4:00 P.M.

May 20 , 2008

In Search of Myself: an Inquiry into Concepts of Self

James H. Belote

Assembly Room, A. K. Smiley Public Library

ABSTRACT

James H. Belote

The paper opens with the presentation of an ethical dilemma. It then attempts to defineitems such as brain and consciousness and discusses the relation of these to the self. Historical views of the self including the Heroic self, the Hindu self, the Buddhist self, and finally the Western self are presented. The evolution of the Western self is given in more detail and includes contributions from religion, philosophy, psychiatry, and technology.

Using the data, the ethical problem is re-examined and shown to be in part created by an Individual’s view of self-awareness. It is emphasized that this type of problem can be avoided by taking advantage of legal rights available to everyone before the situation arises.

Failing to arrive at a satisfactory definition of the self, the question is raised as to what are the functions of the concept. From these, the conclusion is drawn that the concept is a fundamental one of Western society and will continue to persist

In Search of Myself: An Inquiry into Concepts of Self

Background of the Author

James H. Belote is a retired pediatrician, concluding 34 years of practice in 2002. He earned a BA in chemistry at Emory University and an MD at Emory University Medical School. His internship and pediatric residency were performed at Charity Hospital in New Orleans under auspices of Tulane University. After two years in the army as a commanding officer of the Bamberg Dispensary in Germany, he returned to Tulane for a two-year fellowship in blood diseases of infants and children. He is board certified in Pediatrics with a sub-specialty in Pediatric Hematology and Oncology.

Since his retirement, Dr. Belote has served as Medical Director of the Redlands and
Highland laboratories of Beaver Medical Clinic for Quest Laboratory, Inc. He belongs to
numerous social and charitable organizations.

Part I: The Dilemma

N. M. is a 57 year old businessman and father who plays golf for relaxation. One fall Sunday afternoon he returned from his golf game complaining of severe headache. He retired to the bedroom to nap. Approximately an hour later, his wife heard an unusual noise. When she entered the room, she found him stretched across the bed. She was unable to rouse him and immediately called 911. He was observed to have a short seizure on the way to the hospital.

In the emergency room, it was noted that he had a history of untreated hypertension but was
otherwise in good health. His pulse was 40, his blood pressure was 80/60, and his respiration was labored and irregular. Physical findings were limited to the neurological examination. The emergency physician noted there was poor response to pain and other stimuli. Radiological imaging showed a massive intracranial hemorrhage. Further studies showed that a large area of the forebrain was not perfused. On viewing the imaging, a neurosurgeon did not feel that operative intervention would be of any value. A neurologist concurred.

N.M. was transferred to the ICU where he was attached to a ventilator. He was also attached to a cardio-respiratory monitor. An IV was started and tubes were placed. The wife was told that at present the course was one of monitoring and watchful waiting but little hope was held for a recovery. Surprisingly, N.M. recovered both breathing and his gag reflex by the third day. The ventilator and IV were discontinued and a feeding tube was inserted.

Mrs. N.M. either remained by the bed or slept in the waiting room. The physician had talked to her about possible outcomes but she told him that she was too upset to consider anything but the present situation and at any rate, her husband had never expressed any preference about dying. Indeed, he never considered the possibility. Her pastor visited her, prayed, and explained that God had mysterious ways. Her Asian neighbor had visited and advised her not to worry because her husband had been a generous and forgiving man. She was certain he had a happy life ahead. Her husband’s business partner called. The paychecks had to be signed by both partners. When was N.M. going to be in the office?

Their son called from another state. He was too busy to get there immediately. When told of his father’s condition, he said that his father was obviously dying and he would wait to come home for the funeral rather than fly back and forth. Their daughter also called. She became angry when told of her father’s status. She advised her mother not to believe the hospital or the doctors but to take her father home and nurse him back to health.

