Tuesday, August 25, 2009

Intimate Distances - Fragments for a Phenomenology of Organ Transplantation

from the article,

As I peer inside me (but which me?) at the other's liver, the medical gesture explodes into a hall of mirrors. These are the points where the transplantation situation can be carried to the sentimental extremes of either having being touched by 'a gift' (from somewhere, from 'life' or 'god'), or else the simplicity of the doctors who remain set at the level of their technical prowess. In between lies the lived phenomenon, that must be drawn out otherwise, in other parameters.

Transplantation creates and happens in a mixed or hybrid space. There are several subjects that are decentred by exchanging body parts; or decentred as the 'team' that makes the technical gesture, or even further, as the distributed network of the National Graft Centre who that fateful day decided it was my turn. At the same time this is an embodied space, where my body (and his/her now dead) are placemarkers, experiencing the bodily indicators of pain and expectation. As if the centre of gravity of the process oscillates between an intimate inside and a dispersed outside of donor, receiver and the 'team'.

We can start with the embodied sentience of the organism, the 'natural' basis for the study of lived events. Sentience, in this sense, has a double value or valence: natural and phenomenal. Natural because sentience stands for the organism and its structural coupling with the environment, manifest in a detailed and empirical sense. It thus includes, without remainder, the biological details of the constitution and explanation of function, an inescapable narrative. Phenomenal, because sentience has as its flip side the immanence of the world of experience and experiencing; it has an inescapably lived dimension that the word organism connotes already. Moreover, that the organism is a sentient and cognitive agent is possible only because we are already conscious, and have an intrinsic intuition of life and its manifestations. It is in this sense that 'life can only be known by life' (Jonas, 1966, p. 91). This intertwining can be grounded on the very origin of life and its world of meaning by the self-producing nature of the living. Given that the scientific tradition has construed the natural as the objective, and thus has made it impossible to see the seamless unity between the natural and the phenomenal by making sure they are kept apart, no 'bridging' or 'putting together' would do the work. The only way is to mobilize here a re-examination of the very basis of modern science. But this gets, all of a sudden, too ambitious.

Exploring the phenomenal side of the organism requires a gesture, a procedure, a phenomenological method, contra the current prejudice that we are all experts on our own experience. Little can be said about this lived dimension without the work that it requires for its deployment. (In a basic sense, this is also close to the recent interest in 'first-person' methods in cognitive science.) And therein resides its paradoxical constitution: our nature is such that this gesture needs cultivation and is not spontaneously forthcoming. This is why it is appropriate to reserve the name of feeling of existence (sentiment d'existence, a term I borrow from Maine de Biran) as the core phenomenon here, the true flip side of sentience.

The feeling of existence, in itself, can be characterized as having a double valence too. This is expressed as a tension between two simultaneous dimensions: embodied and decentred. Embodied: on the one hand examining experience always takes us a step closer to what seems more intimate, more pertinent, or more existentially close. There is here a link between the felt quality or the possible depth of experience, and the fact that in order to manifest such depth it must be addressed with a method in a sustained exploration. It is this methodological gesture which gives the impression of turning 'inwards' or 'excavating'. What it does, instead, is to bring to the fore the organism's embodiment, the inseparable doublet quality of the body as lived and as functional (natural/phenomenal; Leib/K├Ârper). In other words, it is this double aspect that is the source of depth (the roots of embodiment go through the entire body and extend out into the large environment), as well as its intimacy (we are situated thanks to the feeling-tone and affect that places us where we are and of which the body is the place marker). Decentred: on the other hand, experience is also and at the same time permeated with alterity, with a transcendental side, that is, always and already decentred in relation to the individuality of the organism. This defies the habitual move to see mind and consciousness as inside the head/brain, instead of inseparably enfolded with the experience of others, as if the experience of a liver transplant was a private matter. This inescapable intersubjectivity (the 'team') of mental life shapes us through childhood and social life, and in the transplantation experience takes a tangible form as well. But it is also true in the organism's very embodiment, appearing as the depth of space, of the intrinsically extensible nature of its sentience, especially in exploring the lived body.

These parallel themes serve as the hidden scaffolding for the analysis here. First, the lived body as focus: the intrusion, the alien as flesh, and the always already mobile subject of enunciation and hence the mobility of the lived body's identity. Second, the networks of dissemination playing in unison: the social network of the gift, and the imaginary circles of the images that give this inside a metaphorical concreteness.

On May 28, 2001, Francisco J. Varela passed peacefully away at his home in Paris, surrounded by his family. In theses posthumous fragments, Varela sums up his experiences of battling with the complications of Hepatitis C which had over the years evolved to liver cancer and claimed a liver transplant. This is an shortened version of the text first published in the Journal of Consciousness Studies, 8, No. 5-7, 2001, pp. 259-71. We are very thankful Imprint Academic Exeter and especially to Anthony Freeman who kindly accepted that the essay may be republished for ATOPIA.

Source: http://www.atopia.tk/index.php?option=com_content&task=view&id=28&Itemid=53

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