Dr. Brute Facts doesn’t care about your feelings

Of all of the world’s doctors, and particularly at St. Jude’s Hospital, Dr. Judd Shapiro is a physician with a rare gift. While most doctors consider the physical body a vessel for a living, thinking person first and foremost, and the apperception and treating of the physical body a worthy enterprise because of the comfort that it might bring such a person, Shapiro considers the person to be a mere collection of physical phenomena, of value only as the sum total of the stuff of which it is made. To be even more precise, “it”, the physical body, barely exists to him; it demands no more recognition of oneness or continuity than does the air in a balloon or the water that makes up a particular section of river. This is not just a matter of point of view, but more of the acuity of his senses: he sees the interactions of particles and waves in front of him much like you or I see a fly landing on a window, and thinks primarily on that scale, the scale that is most intuitive and meaningful to him. The scope of his thought can be widened to include constructs we might call “life”, including human life, and on some occasions he be persuaded to adopt our conventions of grouping matter into “cells”, “organs”, and “people”. In this way he has a grasp, in both the general and particular senses, of the true inner workings of the human body, and any body that happens to be in his examination room. He knows both the sequences of DNA (that is, can recite the base pairs) that commonly predispose one to abnormal hemoglobin production as well as the precise location and corpuscular hemoglobin concentration of any given red blood cell in the bloodshot, overworked eye of any of the nurses. The difficulty of working with him lies not in his intellect but where he is inclined to focus it, in convincing him to think of the physical phenomena that he is attuned to as part of a “body” or a “patient” at all. To him, arrangements of matter in the coordinated pattern we call a “human” are but a convenience, a mental shorthand, for those without direct access to the atomic motion that underlies it all. When his opinion is solicited, he has the habit of emerging from a trance-like state to declare, “facts, not feelings” – which, as far as we can tell, is an enjoinder to let go of our parochial attachment to bodies and minds of the patients under our care and focus on simply what is objectively there. To him, a “body” is a random selection of the possible arrangements of matter, only intrinsically appealing to humans because we appreciate things of roughly our own size, and in particular things whose cells contain DNA recombinable with our own. He seems to see no point in putting his answers to us, when we can get them, in body-scale terms, instead phrasing them in the the brute factual language of nature. They often come in descriptions of the states of electrons somewhere nearby, which would be useless to us even if it were clear that these electrons were in the patient’s body and relevant to his complaint. If we manage to elicit a comment on a particular condition, we find that just as often as not he has taken the side of the disease over the patient. At one point, a fellow doctor contributed weeks of study to discern the meaning of one off-hand comment Dr. Shapiro had made about a T being where a C should be (we were lucky that in this case he favored us with an explanation in terms of molecules rather than quanta), thinking that it might hold a clue as to the particular mutation in liver cells that led to a patient’s hepatoblastoma, only to find that Dr. Shapiro’s remark was about the liver’s healthy cells – Dr. Shapiro seemed to see no reason that the patient’s whole liver should not be cancer. Apparently, cancer displays all of the hallmarks of what we call “living”, with the added bonus of not disturbing his trances with irrelevant questions.

I wonder if it would not be a terrible burden on his gift of perception to favor the intuitions of others as to the relative value of different arrangements of matter, seeing that he accepts the incomparably more arbitrary construct that is “employment” as a “doctor” and the remuneration it brings.

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