“But on what grounds could one deny that these hands and this entire body are mine? Unless perhaps I were to liken myself to the insane, whose brains are impaired by such an unrelenting vapor of black bile that they steadfastly insist that they are kings when they are utter paupers, or that they are arrayed in purple robes when they are naked, or that they have heads made of clay, or that they are gourds, or that they are made of glass.”
— Descartes, Meditations on First Philosophy
When I was nine years old, my mother took me to get glasses. Sitting rigidly in the huge vinyl chair, I thrust my chin forward and let it drop into the cool cup, the plastic device designed to hold wayward heads in place. As the ophthalmologist flipped lenses back and forth in front of each eye, I struggled to concentrate, to think, to look, to make sure that the first one really was better than the second. Flip, flip, if I remained silent. “I can’t tell,” I sometimes mumbled, and the doctor responded with a small grunt, impatiently flipping back and forth, “This or this?” I was embarrassed to admit that one seemed as good as the other, or that neither seemed all that good, and the whole thing was giving me a headache.
Two weeks later, my mother and I went back to pick up my glasses. They were heavy and weird on my face; their weight seemed to pull the bridge of my nose down toward my molars. My eyes kept traveling to the part of the rims where my virtually perfect vision ended, my eyeballs worrying those edges like my tongue finding a hole where a tooth used to be. The clerk made sure they fit my face, placing her hands gently at the temples and looking at my brow, twisting the frames, cleaning the lenses.
When we walked outside, I turned around and looked at the mountains to the east and my jaw dropped. There was snow on those mountains, up on the tallest peaks. Edges sharpened: I saw precisely where the parking lot ended and the road began, smudges of dirt on my tennis shoes, pebbles, telephone lines. This is what the world looks like. I had no idea.
I like putting a face to a name, if only in my imagination. When I teach philosophy, I assume my students want the same thing, so I draw scenes for them. As for Descartes, he’s the archetype of a philosopher: something of a dandy, foppish. Lounging around in silk smoking jackets, rising at noon, gazing off into the far distance. Descartes, I tell them, was not a morning person, and they nod their heads in sympathy. He grew up with powerful friends, and was attracted to royal women, especially Christina, the young Queen of Sweden. Christina, in fact, contributed to his early demise: she demanded that Descartes instruct her in philosophy, and he reluctantly moved into Christina’s dank and drafty castle. Sweden did not agree with Descartes. “It seems to me that men’s thoughts freeze here during winter, just as does the water,” he said. He caught pneumonia. He suffered for a week and then died; he was 54.
I tell my students how as a young man—about their age—Descartes joined the army of Bavaria, but of course, that was a different time: during the Thirty Years’ War, armies only fought during summer, and life in winter quarters allowed him the relative peace he needed for his work. He was already a formidable mathematician, and Paris had become a distraction. When he was 23, he had a series of dreams about finding the basis for all knowledge, and he took those dreams as a sign—he left the army to complete his first book, Discourse on Method. Twenty-five years later he published Meditations on First Philosophy, and in between, he came up with analytic geometry.
I think, therefore I exist. Cogito ergo sum. Virtually everyone has heard the phrase, and many know who said it. Fewer people know that it was Descartes’ basis for all knowledge, and he wrote it in the Meditations. He wanted to find one unquestionable thing, a thing on which he could base a theory of knowledge. He decided he could question everything else—his senses, his parents, his religion, even the mathematics at which he was so adept—but he knew something was doing the thinking at that very moment. He didn’t know what kind of thing it was, whether it even had extension in time and space. I am a thinking thing. That’s what he knew.
From this observation, I tell my students, Descartes developed mind/body dualism: the mind is the essence of a person, his spirit, eternal; the body is a machine, merely a spirit-inhabited substance. My students tend to like this theory. He divided the territory: the Church got the mind, Science got the body, and never the twain shall meet. They also like this—keeps everybody happy. This theory, however, has a rather large problem: how, exactly, can non-material spirit like the mind mingle with and influence material substance like the body? My students don’t like this part very much. They want to have their metaphysical cake and eat it, too.
