The Physician Philosopher

Describing oneself as a physician may be something that is more easily understandable to most people than describing oneself as a philosopher. If one were to list one's occupation on a job application as "physician," for example, most people would have a much clearer understanding of what one meant than if one were to list one's occupation as "philosopher." However, if the meaning of the term "philosopher" is restricted to "professional philosopher," i.e. to an individual who has an advanced degree (such as a Ph.D.) in philosophy and who earns their living as a professional philosopher, teaching and writing in the field, then the term becomes somewhat clearer and more comprehensible. But what about those students, writers, thinkers, and other laypeople who engage in philosophy but are not professional philosophers? Can public philosophy be meaningfully engaged in only by professional philosophers?

      I'm a physician and also an aspiring philosopher. I suppose that my ambition to become a "physician philosopher" began a number of years ago when a friend graciously, and quite surprisingly, referred to me as such. I'll leave it to others to judge whether my aspirations are mere pretensions. My profession is that of physician. However, I feel a calling to both medicine and philosophy. Which is the higher calling? Is there a higher calling than that of healing the sick and helping the needy (as in the case of medicine)? Is there a higher calling than that of discovering the meaning of truth and justice (as in the case of philosophy)? Does the career pathway that I've chosen mean that I can never become a "real philosopher"?

      And what exactly is a "physician philosopher"? The question may be an important one, because medical decision-making may in some cases require a physician to be able to think philosophically as well as scientifically. Practice in philosophical thinking may to some degree enable an individual to become a better physician. Indeed, it may be argued that the philosophy of medicine is founded on the premise that philosophical thinking may be useful in analyzing the practice of medicine and the treatment of medical problems; thus, engagement in the philosophy of medicine can yield insights that will lead to improved practice and treatment.

      Perhaps the best answer that I can give to the question, "What is a physician philosopher?" is that a physician philosopher is a person whose vocation is to be both physician and philosopher, inspired by love of both vocations (medicine and philosophy). A physician philosopher is a physician who has qualified as (or been certified or recognized as) a philosopher by virtue of their work (writing, teaching, research) in the field. A physician philosopher may also be a philosopher who is engaged in the practice of medicine, or a physician who does philosophy in an academic setting, or a physician who specializes in the philosophy of medicine, biomedical ethics, the philosophy of neuroscience, the philosophy of psychiatry, or some other related field.

      How can one become a physician philosopher? Simply put, one can become a physician philosopher by obtaining academic degrees in both medicine and philosophy. Many schools offer dual degree programs in medicine and philosophy. Bioethics training may also be available in relevant fields, such as clinical bioethics, research bioethics, public health ethics, global bioethics, health care economics, and health care resource allocation. Job opportunities for physicians with training in clinical or research bioethics may include employment as a board member or ethics consultant for a hospital ethics committee, employment as a compliance officer for an institutional review board (IRB) overseeing scientific research, employment as an instructor in bioethics at a health care institution (hospital, school of public health, medical school, or nursing school), and employment as a faculty member (academic bioethicist) at a center for bioethics. Websites that offer information regarding careers in bioethics may be found at http://www.nature.com/nbt/journal/v22/n2/full/nbt0204-247.html, and at http://www.bioethics.net/jobs/.

      What kind of person should a physician philosopher be? Perhaps the best answer that I can give to this question is that the ideal physician philosopher is a person who has a (moral, intellectual, and social) commitment to, and engagement in, both vocations, and who does not view philosophy as a means to practice medicine or medicine as a means to engage in philosophy. An ideal physician philosopher is a person who has a love for medicine (a love for curing illness and alleviating suffering, not out of any sense of paternalism or superiority in relation to those in need of medical care, but out of a selfless need to help and care for others, and out of a sense of wanting to serve humanity and contribute to human well-being), and who has a love for philosophy (a love of wisdom, clarity, precision, intellectual discipline, and discovering the true nature of things). An ideal physician philosopher is a physician who is engaged in philosophy not merely for its medical applications, but for its wider applications to human knowledge, understanding, and well-being. 

      What role should a physician philosopher play in society? One of the most useful roles that a physician philosopher may play in society is that of questioning and clarifying unspoken assumptions about the nature of human life and existence that impact care for the sick, the helpless, and the needy. The physician philosopher may attempt to clarify and answer epistemological, ontological, ethical, linguistic, social, and political questions that influence our response to sickness and health. 

      Another role that the physician philosopher may play is that of clarifying the meaning of good health, disease prevention, distributive justice in health care, etc., and providing an analysis or explanation of how these goals may best be achieved.

      The following is a list (admittedly, very incomplete) of noted physician philosophers: Galen, Sextus Empiricus, Ibn Sina, Ibn Rushd, Al-Kindi, Moses Maimonides, John Locke, William James, Sigmund Freud, Karl Jung, Albert Schweitzer, Maria Montessori, Karl Jaspers, Victor Frankl, Frantz Fanon, Thomas Szasz, R.D. Laing, Walker Percy, Edmund Pellegrino, Nawal El Saadawi, Antonio Damasio, Nayef Al-Rodhan, Drew Leder, Leon Kass, Daniel Sulmasy, and Deepak Chopra.

      It should be noted that there may in some cases be a closer link between medicine and philosophy in Eastern society (e.g. China, Tibet, Korea) than in Western society. Traditional Chinese medicine, for example, may be more holistic in its approach than Western medicine and may place a greater emphasis on the relation between spiritual and physical healing. The role of the physician as philosopher (or at least as the vehicle of a particular philosophy) may in such cases be a potentially more integrated one than in cases (in the East and West) where there is a more scientific, technological approach to medicine. The latter approach may sometimes make it more difficult to define the proper relation between medicine and philosophy.

Medicine and Philosophy

What do medicine and philosophy have in common? Why should philosophy as a mode of inquiry be of interest to physicians? How can philosophy be a productive and rewarding endeavor for physicians? How is philosophy relevant to the practice of medicine? What can philosophy contribute to the practice of medicine?

      Medicine and philosophy may mutually support and enhance each other in a number of ways. Philosophy has traditionally included such fields as epistemology, metaphysics, ethics, aesthetics, logic, and political philosophy, and each of these disciplines may have practical applications to medicine.

