This is why doctors need a degree of cunning

The problem can be made clearer if one looks more closely at how diagnosis and treatment work in medicine. The fourfold formula [of the four noble truths of Buddhism] above is a pretty good approximation. You start with, “Oh, look, there’s a problem!” Then you look into the possible causes. Then you think about how, knowing the cause, you might treat the problem (sometimes, you don’t need to worry about underlying causes to treat symptoms, but often it can help). Then you prescribe whatever therapeutic course is the best response to the problem. So what is the difference when it comes to philosophy? The difference, I think, is that a good doctor will not assume that there is some kind of fundamental condition of corporeal existence, a fundamental condition for which there is a single cure. A doctor who prescribed antibiotics (or exorcism, or cupping, or a week’s holiday) for everything under the sun — broken legs, viruses or what have you — would be a poor doctor indeed. There is no single fundamental condition that is “illness”; and so there is no panacea for all ills. This is why doctors need a degree of cunning. They need their wits about them, they need to know that bodies are complex and that they behave in all manner of different ways, and they need to know that there are innumerable ways of responding to these complexities. Not only this, but there is not always a problem: a good doctor is also able to diagnose, sometimes, that nothing much is wrong, and that patient can be sent upon their way, reassured that nothing (at least at the moment) needs to be done.

In the light of this, sometimes it seems to me that philosophical diagnosticians lack the cunning of their medical counterparts (not for nothing were the precursors of today’s doctors called “cunning men”). Let us say, for the sake of argument, that if doctors treat bodies and what goes wrong with bodies, philosophical diagnosticians try (at least) to treat lives, and what goes wrong with lives. But it seems to me that good philosophical diagnosticians, just like good doctors, should be capable of recognising that lives too are complex things, and that just as there is no single “human condition” that needs treating, so there is no single treatment that is appropriate. Indeed, a good philosophical diagnostician, I think, should — just like a doctor — have the ability to recognise that sometimes there is nothing much wrong with the way that life is going, and to refrain from offering remedies that in truth remedy nothing (and that may have unwelcome side-effects).

The Myriad Things, Therapeutic Philosophy and the Pharmacopoeia of Humankind


4 comments on “This is why doctors need a degree of cunning

  1. Kevin Kim says:

    I’ve been chewing over this excerpt (without really having read the excerpt in its larger, more proper context), and find I’m of two minds about it, partly because I think Buddhists themselves speak in at least two voices when it comes to questions of “the human condition.”

    On one hand, there are the Buddhists who seem to think that the root problem of human existence “comes down to” something—a startlingly essentialist attitude for a religion/philosophy that preaches metaphysical nonessentialism. This root cause generally turns out to be something like avidya or tanha/trishna or upadana, and this without exception for every human being. The eightfold path then suggests itself as the panacea, the universal solution to this basic ill.

    On the other hand, you’ve got Buddhists who, like Seung Sahn and Hyeon Gak (at least in The Compass of Zen), favor the idea that no proper medicine cabinet holds only one medicine. These Buddhists, leaning heavily, I presume, on the concept of upaya, basically say in the spirit of hard-nosed pragmatism, “go with what works” in your praxis.

    So I suppose that whether the writer’s criticism of Buddhism is actually applicable to Buddhism may depend on which group of Buddhists stands accused. As a matter of phronesis (practical wisdom), I’m generally wary of “it all comes down to X” solutions to basic human problems. “Just follow the eightfold path” is as discomfiting to me as “Just accept Jesus Christ as your lord and savior.”

    Nevertheless, if there is a simple maxim to which I subscribe, it’s the seon Buddhist formulation, “Follow your situation.” Although it, too, smacks of essentialism, as do all prescriptive maxims, the fact that the maxim allies itself with the dynamic nature of reality is reason for me to trust it: by tying itself to ontological flux, the maxim absolves itself, at least partially, of the sin of essentialism.

    • seon joon says:


      It’s worth reading all of Buckingham’s post, to see what he’s driving at with the comparison between religious diagnostic models (specifically Buddhism) and philosophic diagnostic models. I came away from his post intrigued by his explicit critique of philosophical diagnostics that (in his view) over-simplify the matter of existence by erroneously assuming a single, monolithic “human condition.” He brings up Buddhism as an example of a religious diagnostic model, a specific system for addressing metaphysical questions of suffering and happiness within the larger category of “religious thought,” without examining how Buddhism may also be too preoccupied with the notion of a universal human condition to be able to help everyone, universally. His post wasn’t a take-down of Buddhism so much as a critique of a certain philosophical fallacy. Buckingham isn’t interested in his post in Buddhism so much as in using Buddhism’s diagnostic model to highlight the equivalent model in philosophy, and then to look at the problem inherent to that model, in philosophy. He leaves religion, and Buddhism, out of the main of his critique. Which leaves me (us?) the fun of doing it ourselves.

