In last month’s installment I confidently predicted that I would be joining my colleagues in the celebration of the 100 year anniversary of the International League against Epilepsy but I should have added the Muslim’s Insha-Allah, God willing. The insignificance of our desires in the scheme of things was drastically driven home in one instant. From one moment to the next one can be reduced from a self-sufficient individual who looks forward to vacations and meeting with friends and relatives, to a helpless infant who has to scream for his mother.

            While getting dressed and putting on a sock one morning, the prosthetic hip spontaneously dislocated. There one sits, totally immobilized because the slightest movement produces inordinate pain. The phone which would allow one to call for emergency services is only ten paces away but it might as well be on the moon because it’s unreachable. Martha, who always gets up bright and early, is in the kitchen at the other end of the house and has the TV on. So, there one sits and yells at the top of one’s lungs hoping that she might hear. She did, the ambulance was called, and after due time the hip was replaced into its socket in the nearby hospital’s emergency room. By mid afternoon I was basically intact again, from the pelvis on up. Travel was now out of the question because it was the second spontaneous dislocation and what happens twice can recur at any time thereafter. An operative repair to limit the risk of further recurrences is essential and scheduled for the middle of the month.

            When even a simple task, such as putting on a sock, has all of a sudden become hazardous to one’s health this gives one pause to think. Ordinarily whenever something untoward happens we love to blame somebody else or even oneself. But there was no one to blame unless you say it was the will of God. Under those circumstances you can either vent useless fury against an unreachable Deity or think about what the message might be that you have been sent so unexpectedly. I did the latter and this article is part of the outcome.

            A few years ago, after having published The Moses Legacy, I prepared a book about Jesus. It placed the gospel writers and their mental pictures of Jesus in the socio-political-religious context of the First century and looked at the human being, Jesus of Nazareth, from a medical point of view. The manuscript was finished four years ago and then made its rounds to various publishing houses which I thought might be appropriate. It was an exercise in futility. It sat on editors’ desks and the one who appeared most interested finally rejected it after two years in spite of repeated changes which I made on his requests.

            I can’t blame the editors because this type of book simply does not fit into today’s compartmentalized thinking, where a physician has no business to stick his nose into an area that is the prerogative of theologians and historians. In addition, since I am unknown in the circles of literati, it won’t make money for the publisher. I, therefore, abandoned the project for the time being and concentrated on the scientific work that needed to get done and published. But the event in the beginning of last month was a wake-up call with the question: what are your priorities? Since it is obvious that Atropos, who stands poised with her scissors, can cut the feeble strand of life at any moment there is really no more important task than to finish unfinished affairs. The Jesus manuscript was, therefore, re-examined, a new Preface was written as well as a chapter on Pilate’s question, “What is truth?” and an up- to-date Conclusion. Under the working title: Understanding Jesus. A Physician’s Search for the Truth the manuscript is now making its rounds to some friends and colleagues for critique and possibly helpful suggestions. This essay is a somewhat expanded version of one aspect that is covered in the book.

            Before addressing the substantive issues it may be necessary for some readers who did not have the benefit of a classical education to explain the role of Atropos in Greek mythology. The Greeks firmly believed in Fate against which even Zeus was helpless. But Fate was a trinity. Clotho spun the thread of life; Lachesis measured it, while Atropos cut it.  Clotho and Lachesis have been relegated to oblivion while Atropos lives on as the name of a drug: Atropine. But only the names of these deities have disappeared, the essence of what they stood for is now regarded as our DNA and its “longevity gene,” for some of us. Since we didn’t order our DNA from the celestial menu prior to conception we are stuck with what we got and this is our personal fate.

            These considerations bring up not only the question of: Who and What are we; but also of “Free Will” and: “How can Science help us in solving these questions?” I have capitalized the word Science because it has become a substitute for God in the minds of an influential segment of our society. On the one hand Science is looked at with awe by some while it also has been degraded to an extent that “Science” is a subject taught in elementary school. So let us be clear what we mean. Science is an abstract noun which in America tends to mainly cover the physical sciences; aspects of the material world which lend themselves to measurement. The word itself is derived from the Latin scientia and as such has no particular meaning, except that which is currently ascribed to it. In German speaking countries the word is Wissenschaft which is both meaningful and considerably broader in its connotation. Literally translated it is knowledge-creation. Ergo, anything that enhances human knowledge is subsumed under this term, which is then divided into Naturwissenschaft and Geisteswissenschafte. These correspond here to the natural sciences and the humanities. For the German word Geist there is no single equivalent in the English language because it can, apart from ghostly apparition, mean mind, spirit or soul depending on the context. I am mentioning these points because German words, and thereby thoughts, may not be directly translatable into English and when we think we are talking about the same thing we may not be.