      Epistemology may clarify the way in which health care providers (individual practitioners as well as group providers, administrators, and hospitals) form beliefs and opinions, make decisions, and respond to various sources of evidence. Social epistemology may also reveal the social dimensions of knowledge and information, and it may clarify the relevance of social institutions (such as scientific journals, hospital committees, professional licensing boards, and government agencies) to knowledge.

      Metaphysics and ontology may provide models of social reality that are useful in analyzing various kinds of interactions between physicians and patients, between patients and physicians and third parties, and between physicians and society.

      Ethics (particularly, biomedical ethics) is relevant to the practice of medicine, because it addresses such questions as: What ethical principles should guide the physician-patient relationship? Do physicians in private practice have a moral obligation to provide services to patients who cannot afford to pay? Do physicians entering private practice have a moral obligation to practice in geographic areas that are underserved with regard to the availability of health care services? Do physicians in private practice have a moral obligation to accept public health insurance payments as full reimbursement for services provided?

         Other ethical questions regarding health care that are of great concern to society include: How can equitability of access to health care best be achieved? Should an individual's access to health care be based on their medical need rather than their ability to pay? What constitute fair and just principles of health care resource allocation? What corrective measures should be taken to address health care inequities? What should be done to prevent wasteful and unnecessary overutilization of medical services? What should be done to ensure that services are appropriate, timely, and cost-effective? What responsibilities do wealthy nations have to address global health care needs? 

         Biomedical ethics is also an important field of study for physicians because it addresses issues of professional conduct, such as appropriate prescription writing, appropriate provision of services, adherence to reasonable standards of care, respect for patient dignity, respect for patient privacy and confidentiality, respect for the patient's right of informed consent, adherence to standards of professional integrity, and fulfillment of the responsibility to maintain professional competence.

      Aesthetics (specifically, medical aesthetics) is relevant to such fields as dermatology, plastic surgery, reconstructive surgery, and prosthetics.

      Political philosophy is relevant to the practice of medicine insofar as it may be concerned with such questions as: What is justice? How can social justice best be achieved? What constitutes justice with regard to access to health care? Does a just society provide universal access to health care? How can justice in health care delivery best be achieved? 

      The philosophy of language may be relevant to medicine insofar as it may explore styles of communication (among health care providers, between providers and patients, and between providers and the general public), and it may clarify issues related to cultural competence, workplace communication, and peer to peer communication. It may also be useful in determining how scientific problems can be presented more cogently and understandably to the general public. Medical semiotics (the recognition, interpretation, and evaluation of medical signs and symptoms) may also be an area of intersection between medicine and the philosophy of language.

      The philosophy of medicine may be relevant to the way in which physicians view the practice of medicine, and to the way in which they view themselves as practitioners. It may be concerned with such questions as: What is medicine? Is medicine an art or a science? What is good health? What is an acceptable quality of life, from a health standpoint? How can health care providers enable patients to attain their best possible quality of health? How can a patient best be recognized as a whole person, rather than as a collection of disease processes?

To Elsewhere and Forever: a Dream about the Metaphysics of Time

Let me tell you about all the things that happened in my dream. I was in a room with no windows. There were designs on the walls, and the designs were moving. An inscription on one of the walls was printed in short letters, and it said, "Here is where there is ever after." The inside of the wall had a resonance that unlocked the meaning of what had been written. But then I discovered that the inscriptions were my own thoughts that had been written on the walls. I saw another inscription that said, "The ever after is the forever not here." There were scorpions crawling on the walls. The scorpions that ate were the ones I played with. The walls were moving. The colors in the room were running into each other. Orange was turning into red. Black was turning into crimson. Crystal violet left stains on my hands. Red was turning into yellow, and yellow was turning into orange and gold.

      I saw someone at the door who was wearing dark glasses and holding an electric saxophone. He started playing, but he was laughing as much as he was playing. His slurfox grin broke spangles into statements of rhyme. His horn was swaying, and he was striking sparks into flash candles. The notes he played started bursting in my head. His glasses had stars on the edges that glittered. He was striking twilight into dynamite. I looked at the glasses he had on. It was a pair of dark glasses that reflected faces, but I couldn't see the eyes behind them. I could only see the colors in the mirrors of his lenses. The horn player was moving, and he said "You can do the four corners."

      Another door started to open, and I walked through it. There was a wooden horse in the center of the floor that could only turn in one direction. Rocking horse steady faced one way. A pocket watch that was four or five feet in diameter had been left on the floor, and it could only tell spare time. A birdcage was huddled in a tight corner. There was a door that said ELSEWHERE, and I could see halfway through it. A man in the next room was holding a searchlight. His shadow was very long, and he stood beside a giant pair of tweezers that was about to pick him up, but it picked up his shadow instead. He said that he lived in a world of machines. He asked me whether you can live with machines and not become a machine.

      "There are as many machines as human beings," he said. "But the machines I know of are run by human beings. I want to live in a world of human beings."

      His arms were covered by needle tracks. He had used pain medicine at the root of a twisted nerve. His treatment had included freeze therapy and the use of wrestling techniques. But he had found that he could not feel anything. He looked into a cup of water that was electrified. He said that he didn't want to spill it, because he wanted not to forget anything in it ever again. Cryptic statements were written on his forehead. "There is a needle in my head that will end the deadness in my mind," he said. "I'm losing the numbness in my head. I'm starting to feel something."

      He said that there was a window in his room. I looked through it, and he said that yesterday the snow had been falling. There was a bush with spines on it outside his window. The spines were covered by ice, and snow was covering the stems. The spines looked like teeth, but the stems of the bush did not look like it was alive. 

      He held his searchlight in his right hand, and he said that he couldn't remember what the courtyard outside his window had looked like before the snow had fallen. He couldn't remember anything without snow on it. His flashbacks were in winter. Jasmine was what he touched in his dreams.

      "I can't find the answer for anything," he said. "The only answers I can find are my own, and I can't find any."