      To turn to Buddhism and “the human condition,” and especially the thorny paradox of essentialist definitions (“rebirth/existence is dukkha,” the first noble truth, and “avidya is the source of all craving and suffering,” the second noble truth, etc.) in a so-called school of metaphysical nonessentialism: one thing I often point out to myself when talking to people about the Buddha-Dharma for the first time, is that no, not everyone is going to agree with the basic supposition underpinning the Buddhist diagnostic model, that existence is unsatisfactory. (Rendering “dukkha” as “suffering” is inaccurate.) If someone doesn’t agree with that supposition, then the Buddhist diagnostic model of the four noble truths and the application of the noble eight-fold path as the remedy is not useful or applicable. Nor is it, then, universal. Religion (like philosophy, perhaps?) tends toward self-referential conversations, in which people who already agree with the most basic parameters to a problem engage in dialogue about it. You may have strong disagreements within that, like the Prasangika vs. Svatantrika split in Indo-Tibetan Buddhism, but fundamentally the conversation is a bit of an echoing chamber: everyone has already agreed to a certain basic world-view, and now their only discussing issues within those parameters, rather than exploring or even allowing alternate parameters. When push comes to shove with a conservative Jewish or Christian friend, if I’m taking a hard-line or conservative view of the Dharma, we will disagree over whether or not existence is, indeed, unsatisfactory. The Buddhist diagnostic model doesn’t work for them because they don’t agree with the basic assumptions it rests on. It is not, therefore, universal. Only Buddhists hold that it’s universal, making the specious argument that those who don’t see existence as inherently unsatisfactory are merely deluded or foolish. That’s as specious an argument as a Christian who says my agreement with the definition of avidya as “ignorance of the impermanent nature of all compounded phenomena, including the concept of the ‘self'” and my lack of belief in an eternal, personal God is simply because I haven’t experienced grace.

      The example of upaya, sometimes translated as “skillful means,” you brought up in Seung Sahn Kun Sunim’s teachings (Hyon Gak Sunim as well), reveals a similar problematic. Despite all the mentions of God in contemporary Zen dialogues, including Seung Sahn Sunim’s, most of the time they mean a “Zen” God: they use God as a designation for some phenomena, just like the word “enlightenment” is used to designate a certain state of consciousness or existence. The word enlightenment is not the state of enlightenment, but it signifies, and that’s why we use words. I doubt very much that Buddhists using the word God or Jesus think of those words, and what they designate, in the same way that conservative Christians do; we’re talking about different Gods. When Seung Sahn Sunim, or Hyon Gak Sunim, or most other Buddhist teachers talk about the medicine cabinet that holds many medicines, all those medicines still rest on the same fundamental assumption of either the first noble truth (existence is unsatisfactory) or one of the three “marks” (all actions are impermanent, all phenomena are empty, nirvana is bliss). The notion of upaya assumes that, eventually, everything and everyone boils down to the same basic world-view, and that all manifestations of upaya (the medicine) fit within the (Buddhist) diagnostic model.

      This is a lengthy response on my part partly to exercise my brain, I think–it’s helpful for me to think out my own criticisms of Buddhism. I agree with you, that “the fact that the maxim allies itself with the dynamic nature of reality is reason for me to trust it: by tying itself to ontological flux, the maxim absolves itself, at least partially, of the sin of essentialism.” It’s the practicality of the diagnostic model, and the fact that I more or less agree with the first noble truth because of my experiences, that keeps me a practitioner of the Buddha-Dharma in name and action.

      • Kevin Kim says:

        Well! That’s about as thorough an answer as a man could ever want.

        I agree with the idea that Buddhists speak from an inevitably Buddhist perspective; this is exactly what S. Mark Heim contends in his version of Nicholas Rescher’s orientational pluralism: “One and only one position is rationally appropriate from a given perspective.” (Salvations: Truth and Difference in Religion, 1995.) It would be folly to expect a Buddhist not to think and talk in a Buddhist idiom, or for a Christian not to use Christian theology and metaphysics as his/her point of departure.

        Having read a bit more of the quoted author’s full passage, I wonder whether he’s making a “meta” move in the spirit of John Hick: at the end of his spiel, he passes final judgment from on high, saying baldly that “there is no human condition” and being thankful that he can access the whole philosophical “pharmacopoeia” (i.e., “the usefulness of the various philosophical traditions”). That’s a very Hickian thing to say… and Hick isn’t beyond critique, either. Heh.

  2. Kevin Kim says:

    Oh, by the way: Happy New Year!

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