Books: The languages of disease

THE SICKENING MIND by Paul Martin, HarperCollins pounds 16.99

There is a drug, cyclophosphamide, which suppresses the immune system. Using it on laboratory rats simultaneously with a drink of saccharine water, the scientists Robert Ader and Nicholas Cohen made an interesting discovery. After three days, they gave the sweetened water alone and found an identical degree of immune-suppression: the rats' immunity had been conditioned to respond to a taste. Extend this to a human subject and you're face to face with the mind-body problem.

Plus or minus the odd deja vu, few of us regard the mind-body problem as a matter of everyday concern. If the organic and the mental belong to different spheres or the same; whether mind is on a higher or a lower plane than body; whether kinetic inter-actions are possible between the two: these questions we are generally happy to leave to specialised philosophy.

But not in medicine. In health, the relation between mind and body is of crucial practical importance, which makes it hard to understand why, ever since the passing of the Galenic system, doctors have traditionally regarded the subject as exotic and raffish, even dangerous. Scientific medicine likes to tread on solid ground; the mind's domain is foggy and swampy. Best to draw a few vague maps marked "autogenic", "idiopathic", "Munchausen Syndrome", "placebo", and then forget all about it.

Now biologist Paul Martin is here to tell us all this has changed. Medical science, he says, has discovered "extraordinary things" in recent years about the mind-body question, of which the rat-work of Ader and Cohen is just a small detail. Martin has read voraciously about newly-proven ways in which the mind contributes to ill-health. The trouble is, along with these "mind-boggling" discoveries, he has found too many ways of muffing the entire project.

In a truly misguided moment, Martin decides to take illustrations from "great literature". But his superficial pages on Heathcliff, Raskolnikov and other literary sickies never justify a decision that is based on the odd belief that fictional case-histories are more exemplary and more "entertaining" than real ones.

Martin's sense of history is equally fallible. Psychosomatic ideas are certainly not new, as he himself notes, but I wish he'd traced their ebb and flow with more precision. Galen, he writes, was a "suprisingly modern" materialist who nevertheless got a lot of things "embarrassingly wrong". Who's embarrassed? Without access to modern knowledge, Galen was a subtle diagnostician and psychologist, whose notion of balance in applied medicine - whether mental or physical - has always been relevant. For a really "modern" type of redneck reductionist, Martin could have looked at the 18th-century figure of La Mettrie, who believed consciousness to be a side-effect of the need to fuel the body's machine, a position that seems pretty close to Martin's own.

It is hard to see the essay-plan to which Martin is working. Giving space over-generously to his obsessions - heart disease, cancer, the immune system and the trendy discipline of "psycho-neuroimmunology" (yes, it exists) - the argument is all out of kilter. Martin is thorough on the biology of "fight and flight", a multiplex stress-response of certain glands and the sympathetic nervous system that is found chronically in "Type-A" individuals and is of well-documented relevance to heart disease. But he ignores other aspects of the endocrine and nervous systems which are equally central to his argument. There is zilch on fertility or hysteria and nothing (of use) on sexual response or the skin, except for a throwaway remark about blushing. Worse, there is no discussion anywhere of pain.

It is an index of how skewed this book is that, despite devoting a chapter to interpersonal relationships and health, its author gives only four superficial paragraphs to the placebo effect and has nothing to say about the most important relationship in all medicine, the one between doctor and patient. Sigmund Freud's ideas are taken rather less seriously in this volume than those of Ian Fleming, yet it was his central belief, in the words of Lacan, that "there are illnesses which speak". The wisely heterodox Oliver Sacks is a great mentor here, carefully positioning doctors in relation to the subjective and objective meanings (or messages) of disease. As well as the responsibility of identification, stresses Sacks, the doctor has an overriding duty to understand.

But understanding is a trap for reductionists, of which Martin ultimately is one. If subjectivity - consciousness - is involved in disease, then an element of responsibility, the patient's collusion, perhaps, in an illness, ought to seep into the diagnosis. But medical correctness cannot face up to this possibility and nor, judging by the way he shrinks from notions of "blame", can this author, leaving many of the most important implications of his thesis unexplored.

Arts and Entertainment
Jamie Dornan as Christian Grey in Fifty Shades of Grey

film Sex scene trailer sees a shirtless Jamie Dornan turn up the heat

Arts and Entertainment
A sketch of Van Gogh has been discovered in the archives of Kunsthalle Bremen in Germany
arts + ents
Arts and Entertainment
Eleanor Catton has hit back after being accused of 'treachery' for criticising the government.
books
Arts and Entertainment
Fake Banksy stencil given to artist Alex Jakob-Whitworth

art

Arts and Entertainment
'The Archers' has an audience of about five million
radioA growing number of listeners are voicing their discontent; so loudly that even the BBC's director-general seems worried
PROMOTED VIDEO
Arts and Entertainment
Taylor Swift is heading to Norwich for Radio 1's Big Weekend

music
Arts and Entertainment
Beer as folk: Vincent Franklin and Cyril Nri (centre) in ‘Cucumber’
tvReview: This slice of gay life in Manchester has universal appeal
Have you tried new the Independent Digital Edition apps?
Arts and Entertainment