     "Is there an answer for everything?" I asked. Can't there be problems that have no answers? Does every problem necessarily have an answer? Maybe that's the case only if we say that there are problems for which the answers are that there are no answers."

      "If there isn't an answer for a problem," he replied, "does that mean that the problem isn't logical? If you want to find an answer for a problem, can you find an answer for it only insofar as the problem is logical? And what does logic have to do with truth? If some thing or event is logical, does that mean that it has its own truth? If something that has nothing to do with truth can have its own logic, then how is logic involved in defining what truth is? If something is valid, does that mean that it has its own truth? Can something be logical that isn't valid? Can something be valid that isn't logical? Can there be truth in things that aren't logical? Is truth logical? The only answers that I can find are my own, and I know that I can't find any."

      "How does one determine what truth is?" I asked. "If someone makes a statement, doesn't probability theory have to enter, in some way, into whether the statement is true?"

      "If everything is a matter of probability," he replied, "who or what is making the odds? Is there an absolute or only a relative probability of any given event occurring in one way and not another? And is probability merely a measure of uncertainty? If probability is a measure of uncertainty and it can therefore be changed, is there anything that cannot be other than it is? If anything can be changed, then we live with uncertainty. So, if we change something, do we also give it a new probability, namely, the probability of being whatever it is? Are there things that can't be expressed in terms of probability? If we talk in terms of certainty, are we talking any longer in terms of probability? Is uncertainty the law of the universe?"

      While he was talking, I stood two-thirds of the way up. It wasn't possible to stand up straight. He told me that the room had been constructed so that any person standing in that room, regardless of how tall that person was, could only stand two-thirds of the way up. The architect of the building had not felt that it was necessary for anyone to stand all the way up, and had thus imposed a discipline on whoever tried to stand up straight.

      I walked around the room, and found another door. I opened it, and found that the door led into a closet. A mirror in the closet reflected the image in the window on the other side of the room, so that as you looked into the mirror you could see the image in the window. I asked the man with the searchlight, "What's real, the image that I see in the mirror or the image that's projected into it?"

      He said, "You can find the answer inside the door." 

      I looked into the closet, and found a machine that had a handle on it. The machine had instructions on a decoder panel, saying that the machine was nuclear powered. I climbed inside the atom smasher, and reached for the handle and pushed it forward. I couldn't throw the gear change into reverse, because it was only semi-automatic. I could feel myself suddenly moving faster. Microcircuits were being activated. I could see reflectors streaking in square semicircles incredibly fast. Impulses in me that I couldn't control or contain were being converted into electrical energy. The impulses that I couldn't hold in my head suddenly went down to my feet, and the floor started burning. I grinned until my face was hurting. My left hand got caught by my right hand, and I couldn't let go. 

      The man with the searchlight said, "The bones in your hands are showing." I saw someone in the mirror who was trying to get out. I felt another surge inside my head, and the glass prison was broken. The philosopher was blasted into another level of mind. The councils of scions were arrested by arguments of suggestion. Contemporary psychology was driven by cognitive intuition. I could see my life accelerating on a movie projector. It sped past the light ray and the abscissa.

      I climbed out of the atom smasher. Another door opened, and we walked through it. A circular staircase led into an antechamber. We walked around for a moment, and then passed through another doorway that led into other passageways. We came into a hallway that was only a few feet in width. It was lined by stained glass windows. We heard knocking on the door at the end of the hallway, and we went through the doorway and found that a man had been knocking his head on the door. Women in white robes were standing behind him, their faces half-covered by their vestments, so that only their eyes and foreheads were exposed. They were wandering about, and ethereal hymns were playing. The music was given to the underground. I could not remember beats of it. There were huge cracks in the floor where spirits from the past had broken into the present. We climbed down through the crevices in the floor, and we landed about ten feet below in another chamber.

      One of the women in white robes came down behind us and introduced herself. "There are sounds that state what my name is," she said. "The sequence of sounds that state who I am." Her image slowly folded out of an ironing board. She started to walk with very short, halting steps. Then she turned on a strobe light and opened a newspaper that was decades old. She said that she had to notify the timekeeper of the human condition. She had a slide machine in her dark room, and it had already been turned on. There were vents on the machine that looked like blinds. She said that the blinds were talking to her, and that she must close them to stop that talking. I could see her face in the dark. Her lipstick was shining, and it was uneven, with the right side higher than the left. She asked us, "If there is balance in the world, is there someone who balances it? Let your voice answer fully with an answer-gram."

      The man with the searchlight replied, "If I give you an answer with words, is it because you have faith in their meaning? Do you give words meaning, or do words have their own meaning?"

      She answered, "What is faith? What does faith have to do with meaning? Is faith merely a belief in a higher principle of being? Is having faith something that's necessary only for someone who's confronted by arguments for the absence of God? Is having faith the same as believing in God? If faith is something that's achieved in the face of evidence that there's no logical way of proving something, does it have anything to do with God? Is faith an expression of submission to a higher principle of being? And what does faith have to do with reason? What does faith have to do with truth or falsehood? What does it have to do with right or wrong? What do right and wrong have to do with God? Do right and wrong have anything to do with the evolution of the universe? If we describe God as the first cause of the universe, is it possible for us to know God? If we can't actually know God, then is faith as close as we can come to knowing God? If we say that we can know God by faith, then what is faith?"

      We found a doorway, and walked out of the darkness, and found ourselves in the street. An orion was breaking into a light fantastic. There was so much light in the street that all forms seemed to be in negative contrast. The images of our shadows seemed to be burned into the street. The lunar calendar had been dated backwards. There had been a meteor shower that had not fallen to earth. The outlines of human beings were highlighted by neon. Stars and asteroids were shattered overhead. A beam in a spectrum was passing through arcs of light. Three rainbows were being transmitted from power centers in the same city.

