Altered States

If the Lacanian register of the Imaginary bears wakefulness and the panorama of images that appear before consciousness, and the register of the Symbolic bears the sleep where images and themes dance their dreams across the stage of the unconscious, then surely the register of the Real comprises the topos where dreams dream their dreams. Lacan does not by accident locate the divine within the precincts of the Real: God does not first appear in a bush burning in un-consuming flame, or the nightmare of a bloody Cross, but in the trace of these that points to the very heart of the Real, the place with sound but no sense, with melody but no logos, the place without an urge to grasp or otherwise conceptualize, the place before thought, the place where intentionality is not even a dream, a consciousness that is not conscious of something, but where, instead, waits to be born, where awareness waits for a theme.

The register of the Real contains the moment Levinas has described as insomnia. The cite of 'saying', the Real refuses thematization, the prison and ownership of language and image; it harbors the trace of the 'said', but prior to the being of the word.  An eerie place that awaits the things that go bump in the night, insomnia declares a wordless discourse of the infinite, the Cartesian 'infinite in me', an infinite not of me, but nonetheless found there: what Levinas names the il y a---there is.  To maintain the discourse of God beyond essence, to defer the meaning of God and therefore his entry into being, Levinas locates God's transcendence in the non-thematizable space of a wakefulness without a watching, a vigilance that does not already know what it keeps vigil for (or vigilant of), an insomnia that is interruptible, but without the trappings of, or tools for, naming God. For Levinas, once consciousness is a consciousness of something, that something is already dressed in the garb of being and outside the register of the Real. Levinas wants it the other way around: he wants transcendence to 'dress' consciousness in the garb of the 'otherwise than being'.

Levinas opens a space for the discourse of the divine, or transcendence, and that space subverts what he calls the moment of the Other within the Same, that which disturbs the empty---unthematic---wakefulness of insomnia. He names this place without terminus (ad quo/ad quem) 'Infinity' ("The God of Philosophy", in Basic Philosophical Writings, 133), which shakes up insomnia, making the "I" aware that the other is before it. Indeed, the very 'character of insomnia: the Other within the same who does not alienate the Same, but who awakens him" ("In Praise of Insomnia," in God, Death, and Time, Stanford Univ. Pr., Stanford, 2000; 209), puts this wakeful emptiness in the position for an irruption---always on the verge of an encounter.

Levinas's insomnia is not the 'insomnia' encountered commonly in medical offices throughout the world. This insomnia, this awareness of the difficulty in falling asleep, has many therapies, and many avenues for further diagnostics. Rather, Levinassian insomnia has its physiological reflection in the devastating medical entity known as the persistent vegetative state (PVS). Medically defined as 'wakeful unawareness', PVS evokes the infamous cases of Karen Ann Quinlan, and more recently, Terry Schiavo, and the 'right to death' movement. The particulars of these cases notwithstanding, certain things come to mind. Does the Other who is not merely unconscious, but beyond either the unconscious or consciousness, make the same claim on me, participate in the same ethos, as the Other whose awareness precedes itself or me? What ethics comes to the fore when the Other's mind and body are divided? How shall I respond to the 'Infinity' Levinas has posited in the structure of consciousness when the Other remains trapped in the insomnia of wakeful expectation, even if nothing is to be expected---has not the mode of expecting?

Joseph J. Fins, in his Rights Come to Mind: Brain Injury, Ethics and the Struggle for Consciousness (NY: Cambridge Univ. Pr., 2015), presents the compelling cases of patients and their families confronting PVS and the newly recognized diagnosis of the Minimally Conscious State (MCS), a state of profound impairment of consciousness, but a consciousness with demonstrable awareness, that which is absent from those with PVS. Fins, a physician and medical ethicist at Weill Cornell Medical College in New York City, bears his own historical consciousness here, and draws upon civil rights history to point to the civil rights of mind, of consciousness. His call for absolute diagnostic precision in assessing these cases is poignant and powerful. His ethical sense derives not only from medical integrity in diagnosis and treatment, but also from the identification of the presence of consciousness itself, obscured by horrible injury and brain malfunction. The medicine and technology behind what drives Fins to defend the rights of mind, while fascinating, do not command me here; what commands me is the patient before me who cannot be reduced to mind.

