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---wakefulne
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.