Literature, medicine, and the culture wars.

Medicine is dominated by problem-solving; it is a profession that thrives on capability. You can't be a doctor if you don't know how to do things (" Qui ne sait agir n'est pas médecin "), wrote Jean Starobinski who studied medicine before becoming a professor of comparative literature. 1 Literature, by contrast with medicine, has to make do with what John Keats, apothecary's assistant, famously called negative capability: " when man is capable of being in uncertainties, Mysteries, doubts, without any irritable reaching after fact & reason ". Keats' phrase is so current in the humanities as to make one articulate doctor-writer suspect that it may be an excuse for not knowing anything at all. 2 Since it took medicine nearly two millennia to acquire capability, I am curious that it is now seeking a self-image in literature. Does literature's negative capability offer a kind of knowledge that cannot be assayed by common sense? Are the generalisations offered to back up its importance for medicine not riddled with boltholes and exceptions? Do we need " scientific " vindications of our private worlds, or the fact that hell can be other people, especially patients? Not so long ago, doctors knew (without having to be told) that the lives of their patients were intelligible narratives; now that the market has started dismantling the framework which made those lives intelligible, the cues need to be made explicit. 3 This is an old problem: once we start talking about traditions and roots we are actually talking about knowledge, for the real traditionalist does not know himself to be a traditionalist. He takes himself for granted. Now, self-consciousness is afoot in the Garden of Eden, the fruit has been eaten, and in the end we are forced to realise that this kind of arguing about what has been lost is in fact our tradition. " It is very unhappy " Ralph Waldo Emerson wrote in his essay Experience, " but too late to be helped, the discovery we have made that we exist. That discovery is called the Fall of Man ". 4 Does this condemn us, as Denis Diderot thought, to endless role-playing and cue-spotting? Apparently not; Americans are, after all, thought to be " unironic " , at least by Europeans. No other state has ever found its own institutions self-evident. If culture is what we take for granted—what allows us to act …