The Other who appears before me appears to me as the human other, and when the Other appears to me suffering or perhaps dying from devastating disease, appears as the spread body whose call is this is my body, or with a Levinassian tenor, thou shalt not kill. Both phrases intone the unconditional now pressed upon me. In medicine, we imagine we see PVS frequently, but in reality, PVS might be rarer than that. Perhaps, as Fins has suggested, we are better than 40 percent wrong about PVS, and what we are really seeing is MCS; much uncertainty informs the actual state of affairs. Because of the prognostic implications of either diagnosis, medicine simply has to 'get it right'. For Fins, the ethical imperatives drive 'getting it right' so that consciousness can be nurtured and healed, and a person can come home to a family in waiting. This is impossible for Fins: to be aware of the world when the world judges unawareness, and acts this judgement out. It is simply impossible to miss the presence of consciousness; missing it is not an option.

The ethics of the spread body, in the instance of PVS, the separation of mind and body, a wakefulness unaware of its embodiedness, calls from this body decisively: this is my body and thou shalt not kill. There is no greater vulnerability than this; it is equal to the vulnerability and precarity of the consciousness thought to be absent. The space Levinas has opened for Infinity is the mode of existence of the spread body in PVS. It is the physiological equivalent of the pre-phenomenality of insomnia, unaware that is expecting the arrival of consciousness---the disruption of insomnia by consciousness---the moment of transition from PVS to MCS. This place of Infinity, the distance between mind and body, the seeming impossibility of traversal within the vegetative state, the moment of the unthematic Real, bears the trace of the divine, the infinite, the otherness of the other, and opens and announces a sacred place.


Patients in PVS bear the posture of Infinity, which has locked them within itself. Perhaps what has divided here is not simply the mind from the body, but even the mind from mind, the non-intentional consciousness pointing aimlessly toward itself. In this sense, the patient with PVS remains within an infinite circuit whose centripetal vector points to what Levinas sometimes calls "God". This trace of the divine glows perhaps a bit brighter, inscribes its line perhaps a bit bolder, in the face of this other whose eyes move, yet trace no line, whose body moves, yet traces no direction. This is absolute vulnerability whose unconditional call calls me relentlessly: this is my body. This is a vulnerability that claims its right not to be killed, and compels me to be responsible for it unconditionally.

Gentle Rain: Levinas's Conversion to Catholicism, Justice, Jerusalem Sopra Athens

"The proximity of the other is the face's meaning, and it means from the

very start in a way that goes beyond those plastic forms which forever try to

cover the face like a mask of their presence to perception. But always the

face shows through these forms . Prior to any particular expression and
beneath all particular expressions, which cover over and protect with an
immediately adopted face or countenance, there is the nakedness and destitution
of the expression as such, that is to say extreme exposure, defencelessness,
vulnerability itself".  Emmanuel Levinas, 'Ethics as First Philosophy'




Now that I have the reader's attention, allow me to disown the ridiculous assertion of Levinas's conversion. I abuse both 'conversion' and 'Catholicism' here (not to mention Levinas himself) to point to the interesting, fascinatingly gripping, dilemma Levinas articulates in his important essays, "Ethics as First Philosophy" (The Levinas Reader, S. Hand, ed., Cambridge: Blackwell, 1989; henceforth EFP), and "Peace and Proximity" (Emmanuel Levinas: Basic Philosophical Writings, ed. A. Peperzak, et al., Bloomingtion: Indiana Univ. Pr., 1996; henceforth PP). Levinas employs Athens and Jerusalem as metonyms for (among other things) the Hellenistic and Hebraic ethos, respectively, especially as he critiques the notions of Europe and Europeans, and the concept of the West. His 'conversion' is his embrace of a both/and posture, and a sophilology (my coinage and appropriation of 'Catholicism' in this context), the 'wisdom of love' (PP, 169), which always complements philosophy, the 'love of wisdom'. As Judith Butler has suggested in her Precarious Life (London:Verso, 2004, p.135f.), Levinas might very well be getting at a vision of Europe where Jerusalem surpasses Athens in vying for the very heart of the West.