            After considering the semantics we now need to realize that science with or without capital S does not exist in some vacuum. A common statement such as: “science has demonstrated,” is nonsense. Science is a mental concept which doesn’t demonstrate anything, only scientists do! But even if we clarify the sentence to, “scientists have demonstrated,” it is still not particularly meaningful because we are not told the details of what these scientists really did to achieve the result which they regarded as valid. The popular media jump on results, propagandize them as the latest truth only to find out a few years later that what they had believed in wasn’t really so. The various miracle cures we have been treated to during my lifetime are obvious examples.

            The inevitable next conclusion, which results from the non-existence of science per se, is that in regard to scientists we are not talking about gods but human beings who are fallible. Furthermore, the scientist acts scientifically only for a fraction of the day, namely when s/he is actually involved in the conduct and evaluation of a specific experiment. The rest of the time is spent on other duties which nowadays frequently involve grant writing. Our capitalist system has introduced during the past half century the quest for money into the halls of academia where search for truth should have been paramount. It is amazing to me, who fortunately could do most of his work unencumbered by financial considerations, how the situation has changed for the current generation.

The golden era of science for the sake of science ended around the nineteen seventies. Prior to that time one could pursue scientific work strictly because one wanted answers to questions which were not in the books or because one knew that the books were wrong and intended to correct those notions. One’s standing in the scientific community was measured by work one had personally performed, presented at scientific meetings and subsequently published. This is no longer the case nowadays, not only does everybody have to be mentioned under authors who had only the faintest contact with the work his name is associated, but when speakers are introduced at meetings the number of grants they have obtained as well as their amounts are now the hallmarks of their achievements. This intrusion of capitalism will have a profoundly deleterious influence on the quality of scientific work in America. Jesus’ statement about not being able to serve God and mammon is still correct.

I shall limit myself to describe the current situation in this country in regard medical research, where I have first hand knowledge. The mere fact that one has to apply for a grant which has to be approved by one’s “peers” who are appointed by one of the funding agencies, which as far as medical research is concerned involves mainly NIH or the pharmaceutical industry, is only the first problem. These “peers” who judge the applications are human beings with vested interests. They are wedded to a given conventional ideology and will, therefore, approve grants on topics they are familiar with and which are likely to confirm their currently held views. As a result more and more strictly routine work is produced because fundamental new insights occur mainly by serendipity and cannot be properly followed up on because brand new ideas cannot get funded.  

            In the 1970s when grants started to become de rigueur, a joke circulated. The Lord applied for a NIH grant but was turned down. The rejection letter stated: The committee is fully cognizant of the magnificent work the applicant has done in the past but is not aware of any recent achievements and he has never published in English. As money became increasingly scarce a new method was invented so as not to hurt the applicant’s feelings. The grant may be approved but not funded! Countless days and weeks are wasted merely in grant writing and since gifted investigators are not particularly good at flattering the funding agencies with pseudo sophisticated protocols, universities now employ, to some extent, professional grant writers for that purpose.  

            In addition, before a grant can even get submitted it has to pass the “Institutional Review Board (IRB) of one’s facility to immunize it against lawsuits which might be brought against it. The Nazi concentration camp experiments are held up as the example of what happens if physicians are not carefully supervised in regard to their ethical practices. That this aberration was an exception and part of an inherently criminal government during the conduct of a war is not taken into account.