Later, the physician advised the wife that N.M. was now stable. Except for mechanistic functions, he was “brain dead” and appeared to be in what was called a “vegetative state”. Because he was in no immediate danger and because there was nothing to offer beyond maintenance care, his HMO would no longer pay for ICU or hospitalization beyond another 24 hours. He would have to be moved to a chronic care facility. The closest one with an available

bed was 200 miles away. The doctor was uncertain how much of the future cost the HMO would cover. He asked her again if she would be interested in signing a “do not resuscitate” form or considering discontinuing all care in view of the condition.

Mrs. N.M. wondered how the physician could be so cruel in speaking of her husband as dead in his presence. She looked at her husband lying passively on the bed. If only he would sit up and tell her what to do.

Part II: Definitions

The caterpillar and Alice looked at each other for a long time in silence: at last the caterpillar took the hookah out of its mouth, and addressed her in a languid, sleepy voice.
“Who are you?” said the caterpillar.
This was not an encouraging opening for a conversation.
Alice replied, rather shyly, “I-I hardly know, Sir, just at present – at least I know who I was when I got up this morning, but I think I must have changed several times since then.”
“What do you mean by that?” said the caterpillar sternly. “Explain yourself!”
“I can’t explain myself, I’m afraid, Sir,” said Alice, “because I’m not myself, you see.”
“I don’t see,” said the caterpillar.

As Alice indicated in Lewis Carroll’s story “Alice’s Adventures in Wonderland”, we don’t wonder who we are until we are challenged, frequently by “not ourselves” experiences. We will return to the story of N.M. later but first, let’s look at our “self”. I come by this curiosity by personal experience. I practiced pediatrics for many years. Working with children, it is obvious that their self-awareness changes, sometimes on a daily basis. Children rarely ask questions of the doctor. It is to the parents that most medical talk is directed. When children do ask questions, no matter how vague, they are almost always self-referential. The answer must be phrased in tune with their sophistication of their understanding of the concept of self. Regardless of the vagueness of the question, it usually can be broken down to “What will happen to me?” An age appropriate answer must be given as to what the child envisions as “me”. I have had the opportunity to work on the Redlands Community Hospital Ethics Committee for many years. The same question, “What will happen to me?” occurs. “Me” means vastly different things to different people.

Let’s see if we can define some qualities of what the self is and what it isn’t. First let’s start with some definitions, something elementary, like the brain. The brain is an organ in our head that weighs approximately 1400 grams or three pounds. It has 100 billion nerve cells, each of which average 10,000 connections with other cells. The brain is now agreed to be the container of consciousness, thought, memory, and emotion. This simple conclusion required centuries. In the past, various aspects of the brain’s functions have been attributed to the heart, the thymus, the spleen, and possible other organs. One thing is certain; there is no living mammal that doesn’t have at least a spot of neural organization to help keep it organized. As the scarecrow in “The Wizard of Oz” pointed out, you don’t function well without a brain. Part of California’s legal definition of death is complete cessation of all brain function.

The brain is not what we’re seeking however. Elephants and whales have larger brains than humans. Most organisms seem to have awareness limited only to certain aspects of their environment. The less generalized awareness they have, the less respect they are accorded by humans. You are welcome to swat any flies on my property, but if you kick my dog you are in great trouble. As humans see the universe, you are given respect not for having a brain, but for the awareness you exhibit in using it. This awareness is called consciousness. Consciousness is more formally defined “a sense of one’s personal or collective identity, including the attitudes, beliefs, and sensitivities held by or considered characteristic of an individual or group.”

Does that make things clearer? I somehow doubt it. Consciousness is difficult to define and perhaps we would do better describing it. John Searle, a philosopher at U.C. Berkley, has done characterization of the consciousness for us. Here are some of the more important details of his discussion. Consciousness seems to operate within boundaries of time, place, and circumstance. Ever wake from a deep sleep and not know where you were or what time it was? Disorientation is very disturbing. Not recognizing that you are not oriented is considered pathological in our society. Consciousness is composed of finite modalities. You can only operate and predict on the data presented by the senses of sight, smell, taste, touch, pain, and proprioception from the outer environment and memories, associations, emotion, mood, and empathy from the inner environment. From these bits, our brain weaves a seamless picture that changes constantly. In the corresponding environment of my consciousness, I am allowed to operate horizontally which lets me finish a sentence while still remembering why I started it. I can also operate vertically, allowing me to appreciate all these modality inputs at once.