By Descartes’ definition, the mind is a ghost, misty and floating, able to seep through walls, but unable to move physical objects. Spirit, then, it seems obvious, could never affect material substances in any way. This seems inevitable, given the definitions. But Descartes argued that spirit and body come together in the pineal gland, that spirit is a pure and lovely flame, flitting and cavorting deep in the center of our brains. For Descartes, the pineal gland is a magical place where our souls and personality and identity shimmer in a night sky.
My students are justifiably skeptical about the pineal gland idea. They wonder why anyone would question math and their own bodily experiences in the first place. I believe they think Descartes was just looking for trouble. So I tell them about Plato.
Descartes got a lot of his ideas from Plato, and was trying to decide whether and what Plato was right about. Plato thought that eternal things are better than temporary things, and mathematical truths are eternal and, therefore, perfect. The definition of a triangle won’t ever change, no matter what. Senses, Plato believed, deceive; the body deceives—our vision is limited by our perspective; everyone senses things at least a little differently. Plato also thought we are all born with knowledge about everything; we just need a reminder now and again. Plato believed that when we saw Truth, we would recognize it.
I tried therapy when I was 21, working on “career options” and “time management.” I had changed my major—again—and was waiting tables, drinking tequila kamikazes, and missing many classes. My therapist had me make pie charts of my days, cut out pictures in magazines and make a collage of who I wanted to be. The collage had beautiful women wearing purple, diaphanous gowns, and pictures of books. I recall there was a picture of the Great Wall of China, the rings of Saturn, and a silver Porsche.
Pie charts and collages were not particularly helpful.
When I was 23, I started thinking I was crazy, probably crazy enough to be put away. The only thing that could get me out of bed was work; I always went to work. I was passing only one class with a “D,” and it seemed entirely possible that I would wait tables and bartend for the rest of my life.
There were days I couldn’t decide on a laundromat. I’d pull my sky-blue VW Bug into parking lots and coast past windows, hoping for rows of raised washing machine lids and no people. I didn’t want anyone watching me carry my clothes, seeing my back with its bulge of fat over my bra. They’d think, “Fat cow.” I didn’t want anyone watching my underwear whirling around the dryer. Possible stains.
I quit even attempting to go to school. My apartment started giving me the creeps: someone had stuck precisely lined rows of masking tape across all the windows, some bizarre attempt at blinds, and the spaces between the rows were no more than half an inch. I kept trying to see between those lines, my fingernails making little crescents in the tape. Backing away from the glass, I’d plop onto my bed and light a cigarette, contemplate the walls. The world seemed composed of surfaces, flat and opaque and tinged with the grey of primer. Fingers poked me from my insides, their nails piercing the tender lining of my stomach. My belly was green wood, the bark pulling away like a hangnail.
Back then, I was petrified that a “professional” might quickly and correctly identify my sadness, but not really comprehend the danger: with all those intrusive questions, she might unknowingly thrust her fingers into the wrong place and send me completely over the edge. That professional, filled with good intentions, might ask the wrong question, and I’d start crying and end up institutionalized. That professional would recognize madness when she saw it.
At that time, I wanted a pill. It seemed so much safer—easier—than exposing myself to the danger of a complete breakdown. But that meant finding a therapist who would both prescribe it for me and do so without too much prying.
“There’s nothing physiologically wrong with you,” my new therapist told me, calmly flipping through the results of my physical.
I sat there, on the nubby, slate-blue couch, rubbing my forehead, blowing air out between my lips. “So I guess that means no pills?”
She shook her head.
“Let’s talk about this,” she said, and I ended up sitting on her couch once a week, sometimes twice, for the next six years. We created no pie charts or collages. She didn’t ask the wrong question. A couple of times I had to lie down, hang my head over the front edge of the cushions, and will myself out of throwing up. In those six years antidepressants were never discussed again. And I admit now to a certain smugness: I was brave enough and strong enough to get through depression the hard way. I was a Tough Guy.
The first time Prozac was offered to me I was in graduate school studying philosophy. I went to the student health center to see about Nicorette and talked to some woman for about ten minutes. I told her about my past attempts to quit, admitting that when I tried to quit, I usually ended up thinking, “I don’t care if it does kill me. Life is not worth living without cigarettes.” Which ended up with a trip down to the corner store for a pack of smokes.