      We talked with a woman who was making some sketches of people in the street. The crayons she held in her hand were bleeding. She said she had majored in ancient history. She was in command of many dead languages. The words inside her head could not be pronounced, they were dead words. She said that when she tried to write down her thoughts, she looked down, and there was blood on the page. She said that she wanted to unwind in a paperback store. We went with her, and searched for a book on how to stop the bleeding. We met a young woman who was looking at books in the store, and who was wearing a sweater and a leather jacket. She told us that she had an answer for our problem. She said to mix one part moonbeam with one part African wheat. Her sweater had a gold flame on it, and she was lit by a psychedelic underglow. She said she had learned her magic from the stars. She was full of circles: circles of light and circles of love. She was transfused with light.

      We walked outside with the artist who was holding her crayons, and she took some of the sketches out of her notebook. She showed us all the people she had been seen in the street. A saboteur had been running away from an auto factory. Battalions of stormtroopers had been pursuing him through dead end streets. There had been a spy in googles who had pretended to have some knowledge of archaeology. A glider pilot had left his resumé. A sailor had punched out a wine-soaked detective. A pipe cleaner had been folded over by a garage salesman. Men in uniforms had been loading iron bars into armored trucks. The garbage man had wiped the water from his eyes. The gaze-catcher had hoarded old looks. The sorcerer had been instructed by someone from fright college. The tap dancer's steps had rung out on Barnaby Street. There had been a man named Alphabet Sorry who'd been listening to the boogaloo man.

      We walked along the street. A metal trash can was on the corner. The wind blew a plastic bag out of a dumpster. A man who was wearing a t-shirt was kicking empty beer cans into the street. Some teenagers were sitting in a doorway. They saw a man who was wearing dirty clothes pick up a smoldering cigarette off the street, and he started to smoke the cigarette, and they started to laugh. A lot of traffic cones were sitting on the street. A man was eating a hot dog, and it fell out of his hand and dropped into a gutter, and he cursed. A short woman wearing a cowboy hat was standing nearby and laughing. She could only look to the right, and not to the left. She was carrying around a cardboard poster of herself. A man with a stiff leg was walking unevenly toward her. He had a radio on his belt that was playing country music. He looked up at a black balloon over his head. He tried to reach it, but it floated away. It was not round, but was shapeless, and seemed to be always changing shape. It had lumps in it. A man who was leaning out of a window in a four-story building nearby had a needle that he was using to skewer an apple. The balloon floated up to him, and he punctured it instead.

      A newspaper in a rack at the street corner had a headline saying that there was a sale going on at a department store. The classifieds were advertising electric toasters. A bottling company was sponsoring racing machines. We walked over to a retail outlet, and looked in through the window. We could see a stereo set that had a record, half-chrome and half-vinyl, on the turntable. A mannikin was standing behind the stereo, and she was wearing brunette hair and a headband. She was leaning slightly forward, and one of her arms was holding a wooden utensil in a salad bowl, while the other was flexed and holding a cigarette in front of her mouth. She was staring vacantly, but I thought that she looked vaguely unhappy. She had deep-set, glass eyes that seemed to drip glass tears. 

      We walked to a warehouse and to another retail outlet. A wall of freezers was set up in one of the departments. I imagined myself as a goalkeeper in a supermarket. People were shooting cheeses at me with their hockey sticks. A machine in the store had an orb that promoted sleeplessness. The man who had turned it on had red suspenders and a dry sense of humor. The ideas he had were rated by a positron.

      We met a bus driver who took us on a drive out of the city. He looked through the windshield, and said that he could see for miles. We came to an airfield. There was an observation tower that had fences around it. A biplane was flying overhead. We met a pilot who offered to take us on a flight. The skywriter had an alibi for last Thursday. He said that he had not been flying because his prop had been broken. So the mechanics had replaced it. Metal bits had been cut into a crankshaft that was ready to get moving. The landing gear of the plane was driven by remote controls. We climbed into the plane, and put on our safety belts. A propeller was turning, and the machine moved forward. We went flying for about an hour, and then the plane came down in a canyon. The wind was blowing a lot of sand over the airstrip. We could hardly see the runway. Cactus passed the highway by. Passageways under the sand were connected with each other. Tunnels had been constructed from planks of wood. Trestles supported an incline that had auto wrecks underneath. A well had been drilled into the sand, and we looked down into it. The well was lined by a smooth wall. The wind was blowing sand into it, but it was getting deeper as if it were falling into the earth instead of having the sand fall into it. The earth was thirsty, and it never had enough to drink. The well wasn't empty, but we couldn't see what was in it.

      We walked out of the canyon, and came out on a mesa. I let myself fall down on the ground to take some rest for a moment, and dust flew up where I fell. I let my fingers dig deep into the ground. Dandelions were growing around a tambourine. The sirens of locusts were whining around us. A dragonfly was gliding by, and I could see through its wings. I stood up, and looked out over the mesa. In the distance, I could see a valley. Water was falling from a stream into a river. The stream was flowing from rocks, and miners were working nearby. Coal was being piled into loading bins. Dirt was rolling out of a tunnel and down a ramp into a waterfall below. We crossed the mesa and walked down into the valley to where the river started. I dipped my hand into the river, and tasted the metal in the water. We climbed toward the opening of the mining tunnel. One of the miners held a kerosene lamp, and he took us inside. It was very dirty, and he started coughing. He thought that biting the dirt had given him the ague. He wiped his hand across his chest, but his hand was covered with soot, and it left a mark on his chest. Dirt was choking the breath in our bodies. Night light was all that we could see the shadows by. Earthstuff was growing under fluorescent light. Snakes were crawling in the undergrowth beneath us. A snake had turned itself inside out, and the juice from its belly was burning into the floor of the tunnel. The snake had a backbone with many compartments. The miner bent over it, and he said that it had been heading toward the end of the tunnel. He looked at the other snakes crawling on the floor of the cave, and he said that he had no fear of them. 

      "I'm a survivor," he said. "That sidewinder was closer to the backdoor than I was. All that it wanted to do was to keep going. Yeah, I know the creatures from the river. My brother, he wrestled wolves in the outback. He had a dagger bright." 

      But then he looked around, and asked us, "Did you think you saw a polecat?"