My consciousness arranges for me sensory input in order of importance so that the most important is in the center of my attention and those things of less importance are at the periphery. People with the disorders of autism and attention deficiency disorder are incapable of doing this and become either overly active or withdrawn. One way this arrangement is accomplished is by the phenomena of familiarity. The consciousness constantly searches for new things in our environment by comparing everything with previous sensations and shunting those familiar to the background. New attractions are front and center.

Consciousness varies in intensity of awareness. Consciousness is subjective and normally is always in the first person singular. There are rare disorders in medicine called dissociative disorders in which a person has multiple personalities but these always appear one at a time. Every bit of conscious experience has an emotional tag, either added by the thalamus before arriving in the forebrain, or added by the consciousness as an impetus to action or an aid to memory retrieval. Overall experiences also have an emotional tag. You’ll go home tonight and tell your wife either “I enjoyed that” or “What a waste of time!” Finally, Dr. Searle states a conscious state has the purpose of intentionality. It presents the world and how we intend to react. Our consciousness internalizes reality, but equally important, is constantly evaluating it, predicting how it will change and forming intentions as to how to best react to it.

It is from this latter statement that this discussion diverges. Consciousness seems to be as far as science has progressed with the definition of the human experience at present. Scientifically, there is little written about the self and some academic doubt expressed as to whether we even
have one. I would suspect this reticence is due to its fear of being accused of a dualism. Despite this, it would seem that consciousness includes at least two phenomena. One would be the awareness of our external and internal environment. The second part of consciousness would be the self, our awareness of the sum of our own existence and our volition in this recognition. Shakespeare noted this in “As You Like It” when he said:

“All the world’s a stage,
And all the men and women merely players.”

Apart from poetry, there is some medical evidence that the “self” part of consciousness exists independently. In damage to the forebrain, such as has happened to our patient, Mr. N. M., other parts of the brain can continue to acquire data for construction of the inner reality. Patients with massive brain destruction have been described who continue to have a searching gaze of their room and will follow moving objects in the room. It is as if the patient is constructing a stage for an actor who has left the theater. In dreams, you operate on a stage constructed by your inner environment independent of your present environment of your bedroom. Your self is also on its own in experiences with drugs such as LSD or anesthesia.

So let’s see. We all agree we have a brain. And in that brain we have a consciousness. And in that consciousness we have the self. What is unique about the human concept of the self that distinguishes it from the total consciousness? All I have said about the consciousness so far are conclusions drawn from observation of the external self. To define the concept of the self in our society we must realize that there are assumptions made. Let’s look at these.

Look at yourself. You’ll go home very tired after Fortnightly. You hit the bed and sleep through the night. We’ll ignore the bathroom break. Tomorrow morning, you go into the bathroom and look in the mirror. You’ve been unconscious for 7 or 8 hours but you have no doubt that the person looking at you in the mirror is you. One of the hallmarks of our society is the belief that our self has continuity, that it remains the same self from birth to death, or in some instances, from conception to infinity and beyond. This implies permanence. There are exceptions to this. The well-known phenomena of amnesia is one. In certain types of amnesia the individual temporarily or permanently “forgets” his self. He remembers other things but is unable to identify who he was. In coma, head trauma, or drug over dosage, the self also vanishes only to reappear later. The second aspect of this continuity in our society is our body. It is part of our permanent self-image. When you look at a picture of your self at age four, you have no doubt who it is. It’s you. Finally there is the continuity of your mannerisms, your behavior. It is possible to identify someone by their gait long before you see their face. On the other hand, in accidents or stokes involving brain tissue damage, the body can be disfigured or patterns of externally observable behavior and internal memory lost. Where is the self in these situations? Is the intact self still there but unobservable or is it permanently gone? There are approximately six billion people on this planet. Our culture implies that we are each unique. Are we saying that all selves are the same, only modified by our environment, or that there is an intrinsic difference in

each self ever created? These three characteristics, continuity of consciousness, body image, and mannerisms, are the basis of identification of the self in the Western culture. What causes us to think this and how did we get that way? The good news is that we are not the first to consider these questions. Lets see what others made of them in history.