“You know,” she said, “Prozac might help you out with the anxiety, enabling you to handle the stress of quitting.”
“Uh. Mmm,” I grimaced, “Well, I’m not depressed right now. Sometimes I get depressed after I quit. So I’m not sure…but I’ll think about it. Thanks.”
No way, I thought. I’m a Tough Guy.
My best friend was taking Prozac, and he liked it a lot. He said he liked that it made him less introspective and more productive. He told me about how much energy he had. I squirmed a bit during his description: he was like a missionary sitting in my living room, glowing and earnest. He thought my taking Prozac was a great idea. “No, I haven’t been saved,” I wanted to say. “And truth be told, I don’t really want to give myself over to God.” I’d shrug, “Sorry.”
A year or so later, I started seeing a new therapist, and within two weeks, she also suggested antidepressants. I remember thinking, “What is with you people? I have indigestion, too. How ‘bout some Prozac? Prozac is the very greatest thing ever. It can fix anything!” Obviously, I hadn’t made my Tough Guy status clear.
This therapist was reacting to my admissions about my trouble sleeping and focusing on my thesis. My father had Alzheimer’s, so I was feeling overwhelmed. And my last boyfriend had committed suicide about six months earlier. We weren’t together at the time; he was in law school and actually had a new girlfriend by then. But still. I was also convinced that I had gotten into grad school on a fluke, and I wasn’t all that sure I was actually any good at philosophy.
I wondered whether I needed to alter my brain chemistry. Seemed pretty clear to me that I had some good reasons to be sad. And I had spent six years, not to mention thousands of dollars, learning to recognize and respond to my feelings.
The idea kept nibbling at me. That old attraction of taking a pill and feeling all better recaptured my imagination. And there was a new element: I read about the transformations, stories about how some people don’t just get over the depression; their personalities change, they change. Wallflowers emerging as Prom Queens. The meek becoming motivational speakers.
I began to ponder the possibilities: I’ll be razor-thin, a svelte sex-goddess. Yes! I’ll fall in love, or at least be flirty; I’ll talk in class, say all those things I want to, but never do. The other students will lean back in their chairs in admiration, thinking Wow. I wish I’d said that. My thesis will be ground-breaking, and I might become the first female philosopher on the faculty at Harvard. Of course, then I could quit smoking. I’ll definitely stop procrastinating. Maybe I’ll even be patient enough to sit in the sun, get a tan.
Then Descartes in his smoking jacket and Plato in his sandals, each raise a finger: “Are you really sure you want to do this? Why do you want to be a svelte sex-goddess?” They look at each other and shake their gigantic heads.
At the age when Descartes was in the Bavarian army dreaming about his deductive system, I was working in a pizza place in South Carolina. On my way home one night, a drunk lost control of his Corvette and hit the car I was riding in head-on. My face went through the windshield of a ‘77 Toyota Celica. My forehead, chin, and upper lip got scraped, and the tip of my nose hung by a little flap of skin. Months later, dragging your finger across my nose or forehead was like stroking a closed zipper.
“Fix it,” I thought, and that’s all I thought. Didn’t hesitate. My stitched-up face was scaring small children, and I didn’t quite recognize myself—I’d glance in a mirror having forgotten that my forehead bore a remarkable similarity to Frankenstein’s head and do a double-take. Not who I am, and not who I want to be. I wanted to get back to normal, or at least normal for me.
I didn’t complain, though, when the plastic surgeon finished with my nose and it looked straighter and narrower, almost thin. It looked almost Roman, almost classy. Not exactly the way it used to be, but it’s an image I’ve gotten used to. To this day it’s still a little numb at the tip and prone to sunburn, but all in all, not bad.
I would never have had plastic surgery if my face hadn’t gone through that windshield. I would have continued thinking the little bulb at the end of my nose was somehow charming, and would have lived a life where that particular, idiosyncratic body part never really entered my mind unless it itched or sneezed. It would have remained an anonymous member of my collection of parts, routinely ignored.
