Coming Soon:

The following books by Robert Paul Wolff are available on Amazon.com as e-books: KANT'S THEORY OF MENTAL ACTIVITY, THE AUTONOMY OF REASON, UNDERSTANDING MARX, UNDERSTANDING RAWLS, THE POVERTY OF LIBERALISM, A LIFE IN THE ACADEMY, MONEYBAGS MUST BE SO LUCKY, AN INTRODUCTION TO THE USE OF FORMAL METHODS IN POLITICAL PHILOSOPHY.
Now Available: Volumes I, II, III, and IV of the Collected Published and Unpublished Papers.

NOW AVAILABLE ON YOUTUBE: LECTURES ON KANT'S CRITIQUE OF PURE REASON. To view the lectures, go to YouTube and search for "Robert Paul Wolff Kant." There they will be.

To contact me about organizing, email me at rpwolff750@gmail.com




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Saturday, December 4, 2010

INDEX NUMBERS YET AGAIN, AND THE PROBLEM OF OTHER MINDS

Faithful readers of this blog will recall that in October, in response to a question, I posted a multi-part discourse on the study of society, one part of which was devoted to the vexing subject of index numbers. In that screed, I chose as my example the Consumer Price Index, but earlier this week I had occasion to revisit the problem of index numbers in a more immediate and personal way. Interestingly, this encounter with the conundrum of index numbers also led me into reflections on that old and familiar philosophical puzzle, our knowledge of other minds. [This really dates me, inasmuch as the problem of other minds was on everyone's mind -- so far as one could tell :) -- in the mid 1950's.]

On Tuesday, having just recovered from more than a week of an extremely debilitating flu that I probably picked up during a seven hour layover in Heathrow Airport in London, I was suddenly struck down by a blinding headache on the right side of my face and head. My primary care physician only sees patients on Wednesdays, and besides was himself sick, and the Same Day clinic at UNC Health Services had no room for me, so in desperation I drove myself to the Emergency Room of the UNC Hospital. There I spent seven hours, while they poked and prodded me, did a CT scan, and eventually concluded that I had an infected sinus, not a migraine, as I had thought.

Once I was admitted and had changed into a hospital gown [always a diminishing experience], a nurse asked me, "On a scale of 1 to 10, with 10 being the worst pain you can imagine, how bad is the pain?" This question was repeated periodically for the next seven hours, until I was able to say that I was pain free. [Three small doses of morphine, delivered intravenously, had no effect on the pain whatsoever, so I think I can stop worrying about becoming a dope addict, but some arcane combination of pain meds late in the proceedings did the trick.]

As soon as I was presented with the question, I recognized that I faced at least three problems of varying philosophical interest. The first problem was a purely practical matter of self-interest and self-preservation. If I took the question seriously, I would have to conclude that a 10 represented agony so extreme that I was on the point of death, screaming uncontrollably. By that measure, I could not honestly rate my pain as more than a 4 or 5 [assuming a linear scale, but never mind that]. But I had a suspicion that if I said "five," they would decide I was not doing so badly, and would wander off to treat someone who had said "ten." So I hedged my bets and said "seven, or eight."

The second problem returned me to the question of index numbers. For a while, nothing changed, and I kept responding "seven, or eight." But then the nature of the pain itself altered. Instead of being focused and sharp, it became duller and more general, so that I felt invaded and compromised by it in a way that unmanned me. Was this a reduction to 6 or 5, or perhaps even an increase to 8.5? Miserable though I was, I am and shall always be a philosopher, which means not that I tolerate pain without complaint, but that I recognize a philosophical problem when it presents itself. Put simply, pain is multi-dimensional, and no linear index can adequately represent its structure and variation. Now, I understand why ER nurses ask this question, but I simply could not acquiesce in a diagnostic procedure that I recognized to be flawed. The net result was that I became known to the very nice and attentive ER nurses as "the one who does not like numbers."

The third problem was even more intractable. Suppose I was an extremely sensitive plant who cringed at a pinch and cried at an ingrown toenail. My ten might be any normal person's three. Alternatively, I might be a stoic who replied "six" as he died under torture. There is no satisfactory way of making what in the Economics trade came to be called interpersonal comparisons of utility. Hence indifference maps and all manner of other adjustments to the original apparent transparency of utilitarianism. Wittgenstein to the contrary notwithstanding, this is a problem with no solution. [Just try asking a woman who has given birth without an epidural about her big, strong husband and his complaints about sports injuries.]

The story has a qualifiedly happy ending. After the lovely Nurse Practitioner, Megan Randall, approved my release, I went home pain free. The next day, some pain had returned, and when I tried to get a follow-up appointment at the ENT clinic, they blithely told me they could fit me in in two weeks. In the interim, they prescribed a new anti-biotic and a nasal spray. Several days of that had me feeling well enough to go out to dinner with Susie, but then, yesterday morning, I had blinding, stabbing pains on the other side of my face. A trip to my dentist [I thought it was a not yet completed root canal procedure] reassured me that I was suffering another sinus infection, and this time, the pain medication my dentist prescribed [Percocet] did the trick. So here I am on Saturday morning, pain free and able to turn all of this misery into a blog post that I hope will amuse.

Meanwhile, I notice that the real world is going to hell in a hand basket, but more of that anon.

5 comments:

Brenda said...

Granted that the pain scale depends on the sensitivity of the patient, repeated questioned can establish increase or diminution. This is far better than never having asked the question, which was the case not too long ago when pain was off the diagnostic screen entirely.

Robert Paul Wolff said...

Oh, I know. I was just being difficult because I hurt. Not very mature of me, I know.

Murfmensch said...

While in labor, my wife answered a one-to-ten question this way:

"Seven, but all of my earlier sixes should now be changed to twos."

John Gee said...

At least they didn't try to map the scale to something other than numbers. Reminds me of an amusing article about a pictorial pain scale, with suggested improvements.

http://hyperboleandahalf.blogspot.com/2010/02/boyfriend-doesnt-have-ebola-probably.html

john c. halasz said...

The McGill pain index:

http://en.wikipedia.org/wiki/McGill_Pain_Questionnaire