'Pain and Pleasure: Part 3'

CAERS SUBSTACK ARTICLE #75

‘Pain and Pleasure: Part 3’

CAERS Substack Article #75

Philosophers of science tell us that all observations are theory-laden. That means that every observation we make is made on the basis of our pre-existing idea of how the universe works. When we notice an apple leave a tree and make contact with the earth, we assume that the apple fell down to earth, not that our entire planet rose up to the apple. This may seem like a silly example but it illustrates the point that we often see what we already believe to be true.

Our desire for pleasure and distaste for pain are partly responsible for the way we filter reality, how we ‘see’ the world. We have a tough time admitting when we are mistaken or mess up, for example. As John Kenneth Galbraith once wrote: “Faced with either changing one’s mind or proving that there is no need to do so, almost everyone gets busy on the proof”. We will work to make the universe appear as we believe it should be, especially if we look better in the process.

Leaders have capitalized on this for millennia. They try to convince us that they have all of the answers to our problems with ‘happy talk’ that lulls us into a complacent vision that all will turn out well if we just leave everything to them. We want to believe in simple, pain-free and risk- free solutions so we immediately recognize and buy into them when they are skillfully presented to us.

In a similar vein, we can be lured into thinking that capitalism and big business are the enemy that must be subdued. We are reluctant, however, to accept our responsibility in all of this. No company will ever produce a product or service if no one is willing to pay for it, and many of the things we get lured into buying are far from being necessities of life. Equally, a corporate culture with questionable moral conduct succeeds in part because everyone in that corporation goes along with it, not just those at the top. If no one except the CEO and various VP’s played along with such behaviour, no business would get very far; hundreds or thousands of employees must play along with, or at least ‘turn a blind eye’ to, corporate misdeeds, including outright lying, for the company to survive and flourish.

In medicine we are obligated to provide the truth to patients, even if it is a painful truth. We must be honest and transparent about the limitations of our treatments as well. Of course, we must not eliminate hope, but we cannot tell fairy tales either. Facing the truth, as bitter as it may be, is essential for moving forward; it is the essence of every addiction rehab program, for example.

So, it is interesting that we were told very early on that the vaccines for COVID were the only way to escape the pandemic. Many of us trusted the scientists, doctors and other authorities who said this. And yet, not surprisingly to some of us, it is now obvious that the inoculations did not prevent disease or transmission very well at all. Is it possible that such a promise was known to be inaccurate or, given the radically new nature of the vaccines, that it should have been known to be wildly optimistic right from the start?

Nearly 200 years ago the philosopher J S Mill said that it is “better to be a human being dissatisfied than a pig satisfied”. It is a variant on the Socratic dictum that an unexamined life is not worth living. Except for those at the psychopathic end of the human spectrum, most of us at some level would agree with this sentiment. But examining things deeply takes work and is risky because it exposes us to the potential for pain.

Individually, and collectively, we tend to live life in cycles and phases; there are good times and bad times. It can seem as though, like a pendulum, we swing from one extreme to the other, spending too much time at the extremes and too little time in the in-between. However, humans have proven repeatedly throughout history that we are capable of not just surviving but flourishing through adversity when we work together to discover and face the truth no matter how painful. To paraphrase G. Michael Hopf: good times create soft people, soft people create hard times, hard times create strong people, strong people create good times.

This occurs because sooner or later, perhaps when we have little left to lose, we realize that facing reality, as painful as it may be, is the only way to find the deeper truths we need to function best. We come to understand that denial and avoidance based in pain and pleasure will not fully satisfy in the long term.

We may be at such a point in human history at the moment. We have been the recipients of great gifts and blessings, for which our ancestors sacrificed far more than we have ourselves. It might be time to ‘face the music’ so to speak and realize that there are some important and difficult issues that must be dealt with directly. It will necessitate asking awkward or even dangerous questions not only of those in positions of authority but also of ourselves. We all own something in how our society functions; silently hiding under the bed is not an option. A decision to do nothing is still a decision.

Transparency and truth telling are critically important ethical principles, and we must hold one another accountable as compassionately and respectfully as possible. Genuinely trying to understand one another through constructive dialogue, and appreciating that we are all driven to some degree by pain and pleasure, are good foundations upon which to grow together.

Someone who wants to do science well acknowledges that all of their observations are theory- laden and accommodates for that by remaining open-minded and questioning all results and conclusions. We would be wise to do the same. Every one of us interprets life through a unique lens and from a specific perspective, which means that like any scientific theory those interpretations are incomplete and not wholly accurate. The more carefully we listen to each other, so as to understand one another better, the more likely we are to see the truth as clearly and correctly as possible.

Do not fear hard times to the point of paralysis; pain, when addressed with integrity and courage, can make us stronger, especially if we work together. How long we remain in this present phase depends largely on our willingness to work through our collective pain.

J. Barry Engelhardt MD (retired) MHSc (bioethics)

CAERS Health Intake Facilitator