My therapist kept suggesting antidepressants, and referred me to a psychiatrist. Tough Guy was becoming too heavy, slung over my shoulder, harping. I was about ready to slap Tough Guy.
I sat in the psychiatrist’s office, trying to appear relaxed and attentive. I knew I must pass this man’s test to get Prozac. “Yes,” I say, “members of my family have used antidepressants before, but not Prozac. My mother, father, and both of my sisters. My mom has for years and years. Well, I’m having trouble sleeping, getting to sleep. I’m kind of tired all the time because I’m not sleeping well. Yes, I’d say I’m anxious. There’s a lot going on—my father is ill, I’m trying to write my thesis, I’ve been very sad about a friend’s death. Yes, I’m seeing someone at the counseling center.”
He starts flipping pages on a giant tablet of paper resting on an easel, looking for the diagram that explains how Prozac works.
“This is your brain,” he says, pointing to the top of the page. “These are neurons,” he motions with his pen, pointing at a spot on the page that looks like a barren tree in winter. He has clearly run through this spiel hundreds of times before: the paper is ragged at the edge, and some of the neurons are a little smudged.
I jiggle my knee as I wait for the pharmacist to fill my prescription. I don’t know what to say when she asks about sending the bill to my insurance company. My mind casts back to an insurance salesman who very casually told me to lie on my application. Not about smoking, which was one of the yes/no questions, but about having ever been treated for mental illness. He told me they’d turn me down if I answered “yes.”
I decide to pass on the insurance. Out in my car, I shake the half-full bottle of little green and beige capsules, one month, fifty dollars’ worth. I read the list of possible side-effects: nausea, excessive energy, headaches, sexual dysfunction. Holy crap. Take one every morning with food. Okay.
I call my two closest friends and command them to keep an eye on me. If I turn into the Bluebird of Happiness or the Stepford Graduate Student, notify me immediately. I may lose touch with myself. I may act strangely and not know it. It has something to do with serotonin uptake and neurons. I’m not really sure. It will probably take three weeks to kick in, but some people experience change in a matter of days. Just let me know.
Days pass, and I vigilantly watch for my reactions. Nausea? Yes, definitely. Headaches? Some, but no worse than before. Loss of libido? Not that I can tell. Maybe I look different. I critically examine myself in a mirror. Like the day after I slept with someone for the first time, I was sure that you could look at me and tell the difference—surely my eyes were greener or something. But no, same old face.
I did sleep, and I slept hard. It was such a relief to go to bed and simply fall asleep. The hours of clock-watching were replaced with quick oblivion. And waking up was radically different. Usually I wake up a little furred: I hug my head, bury my face in pillows, sometimes hum an abbreviated scale. I scissor my legs against flannel sheets, floating. Language is completely out of the question. But with Prozac, my eyes popped open and I was fully awake. No lolling around in my bed vaguely contemplating the ceiling, just up, up, up. And my thesis didn’t seem any easier to write. Mountain Dew and barbeque chips retained their awful allure, and my body kept up its demand for nicotine. Eloquence and elegance eluded me, as always. After five months, the nausea sharpened; it began to make falling to sleep a horrible process again. Every night I sat up in bed, nibbling Saltines and sipping flat Coke. Again I anxiously watched the blue iridescent numbers on my clock.
So I decided to stop taking Prozac. I was the same person I had always been, only nauseous. And besides, I like the minutes of softness before I reach for the clarity of day.
In 2003 President Bush received a report titled Beyond Therapy: Biotechnology and the Pursuit of Happiness. Bush had commissioned the report and established The President’s Council on Bioethics, made up of 17 Ph.D.’s and M.D.’s and J.D.’s who would consider the implications of biotechnology. I have my students read parts of this report, and we speculate about what biotechnology might become during their lifetime. They are mostly enamored of technology, and they think critics are Chicken Littles, big, fretful babies. They have little patience for the text, until they start reading it.
The Council’s recommendations revolve around the premise that “[i]n enjoying the benefits of biotechnology, we will need to hold fast to an account of the human being, seen not in material or mechanistic or medical terms but in psychic and moral and spiritual ones.” The Council believes biotechnology has the potential to blunt, if not essentially destroy, what it means to be human.
