornography serves in capitalist society as an initiation into the not-now structure of schizoid life, swindled out of its own time. It sells the origi- nal, given, and self-evident as a distant goal, as Utopian sexual stimulus. The beauty of the body, which in Platonism was recognized as a signpost for the soul to the highest enthusiastic experience of truth, in modern pornography serves to reinforce the lovelessness that in our world has the power to define what reality is.
Medical Cynicism
Doctors have two enemies: the dead and the healthy
Proverb
In every culture there are groups of people who, through their professional tasks, are led to develop various realisms in their dealings with dying or dead bodies: the soldier, the executioner, the priest. In medical practice, however, the most thorough realism of death is constructed--a consciousness of death that, techni- cally more intimate than any other, knows of the body's fragility and reveals the death-oriented course of our organism, no matter whether it is called health, sick- ness, or aging. Only the butcher possesses a comparable and similarly craftsman- like knowledge, anchored in routines, of the material side of our death. Medical materialism is able to intimidate even philosophical materialism. The corpse would be thus the properly qualified teacher of an integral materialism. To keep pace as a layperson with the medical realism of death, one would have to stock up on a large ration of sarcasm, black humor, and romantic mischievousness, and not shrink back from a philosophical view of the corpse. To expose oneself with open nerve endings to the impact of a postmortem--only that can provide the ex- perience of "naked" death. The anatomical gaze, "more cynical" than any other, knows a second nakedness of our body, when, on the surgeon's operating table, the exposed organs present themselves in an "ultimate" shameless nakedness. The corpse too has long known the titillation of putting on a show --exhibition of corpses, nudism of death, existential night plays in the Callotian manner. An ar- chaic desire to look, suffused by horror, is directed at the corpse, as earlier execu- tions demonstrate, as do public burnings, the mortuary romanticism of long ago, and the lying-in-state of political cadavers.
THE CARDINAL CYNICISMS ? 267
Part of today's crisis in medicine comes from the fact that, and the way that, it has surrendered its once functional connection with the priesthood and since then entered into a convoluted, ambivalent relationship with death. In the "struggle be- tween life and death," priests and doctors are now in opposing camps. Only the priest, without becoming cynical, can take the side of death with a kynically free perspective on reality because, in living religions and cosmologies, death is held to be the self-evident price for life and one phase in the grand designs with which the knowledge of priests once knew itself to be conspiratorially (etymologically: "breathing together") connected. Mortality in general must embarrass the priest
just as little as the individual fight against death in particular. In both, a facticity of a higher type is effective in which our will plays no part. For the doctor things are different. Doctors define themselves through having to take the side of life. All of medical idealism derives from this unconditional partiality; it is this idealism that even today, down to the most cynical twists, guides the absurd struggles of medicine for the life of moribund bodies, long since decayed. The doctor takes the side of the living body against the corpse. Because living bodies are the source of all power, the body's helper is a man (Mann) of power. To this extent, the helper himself becomes a kind of wielder of power, since he gains a share of the central authority of all hegemonic powers, the power over the life and death of others. Thus the doctor comes into a mediating position: on the one hand, an "absolute" supporter of life; on the other, a partaker in the power of hegemonic powers over life. Herewith, the stage is set for the appearance of medical cynicism. Sure, why shouldn't medical students bowl in the corridor of the anatomical institute with skulls? We were not particularly upset when our biology teacher brought a skele- ton into the classroom for demonstration purposes, let its jaw snap, and explained that it had been only a criminal anyway. I wish the whole of medical cynicism, like these examples, could be treated under the rubric of black humor. But because medicine for the most part participates in the exercise of power, and because power, in a philosophical respect, can be defined by its virtual lack of humor, there is nothing humorous about medicine and its cynical tendency.
All power proceeds from the body, it was said earlier. How does this apply to medical power? There are three possible answers to this question.