IRBs are now mandated by law and have to decide whether a given proposal meets ethical guidelines and to what extent the proposed work might lead to risks for the patient/volunteer. This means that all of us have to take periodic, multiple choice, “ethics exams” to demonstrate that we are fully cognizant of past abuses and a certificate of having successfully passed must be presented. The Hippocratic Oath and “above all do no harm” no longer suffice. These tests are generic and have nothing to do with the work that is intended to be done. They and the IRBs are eyewash but will prevent important new discoveries from being made. Neither Pasteur or Jenner nor possibly even Salk, would nowadays have passed inspection by an IRB. There is, of course an obvious fallacy in all these “safeguards.” Ethical conduct cannot be vouchsafed by multiple choice tests because it is easy to cheat and if a given human being does not have inherent ethical standards they will not be achieved by the measures cited above. But as mentioned, it really has nothing to do with ethics per se. All of this results from the fear of lawsuits, which is another major limiting factor for innovative research.

While this situation is unfortunate for the physician who does not have to rely on his research to provide the daily bread, it is infinitely worse for the PhD who works in basic research. Grants are now the sine qua non and once a grant has been obtained the application for renewal has to be prepared. What happens in practice is that the investigator knows the essential result after a few experiments but is now forced to repeat them in a routine manner to meet the demands of the protocol which specified that a given number of tests will have to be carried out in a given manner. Since grants need to be renewed the investigator cannot strike out into the unknown with a hypothesis which might or might not pan out. For this reason before a particular grant is written the investigator already has to have a reasonably good idea of what will work because if the grant money doesn’t keep coming, the family can’t be supported. With other words, our brightest people, who are supposed to produce original thoughts, are reduced to the level of assembly line workers who have to keep to a rigid protocol.

Assume now that by sheer good luck the investigator has come up with a finding that has a significant impact on the field. Assume further that it invalidates previously held cherished views. Obviously the finding will need to be published in a first class scientific journal but now comes the next hurdle. Editors of journals have their pet views and whatever doesn’t fit is not allowed to exist. The situation in 2009 is really not much different from 1610 when Galileo’s “peers” refused to look through his telescope. They already knew the answer, because the Bible told them so, and, therefore, whatever Galileo told them must be wrong. One may doubt the veracity of this statement but it results from current personal experience. The Bible has simply been replaced by secular dogma which is held on to with the same religious fervor.  

            These are the facts, especially in the medical scientific establishment, of which the general public tends to be unaware. But there are wider questions that need to be addressed: Can the natural sciences lead us to objective truth about the world we live in and especially about ourselves? Are there limits to the information scientific work can achieve and if so where are they? These questions are not new but were raised by Emil du Bois Reymond in the 1870s. He is rightfully regarded as the father of electrophysiology having discovered among other aspects that the “nerve impulse” is an electric current which is now called the action potential. As such, Du Bois Reymond had impeccable scientific credentials but his interests were not limited and encompassed also history and philosophy. These were the foundation upon which rested his most remembered speeches that ended with “ignorabimus” and “dubitemus.”

            The first lecture “Über die Grenzen der Naturerkenntnis” - On the Limits of Natural Science, was given in Leipzig in 1872.  It is available on the Internet and well worth reading because the scientific optimism which pervaded Europe during the 19^th century is still that of America’s in the 21^st.  In the 1872 presentation Du Bois Reymond referred to a sentiment, expressed by Vogt in the 1850s that all mental activities are merely functions of the brain. “To put it crudely, thoughts stand in the same relationship to the brain as bile to the liver, or urine to the kidneys.” Du-Bois Reymond rejected this thesis as unwarranted because even in regard to some of the most essential aspects of the material body we have to admit to ignorance, “ignoramus.” While this statement would have been accepted by the audience his final conclusion created uproar and he was severely criticized by the powers of the era.  Because of its importance for our time I shall translate the last paragraph of his speech here.

“In the face of the riddles the physical world presents us with, the natural scientist has for quite some time been accustomed to state with stoic resignation [maennlicher Entsagung] his ‘ignoramus’. But looking back upon victorious past achievements he harbors the silent awareness, that what he does not know at present, he may under certain circumstances, perhaps come to know in the future. But in regard to the riddle of: what is matter and what is energy [Materie und Kraft] and how they are able to think he has to admit to himself the much more difficult truth: ‘Ignorabimus.’”

For this ignorabimus, by which he meant that we are inherently incapable of ever knowing the answer to this most fundamental question of our being, he was, as mentioned, severely criticized and subjected to ad hominem attacks. He, therefore, followed it up eight years later as part of a Leibniz celebration with, Die Sieben Welträthsel, The Seven Riddles of this World. In it he met his critics, who had not bothered to properly read his first speech, head on and explained why he said what he had said. Since these two presentations form a unit I shall now present their essence working backward from the second to the first.