"Let justice descend, O heavens, like dew from above, like gentle rain let the skies drop it down" (Isaiah 45:8).


For Levinas, justice can only be the Derridean justice to come. "But the order of truth and knowledge has a role to play in the peace of proximity...the ethical order of human proximity...calls for the order of objectivity, truth and knowledge...the very sense of Europe: its biblical heritage implies the necessity of its Greek heritage." Levinas denies a "simple confluence of two cultural currents" which, he declares, "do better than converge." Europe is the "concreteness" where peace and proximity "demand a reason that thematizes, synchronizes and synthesizes...concepts necessary for the peace of humanity" (PP, 168). This gentlest of rain is "the first question of the interhuman."


The iconic (pace Jean-Luc Marion) face of the other means this proximity (EFP, 82). In fact, there can be no justice if such a justice traces itself back merely to truth and knowledge. We need to know just what brand of justice we are to embrace, to hope for, whose advent is always just on the horizon. We need, as Levinas asks, to know if such 'justice' comes from war (and the risk of perpetual war and conflict) and destruction and violence, or from "the irreducible responsibility of the one for the other" (PP, 169). Such responsibility is the claim of the Other upon me, a claim that does not 'lay claim' upon some deontological imperative, something I bring to the table, but a claim that comes only from absolute alterity:




"But, in its expression, in its mortality, the face before me summons me, calls for me, begs for me, as if the invisible death that must be faced by the Other, pure otherness , separated, in some way, from any whole, were my business. It is as if that invisible death, ignored by the Other, whom already it concerns by the nakedness of its face, were already 'regarding' me prior to confronting me, and becoming the death that stares me in the face. The other man's death calls me into question, as if, by my possible future indifference, I had become the accomplice of the death to which the other, who cannot see it, is exposed; and as if, even before vowing myself to him, I had to answer for this death of the other, and to accompany the Other in his mortal solitude" (EFP, 83).



This is the face, in its iconic stature of the saturated phenomenon, in its 'regarding' of me, gazes upon me, even before I turn my gaze, and seizes me, positions me to see that the face is seen, that I recognize the condition of threat, the state of siege that the face of the other finds itself (Befindlichkeit). Perhaps a mutual illumination presents itself here,  the call of the spread body as coming from an elsewhere and an itself, a coming from the presentation of the spread body and the appresentation of the personhood of the itself. Levinas boldly appropriates Husserl's 'appresentation' as the 'epiphany' of 'the unicity and alterity of the unique' as 'concretely the face of the other human' (PP, 166). May I now be equally bold in appropriating the epiphany of the icon of the face, now as the voice, the call of my patient's body lying in her bed on the hospice care unit? Thou shalt not kill is the this is my body transposed into another key in the same symphonic motion of the Other's appearance before me. Both unconditional calls from the iconic face of the Other, one calls me to the movements of society and the polity of the 'one for the other'; the other calls me to the movement of my patient under siege, under the threat of death, of dissolution and expansion into oblivion, and the movement to healing.


These biblical warrants, the thou shalt not kill and the this is my body, make claims upon any "I" encountering any Other. For Levinas, the 'one for the other', the wisdom of love, tends to obviate any recourse to violence, would render a response of violence unintelligible. The hybridization of the Hellenic and the Hebraic would write into Europe itself the face of the Other and the one for the other. The wisdom of love, the both/and of the body and the human person (the recognition of a hybridization), plays out at the bedside of the suffering and dying as presentation and appresentation of the spread body and human person, respectively. Only in the peace and proximity of the face does the call of the spread body receive its voice.