1. Doctors' work is based on their alliance with the natural tendencies of life toward self-integration and the avoidance of pain. Two allies aid them in this: the will to live and artificial medical means. Physicians who know how to use both can regard themselves as competent helpers. Medical power is legitimated and confirmed in the effectiveness of vital suggestion (whatever that may mean) and in practical measures for treatment (medicaments, surgery, dietetics). Healthy societies will be recognized, above all, by the way in which they remunerate their helpers and integrate them into the social framework. One of the most profound ideas of traditional Chinese village medicine was the custom of paying the helper
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as long as one was healthy, and of stopping payment when one became sick. This institution cleverly hindered the splitting of the power of the helper from the vital interest of the communities. For us it is especially significant that the Chinese ex- ample represents a folk medicine tradition. For it is this that, in medical matters, embodies what we called in the other domains of values the kynical impulse. Here the art of helping remains under the control of a communal consciousness that, for its part, commands the art of dealing with the helper's power. Above it, how- ever, stretches an old line of masters' medicine that always knew how to escape the control of remuneration from below. It always preferred payment in the case of sickness and thus created for itself a powerful lever for extortions. Of course, there is also a productive perspective in this. The freedom of medicine, where such freedom exists, is based not least of all on the economic autarky of the doc- tors, which they know how to protect through their demands for fees. (To this extent, there is a parallel between Greek medicine and Roman law, namely, the principle or private consultation and payment for each case, which is supported by the idea of a "contract for treatment. "
2. The will to live, an important agent in any healing, feels threatened by self- doubt in the case of "serious" illnesses. Where the tendency toward life grapples with that toward death, sick persons need an ally in whose unconditional pact with life they can believe. Patients thus project the self-healing powers of their bodies onto the doctor, who knows better how to stimulate and strengthen these powers than the patients alone, in their debility and anxiety, could do. In a crisis, patients who can believe in their own will to live, concentrated in the helper, have a deci- sive advantage over the person who is left alone and who thus wrestles simultane- ously with sickness and doubt. In this drama, sick persons who can trust place all of their own strength in the hands of the one who is helping them. Perhaps this way of looking at things sheds light on the quite amazing successes of old magical medicine, e. g. , shamanism. In the magic healing ritual, the shaman ex- tracts the "evil" from the sick body, perhaps in the form of a skillfully placed for- eign body -- a worm, a larva, a needle. In cases in which the ritual was successful, such extractions, often performed at the height of a crisis, formed the turning point at which the self-healing processes began to take over. (To a certain extent, the extractions were enactments of the inner dynamic drama. ) Up to the present day, doctors draw their magical status from such, and similar, mechanisms, inso- far as demoralization and cynical body technocracy are not readily apparent in them--which, by the way, is happening more and more. Wanting to completely take such magic functions away from doctors would mean to dump the prevailing system of medicine. That there are good grounds for such radical demands is a common topic in magazine articles. For the less credibly the pact with life and
the healing-magical motive is embodied by today's doctors, the stronger will be the incentive to reflect and to seek ways of self-help. Once they know how the
THE CARDINAL CYNICISMS D 269
Thomas Rowlandson, Lecture with Doctor Gall.
suggestive part of healing functions, then gradually the time becomes ripe for pa- tients to draw the outwardly directed projections of the will to live back into them- selves. A broad field of alternative help will open up here.
3. The power of physicians reached its apex through royal bodies. If the king fell ill, then for a time the physician ruled de facto over the "body of power. " The ability to cure princes raised the art of healing for the first time completely to the level of masters' medicine. The ruling medicine is thus the medicine of the rulers. Those who heal the powerful themselves become central bearers of power. In old theocracies and priest-controlled dominions, this connection was still direct by virtue of the personal unity of ruler and healer. Later, the healer was differen- tiated from the prince, and this precisely to the extent that the art of healing devel- oped into an art with a technical core of experience that could be distinguished from magical manipulation. The German word Arzt (doctor), according to Duden [the authoritative German-language reference books;-Trans. ], comes from the adoption of the Greek word for the ruling medico, arch-iatros -- the chief doctor.
? 270 D THE CARDINAL CYNICISMS
? Pitt and the king of Sweden consult Doctor Gall incognito.
This was the title of court physicians of ancient princes, first established for the Seleucids of Antioch. The word came to the Frankish Merovingians through Ro- man doctors. From the monarchs' courts, the title then went over to the physicians of spiritual and temporal dignitaries and became the general name for the profes- sion in Old High German times. Significant in this word migration is, above all, that the title "doctor" (Arzt) suppressed an older name for the healer, namely, lachi, which means roughly "the conjurer. " The change of words signifies a change in praxes: The quasi-rational masters' medicine began to suppress the magical folk medicine. The statement in Duden that Arzt was never really used by "the folk" can give cause for reflection. The word "doctor" (Doktor), however, has been in common use since the fifteenth century. The "doctor"-as the learned exorciser of sickness--to the present day is more likely to gain trust than the "ar- chiater," the masters' medico. There is, in fact, a kind of medicine that has always been recognized as a dubious shadow of power.