The Council is concerned about many technologies, including drug therapies like antidepressants. The worry is that antidepressants are one way of leading us down a slippery slope to a loss of our humanity. The pursuit of “happy souls” is the topic of an entire chapter in the report, and there is worry that we are blindly moving forward with a technology that will not only be used to help the girl who flunked out of school and couldn’t do her laundry, but will be given to the girl who wanted to be Prom Queen—and she will succeed. Transformation without work, achievement without effort, a buffet line of happy emotions, with vacuous, wealthy Americans picking out little bowls and setting them on a tray, to be paid for later: mashed potatoes (serenity), coconut cream pie (happy memories), and macaroni and cheese (comforting fullness). Not exactly healthy, but damn, it tastes good.
Perhaps a more accurate metaphor would be steroids for mood. Happiness, on this model (which is quite Aristotlean, interestingly enough), is like other skills to be developed and nurtured: whacking a baseball out of the park or winning an Olympic medal should be attained through hard work, training, and practice, not by taking a drug. Even more serious would be the potential use of steroids to make otherwise sub-par athletes into very, very good ones. Most people don’t have the innate ability to be gymnasts, but we could monkey around with things until virtually everyone could. The psychic, moral, and spiritual result: banality, a race that has lost its capacity to feel a whole range of emotions and, thus, will not have the motivation to strive for a good life. The feeling will be there, so why do the work?
It seems the Council is arguing that some people’s chemistry does not include happiness, and maybe that’s the way it should stay.
Descartes, of course, would roll his eyes at all this—a pill could never affect the essential nature of a person. He might even be a little cranky with this Council: meddle if you must with chemistry, but do not delude yourselves into believing you will ever touch a soul. That would be impossible, you poor, deluded creatures.
I’m currently taking an antidepressant—Lexapro is its name. I have been for a couple of years, and while I don’t have the zeal of a convert, I am happy to report that I sleep well, wake up with delicious furriness and can do my laundry, and I no longer smoke. And, I’m here to tell you, my soul is not uniformly happy—the chemicals don’t reach that place, wherever it is. The War in Iraq, general meanness in the world, global warming, all wound me. Friends have cancer, students hate my classes. I despair, sometimes, because I am connected to a world and circumstances that are by no means ideal. I have issues, as they say. Lexapro hasn’t magically made them disappear.
Camus wrote a wonderful version of the Myth of Sisyphus where Sisyphus was happy. Sisyphus is the guy who so enraged the gods that they punished him by making him roll a brutally heavy rock up a hill. Just at the crest of the hill, the rock rolls back down, and Sisyphus trudges back down to start his work again, over and over, for eternity. Camus thinks Sisyphus is happy because he has that time while walking down the hill to think his own thoughts, and that is the best any of us can hope for. Camus thinks we create meaning, no matter the circumstances. That is each human’s struggle and responsibility.
If I asked Camus about what he thought about the use of antidepressants, he’d have a cow. He’d think that life is struggle, and it’s perfectly fine that people are depressed. They should be depressed, in fact, if they have any sense at all.
If Camus were sitting in my living room right now, sipping a cup of hot tea, I’d tell him that there will always be rocks to roll up hills, whether or not I use antidepressants. A pill may ease the physical effort, but it does not—cannot—obviate the human need to create meaning. That act of creating meaning is the best and really only avenue to achieving a “happy soul.” Chemistry won’t do it. In fact, happy feelings and happy souls are different things. Aristotle understood that, and it’s a uniquely modern idea that happiness is a feeling, instead of a state of being. Drugs can affect feelings, but not the state of one’s soul. In this, I’m surprised to say, I see things the same way Descartes does.
There is something intuitively correct about Descartes’ postulation about the mind and body being fundamentally different. I nod my head when I read his arguments about how different the mind and body are: you remodel my nose and I remain. But cut into my brain, and I alter, irrevocably and completely.
I chose “the life of the mind”—philosophy—in no small measure because I am a terrible romantic. I imagined myself wearing a beret and smoking cigarettes, arguing about the existence of god and whatnot. It seemed refined and as elegant as a purple, diaphanous dress. A “pure and lovely flame” to shield this betrayer, my body.