      We came out of the cave onto a road that led to an area of brushland. Rainbirds were flying at low altitudes. A braintree stood in the center of a clearing that was surrounded by mud and clay. It was bare and had no branches, and it emoted its thought. Dried stalks were standing upright in a dirt field. Insects were flying about, gray riders and black riders. A forest beyond the clearing was full of tall trees. Ladder branches were made by trees that stood forever. The miner had told us that some people lived to cut down the trees. Some people lived to use the wood that was cut down. But the people did not live on. The only things that lived on were the trees that had not been cut down.

      A large crater blocked our path, and steam was rising out of it. A hollow tree had been cut off about two feet above the ground. Water, and then smoke, intermittently spurted out of it. A black beetle was crawling on my hand, and I brushed it away. I picked up a stone that was as smooth as glass, and the stone was warm, and it almost burned my hand. The earth all around us was warm. A woman with long black hair stood next to the tree stump that was smoking. She had chalk across her face. She showed me a cloth that had colors woven into a black background. The colors formed a circle like a bracelet on the cloth. She gave me the cloth, and I wore it under my belt as we advanced into the forest.

      We came to a glen that was filled with still water. The water reflected the trees. A tree had been cut into by an axe and had reddish fluid oozing from its wounds. Men nearby were hunting with spears. The spears had blood on them. An empty boat was drifting into the glen, and some of the hunters climbed into it. Trembling passages were marked by discoverers of tribal ritual. That current of sweat that told them that their legs were shaking. They had waded into the water up to their chests, and the silt in the water was still clinging to them. They held arrows over their chests, and they said that they were free. An oar had been lying inside the boat, and was left behind in the mud. Slugs were floating in a shallow pool of dirty water. A man who was sitting beside the bank was playing a stone pipe. Chilblains made him fold his limbs. He said that he had been having dreams about insects flying around his head. He decided to leave his scepter to the sailing party.

      The man who had been playing the instrument watched the boat filled with the hunters moving away. He looked back into the forest, and said that the trees could live forever. He asked us, "If the universe is infinite, does it have a beginning and an end? What, if any, are the limits of time and space? What do time and space have to do with the universe? If the universe is infinite, can it expand and contract? If the universe can expand and contract, can it expand or contract infinitely? If the universe is finite, what are the dimensions of the universe? If the universe is finite, what is outside it? And what does the universe have to do with matter and anti-matter? If in a place there is or is not matter or anti-matter, does that determine whether it is part of the universe?"

      

What is the nature of explanation?

Some questions about the nature of explanation:

      What is an explanation? What kinds of explanations are there for things? What constitutes a sufficient or adequate explanation for something? How is descriptive adequacy different from explanatory adequacy? How is a theoretical explanation different from a practical explanation? What are the criteria for a sufficient explanation of something? When is a causal explanation a complete explanation? Can a causal explanation be a complete explanation? Is there such a thing as a complete explanation? What are the necessary and sufficient conditions for an adequate explanation of something? Can a sufficient explanation of something not be a logical or rational explanation? What degree of certainty must belong to an explanation in order for it to be considered a possible, probable, likely, or certain explanation? What makes explanations necessary or unnecessary? What are the possible motives for, and consequences of, seeking and providing explanations for things?

      

Some propositions concerning the nature of explanation:

      Explanations, in their content, may be adequate or inadequate, sufficient or insufficient, complete or incomplete.

      Explanations, in their form, may include arguments, demonstrations, and inferences (deductions, inductions, and abductions).

      Explanations, in their modality, may be possible, actual, necessary, not possible, not actual, or not necessary.

      Explanations, in their power and adequacy, may be plausible or implausible, convincing or unconvincing, definitive or in need of further corroboration. They may have varying degrees of explanatory power (efficacy) and adequacy.

      Explanations render things understandable.¹ An adequate explanation of something renders that thing understandable.

      The intelligible world consists of things for which there are (or can be) explanations, and for which we can potentially or actually find explanations.

      Those things for which there are no explanations, or for which there cannot possibly be any explanation, or for which we cannot possibly or actually find any explanation, may be unintelligible to us.

      In order for an explanation to "make sense" and be logically consistent, it must not be self-contradictory. In order for an explanation to render something understandable, it must itself be understandable.

      To explain is to account for, to make clear the reason for, to render intelligible, or to shed light on whatever has previously been, or would otherwise be, obscure and unintelligible. Explanations are, for the most part, not required for things that are self-evident.

      The following propositions may be true of explanation:

       1.  p "explains" q if and only if p accounts
               for q

       2.  p accounts for q if and only if p is a
               sufficient condition for q

       3.  if p is a sufficient condition for q, then p
               "explains" q

      Explanations have pragmatic dimensions; they have a variety of uses, purposes, and functions.

      Explanations may be classified in many ways. One possible way of classifying them may be to divide them into logical (formal), nomological (teleological or doctrinal), empirical (causal, material, or physical), and social (psychological, cultural, or historical) explanations.

      There may be many explanations for a given event, fact, or phenomenon, and they may vary in their form, content, modality, efficacy, and adequacy.

      To sufficiently answer any question of the form, "Why is A the case?" is to give a sufficient explanation of A. Any adequate answer to the question of why A is the case entails giving an adequate explanation of A.

      A purported explanation of something may not be a true or actual explanation of that thing. An explanation that turns out to be false in its premises or conclusions may not actually explain whatever it is purported to explain.

      Explanation may in some cases be a condition for understanding. In order to understand something, we may have to be able to explain why it is as it is and why it is not otherwise.

      Any clause that begins with the word "because" is a causal explanation.

      An event that previously served as an explanation for a second event may no longer explain that event if the conditions for that event have changed.

      There may be primary and secondary explanations for things.

      If the motives of an individual are the primary reason for (or explanation of) his or her actions, then the moral quality of those actions may be entirely different from the moral quality of those actions whose expected or intended consequences were the primary reason for (or explanation of) their having been performed.

      There are some truths that appear to be certain or highly probable but that elude or defy complete explanation.

FOOTNOTES
¹Peter Achinstein, The Nature of Explanation (Oxford: Oxford University Press, 1983), p. 63.

