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Issue 23 — Pathology

23 PATHOLOGY
numero-22-03 (2)

PRETENDING TO BE HEALTHY?

EDITORIAL

Several concepts today strongly need rethinking. Among them are certainly the (largely but not entirely overlapping) concepts of nature, normality, and, perhaps, even health. Reconstructing these concepts is undoubtedly a gigantic undertaking. The proposal we put forth here is an invitation to contribute to their revision by examining a specific concept that appears to be their opposite, namely, pathology.

The task is to tackle a particular concept that, by contrast, is capable of enlightening at least one aspect of the more general and fundamental concepts we have just mentioned. This is not all, though. Being able to think of pathology is a test to ensure the availability of concepts of nature, normality, and health that live up to the demands that are placed on them by the current times.

As far as the concept of nature is concerned, we might in fact think of nature in terms of everything that exists or, at least, is not constructed by humans; from this point of view, something like a cold or cancer are as natural as any other organic process. In the specific case of pathology though, we encounter something natural that goes against nature, against physiological processes and hinders, interrupts, and diverts them leading the organism to destruction. Only if the concept of nature we employ allows us to think of nature’s going against nature, that is, of an opposition of nature to itself, is the concept of nature not flattened out onto the mere hodge-podge of everything that exists.

The same applies to the concept of normality: the possibility of thinking of pathology is what prevents reducing the concept of normality to a merely statistic concept; a pathological condition cannot in fact be considered normal simply because of its widespread diffusion.

Finally, a serious reflection on pathology allows us to avoid reducing health to being the gratified perception of the conformity between state of the organism and subject’s desires. Considering the concept of pathology in fact allows us to recognize the existence of desires that are, indeed, pathological (for example, the desires of those who are anorexic, alcoholic, drug addicts, etc.).

The concept of pathology forces us to consider that when speaking of nature, normality, or health we are referring not to something that is or exists out there but, rather and above all, to an ideal dimension or to an ought-to-be. This of course entails the risk that the institution of such an ideal may serve a power that uses it for its own self-consolidation while banishing to the realm of the pathological everything that escapes its control.

The abovementioned themes gravitate around the concept of pathology; yet, through a thorough examination of such a concept, they enable a redefinition of the notions of nature, normality, and health.

***

For all of us, being sick or healthy is essential; likewise, the question of pathology brings us to ask decisive questions that are suspended between ultimate and penultimate.

The question of pathology seems to be tightly intertwined with the issue of normality. What is truly normal? Is it normal to be healthy and thus being unhealthy is abnormal? Or are health and sickness two poles – never truly attainable in their purity – on a continuum that alone constitutes true normality (as the indissoluble meshing of physiological and pathological)?

Ever since Plato, philosophy has wondered about perfect health as distinct from “ordinary” health and nevertheless as entailing nothing less than the risk of the disappearance of the human being. What is the telos of the soul? Is it to remain within the “physio-pathological” spectrum (Petrucci) by controlling yet not suppressing one’s own worst part? Or is it to push the threshold that leads from finitude (which is always partly healthy, partly suffering) to the pure light of a form of health void of all sickness? How could individual human beings survive such height? Would wholly healthy human beings, alien to even the possibility of getting sick and dying, still be human beings? Or would they instead be “healthy dead”? Or, on the contrary, is the very unavoidability of sickness part of some kind of universal pathology, as Augustine seems to think (Guglielminetti)?

Spaemann’s consideration of the unnaturalness of sickness and death is based on the recognition of a natural instinct to life; in all biological facts, and not simply in the facts that pertain to human beings, there is directionality. If we do not recognize this element, we do not understand living beings (Allodi-Miranda).

A reflection on the various ways of understanding sickness shows the promising contributions of a perspective that looks at it as at the malfunctioning of something good (Pellet). As shown by Canguilhem, the pathological differs from simple anomaly because of its capacity to be an impediment, a stumbling block for the living beings (Vissio). As Malabou claims, sickness may then appear as a “deep furrow” that opens up in one’s personal biography, a wound that forces us to revisit traditional ontological grammar in the direction of an ontology of the accident (Isetta, Maggiore).

New scientific discoveries make it increasingly difficult to speak of a “normal” genome; what is normal is variation (Pareti). If this is the case, conjectures and uncertainty become unavoidable within the medical sciences (Giaretta). Because of this as well as due to the enormity of what is at stake, health sciences cannot avoid the confrontation with philosophy (Gallizia).

 Ezio Gamba, Enrico Guglielminetti

(translated from Italian by Silvia Benso)

Issue 23 — Pathology

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