Medical kynicism begins at that moment when the helper, as supporter of life, uses his knowledge of the body and of death frivolously and realistically against the delusions of sick people and the powerful. Often the doctor is dealing not with a fateful suffering but with the consequences of unawareness, carelessness, ar- rogance, idiocy with the body, "stupidity," or an unhealthy life-style. Against evil of this kind, the kynical medico's intimacy with death can serve him as a useful weapon. This is portrayed nowhere more spendidly than in Johann Peter Hebel's Der geheilte Patient (The healed patient). A clever doctor had given advice to a
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rich, overstuffed citizen of Amsterdam that, in its kynical coarseness, left nothing to be desired. Because rich people have to endure diseases "that, God be praised, the poor man does not know of," this doctor thought up a particular form of ther- apy: "Wait, I soon will have cured you. " So he wrote the patient the following exemplary letter:
Good friend, you are in bad shape, but you can still be helped, if you want to follow. You have a nasty animal in your belly, a dragon with seven mouths. I have to speak with the dragon myself, and you must come to me. But you are not to drive or to ride a pony; come instead on the shoemaker's mare, otherwise you will shake the dragon and it will bite off your intestines, seven intestines, completely ruined in one stroke. Second, you're not to eat more than twice daily, a plate full of vegetables; at lunch you can have a bratwurst with it, at night an egg, and in the morning a cup of bouillon with chives sprinkled on top. What you eat in excess of this will only make the dragon larger, so that it will squash your liver, and the tailor won't have to measure you any more but the carpenter will. This is my advice, and if you don't follow it, you will not hear the cuckoo sing next spring. Do what you like. " (Johann Peter Hebel, Das Schatzkastlein des Rheinischen Hausfreundes, 2nd ed. [Munich, 1979], p. 153).
What modern doctor would dare speak to his civilized patients in this way? And how many patients are put into the situation of having to admit on the day of a consultation, "I could not have picked a more inopportune time to become healthy than now, when I'm supposed to go to the doctor. If only my ears would ring or I would bleed someplace. " And what doctor today, when he asks the pa- tient what is wrong; gets an answer like, "Doctor, God be praised, there's nothing wrong with me, and if you are as healthy as I am, then I'd be glad. " The extent to which Hebel's sarcastic story closely follows a folk-medicine way of thinking is revealed also by its conclusion, which says that the rich stranger "lived 87 years, 4 months, 10 days, as healthy as a fish in water, and every New Year sent the doctor 20 doubloons as a greeting. " The sick/ee has become the New Year's greeting of a healthy person. Could there be a better indication of that "other help- ing" in which the healers are rewarded for doing their bit so that their fellow hu- man beings do not get sick in the first place?