Systems of Signification in African-American Culture

Perceptions that individuals are racially different may often begin as perceptions that individuals are physically different. Perceptions of the differences that individuals may have in their skin color, hair texture, complexion, facial features, height, body build, etc. may often lead to presuppositions about the particular racial group that those individuals belong to. Differences in the physical characteristics of individuals may often be presupposed to signify racial differences, and racial differences may be presupposed to signify social and cultural differences.

     The dialectic of sameness and difference may also be the dialectic of insider and outsider, inclusion and exclusion, belonging and alienation, acceptance and rejection. To be racially or ethnically the same as the majority of members of society may in some cases be to share a socially important and perhaps advantageous mode of sameness with them, but this racial or ethnic sameness does not, by any means, imply any other kind of belonging to, or acceptance by, that society. An individual member of a racial or ethnic majority may feel just as alienated from the majority of society as an alienated member of a racial or ethnic minority. On the other hand, an individual who is perceived as racially or ethnically different from the majority of society may necessarily have to define their personal identity in the context of this difference or "otherness."

     The marginalization (political, social, economic) of an (ethnically, racially) "other" may take the form of a mode of discourse by which a (racial, ethnic) majority says, in effect, to a minority, "This society is ours and not yours." The majority may say to a minority, "The political, social, and cultural institutions of this society belong to us and not to you." Thus, the minority may, to some extent, be denied a sense of belonging to that society. This mode of discourse may be a means by which the majority says to a minority, "If you want to become a full-fledged member of this society, then you will have to become more like the majority. You must be the same as the majority and not different."

     Are there any innate racial differences among human beings (in behavior, or in mental or physical characteristics, for example)? Is the concept of race actually a viable and useful concept? If so, are racial differences among individuals biological or socially-constructed? These questions have been intensely debated, and continue to be disputed. However, a viewpoint commonly shared among social scientists and cultural theorists today is that racial identity is most accurately defined as a socially constructed, and not biological, category. The sociologist Stuart Hall, for example, has eloquently articulated the concept of race as a discursive category. Hall (1966) describes race as a "floating signifier" that may be defined by social context, cultural setting, and historical situation.

     It should be noted that to describe race as a discursive category is not to say that racial differences among individuals aren't real or don't actually exist. However, Hall has shown that perhaps the most productive means of understanding these differences is to analyze them as discursive, socially constructed categories.

     In connection with this mode of analysis, the Italian philosopher Umberto Eco (1976) has noted that there is a difference between saying that a culture can be studied as a system of structured significations and saying that a culture is only a system of structured significations. To say that a culture can be studied as a semiotic phenomenon is not to say that it can only be studied as a semiotic phenomenon.¹

     If discourse about race is a metalanguage, then it may itself become the object language of a metalanguage. It may be formal or informal, contemporary or historical, monological or dialogical. The study of African-American culture as a semiotic system may be a metasemiotic, whose object semiotic consists of the signs and symbols that are meaningful to African-Americans.

     Racial signifiers (such as skin color, body language, styles of speech) may be integrated into systems of signification that govern the construction of concepts of social reality. These signifiers may reflect the way in which we view ourselves and each other. The signifying or discursive practices of each racial or ethnic group in society may include the usage of various kinds of signifiers in order to denote perceived racial or ethnic differences. These signifiers may also be used to denote the racial or ethnic (and social or cultural) identity of individuals.

     Social signs stand for (or signify) real or supposed social facts (cultural realities). The signification of signs may consist in their standing for facts or realities. The truth of signs may be determined by whether they signify objective facts or realities (physical, social, cultural, or historical). However, the precise signification of signs, as well as their objective truth, are matters of interpretation. Thus, our concepts of reality may, at least to some degree, be socially constructed.

     The surface meaning of a sign may include its sense (its mode of presentation), its mode of reference to an object, and the particular concept, fact, or reality that it represents (its referent). The underlying meaning of a sign may include its relation to other signs, its interpretants (its representations in the minds of producers and interpreters), its range of connotations, and its relation to the system of beliefs or values it stands for.

     The presentation of a sign may be overt or covert, and its meaning may be apparent or inapparent, disclosed or undisclosed. The realm of discourse in which signs function as signs is a domain in which producers and interpreters can determine the level of openness, honesty, cooperation, and respect with which they will communicate with each other. They can also determine by general agreement or convention the syntactic, semantic, and pragmatic rules that will govern their communication with each other.

     The Swiss linguist Ferdinand de Saussure (1916) defined a sign as a link between a concept and a sound-image, and he described language as a structured system of arbitrary signs. According to his model of the linguistic sign, each sign arbitrarily employs a sound-image (or signifier) to represent a signified idea or concept. Every sign includes both a signifier and a signified.

     The American philosopher Charles S. Peirce (1903) defined a linguistic sign as anything that denotes an object, and he defined an object as anything that can be thought. According to Peirce, linguistic tokens are actual things or events that act as signs, and linguistic types are signs that have been agreed upon as a matter of convention. Symbols are types that act through tokens, and tokens are replicas (individual examples, or instantiations) of types.

     In terms of the dynamics of racial identity, the type-token distinction may be applied to the modes of production of racial signifiers and related sign-vehicles. Racial signifiers may have content-types and content-tokens as well as expression-types and expression-tokens. Stereotypes may be symbols, general types, or models that are replicated by concrete tokens (such as physical objects, images, or representations of behavior). Stereotypical tokens may have individual differences as long as they conform to the relevant characteristics that are dictated by the type (symbol or model).

     Stereotypes are characterized by rigidity, oversimplification, and inability to recognize differences among individual members of the group that is being stereotyped. Stereotypes are also characterized by exaggeration, one-sidedness, and resistance to change. They may express sexist, racist, ethnocentric, xenophobic, or other socially biased viewpoints.

     If a stereotype signifies a set of characteristics that are attributed to all members of a particular social or cultural group, regardless of any individual differences among members of that group, then the token of that stereotype may be produced by replicating those characteristics in an object or act, such as an image, picture, verbal expression, description, or characterization.