ebooksNow available in paperback
Arts and Entertainment

ebooks
Arts and Entertainment
‘A Day at the Races’ still stands up well today
film
Arts and Entertainment
‘The Royals’ – a ‘twisted, soapy take on England’s first family’
tvAnd its producers have already announced a second season...
Arts and Entertainment
Kraftwerk performing at the Neue Nationalgalerie (New National Gallery) museum in Berlin earlier this month
musicWhy a bunch of academics consider German electropoppers Kraftwerk worthy of their own symposium
Arts and Entertainment
Icelandic singer Bjork has been forced to release her album early after an online leak

music
Arts and Entertainment
Colin Firth as Harry Hart in Kingsman: The Secret Service

film
Arts and Entertainment
Brian Blessed as King Lear in the Guildford Shakespeare Company's performance of the play

theatre
Arts and Entertainment
In the picture: Anthony LaPaglia and Martin Freeman in 'The Eichmann Show'

tv
Arts and Entertainment
Anne Kirkbride and Bill Roache as Deirdre and Ken Barlow in Coronation Street

tvThe actress has died aged 60
Arts and Entertainment
Marianne Jean-Baptiste defends Joe Miller in Broadchurch series two

tv
Arts and Entertainment
The frill of it all: Hattie Morahan in 'The Changeling'

theatre
Arts and Entertainment
Gillian Anderson and David Duchovny may reunite for The X Files

tv
Arts and Entertainment
Jeremy Clarkson, left, and Richard Hammond upset the locals in South America
TV
News
A young woman punched a police officer after attending a gig by US rapper Snoop Dogg
people
Arts and Entertainment
Reese Witherspoon starring in 'Wild'

It's hard not to warm to Reese Witherspoon's heroismfilm
Arts and Entertainment
Word up: Robbie Coltrane as dictionary guru Doctor Johnson in the classic sitcom Blackadder the Third
books

Arts and Entertainment
The Oscar nominations are due to be announced today

Oscars 2015
Arts and Entertainment
Hacked off: Maisie Williams in ‘Cyberbully’

Maisie Williams single-handedly rises to the challenge

TV
Arts and Entertainment
Eddie Redmayne in The Theory of Everything and Benedict Cumberbatch in The Imitation Game are both nominated at the Bafta Film Awards
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    Isis hostage crisis: The prisoner swap has only one purpose for the militants - recognition its Islamic State exists and that foreign nations acknowledge its power

    Isis hostage crisis

    The prisoner swap has only one purpose for the militants - recognition its Islamic State exists and that foreign nations acknowledge its power, says Robert Fisk
    Missing salvage expert who found $50m of sunken treasure before disappearing, tracked down at last

    The runaway buccaneers and the ship full of gold

    Salvage expert Tommy Thompson found sunken treasure worth millions. Then he vanished... until now
    Homeless Veterans appeal: ‘If you’re hard on the world you are hard on yourself’

    Homeless Veterans appeal: ‘If you’re hard on the world you are hard on yourself’

    Maverick artist Grayson Perry backs our campaign
    Assisted Dying Bill: I want to be able to decide about my own death - I want to have control of my life

    Assisted Dying Bill: 'I want control of my life'

    This week the Assisted Dying Bill is debated in the Lords. Virginia Ironside, who has already made plans for her own self-deliverance, argues that it's time we allowed people a humane, compassionate death
    Move over, kale - cabbage is the new rising star

    Cabbage is king again

    Sophie Morris banishes thoughts of soggy school dinners and turns over a new leaf
    11 best winter skin treats

    Give your moisturiser a helping hand: 11 best winter skin treats

    Get an extra boost of nourishment from one of these hard-working products
    Paul Scholes column: The more Jose Mourinho attempts to influence match officials, the more they are likely to ignore him

    Paul Scholes column

    The more Jose Mourinho attempts to influence match officials, the more they are likely to ignore him
    Frank Warren column: No cigar, but pots of money: here come the Cubans

    Frank Warren's Ringside

    No cigar, but pots of money: here come the Cubans
    Isis hostage crisis: Militant group stands strong as its numerous enemies fail to find a common plan to defeat it

    Isis stands strong as its numerous enemies fail to find a common plan to defeat it

    The jihadis are being squeezed militarily and economically, but there is no sign of an implosion, says Patrick Cockburn
    Virtual reality thrusts viewers into the frontline of global events - and puts film-goers at the heart of the action

    Virtual reality: Seeing is believing

    Virtual reality thrusts viewers into the frontline of global events - and puts film-goers at the heart of the action
    Homeless Veterans appeal: MP says Coalition ‘not doing enough’

    Homeless Veterans appeal

    MP says Coalition ‘not doing enough’ to help
    Larry David, Steve Coogan and other comedians share stories of depression in new documentary

    Comedians share stories of depression

    The director of the new documentary, Kevin Pollak, tells Jessica Barrett how he got them to talk
    Has The Archers lost the plot with it's spicy storylines?

    Has The Archers lost the plot?

    A growing number of listeners are voicing their discontent over the rural soap's spicy storylines; so loudly that even the BBC's director-general seems worried, says Simon Kelner
    English Heritage adds 14 post-war office buildings to its protected lists

    14 office buildings added to protected lists

    Christopher Beanland explores the underrated appeal of these palaces of pen-pushing
    Human skull discovery in Israel proves humans lived side-by-side with Neanderthals

    Human skull discovery in Israel proves humans lived side-by-side with Neanderthals

    Scientists unearthed the cranial fragments from Manot Cave in West Galilee