He listed the Seven Riddles as: the essence (Wesen) of matter and energy; the origin of motion; the origin of life; the apparently intelligent plan in nature; the origin of sensation; the origin of rational thought and speech; and freedom of will. Three of these puzzles he thought were potentially eventually amenable to solution by the scientific method. For three others the answer was no and for one: “freedom of will” he hedged his bets because it depends on the three unsolvable ones: the essence of matter and energy, first motion and first sensation. Since the speech was given in honor of Leibniz who had thought that he solved all of these problems to his own satisfaction, Du Bois Reymond ended his presentation with the comment that if Leibniz could stand today on his own shoulders he would probably agree with what had been presented and conclude with him in “dubitemus,” we are not quite sure.

This is not the place to engage in a polemic to what extent the ignorabimus was justified but it is clear that we still have to say ignoramus for all the seven puzzles. For whether or not some of them are solvable by the scientific method, the dubitemus is also correct as will be shown. In former years, e.g. the era of Descartes and Leibniz, God was a reality and so was the dualism of body and mind/soul. One was a material entity upon which the immaterial one somehow exerted its influence. Under those circumstances free will for instance was understandable as a gift of the spirit while it must be denied, if one is intellectually honest, when only purely physical forces operate in a mechanistically determined universe. While chance events can occur, purpose which exerts its will towards an end can not. Because the question cannot be solved by scientific means it is shunted to the realm of philosophy but that is, to put it bluntly “a cop out,” for believers in science as the ultima ratio. As scientists we are also human beings and this fragmentation in regard to fundamental problems of human nature is not in the best interest of the species. Socrates reportedly said: the unexamined life is not worth living. It is, therefore, up to us to fulfill our human potential by truthfully examining all aspects of life and when we reach the limits of understanding accept them and fearlessly present them as Du Bois Reymond did.

The fundamental problem of awareness or consciousness was formulated by Du Bois Reymond as: a statement that awareness can be explained on basis of mechanics needs to be denied, but a statement that awareness depends upon mechanics is undoubtedly correct. With other words our brains, acting on mechanical electrochemical principles, are required for awareness and the content will be shaped by its state in health and disease but that does not mean that mechanical principles, therefore, explain the origin of awareness. He quoted Leibniz for further explanation:

“One is forced to admit that awareness (Wahrnehmung) and everything that depends upon it cannot be explained on a mechanical basis; that is through objects and movement. Let one imagine a machine which is so constructed that it produces thought, feeling and awareness. Let us now magnify it to an extent that one can enter into it like a mill. Under these circumstances one would find in its interior nothing else but parts, which push at each other but never anything from which one could explain awareness.”

While thinking about this problem other examples came to mind. We can scientifically examine Michelangelo’s Pietà in St. Peter’s Cathedral to the nth degree but this will never allow us to say anything about what the artist wanted to tell us. Or, imagine that a UFO from outer space abducts a car from a street and brings it back to its planet where such contraptions have never existed. The scientists and engineers of that planet would then take it apart piece by piece, examine the parts in detail put them together in various combinations but they still would not have the faintest idea what the purpose of that contraption was in the first place. Nevertheless, this is our scientific method and Goethe was already aware of its limitation. In Faust there is a scene where Mephisto impersonates the old scholar and explains the various branches of university study to a student who had come for advice. A pertinent quote is:

           „Wer will was Lebendiges erkennen und beschreiben,

                                    Sucht erst den Geist heraus zu treiben,

            Dann hat er Teile in der Hand,

            Fehlt leider! nur das geistige Band.

            Encheiresin natuare nennt’s die Chemie,

            Spottet ihrer selbst und weiss nicht wie.“

One might paraphrase this stanza as follows. Whoever wants to understand and describe a living entity attempts first of all to drive out its spirit. He then has the parts in his hand but alas what’s missing is the band which held it together in the first place. This lack is being excused by referring to nature’s handiwork (my approximate rendering of encheiresin naturae) thereby mocking ones efforts by not realizing what one has actually done.