     The American philosopher Charles W. Morris (1971) defined a linguistic sign as any preparatory stimulus that produces a disposition in the interpreter to respond to something that is not at the moment a stimulus.² In his view, all signs are either signals or symbols. Signals are not interpreted to signify other signs, but symbols are interpreted to signify other signs. Signs may be categorized according to their modes of signifying as identificative, designative, appraisive, prescriptive, or formative. Signs may also be categorized according to their primary usages as informative, valuative, incitive, or systemic (organizational). Modes of discourse (including poetic, scientific, legal, moral, religious, and political discourse) may thus be distinguished from each other by their primary modes of signifying and their primary usages of signs.

      The word "white" or the word "black," when used to signify the racial identity of an individual, inevitably oversimplifies that individual's social identity, since their identity may also be defined by such factors as age, gender, ethnicity, sexual orientation, economic status, religion, and nationality. "White" or "black" can never be regarded as a sufficient description of an individual's social identity, if the diversity of attitudes, viewpoints, and modes of experience that belong to that individual (independent of their racial background) are considered.

     Nevertheless, the words "white" and "black" are often used not only to denote the racial identity of individuals, but also to denote particular sets of social characteristics that are assumed to belong to individuals because of their racial identity. It is precisely because such signifiers oversimplify the social identity of individuals that they are found to be useful by those who desire to promote oversimplified and stereotypical notions of racial differences. For those who have racist preconceptions, the use of such signifiers may express a basic unwillingness to look beyond race or skin color in forming opinions about individuals.

     For those "whites" (in whatever way this term is defined) who believe that "blacks" are socially inferior, the fact that an individual's skin color may be described as "black" may outweigh any other characteristic that may distinguish that individual's social identity. Thus, the architect, photographer, or physicist who happens to be black may be marginalized by being described as a "black architect," a "black photographer," or a "black physicist."  The victim or target of such racist preconceptions may be compelled to respond,"Yes, I'm black, but I'm also an individual with various skills and abilities that do not depend on my being black."

     The very fact that individuals who are described as "white" or "black" are not literally white or black in their skin color indicates that these descriptions are merely figurative and based on social convention. The racial signifiers "white" and "black" may not be literal descriptions of skin color, with some "whites" appearing more "black" than "white" in skin color, and some "blacks" appearing more "white" than "black" in skin color. Moreover, some individuals may be difficult to classify as "white" or "black." Some individuals may refuse to be labeled or may not see themselves as either "white" or "black." The matter of an individual's racial or ethnic identity is always to some extent a matter of self-definition, insofar as each individual must decide for themselves what it means to be "white," "black," "Latino," "Asian-American," and so on.

     In a society in which black people have historically been marginalized (politically, economically, socially) by white people, blackness may be seen by white people as an "otherness." Being black may mean having to accept otherness and learning how to affirm the positive aspects of one's self in one's otherness, or it may mean refusing to accept otherness and demanding to be accepted as equal. Thus, the American civil rights movement of the 1960's may, in a certain sense, have arisen from a refusal by African-Americans to accept "otherness." It may, at least in part, have proceeded from their desire to be accepted as citizens who have the same rights as others to fully participate in American society.

     The most obvious sign of racial discrimination--the sign that says "whites only"--is both a sign and symbol of the exclusion of blacks from various levels of participation in society.

     Linguistic signs that stand for concepts of race may evolve over a period of time. Thus, racial signifiers may be analyzed diachronically (with respect to changes in their signification over a period of time) and synchronically (with respect to their signification at a particular moment in time). Linguistic signs such as the words "black," "Negro," and "colored" are examples of signs that have, over a period of time, changed in their signification.

     Names of people, places, concepts, objects, and events may be both signs and symbols. For example, "the white man" and "the black man" are names that may be used to symbolize the general concept of white people and black people. The name "Rodney King" may symbolize the victimization of black people by police brutality. The name "Emmett Till" may symbolize the suffering endured by black people because of their being subjected to racial violence and intimidation. The words "brother" and "sister" are other examples of sign-symbols. They can be used to address not only family members, but also friends and acquaintances. They may symbolize not only a familial kinship, but also a sense of shared fellowship and humanity.

     The names that parents give to their children may also reflect their racial or ethnic identity. Indeed, the recognition that such names may imply their racial or ethnic identity may be used as a basis for "racial profiling" and other forms of discrimination against them by those who have racially biased viewpoints.

     The most obvious connotations of the word "white" are, of course, positive attributes such as "pure," "innocent," "clean," and "unblemished," and the most obvious connotations of the word "black" are often negative attributes such as "dark," "evil," "unclean," and "dirty." Such connotations can easily be made the basis for prejudicial characterizations and stereotypes of "whiteness" and "blackness." Thus, for those who accept such stereotypes, the white-black antithesis becomes a conflict of good and evil, right and wrong, light and darkness, the civilized and the uncivilized.

     Racial or ethnic stereotypes become a means to dehumanize and ridicule those who are viewed according to racist or ethnocentric ideology as racially or ethnically inferior. Thus, some of the racist caricatures of black people that have been presented in Hollywood films have included the minstrel or buffoon (with blackface makeup, wooly hair, and raggedy clothes) and the "mammy" (the sassy, overweight black maid). Black people have been portrayed in media such as magazines, comic books, and films as having big noses, big lips, big buttocks, kinky hair, and stereotypical patterns of speech ("negroid" features and dark skin have been portrayed as ugly, while "caucasian" features and light skin have been portrayed as beautiful). More recent stereotypical images of blacks that have been spread by mass media include the image of the drug-dealer, pimp, homeboy, hustler, and "gangsta."

     Racial stereotypes may also express racist and blatantly nonsensical presuppositions about individuals (e.g. that if an individual is black, then they must be able to dance and play basketball).

     Racial codewords may be used to convey racist ideology, e.g. "blacks" may be used as a codeword for "crime," and "forced busing" may be used as a codeword for the enforcement of laws designed to end racial segregation in public schools. The term "affirmative action" may be used as a codeword by those who are opposed to measures to correct social inequalities and who believe that the effect of such measures will be to provide employment or educational opportunities to individuals solely because they belong to a minority group, and not because of their personal qualifications or merit.