To today's popular realism, in spite of science, in spite of research, in spite of grand surgery, doctors appear only as questionable supporters of life, and one sees all too often how easily they can change over to the side of sickness. For a long time it has been a distinguishing feature of masters' medicine that it is in- terested more in the sicknesses than in the sick person. It is inclined to establish itself smugly in a universe of pathology and therapy. Medicine's clinical way of living increasingly robs doctors of an orientation toward health and destroys the roots of healer consciousness in a life-affirming realism that would really rather
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? George Grosz, The Faith Healers or the K. V. Machines, 1916-17. ((C)S. P. A. D. E. M. , Paris/V. A. G. A. , New York, 1987. )
have nothing at all to do with medicine. Doctors like the one in Hebel's story be- long to a dying species --doctors who show the candidate for sickness how su- perfluous medicine is for people who suffer not from a disease but from the inabil- ity to be healthy. It used to be said that the best doctors were often those who wanted to be something else, such as a musician, writer, captain, pastor, philoso- pher, or vagabond. It was still understood that those who know everything about sicknesses do not necessarily know anything about the medical art. The inclina- tion "to help willingly" is as human and joyful as it is joyless and suspect when the helping bears some relation to evils that arise from self-destructive tendencies in civilization. A doctor will be all too easily pushed into the camp of masters' cynicism when, like the great Doctor Hiob Praetorius of Curt Goetz, he is no longer allowed to oppose self-destructive "stupidities" that frequently underlie the "sick raw material. " The more sicknesses are produced by the political relations in civilization, indeed even by medicine itself, the more medical praxis in our so- ciety is caught up in the twists and turns of a higher cynicism that knows that it itself furthers with the right hand the evil for whose cure it takes in money with the left. If doctors, as learned supporters of life, really saw their task in hindering
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sicknesses at their source, instead of accommodating themselves to them parasiti- cally (and, in effect, helpingly), they would have to open up for candid discussion again and again their relation to and use of power. Today a medicine that radically insisted on its pact with the will to life would have to become the scientific core of a general theory of survival. It would have to formulate a political dietetics that decisively intervenes in the social relations of labor and life. However, in general, medicine lurches ahead in a cynical shortsightedness and interprets its pact with the will to live in such a dubious way that only from case to case could one specify the position in the kynical-cynical spectrum to which it relates. Is it the kynicism of simplicity, as practiced by the good parson Kneipp? Is it the cyni- cism of complicatedness as started recently by Professor Barnard with his heart transplants? Is it the kynicism of a medical resistance that refuses to collaborate with self-destructive institutions and mentalities? Is it the cynicism of a medical collaboration that gives the causes a free hand in order to profit from the effects? A kynicism of the simple life or a cynicism of the comfortable death? A kynicism that healingly pits the threatening certainties of death against unawareness, self- destruction, and ignorance? Or a cynicism that collaborates with the repression of death, which is constitutive for the system in overmilitarized and overstuffed societies.
Because doctors must protect their hearts from the many hardships of the profession, popular reason has always granted them a bit of cynical coarseness that it would never have tolerated in others. The people recognized its real allies in those who possessed enough heart to hide it behind black humor and coarse manners. Medical jokes --more cynical than any other kind --always had an ac- cepting audience of laypeople who, on the basis of the strong cynicism of their helpers, could convince themselves of the latters' good intentions. Icy coldness surrounds the medicine that no longer knows any jokes and has completely con- gealed into the exercise of its own and delegated power. There is a medicine that is nothing other than archiatry--the realm of chief doctors. As was the case for all battered masters' mentalities striving for disinhibition, the hour for this medi- cal cynicism arrived when fascism came to power. The latter created the scenario in which all those unperpetrated brutalities could emerge with which repressively civilized society is laden. Just as there was an older, camouflaged, cynical com- munity of interests between the execution of punishment (which left a trail of corpses behind it) and scientific anatomy (which is notoriously hungry for corpses), so there was a community of interests between medical masters' cyni- cism and Fascist racism that at last allowed it to satisfy its hunger for corpses on its own. Those who have the nerve should read the protocols of the Nuremberg trials in which the crimes of German medical fascism against humanity were heard. I do not choose this expression lightly; the phrase "medical fascism" does not come from a critical whim but encapsulates a phenomenon as pregnantly as possible. What was swept to power in medicine at camps and universities between
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1933 and 1945 reveals not the accidental straying of individual doctors to Nazi ideology but rather an old, masters' medical tendency, which was encouraged by fascism to reveal itself; this tendency had always found that there were too many people whose treatment was not "really" worth the trouble and who were just good enough to become experimental objects. Alexander Mitscherlich wrote on this.
Of course, one can do a simple calculation. Of about 90,000 doctors active in Germany at that time, around 350 committed medical crimes. That is still a considerable number, especially when one thinks of the enormity of the crimes. But in relation to the entire medical profession, it was still only a fraction, about one in three hundred . . . every third hundredth doctor a criminal? That was a proportion that never before could have been found in the German medical profession. Why now? (Medizin ohne Menschlichkeit, Dokumente des Niirnberger Arz- teprozesses, ed. A. Mitscherlich and F. Mielke [Frankfurt, 1962], p. 13)
Mitscherlich shows that behind the criminal leaders stood a large medical ap- paratus that had already step by step advanced to a considerable extent the trans- formation of patients into human raw material. The criminal doctors "only" had to take one more cynical leap in the direction in which they were already headed. What today goes on quietly without being seriously disturbed by anyone--torture research, genetic and prosthetic research, military-biological and war- pharmacology research --already has within it everything that will provide the tools for the medical fascism of tomorrow. The horrifying living experiments and notorious collections of skeletons in Nazi medicine will be "nothing by compari- son. " "Nothing by comparison": That is cynical one-upmanship, yet it simply ar- ticulates a tendency of reality. In the area of cleverly thought out cruelty, the twenty-first century has already begun.