Part III: The Self in History

The Heroic Self

Who am I? How do you know me? When I joined the Fortnightly Club I was required to submit, in one form or the other, a curriculum vitae or resume. This is a summary of my accomplishments and awards in my lifetime. Does this sheet of paper really tell you who I am now at the present time? It may grow longer as I grow older but it may also become less and less accurate in predicting what I’m going to do. It may only tell you that the older I get, the better I was. This method of evaluating human behavior originated with the Greeks who in their later civilizations referred to the period of 700 to 500 BCE as the Heroic Age. By their later accounts, men were nobler at that time because they performed virile deeds. Originating out of codes derived from the Homeric epics, the warrior became the idealized man. Achilles, the hero of the Iliad, when given the choice between a long humdrum life and a short but achieving one, chose the latter; honor and glory were far more desirable than mere existence. Immortality was not an option. Only the gods were immortal and man could achieve it only through their gift. The self was dependent on the body for its existence and in general, the self and the body were the same. You were what you had done. Emphasis was on training the body and the mind for the purpose of domination. If there was any existence after death it was as a shadowy memory in a distant place. Even then, as Odysseus found in the Odyssey when he sailed to visit the shades in the land of the death, it was necessary to offer the spirits the physical substance of blood before they could communicate. The belief that the self is dependent on the flesh for its existence may offer some understanding of animal sacrifice. Recognizing individuals on the basis of their achievements has continued throughout history. Every time you walk past a trophy case, watch a John Wayne movie, or admire a chest filled with medals, you are looking at remnants of the heroic self. The concept of the self as dependent on the body and mutually fused still survives and may be found in religions such as Judaism and the Greek Orthodox Church. Many branches of Christianity teach that the self and the body will be eventually united after death, though they are vague as to why this is necessary or desirable.

The Hindu Self

Interestingly enough, around 3000 BCE a group of individuals in what is now India began to consider the same topic that is being discussed. This culminated in a series of sacred writings from 500 to 100 BCE called the Upanishads consolidating the religion. These are the basis to a fascinating religion but we will confine ourselves to what pertains to the concept of self. These

men asked themselves the question, what is the essence of a human? They peeled away human characteristics as if they were peeling an onion. To these men, sexuality and body image obviously did not determine what we truly were. Neither did other characteristics such as memory, age, and personality. All of these could change within a person’s lifetime so they weren’t permanent characteristics. They arrived at the conclusion that at the center of being was a pure essence they called the “atman” which they conceptualized as a part of God in each person. If this was true, they reasoned, then it couldn’t be destroyed or created but would be passed from person to person. When one person died, then the atman would pass to one being born. This was the doctrine of reincarnation. The atman, the essence that was passed, contained neither memories nor personality, but only the essence of being. One professor has likened the atman to a Teflon coated B-B. With each transition, a person had to start a new life. While reincarnation seems like a good idea (It would be nice to see how the grandkids grew up or what happened to the Republican party.), at the time the idea was conceived, it was definitely not. Life meant suffering, and to have to repeat it endlessly meant you would suffer endlessly. You could have some say in the future destination of your atman through Karma. Karma was the total of the good and evil you did in your life. If the total were good, then your subsequent birth might be of a higher rank. To summarize, at the start of this religion, the self was defined as an immortal and eternal essence with acquired learning and characteristics.

The Buddhist Self

At the same time the Upanishads were being written, a wandering monk was thinking things over about Hinduism. He tried to find his essence, the atman, in meditation, but only met with frustration. “I don’t find an underlying self when I meditate,” he said, in effect.” All I find is a lot of questions and interruptions.” This monk, who was known later as the Buddha, concluded that therefore there was no single object called the self. What he thought was there can best be illustrated by a Buddhist riddle from the twelfth century. A king had a servant light a candle in his hall every evening at bedtime. In the morning, the servant returned and put it out. Is the flame extinguished in the morning the same one lit at dusk?

