TANRIMADAN DÖNEN FELSEFE BİLİMCİSİ

I develop a framework for understanding illness experiences in my bookIllness(2018) which uses phenomenological concepts such as Heidegger’sbeing-in-the-worldandcare, Jean-Paul Sartre’s analysis of health as transparent, and Maurice Merleau-Ponty’s notion of thebody-subjectso as to build a full picture of illness as it is lived. The foundational claim of this framework is that illness changes – often profoundly – not only thetypeof experiences we have, but also theexperiential framingwithin which we have experiences altogether. For example, our sense of space and time fundamentally changes when we become incapacitated or disabled by illness, or when our life prospects diminish. Our attitudes and values also shift in light of diminishing choices and resources. Perhaps what was once critical to one’s self-image (e.g. good looks) becomes laughably insignificant. A complete revision of what one considers desirable, acceptable, and liveable often accompanies disease progression. In other words, illness is atransformative experiencethat changes the ill person both epistemically (what they know) and personally (what they value).

Bodily doubt makes the person experiencing it feel rather incapable. Confronting the loss of abilities and the frustration involved in ‘being unable’ (‘I cannot’) can be sharply contrasted with the normal (well) feelings of competence and ability, even when this ability is punctuated by occasional failure. For example, if I decide to go for a walk, I know I cannot walk indefinitely, but I have enough bodily certainty such that the project (going for a walk) dominates the action. I walk until I am satisfied, so in effect, I have walked without any limit. But in a state of bodily doubt, I am immediately restricted by my bodily limits. Thus, I must plan before I act (how far I can go? will it be too steep?) such that my bodily limits (and not the project) determine the action. The sense of my open horizons, as extending beyond myself and into the world, collapses back onto my actual physical being. In this way, bodily doubt exposes the structure of how things actually are and is hence philosophically revealing.

This passivity is constituted by one’s physical state: ill people in intensive care can almost do nothing for themselves. Their ability to advocate for themselves is compromised; they often cannot speak or are unconscious. But it is also constituted interpersonally by those who look after the incapacitated person, not due to malice but simply in virtue of the situation. This passivity is baked into the interpersonal dynamics: the patients are mostly unconscious, disoriented, or unable to speak, which creates real physical and communicative barriers. Those who care for you play an important role in sustaining, restoring, or further eroding a sense of bodily subjectivity and agency. The ill person’s most basic agency, that of bodily location, is enabled or disabled by others. Bodily capacities are appropriated: patients in intensive care are fed via a nasogastric tube; their vital functions are supported and regulated externally. One risks being reduced to a passive, manipulable object before the clinical-other, not just for a moment but in an enduring way.