What will help against the masters' helping profession of today and tomorrow? Several answers are conceivable.
First, from a society with the will to live and from its philosophy--to the extent that it captures the will to live of its time in concepts--must come an offensive that rehabilitates the idea of the "good doctor" and brings a "helping at the source" into battle against the universal, diffuse cynicism of modern medicine. What good help and what a real healer are, medicine by itself has never been able to define. A social order like ours furthers almost by necessity a medicine that, in turn, tends to further the system of sicknesses and of making people sick rather than life in good health.
Second, only self-help helps against masters' helpers. The only defense against false or questionable help is to have no need for it. Moreover, for a long time now we have been able to observe how capitalist masters' medicine attempts to
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bring self-help traditions in folk medicine under its domination--after centuries of defamation and rivalry--by absorbing them as part of orthodox medical rea- son. ("It's been scientifically proven: There really is something in some herbs! ") The interest of the institutionalized medical profession works with all possible means toward a state of affairs in which everything corporeal will be totally medicalized--from occupational medicine, sport medicine, sexual medicine, digestive medicine, nutritional medicine, fitness medicine, accident medicine, criminal medicine, and war medicine to the medicines covering the competency to supervise healthy and unhealthy breathing, walking, standing, learning and newspaper reading, to say nothing of pregnancy, birth, dying, and other caprioles of human corporeality. The "health" system is heading toward a state of affairs in which the masters' medical control of the somatic dimension will become totalitarian. A point can be imagined at which private bodily competencies will be expropriated completely. In the end, one will have to attend urological classes to learn how to piss correctly. The central question in the current medical-cynical process is whether "orthodox medicine" will be able to destroy the lay helper movements that have arisen for numerous cultural reasons (self-actualization, the women's movement, ecology, rural communes, new religions, etc. ). This ques- tion runs parallel to the question of the intramedical chances of "political" tenden- cies in professional medicine: psychosomatic internal medicine, occupational medicine, gynecology, psychiatry, and so on. These are the professional medical disciplines that, for logical reasons concerning their occupations, should know best that everything they do runs the risk of harming more than helping, as long as another direction for helping--coming from life, freedom, and conscious- ness--is not pursued.
Third, in the last instance, only the conscious embodying of our fragility, our being sick, our mortality, can help against the medical splitting off of responsibil- ity for our own bodily existence. I do not have to say how difficult that is, for the fear, when it becomes great, makes us all the more inclined to repress our responsibility for the life and death of our own body or to delegate it to doctors, not considering that even the most perfect conservation medicine, in the end, hands back to us the entire responsibility and unsharable pain in our most helpless moment. Those who recognize that the circle of alienation and flight must always finally close in one's own death must also be aware that it would be better to re- verse toward life rather than anesthetization, toward risk rather than security, to- ward embodiment rather than splitting.
Religious Cynicism
And what will you do with the grail when you have found it?
Benjamin Disraeli
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. . . even grinning is mixed in with it, like that of the skull it- self: because the fact that long-planning human beings depart like cattle is also somehow funny.
Ernst Bloch, Das Prinzip Hojfnung (p. 1299)
Suddenly, someone leaves the visible and continuous world common to all and ceases to share existence with us. His breathing has stopped, his movements have ceased. At first, death manifests itself negatively; something is extinguished and passes over into stillness. A little later, this cessation shows also its positive side, the body becomes cold, starts to putrefy, rot. The skeleton then steps forth as the part that resists decomposition longer than the other parts. It takes over the representation of what remains of us in materia, hence the skeleton as death im- ago. The framework of bones symbolizes the end that all who live already carry within themselves. Everyone of us is our own friend Mr. D. , the bony forerun- ning of one's own departure.