The question is easy to answer if one realizes that the flame is a process, not an object. The self therefore, the Buddha concluded, can be best thought of as a process, one that changes constantly. You are not the same now as you were as a child. Indeed, there are Buddhist sects that say, “breathe in, breathe out, you’re a different person.” This concept is appealing to Westerners because it portrays the self in a dynamic continuum, a status compatible with some parts of western ideology. The Buddhist “process” is metaphysical, however. The Buddhists retained the concept of reincarnation but stressed conquering suffering by freeing one’s self of desire. Buddhism, like Hinduism and Christianity, has evolved into many different disciplines.

The Western Self

Current concepts of the self in the West had their origins in Greece. We have already discussed the Heroic Self of the early Mediterranean. By 300 to 100 BCE, many other concepts were

developed. Plato, through his writings on Socrates, popularized the concept of Dualism. The self, he said, was a transient visitor who was more at home away from the body than with it. Socrates argued that the self must be immortal. Christianity was not far behind in adopting these concepts to religion and naming the result the “soul.” Paul became the theologian primarily responsible for Christian dualism. His work was later amplified by Augustine in late 300 AD. It was said by Richard Tarnas that what was implicit in Paul was made explicit by Augustine. Augustine’s codification of the Christian religion lasted 1000 years. The concept of soul was refined by Thomas Aquinas who in the 1200s elaborated on an earlier definition laid down by Plato. Catholic philosopher Jacques Maritain summarized Aquinas:

“A spiritual soul cannot be corrupted, since it possesses no matter; it cannot be disintegrated, since it has no substantial parts; it cannot lose its individual unity; since it is self-subsisting, nor its internal energy, since it contains within itself all the sources of its energies. The human soul cannot die.”

During the Age of Enlightenment, religious precepts were increasingly challenged. Descartes who lived in the mid 1600’s might be said to have begun the modern era. Descartes, a noted scientist and physicist, developed a thought experiment in which he essentially questioned every source of knowledge. He reasoned that everything, his environment, his sensations, his memory, could all be falsified. Even if everything was false, his mind could still function to doubt what was being presented to it. His mind, his reason, was the one true thing he could trust. “I think!” he exclaimed. “Therefore I am!’ So what is new here? We still have dualism with a metaphysical self. The proof is filled with problems. Right off, I may exist but what about you? Nevertheless, for a non-clerical person to reach this conclusion was a great intellectual advancement of the day. It implied that my self is free to reach conclusions of my own. Religion can concern itself with the metaphysical world without having to reference it to reality. Science and technology can investigate and codify reality without having to venture into the supernatural. The metaphysical mind and the physical body communicated with each other by the pineal gland, the only structure not duplicated in the brain. Using Descartes as a springboard, a variety of philosophers and theologians were inspired to speculate as to what we are and how we exist.

The next great step taken in understanding ourselves was not made by a philosopher but a physician. Sigmund Freud was a physician who practiced in Vienna in the late 1800’s. He postulated a self that not only was wholly organic in origin but also was fragmented into at least 3 parts, the Id, the ego, and the superego, with the ego most identified as being the self. Freud also held that most of our motivations, fears, and irrational ideas were hid from us in a section of the mind he called the subconscious. Further they could not be brought into awareness voluntarily but could be accessed through therapy he had devised. We are so used to these psychiatric concepts and terminology now that it is difficult to imagine the impact this knowledge had at the time it was first elaborated. The picture of a self involved in a hidden internal dialog entirely subject to the laws of chemistry and physics has not only stimulated science but also art and literature.