The Call of the Spread Body: From Anamorphosis to Anagnorisis, A leading-in to a Recognition

In the last two posts to this blog I have tried to describe the experience of the suffering and dying body, which, in turn, has important implications for personhood, the human person, human dignity, and an ethics for caring for those at the end of life. At first, it seemed as though the spread body could be thought through the this is my body, and distinguished from the my body. Unfortunately, the New Testament texts of the words of institution of the Eucharist clamored with such interfering turbulence, little communication could be heard over such deafening noise. Methodologically, the body had to be thought more deeply, more phenomenologically, and somewhat differently: the this is my body re-emerges, not as the spread body as such, but as its voice, its unconditional call. The this is my body might return to this analysis of the spread body, but for now, I am subsuming that term into the 'call of the spread body'---the pure call of the spread body, the unconditional givenness that inaugurates its entry into phenomenality, from, by, through, in and of itself. The call comes from two lungs, of the person and of the body, which is to say, it comes unconditionally without sovereignty from something both pushed apart and pulled together. Illness and dying drive the engines of these bidirectional vectors,  which threaten the integrity of the body and the person.

Phenomenologically, I begin in my patient's body, a body threatened by life-limiting illness and dying itself. My patient's body is always the body of someone, a person; yet the very structures of such experience shout out for recognition and understanding that transcend the uniqueness of my patient.  Still, I begin with a particular person who has come to me because I have promised her re-humanization, to restore her humanity lost to the paradigm of the cure (itself a promise to restore her to the health of premorbidity, the time before the illness). I have promised her not cure, but care, care of her body and of her personhood, her self. Paradoxically, she comes before me as fully alive but dying. Her life, her personhood, is replete with history, a past and a present; but a personhood irreducible to her story without remainder. She is always in excess of what could be said---language could never complete her. Nonetheless, the narratives provide the interstitium of her person and her place, the matrix she moved and moves within as she was and is.

Illness throws the body centrifugally so that the spread body, pushed apart, becomes palpable, visible, smell-able; simultaneously a natural, primordial vector pulls it back toward the center, centripetally, in a struggle to maintain integrity. My patient as person is along for the ride, as her personhood is threatened by the same vectors. My patient's body is at a distance from itself, receding from itself. This spread body calls me to itself: it is a call that shapes how it gives itself from itself and positions me (tells me where to stand so that I can decipher, discern, see it) it relationship to it. Because this call is from this body, it is this body's own call, for itself from itself. Having no agency of its own, though, its only recourse to itself is to get itself done, through my agency in the event of rediscovery and recognition. I am not obligated by any sense of duty prior to the call. The obligation that arises is called for by the givenness of the spread body whose singular thisness, which is for, by, in the 'itself' of this body that unconditionally makes a claim on me.
But this call, while only from, of, by, in my patient's own body, is not solely for me. My experience of it is the structure of its experience for anyone with eyes to see, ears to hear, a body to touch. How does my agency, anyone's agency get the 'itself done' of my patient's body? This is the event, the event released: when I discover, recover, recognize, acknowledge the humanity and personhood before me, made to recede by the situation of the spread body in the hospice, the 'itself' getting itself done by my agency, finds in my agency of recognition and recovery its own self-recognition, recover, rediscovery. In conventional terms, this is 'healing'.


The key structures of the givenness of the spread body and its call are its directing of my gaze, for a [re]positioning and a recognition. When I speak of this positioning, the anamorphosis proper, "the aim here is to shift this gaze to the point of view...that, on the basis of which and according to the demands of this sudden phenomenon giving itself, would succeed in showing itself" (Jean-Luc Marion, in Givenness and Revelation, NY: Oxford Univ. Pr., 2016; p. 65; emphasis Marion's). "In this way, we better understand that the phenomenon can come at once from 'elsewhere' and from itself" (Marion, Being Given, trans. J. Kosky, Stanford: Stanford Univ. Pr., 2002, p. 124). In this instance, of phenomenalization, I provisionally place personhood 'elsewhere' and the spread body in the place of the call. Everything now in its place, my gaze, now oriented by the call of the spread body, its very thisness, intends what is intended by my patient's own gaze, looking back toward me, with unconditional purity of the call, calling for the release of the event of recognition: anagnorisis.