From the perspective of this side of death, the only one usually observable, the idea imposes itself on living persons that an invisible force is at work in ani- mated bodies that allows them to breathe, jump about, and remain form-coherent, whereas this invisible something must have departed from the dead, so that they grow stiff and decay. The invisible something stimulates breathing, movement, feeling, alertness, and the maintenance of the body's form --it is the epitome of intensity and energy. Its activity creates, although not visibly or in a way that can be isolated, the most real reality. This invisible force has many names: soul, spirit, breath, ancestors, fire, form, God, life.
Experience teaches that animals like us are born and die, that plants germinate and pass away, and that they too, in their own way, participate in the rhythm of death and life, form constitution and form dissolution. Without doubt, the human "soul" is surrounded by a cosmos of animal and plant life and by mysterious energy subjects that are active behind day and night, storm and calm sky, heat and cold. In nothing does this being surrounded suggest a "domination" of hu- mankind over nature and the environment. Rather, the naked biped appears as a being that is tolerated and endured by the whole, insofar as it controls the inter- actions with the bringers of bounty and danger from the animal and plant world.
Life and death, coming and going, they are initially natural constants, pulsat- ing beats in a rhythm in which what is pregiven outweighs what is added later. In the course of civilization, however, the relation between submission and ac- tion, suffering and doing has shifted --also with regard to the experience of death. What appeared to be an aspect of natural pulsations becomes in more developed societies a more and more profound and more and more embittered struggle be- tween life and death. Death is then no longer so much an event that nothing can influence, but is itself something that our violence and caprice bring about. Its primary image is no longer the unavoidable coming to an end, nor the peaceful
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self-exhaustion or the quiet and unresisted burning down of life's flame, butacon- tested, horrifying happening imbued with premonitions of violence and murder. The more people think of death as being murdered rather than as being peacefuly extinguished, the more violently must the flood of the fear of death swel up in higher and more violent civilizations. For this reason, the historical states and empires, wherever we look, are religious states and empires. They constitute so- cial worlds in which the fear of a violent death is a realistic one. We al have a thousand images of violence before our eyes: surprise attacks, massacres, rapes, public executions, wars, scenes of torture, in which human beings develop them- selves into diabolical fiends in order to extract a maximum of agony from the death of others. In addition, class societies suppress the vital energies of subjects and slaves through physical and symbolic violence in such a way that shadowy hollows of unlived life unfailingly open up in bodies, where wishing, fantasizing, the yearning for the divined otherness of a full life begin to brood. This unlived life combines its Utopian energies with the fears of annihilation that are distiled in the individual in violent societies from infancy onward. Only out of this combi- nation comes the absolute defiance of death in civilized human beings, a defiance that seemingly cannot be dissolved by anything. This is the answer to the pro- foundly terrifying experience of civilization. Our being in society comprises al- most a priori the threat that we will not be allowed to realize the vitality with which we were born. Every socialized life lives with the premonition that its ener- gies, time, willing, and wishing will not be at an end when the death knell rings, Life builds residues-an immense, burning Not Yet that needs more time and fu- ture than is granted to the individual. Life dreams beyond itself and dies ful of defiance. For this reason, the history of higher civilizations vibrates with count- less and boundless Not Yet screams-with a million-voiced No to a death that is not the expiration of the dying embers of life but a violent suffocation of a flame that in any case did not burn as brightly as it could have done in a vital fredom. Since that time, devitalized life in class and military societies ponders its compensations-whether in further lives, as supposed by Hindu consciousness, or in heavenly existence as promised by Christianity and Islam - for the thwarted dreams of their believers. Religion is not primarily the opiate of the people but the reminder that there is more life in us than this life lives. The function of faith is an achievement of devitalized bodies that cannot be completely robbed of the memory that in them much deeper sources of vitality, strength, pleasure, and of the enigma and intoxication of being-there must lie hidden than can be sen in everyday life.
This gives religions their ambiguous role in societies: They can be used to legitimate and double (verdoppelri) oppression (see the Enlightenment's critique of religion in chapter 3, the section entitled "Critique of Religious Illusion"). They can, however, also liberate individuals to a greater power of resistance and creativity by helping them to overcome fear. Thus, depending on circumstances,
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religion can be both an instrument of domination and the core of resistance against domination; a medium of repression and a medium of emancipation; an instrument of devitalization and a precept of revitalization.
