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5 of 5 people found the following review helpful:
5.0 out of 5 stars
A fantastic achievement, 19 Sep 2008
This book is a tremendous achievement, as well as being a very moving personal document. It is a philosophical meditation on the nature of and social meaning illness, disease and death. It discusses philosophical and psychological literature, Epicurus, Heidegger and Merleau-Ponty. But it is also a personal memoir, it is about Carel's experience of being diagnosed with a life-threatening illness, about what that meant for her presence in the world, about how she appeared in the eyes of others, and how she felt she appeared. It is about the encounter with medical professionals and their detached and external perspective on another's catastrophe; it is about the varied reactions of friends, some of whom couldn't maintain friendship. It is about how to confront the fact that all your assumptions about how your life is going to go: career, relationships, family, old age, can just be taken away. Carel was diagnosed with lymphangioleiomyomatosis (LAM), a rare disease that affects young women, and for which the progosis is about 10 years from the onset of symptoms. The sufferer experiences a progressive decline in lung-function over that time. Life may be extended by a heart-lung transplant, but that's, obviously, a difficult business.
I'm not much of a fan of "contintental" philosophy, because I've often found it obscure to obscurantist. Carel, however, is trained in that tradition and is really good at overcoming the resistance of sceptics like me. She uses Merleau-Ponty's ideas about embodied subjectivity throughout the book to explore what illness is like for the sick person and how powers and abilities that are invisible to and taken for granted by the well person become all too manifest to the sick (or disabled or ageing) person. All the time, she is constantly moving backwards and forwards between this theoretical discussion and the fact of her own experience: the first onset of symptoms, "denial", diagnosis, treatment, the foreclosure of plans, projects, possibilities. The phenomenology of social situations gets explored too: how people react, their sensitivities and insensitivities, callous reactions, stupid injunctions from ignorant people to try faddish diets of exercise routines.
The discussions of Heidegger and Epicurus I found a little hard going at times. Carel does a brilliant job, I think, of making Heidegger clear. But in doing so she brings to the surface, of my mind at least, the suspicion that, far from being a radical philosopher, he was often turning into universal truths the parochial facts of European bourgeois life: not everyone has a career, nor sees their life as a structured series of projects. But then I'm not a Heidegger scholar, and perhaps I'm being unfair to him. In a sense, issues of Heidegger interpretation don't matter, because Carel is just using the philosophical traditions most available to her to reflect on the social and personal meaning of the imminence of death.
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2 of 2 people found the following review helpful:
5.0 out of 5 stars
A beautifully convincing book, 8 Nov 2008
I started reading this book on the way home from work and didn't stop until I went to sleep that night. This is not your usual philosophical work. I was grabbed by the reality of the issues discussed through Carel's poignant first-person descriptions of her experience of illness. However, this does not in any way diminish the philosophical merit of the work. In fact, it is the irreducible importance of this first-person perspective that is the work's whole point.
Carel argues that medicine (and, indeed, everyone) needs to take into account what it is like, moment to moment, day to day, for a patient to live their life within illness. She describes medicine as currently working from an objective, nonvalue-laden conception of disease, thus ignoring the patients subjective point of view. I actually think that this is a bit too strong. I think that medicine, at least implicitly, treats disease as a value-laden concept, and to a certain extent is set up to treat patients in such a way. However, the clever part of Carel's project is that it is impossible to go on and ignore the issue of a patient's lived-experience even if you think you have got the philosophical arguments out of the way. I do not think that phenomenology (a subjective first-person perspective) is the complete answer (I believe that medicine also needs a value-laden objective theory of disease in relation to an individual's flourishing, capabilities and functionings). However, Carel does not just illustrate, but through doing so, proves that it cannot stop there. Medicine will always need to take note of a first-person narrative account of illness. Exactly how a disease effects an individual's life cannot be fully got at in any other way.
Carel points the way towards a more holistic, value-orientated style of medicine. In my opinion, a lot more work needs to be done to show how this could be possible. But, most importantly, Carel shows why this work is a necessity.
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1 of 1 people found the following review helpful:
5.0 out of 5 stars
Philosophy at its best, 31 Mar 2009
This is a fantastic book - it's philosophy at its best.
It is a deep book, born out of own lived experience as well as scholarly labour. It is a book about being alive, about living, about living with the certain knowledge of own death.
AND - it is extremely well written - a real page-turner - something you don't get with many philosophy books.
Make sure you read this book.
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