For now, I leave Aristotle's discussion of peripety and anagnorisis in the Poetics, and among the aesthetes; yet, in order to full explore the phenomenality of the call of the spread body, I will attempt to illustrate how 'recognition' works in those scenes where Odysseus makes his home-coming: for the anagnorisis called for by my patient shares similar structures. Of course, on the strictly mimetic (hence, ontic) level, Odysseus, the great tactician, with the assistance of Athena, steers events and the gradual unfolding of his identity until the catastrophe in the hall reveal him in his full regal stature. On the ontological level of Odysseus' movement from beggar to king, however, we are very much made privy to the tension of a beggar becoming a king again, in all its uncertainties and conditions. The chance that the beggar will remain a beggar threatens the return of the king.

With each unfolding recognition, first by the royal Argos, whose animality immediately connect him to Odysseus, through the recognitions of Eumaeus, Eurykleia, Telemachus, Penelope (who is the deal-breaker here, and whose steadfast love remains anchored to the royal bedpost), through the stringing of the bow whose plucked tone heralds the arrival of the Odysseus the king and bloody justice, the beggar is reunited to himself: personhood, identity is incrementally restored to the body of the king, now made whole, even renewed. Each successive recognition by others, brings Odysseus to recognize himself regained, made whole, in his former regal stature. Some may argue that these recognition scenes are charged with ambiguity, that perhaps not every character 'recognizes' Odysseus in the timeline I suggest; yet the stakes are high---recognizing the king in the beggar before the beggar comes into his own can be lethal business in Ithaka. A king must be kingly or he is not a king at all. The violence at Ithaka, the restoration of a king, is risky business, and is no stranger on the hospice, where bodies are under constant threat of violence, constant threat of being pushed further apart, splayed into unquenchable space. Those at the bedside, my patient's very own Eumaeus, Telemachus and Penelope, are invited by the same call---to my patient's return to Ithaka, the recognition of her own self in the recognition of others.

I do not direct, invoke, or otherwise prescribe the experience of recognition that my patient phenomenalizes. Recognition comes from her alone, and she alone makes use of the conversion of my gaze which she herself has converted, and my gaze, though constituting her wholeness which is for me, finds its way into her knowledge of herself and recognized as and for herself. I know nothing of her experience apart from my own experience of her self having an experience of recognition, recovery, and healing. I can know of her experience more concretely, as when she might tell me she feels more herself (if she can utter such words), or when she laughs or smiles. Or I might know this from a loved one, whose experience of being at the bedside of the dying becomes transformed, and perhaps informed by an ineffable hope, perhaps even in what Simone de Beauvoir, in her A Very Easy Death,  has called a 'miracle'.

The call of the spread body takes the shape of a whispered phrase, whose contours mouth this is my body, whose urgency gives and shows itself. By my being present at the bedside, the solemn givenness of my patient's spread body disposes and poises me to enter into the phenomenality giving and showing itself unconditionally. Without an agency of its own, a call alone invites me into to the event harbored in suffering organicity whose blood vessels, fluids, discolored skin gains a voice from its self-donation. The call comes from the elsewhere, the distance of my patient's self and from the nexus of vasculature and other (barely) human tissue. The bilocations of what is pulled and pushed in opposite directions converge in a single phenomenality that enters my experience of a unity under threat of dissolution and extinction into oblivion. Of the experience of being expanded and splayed, which belongs only to my patient, I know only of its call for recognition, which elicits acts of healing.