The first case of religious Kynicism in the Judeo-Christian tradition has no one less than the original father, Moses, in the role of kynical rebel. He committed the first blasphemy of grand dimensions when, on his return from Mount Sinai, he smashed the tablets; "they were tables of stone, written on by the finger of God" (Exodus 31:18). "And the tables were the work of God, and the writing was the writing of God, graven upon the tables" (32:16). Moses, who, with the divine laws under his arm, came down from the mountain and found his people dancing around the Golden Calf, set an example for the religious kynic's behavior with respect to the sacred: He smashed everything that was not spirit but letter, not God but idol, not the living but its representation. It is emphasized that he did this in anger and that it was a holy anger that gave him the right and the necessary impertinence to lay violent hands on God's personal handwriting. That needs to be understood. Namely, immediately after he had shattered the tablets, so the bib- lical account says, Moses seized the Golden Calf, melted it in the fire, "ground it to powder, and scattered it upon the water, and made the children of Israel drink
of it" (32:20). Later, Moses had to chisel new tablets so that God could inscribe them a second time. He also received from God the commandment: "Thou shalt make no graven images. " Moses' kynical blasphemy came from the knowledge that people are inclined to worship fetishes and to indulge in the idolization of objects. But nothing material can be so holy that it may not be smashed as soon as it becomes apparent that the representations of the sacred have begun to over- shadow the spirit of the religion. In this regard it can happen that no distinction is made between the stone tablets of the dear Lord and the Golden Calf. If it is a representation, or idol, then smite it. That is the spiritual-kynical core of the commandment to make no image of "God. " Image and text can fulfill their func- tions only as long as it is not forgotten that both are material forms and that the "truth," as a material-immaterial structure, must always be written and read anew, that is, materialized and, at the same time, immaterialized anew --which means that every materialization will be shattered whenever it begins to force it-
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All primary blasphemies are borne by the kynical impulse to not let oneself be made a fool of by any idol. Those who "know" something of the gods know the great rage of Moses and the kynical lightness in dealing with representations of the divine. Religious persons, in contrast to pious persons, are no buffoons of the superego; it knows the laws, and religious persons know that it knows the laws, and they let them speak and they obey them too when it seems appropriate- This distinguishes the primary blasphemy of mystics, the religious, and the kyni- cally alive, from the secondary blasphemies that arise from resentment, uncon-
self into the foreground.
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? Max Ernst, The Virgin Disciplines the Christ Child 1926. ((C)S. P. A. D. E. M. , Paris/V. A. G. A. , New York, 1987. )
scious compulsions for vices and an unfree desire to drag down whatever is elevated.
The first cynicism of the religious type likewise is found in the Old Testament. Significantly, it is contained in the story of the first murder in human history --in the story of Cain and Abel. Adam and Eve had two sons among their children. Cain, the firstborn, was a farmer, and Abel, the second, was a shepherd. One day both brought sacrifices to the Lord, Cain from the fruit of his fields and Abel from the youngest of his herd. The Lord, however, welcomed only Abel's offering and
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cast scorn upon Cain's. "And Cain was very wroth and his countenance became distorted . . . Cain talked with Abel his brother: And it came to pass, when they were in the field, that Cain rose up against Abel his brother, and slew him. And the Lord said unto Cain, Where is Abel thy brother? " (Genesis 4:5-9). With this question, the stage for religious cynicism is set. The art of dissimulation, spo- ken of here for the first time, is directly connected with the cynical turning of a
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violent consciousness against the other.
said, it would have to be cynical -- for, in truth, he does not intend to tell the truth. The communication with the questioner is distorted from the start. Cain could, if he felt he had nothing to lose, answer his God: "Don't be so hypocritical, you know as well as I do where Abel is, for I have killed him with my own hands, and you not only looked on calmly, but even gave me occasion to do it. " Cain's real answer, in its brevity, still has enough cynical bite: "I know not: Am I my brother's keeper? " (Genesis 4:9). An all-knowing and infinitely just God, as Cain's testy retort suggests, should be able to refrain from such prickings of con- science. What kind of God is it who treats people unequally and at the very least provokes them to crime, but then, with pretended innocence, asks questions about what has happened?
