Our piece, Dr. Sloan Misses The Point: A Fighting Spirit Is Vital In Overcoming Illness, brought many notes. Some just found the subject interesting:
Kudos on the February 2, 2011, edition of the Perishable Pundit.
From your assessment of Dr. Sloan’s comments on the “Fighting Spirit” to the great video focused on trading with Terminal Markets, it was thought-provoking and interesting.
Keep up the great work.
— Chuck Zambito
Zambito Produce Sales
Others thought we were on target. A noted editor of a respected journal of technology and science in Washington, DC, one that has published our own work on food safety here, thought our critique on the money:
I read with interest your commentary on Richard Sloan’s New York Times piece. Kudos—you’re exactly right.
Mr. Sloan has written skeptically for years about religious belief and medicine (the subject of his 2006 book Blind Faith), and here extends his argument to cover the wider range of beliefs and feelings. But he ignores the growing body of scientific evidence that shows that depression and sickness can reinforce one another. Such findings should surprise no one: we are psychophysical unities.
Moreover, his argument in the Times fails in just the way you describe. Seeking treatment, seeking good treatment, putting up with a treatment regimen and its side effects—these require at least a belief that all the effort is worthwhile, that the treatment might succeed and that life is worth living, so successful treatment is desirable.
No responsible commentator would claim that beliefs, feelings, or a “fighting spirit” are sufficient for successful medical treatment. But they can be necessary preconditions for successful treatment.
— Adam Keiper
The New Atlantis
One note stood out as simply brilliant:
I love science but sometimes those of us with a Ph.D. and/or an M.D. are just full of ourselves.
I think that Dr. Sloan would benefit from reading some of Viktor Frankl’s accounts of the will to survive in Holocaust victims.
Then again, in part we might measure the level, quality and/or attitude of caregivers toward positively disposed individuals or ones with loving attentive families.
I always thought it a bit beyond chance that Jefferson and Adams both died on July 4th, 1826, exactly 50 years to the day of the signing of the Declaration of Independence. Exclusively a statistical anomaly, really!
Humans are the “Ultimate Resource” in even more ways than Julian Simon intended.
Santa Maria, California
That would be Robert Stovicek Ph.D. writing the note!
Our list of ways in which a “fighting spirit” could help one survive a serious illness was mostly quite practical, and in raising the question of how an ill person’s attitude affects the attitudes and actions of caregivers and family and friends, Bob continues in that vein. There are exceptions, but if a patient gives up on himself, how much more likely are others to give up on the patient as well?
Viktor Frankl was a neurologist, psychiatrist and a concentration camp survivor. He wrote many books and his Man’s Search for Meaning, his most well-known work, chronicles how he and others found a reason to live even in the despair of the concentration camp and its aftermath. This book is considered one of the most influential books ever written and well worth reading.
Frankl’s key conclusion, around which he built logotherapy—the third great school of psychoanalytic thought along with those of Freud and Adler—was that even in the most horrible and debased of situations, life includes the potential for meaning. This fact makes even horrible suffering meaningful. Put another way, Frankl explained what makes people give up and simply die. Yet he also explained why human beings can and should fight to live, despite despair.
That Frankl believed in the “fighting spirit” is of little doubt. He wrote that “Those who know how close the connection is between the state of mind of a man — his courage and hope, or lack of them — and the state of immunity of his body will understand that the sudden loss of hope and courage can have a deadly effect.”
He also tried to give a guide map for dealing with suffering. He explained that “When we are no longer able to change a situation—just think of an incurable disease such as inoperable cancer—we are challenged to change ourselves.”
In Man’s Search for Meaning, there is a story of how when Frankl was sent to the concentration camp he had sewed into the lining of his coat the unpublished manuscript of his first book. But the Nazis took his clothes and gave him the rags of a prisoner who had just been sent to the gas chamber.
He despaired, as he had no children and now no work of intellectual brilliance to bequeath to the world. As the odds of surviving the camp were only 1 in 28 — less than the odds of surviving pancreatic cancer — Frankl’s life seemed to him meaningless and pointless. Why endure the misery of the camp only to die in a gas chamber or as a slave laborer having contributed nothing to the world.
Yet in the pocket of the ragged coat he had been given he found not his precious manuscript but instead a single page torn from a prayer book containing the Shema Yisrael, considered the most important Jewish prayer.
It begins this way:
Hear, O Israel: the Lord our God, the Lord is One.
Blessed be His Name whose glorious kingdom is forever and ever
And thou shalt love the Lord your God with all your heart and with all your soul and with all your might.
And these words, which I command thee this day, shall be upon they heart;
And thou shalt teach them diligently unto thy children, and shalt speak of them when thou sittest in thine house, and when thou walkest by the way, and when thou liest down, and when thou risest up. And thou shalt bind them for a sign upon thine hand; and they shall be for frontlets between thine eyes. And thou shalt write them upon the door-posts of thine house, and upon thy gates.
Frankl wrote: “How should I have interpreted such a “coincidence” other than as a challenge to live my thoughts instead of merely putting them on paper?
How Dr. Sloan could dismiss the sheer will to life that kept so many fighting during the Holocaust is, indeed, a question Dr. Stovicek is right to pose.
We’ve written about Julian Simon before in pieces such as this one, mostly in connection with the famous Simon-Ehrlich wager. Simon was a business professor; Ehrlich a biologist. Ehrlich wrote a book called, The Population Bomb which basically said that the world was being overrun with people and catastrophe was around the corner due to a shortage of resources. Famously Julian and Ehrlich bet on the price of a basket of metals, Julian saying they would go down and Ehrlich up. Despite the fact that Ehrlich was permitted to choose the commodities in the bet and select the date the bet would be finished, and despite the fact that the population did grow substantially, prices still went down. Ehrlich’s other claims such as that there would be mass famine with “hundreds of millions of people starving to death” also did not come true.
Julian Simon’s book, The Ultimate Resource turned on its head the conventional wisdom that people were a burden on the planet. Simon argued that people, with their ability to create and innovate, are the solution to problems of scarcity, not their cause.
Now Robert Stovicek goes beyond the obvious creative abilities of human beings and, looking at the statistically improbable deaths of both Thomas Jefferson and John Adams on the 50th anniversary of the Declaration of Independence, suggests that the human will contains forces we know not how to measure.
The mystery of Thomas Jefferson and John Adam’s deaths has been wrestled with by many. Perhaps none more clearly and methodically than Margaret P. Battin in her famous essay excerpted from her book, “July 4, 1826: Explaining The Same-Day Deaths of John Adams and Thomas Jefferson,&rquo; excerpted from her book, Ending Life: Ethics And The Way We Die.You can read the excerpt here.
She doesn’t resolve the question, and her purpose in defining six possible explanations is really to discuss bioethical issues. She acknowledges, though, that any resolution must, in fact, “attend to the remarkable synchrony of their deaths.”
With little or no evidence of easily explainable things — say joint suicide — one is left with… as Dr. Stovicek intimates… the thought that it is “a bit beyond chance that Jefferson and Adams both died on July 4th, 1826 exactly 50 years to the day of the signing of the Declaration of Independence.”
Perhaps in seeking to limit the influence of a “fighting spirit” upon an illness, Dr. Sloan ought also to acknowledge the limitations of the surveys and studies he points to, as science, that supposedly prove his case.
Many thanks to Chuck Zambito, Adam Keiper and Robert Stovicek for helping us think through this important issue.