Why should the practitioner of internal medicine care if another method, rivalling his state-of-the-art medicine is available? I argue that this is an illusion. If the primary or the internal physician, who see most patients, does not take the time to explore the patient’s being, how could psychiatric disease or even existential suffering be detected? The best method might be a synthesis of modern algorithm- and evidence-based medicine with existential-phenomenological approaches since the physician does not know what ails the patient if there is no insight into his mode of being.
Medicine has a growing interest in existential phenomenology and existential literature has a negatively connotated but nevertheless relevant interest in medicine. As is shown in the case of Ivan Ilych, we should strive to translate the fields into one another to further understanding: what does it mean for an illness to be existential? Great progress has been made to operationalize this concept by the likes of GRECH, MARKS (2017). Now it is time for doctors to pick it up and put it to good use in two ways: first, understand the patients’ existential worries; second, communicate in existential terms, not esoteric pathophysiology.
Table of Contents
1. Introduction
1.1 Existential phenomenology
1.2 Idiopathic Parkinson’s disease
1.3 Research questions and working hypothesis
2. Methods
2.1 Analysis of existential literature via Tolstoy: The death of Ivan Ilych
2.2 Analysis of medical literature via Pubmed queries
3. Results
3.1 Analysis of existential literature
3.2 Analysis of medical literature
4. Discussion
4.1 What is it that constitutes an illness or sickness as existential?
4.2 What factors make Parkinson’s disease an existential disease?
4.3 What kind of influence did existential philosophy have on the medical field?
5. Conclusion
Objectives and Topics
This work aims to explore the intersection of medical practice and existential phenomenology using Parkinson's disease as a primary case study, addressing how illnesses can be understood as existential states rather than mere assemblages of symptoms.
- Integration of Heideggerian existential philosophy with modern medical perspectives.
- Application of existential domains—mortality, freedom, meaninglessness, and isolation—to the experience of Parkinson's disease.
- Evaluation of how medical practitioners can address the subjective, lived experience of patients.
- Comparative analysis of existential themes in literature and medical scientific discourse.
- Advocating for a synthesis of evidence-based medicine and phenomenological understanding in clinical care.
Excerpt from the Book
What factors make Parkinson’s disease an existential disease?
So, what exactly do we have to imagine when we speak about an existential disease? I hope to elaborate convincingly on Parkinson’s disease so that it will be able to stand as a stereotypical example by use of the four existential domains cited earlier:
(1) Mortality: Patients struggling with Parkinson’s disease do not usually die because of the illness itself, but rather through consequences of it, indirectly. They acquire difficulties in swallowing, slowly worsening with drooling and aspiration of small parts of their meal. The process of aspiration can either lead to asphyxiation or, more usually, to pneumonia, the putative ‘old man’s friend’ (RIJKERS, PELTON, 2018; SUTTRUP, WARNECKE, 2016). Depending on the individual, this conscious worsening might lead the individual to the painful decision to become aware of imminent death and to use defenses as put forward by Terror Management Theory (BASSETT, 2007; BECKER, 1997). Or, depending on resilience of the individual and care provided, might lead to authentic being-towards-death as described by Heidegger: ‘anticipation reveals to Dasein its lostness in the they-self, and brings it face to face with the possibility of being itself’ (HEIDEGGER, 1962, p 304 ff.)
(2) Freedom: This aspect harms the Parkinson’s patient in various ways. Not only are they hindered to do what they enjoy, their hobbies, their occupation. Just as much do they lose the freedom to use their own body as they would like to. This comes about because of main symptoms like action tremor, making them spill a glass of water before it reaches the mouth. But just as much do lesser known symptoms matter like freezing, which makes the patient incapable of moving for a short time, the body resisting the strong inner urge of the person to move (GARCIA RUIZ et al., 2011).
Summary of Chapters
Introduction: Defines the core concepts of existentialism and phenomenology and introduces the clinical background of Parkinson's disease.
Methods: Describes the literary analysis of Tolstoy’s work and the systematic PubMed search methodology used to investigate the presence of existential themes in medical literature.
Results: Presents findings from both the literary review, highlighting the breakdown in doctor-patient communication, and the medical database search, indicating a growing trend of existential discourse in clinical fields.
Discussion: Connects the four domains of existential suffering—mortality, freedom, meaninglessness, and isolation—to the lived reality of patients with Parkinson's disease.
Conclusion: Summarizes the need for physicians to move beyond pure pathophysiology to incorporate an existential-phenomenological approach in patient encounters.
Keywords
Existential phenomenology, Parkinson's disease, Medical humanities, Heidegger, Patient-centered care, Existential suffering, Mortality, Freedom, Isolation, Meaninglessness, Clinical practice, Existential illness, Bioethics, Narrative medicine, Subjectivity.
Frequently Asked Questions
What is the central focus of this work?
This work focuses on bridging the gap between clinical medicine and existential philosophy by analyzing Parkinson's disease through the lens of existential phenomenology.
Which thematic fields are central to the study?
The study centers on medicine, existential philosophy, phenomenology, and the psychological impact of chronic illness.
What is the primary research goal?
The primary goal is to determine how an illness can be classified as "existential" and how a phenomenological approach can improve the standard of care for patients with Parkinson's disease.
Which methodology is employed?
The author uses a dual approach: a qualitative literary analysis of Tolstoy's "The Death of Ivan Ilych" and a quantitative systematic search of medical literature via PubMed.
What topics are discussed in the main section?
The main section covers the conceptualization of existential disease, the application of existential domains (mortality, freedom, etc.) to Parkinson's symptoms, and the role of the physician in addressing these concerns.
Which keywords characterize this paper?
Keywords include existential phenomenology, Parkinson's disease, patient subjectivity, medical existentialism, and clinical empathy.
How does the author characterize the role of the physician in the case of Ivan Ilych?
The author portrays the physician in the novella as distant and focused purely on technical or physiological data, often failing to address the patient's existential search for meaning and understanding of their own mortality.
Why does the author argue that psychiatrists might be more "existentially aware" than other specialists?
The author suggests that because psychiatry relies less on rigid algorithmic treatments compared to fields like hepatology, psychiatrists are forced to engage in dialogue and confront the phenomenological reality of the patient's existence.
- Quote paper
- Julius Friedrich Wilhelm Schulten (Author), 2020, Being-With-Parkinson’s. The role of existential phenomenology in modern medicine, Munich, GRIN Verlag, https://www.grin.com/document/1288091
