Ponderday, Jesterary 17, 40 A.B.


"Truth is the most valuable thing we have.

Let us economize it."

- Mark Twain


 

     I've been thinking about honesty today.  What it is.  Where it lives.  Why I never see it appraised on PBS's Antiques Roadshow.
     Several things recently brought the subject to mind.
     
     First, I'm still reading Phantoms in the Brain (oh, like it's never taken YOU forever to get through a book) and it describes several medical cases in which dishonesty was an essential part of the treatment.
     Consider Mary Knight.  In 1932, at the age of 32, she went to see a doctor.  Mrs. Knight was 9 months pregnant and she wanted to be sure everything was ok.  It was her first pre-natal visit.  Depression days, you know.  Her husband was unemployed.  She just couldn't afford to go earlier.  
     The doctor checked her out.  Almost all the signs of a normal pregnancy were there.  Morning sickness.  Odd food cravings.  Cessation of menstruation.  Swollen belly.  Swollen breasts.  Kicks.    
     Alas, the doctor couldn't find a fetal heartbeat.  
     And then he noticed a tell-tale physical sign in Mrs. Knight that tipped him off to her true condition.
     She had a normal navel.  It was news to me, but apparently all pregnant women have an "everted" or pushed-out navel.  
     Hers was clearly inverted.
     The doctor correctly concluded that Mrs. Knight wasn't really pregnant at all.  She was suffering from pseudocyesis - a false pregnancy.  Her body had gone through all the changes associated with a real pregnancy.  There just wasn't any baby at the center of it all.
     A not uncommon thing.  Apparently 1 in 10,000 pregnancies are false ones like this today.  Two hundred years ago, when pressure to have babies was higher and medical care more rudimentary, maybe as many as 1 in 200 were.
     Her doctor could have told Mrs. Knight all this and more but he didn't think she'd believe him.  So instead he told her the baby was coming right then and he rendered her unconscious with ether - a common practice in the 1930s.  When she awoke, he sadly told her that the baby had been stillborn.  
     Of course she was unhappy to hear this.  
     What's remarkable is that her belly started shrinking in the face of this news almost immediately.
     As it happens, she was back in a few days, "pregnant" as ever.  
     Demanding to know why the doctor hadn't delivered the twin.
     The question remains: Was what the doctor did wrong?  Was his treatment of a false pregnancy with a lie unethical?

     A second case described in the book involved a man who suffered a stroke.  He recovered from it fully except for this: He was convinced that his parents were impostors.  
     Apparently when we look at the faces of others, two pathways in the brain are activated.  One allows us to determine whether or not a face is familiar.  The other brings to consciousness all the emotional associations a face might have for us.

     This man's stroke destroyed the second pathway.  He could recognize the faces of his parents but he felt nothing for them.  Instead of interpreting this to mean "I've had a stroke affecting the area of my brain involving emotional associations" he interpreted it to mean "These people are utter strangers merely pretending to be my parents."  
     What to do?
     A ruse was arranged with the help of the author of Phantoms in the Brain.  The man's father one day appeared before his son and announced "Yes, it's true - an impostor had, in fact, assumed my identity.  But no more!  I, your real father, have returned!"
     It worked.  The son's delusion vanished.
     For a couple weeks, anyway.
     The question remains: Can a lie ever be accepted as appropriate treatment?

     And another question:  If a sugar pill can actually reduce pain - but only if the patient doesn't know it is a sugar pill - is it ok to lie to the patient about its actual ingredients?

     Fast-forward to tonight.
     My wife visits an online forum.  Tonight someone asked the question "How much of your past should you tell your current partner?"
     My wife said "Everything."
     The majority of other respondents seem to disagree.  They talk of the past being the past, of the need for zones of privacy, of their own desire to be kept in the dark about the past of their partners, and of everyone having secrets best left unshared.
     It is a point of view she is having trouble understanding.
     I can understand it.  I even could have predicted it.  But it remains alien to my nature.
     I guess I see us all as small, limited explorers of life.  Anything which expands our knowledge base is desirable.  Since our partners can be among the most reliable conveyors of info we're ever likely to meet, it seems odd to me to limit the areas open for discussion.  
     Apparently that's a minority viewpoint.
     Which apparently means that most people believe that their relationships - or at least their personal happiness - depends to some degree on silence and secrecy if not outright dishonesty.
     Hmmmm.
     Are interpersonal relationships really such emotional minefields that the best we can do is agree never to step into certain areas of them?
     
     Back to last night.
     After discussing the above medical cases with my wife, we discussed how doctors used to not tell people when they had terminal cancer.  As I understand it, many doctors still buffer bad news to such an extent that the patient goes away with an unrealistically rosy impression of his or her prognosis.
     So: Would you want your doctor to be 100% honest with you?
     Would I?  Well, A) I'm already always convinced I have a terminal disease and am on the verge of dying; and B) I don't much trust doctors to know what the hell they're talking about.  
     How's that for a dodge?
     Now - what about you?
     Tell me what you think and maybe I'll post it.
     Especially if it's funny, since serious entries like this do little to bring me closer to the "Actually  A Jester" status I crave.
     Yes, it's admittedly a weird craving.
     Very weird, when you think about it.
     Gee... I wonder if I'm pregnant....


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(©Now by Dan Birtcher)

(at least that's what he told his wife his name was)