This is the inherent limitation of the scientific method as currently used: we can only describe and analyze, which is essentially the same process. By describing a tree I separate it mentally into roots, trunk, branches and leaves. If I am an arborist I can go further, measure the various component parts, and conjecture how they might fit together to make the tree we behold. The latter process is called forming a theory/hypothesis. This theory is, however always incomplete and will be improved upon or invalidated by others in the future. As such science is an ongoing process and any conclusion that is currently accepted as true is entirely dependent on three aspects. These are: a) the instrumentation that was used for measurement; b) the conditions under which the measurement proceeded and c) the interpretation that was applied to the observed result. Since c) always involves deductions by the human mind, which can only put new information into some type of known framework, the presumed objectivity of scientific endeavors is unachievable, even under the best of circumstances. All we can hope to obtain is common consensus based on common experience but we are not justified to regard this as final reality.

This is not to deny or to diminish in any way the impressive scientific progress that has been achieved over time but it is necessary to recognize the limitations imposed by the scientific method because in so doing we become considerably more humble, especially in regard towards aspects of life which elude rational thought.

Up to know I have limited myself to the world as we experience it on a daily basis and upon which we have built our laws. In the popular mind they can be summarized as either-or. There are mountains and there are oceans, but if you were to declare one to be the other you would be regarded as either a liar or suffering from mental illness. Likewise in criminal law one is either guilty or innocent. There is no room for yes-but or may be. In the current context, one is largely regarded either as a scientist or as a religious person and the one is not supposed to trespass on the domain of the other. I was told so when the Jesus book was rejected by publishers. Our civilization assigns us slots to which we are supposed to conform and not move out from. But this attitude leads not only to false assumptions; it does not even reflect all aspects of our material world.

In our quest “to get at the bottom of things” we have split objects into ever smaller parts and did not stop at the level of the atom. It also was smashed to bits and the result of our handiwork – the bomb – now threatens to destroy us. But by splitting the atom we have entered the subatomic world of particle physics which behaves not at all the way we expected. Rather than as “either-or” this world seems to run on “as well as.” A subatomic particle may behave as a particle or as a wave and “what it really is” depends on the instrumentation used for observation. Particle physics has introduced the “uncertainty principle” and even worse the idea that two different states may co-exist at the same time. What is “real” is determined only when an observer enters into the picture.

 Erwin Schrödinger, a well known Austrian atomic physicist and 1933 Nobel Prize winner, performed a mental experiment which has become known as “Schrödinger’s cat” where the cat can be both dead and alive at the same time. These apparent absurdities are the problems atomic physicists struggle to make sense of and you may enjoy reading about it from the cat’s point of view by typing “Viennese Meow” into Google. Being “dead and alive” at the same time is obviously a fantasy and there are other explanations, but that particles once they have met are then wedded to each other and behave in relation to each other, regardless of the distance that separate them, is an observable phenomenon that has been called Verschränkung by Schrödinger and entanglement in English.  

Bernard d’Espagnat, a highly respected atomic physicist and Professor Emeritus of Physics at the University of Paris-Orsay, has recently published a book on Physics and Philosophy in which he discusses the puzzles which flew out of Pandora’s Box when we smashed the atom. In the Introduction he wrote, “Great philosophical riddles lie at the core of present-day physics and most people, by now, are aware of their existence even if but a few have a precise idea of their nature.” The book is not easy to read and must be carefully studied but what comes through loud and clear, even for the lay person which includes everyone who is not working in that particular field of science, is that even the material world is infinitely more complex than we have been willing to admit. Pride in human achievements has no room in quantum physics because even the experts admit that we don’t know what we are talking about when it comes to “reality.” While the experts are busy trying to detect even smaller particles at CERN by smashing them in a super collider, relatively few people have started to consider the implications of what we are doing and what we are trying to accomplish for what purpose. 

One of these implications ought to be obvious. Faith and Science are not mutually exclusive.  Even the scientist relies on faith that the work s/he is doing is going to be of some use. Just as Science does not exist in the abstract neither does Faith. It is always attached to something and the person who cannot muster faith in God will simply place it on some terrestrial object or idea. No one can live without faith in something and even Nietzsche would have killed himself, as he intimated in his letters, had he not held to the firm belief in posthumous fame. Faith is innate, we are born with it and how we use it is part of our free will. 

In view of the importance of the subject the discussion will be continued in the next installment on August 1; Insha-Allah.