     The production and interpretation of signs require the use of codes in order for the expression of those signs to be correlated to their content. A code may be a correlational device for determining the relation between signifiers and their signified concepts.³ Code switching may occur when blacks and whites talk to each other, because they may adapt their conversational styles in order to facilitate communication. Blacks may move back and forth between African-American vernacular English and standard American English, although these varieties of English (which may be described as ethnolects or sociolects, because they are varieties of language that may be associated with particular ethnic or social groups) may be a continuum, and may not be rigidly separated from each other. Code switching may include changes in formality, vocabulary, syntax, and phonology (pronunciation), as well as in nonverbal communication.

     Terms such as "Jim Crow," "the middle passage," "sit in," "black power," "Harlem Renaissance," "NAACP," "freedom rider," "Black Panther," "rhythm and blues," "jazz," and "hip hop" are signifiers of historical movements or events that have powerful connotations for African-Americans. Racially-charged symbols, such as the confederate flag, the hood of a Ku Klux Klansman, a burning cross, a lynching rope, a swastika, neo-Nazi symbols, and slave shackles may also have powerful connotations. Racial epithets, such as the "n-word," also have powerful connotations and are signifiers of racial hatred that have been used by some whites in the past to express their scorn and contempt for blacks and other people of color.

     Other symbolic expressions include the racial epithets "boy," "token Negro," and "Uncle Tom."

     Racial signifiers may become vehicles of racial (and racist or ethnocentric) iconography. Examples of such iconography include depictions of God or Jesus as white, depictions of white superheroes such as Tarzan and the Lone Ranger who are symbols of white supremacy, and demeaning characterizations of people who are deemed to be of low social status, such as Amos 'n Andy, Little Black Sambo, Stepin Fetchit, Buckwheat, and Aunt Jemima, who are also symbols of black servitude.

     Iconic signs (signs that resemble the things they signify) may take the form of emulation of a particular style of speech, dress, or fashion. Indexical signs (signs that demonstrate the influence of the things they signify) may take the form of changes in an individual's physical appearance (such as their having a shaven head or wearing a tattoo or an earring) in order to denote a particular set of social attitudes. Symbolic signs (signs that by convention refer to the things they signify) may take the form of a gesture such as a handshake, a high-five, a black power salute, or a colloquial verbal expression such as "what's up?" or "what's goin' on?"

     Historical events of symbolic importance to African-Americans include the Dred Scott Supreme Court decision (1857), the Emancipation Proclamation (1863), Jesse Owens' winning four gold medals at the Olympic Games (1936), Jackie Robinson's becoming the first black baseball player in the major leagues (1947), the Brown vs. Board of Education Supreme Court decision (1954), Rosa Parks's refusal to give up her seat on a bus in Alabama (1955), the Montgomery bus boycott (1955-6), the March on Washington (1963), the assassination of Dr. Martin Luther King Jr. (1968), the declaration of Martin Luther King Jr. Day as a national holiday (1986), and the election of Barack Obama as President of the United States (2008).

     Protests are by their nature symbolic forms of social expression. Thus, when African-Americans have engaged in social protests in the past, they have symbolically articulated their demand for social justice and equal legal and civil rights.

     Individuals who are symbols of excellence and achievement, and who are "cultural icons" include Martin Luther King Jr., Malcolm X, Frederick Douglass, Sojourner Truth, Harriet Tubman, Marcus Garvey, W.E.B. DuBois, Rosa Parks, George Washington Carver, Charles Drew, John Hope Franklin, Richard Wright, James Baldwin, Langston Hughes, Lorraine Hansberry, Zora Neale Hurston, Toni Morrison, Bessie Smith, Billie Holiday, Louis Armstrong, Miles Davis, John Coltrane, Sidney Poitier, Michael Jackson, Oprah Winfrey, Michael Jordan, Willie Mays, Jackie Robinson, Hank Aaron, and Muhammad Ali.

     Other symbolic signs of African-American culture include Negro spirituals, gospel music, the Negro National Anthem, the colors of Akan Kente cloth, the celebration of Kwanzaa, and the song "We Shall Overcome."

     Symbolic rituals in the everyday lives of African-Americans include rites of religious worship, everyday work routines, weekend recreational activities, weddings, funerals, birthday celebrations, holiday observances, school graduation ceremonies, family rituals (such as saying a prayer or blessing before meals), and patriotic observances (such as standing up and facing the flag during the playing of the National Anthem).

     The signifying practices of African-Americans include art, music, religion, oral and written narrative, folklore, literature, science, rhetorical discourse, political discourse, and other signifying practices. Fashion and design are other examples of signifying practices (formal and informal) that may take the form of simply wearing a particular type of clothing or choosing a particular hairstyle (thus, the adoption of a particular style of dress or the driving of a particular type of car may be a sign of one's lifestyle, social attitudes, level of income, economic status, etc.). These signifying practices (or enunciative modalities) on the part of African-Americans may be informed by the historical struggle to overcome social oppression, and may in some cases be part of the continuing quest for human dignity and freedom.

     Racial signifiers may take the form of words, images, or modes of behavior. They may have positive or negative connotations (thematic paradigms) that may be subject to varying interpretations, depending on their context, mode of presentation, and the particular preconceptions, opinions, and attitudes of the producer or interpreter.

FOOTNOTES 

¹Umberto Eco, A Theory of Semiotics (Bloomington: Indiana University Press, 1976), p. 22.

²Charles W. Morris, Writings on the General Theory of Signs (The Hague: Mouton, 1971), p. 366.

³Eco, A Theory of Semiotics, p. 38.

REFERENCES

Eco, Umberto. A Theory of Semiotics. Bloomington: Indiana University Press, 1076.

Hall, Stuart. Race: The Floating Signifier (video lecture). Northampton, Mass: The Media Education Foundation, 1996.

Morris, Charles W. Writings on the General Theory of Signs. The Hague: Mouton, 1971.

Peirce, Charles Sander. Collected Papers of Charles Sanders Peirce. Cambridge: Harvard University Press, 1960.

Saussure, Ferdinand de. Course in General Linguistics. Edited by Charles Bally and Albert Sechehaye, in collaboration with Albert Riedlinger. Translated by Wade Baskin. New York: McGraw-Hill Book Company, 1966.