Following World War II and during the cold war period, there were advances in technology that produced new insight in neurology, neurosurgery, neuroradiology, and neurochemistry. The

computer tomography or CT scan, a computer driven three dimensional x-ray machine that can help pin-point traumatic lesions and the MRI have led a revolution in imaging. MRI, which stands for magnetic resonance imaging, is a radical new method of investigating the body. Briefly, it aligns the hydrogen atoms of the body in a powerful magnetic field. The body has plenty of these, hydrogen being a component of water. The alinement is then disrupted by radio frequencies. This continued disruption and re-alinement causes the hydrogen to emit signals that can be detected by surrounding instruments. These signals can then be assembled by a computer to form a three dimensional picture through which slices can be taken and viewed as desired. This allows us to visualize in detail soft tissue structures in the skull. Refinements, such as the functional MRI, or fMRI, allows us to watch oxygenated blood flow in the brain. Using these techniques, we can measure the activity of a part of the brain. This means we can ask a patient to perform a task and see what area of the brain is being utilized. Articles are now appearing which describe how the brain responds to such things as meditation, ethical questions, and glossolia (speaking in tongues).

This seems to make a strong case for materialism, which is not a new philosophy but also originated with the Greeks in ancient times. Materialism is the belief that everything in the universe could be explained by laws of physics and chemistry. It disappeared during the centuries of religious persecution only to reappear during the Age of Enlightment lead by Voltaire. Advancing technology has given its arguments more substance in this century. We can now unite form and function. If we state that the self is purely a neural phenomena and a property of the brain, we don’t have to worry over how a metaphysical self communicates with the body. If the body communicates with neural impulses, then isn’t the self nothing more than a self-referral neurological system? That greatly simplifies things. We can get rid of all metaphysical systems entirely. Unfortunately, philosophy stands at our elbow like a nagging wife. First of all, granting the argument that the body is purely mechanical doesn’t rule out other metaphysical orders. It is possible that there is a God or Gods that merely chose to create the human as a mechanized being. The Greek heroic age we discussed earlier came close to this. Second, lights going on and off don't tell you anything about who lives there. We still are looking at the outside of the house so to speak in our studies of the brain. It is possible that the body acts independently of the self and the self is an illusion that follows the body action like a shadow follows a horse. There is experimental work suggesting that the mind conceives of action and undertakes it before the consciousness is aware of what is happening. It also turns out that there are also varieties of materialism one must chose from, ruining the simplicity argument. One can be a reductive materialist and have faith that one day science will understand neurochemistry to the extent that we will be able to duplicate the thought process in the laboratory. One can be a non–reductive materialist. This holds that while the brain is mechanistic, language and culture are so intimately involved in the formation of intelligence that human will always be incapable of the duplication. There is also the question of whether there are dedicated neurons that form consciousness of whether consciousness is achieved from the patterns generated by neuronal action. Stay tuned. The argument continues.

Part IV: Bringing It Home

We have covered at least ten different concepts of the self, ranging from 500 BCE to present. Most of these are religiously driven, although in a number the religious concept has changed since the origin. Some of these concepts allowed for a dynamic interpretation, some thought the self was static or unchanging. In some of these concepts immortality was a necessary construct, in some it was negligible. All of these concepts of the self are not fiction but what people in some cases have adhered to for centuries and still do. Many people have died for their right to do so.

Taking these concepts, let’s take a look at N.M., whose dilemma began this talk. We don’t really know him, do we? We’re not alone about this. He never talked to his wife or children about himself. He took it for granted that they all knew whom he was and how he would react in any situation even if he were unconscious. They didn’t. This forced them to respond to the situation with conclusions drawn from their concepts of their own selves. Each of us would like to think that we are ethical and follow the Golden Rule when making decisions. “Do unto others as you would have them do unto you” can become very difficult if you are unaware of what others think they are. In this case, each is attempting to impose on others their own idea of care. To the wife, this is initially a situation of dualism. The fact that tissue destruction is irreversibly present does not mean to her that no one is home because the lights are out. Her hope for recovery of her husband will continue into the future. Her pastor did not know her husband. He is concerned about the soul of N. M., a different concept from that of both Mrs. N. M. and the physician. The body is simply a vehicle that the soul is now abandoning. It is to this concern that his remarks are addressed. Her Asian neighbor is Buddhist and is not suggesting that N. M. has a long life ahead. She is saying that in his next reincarnation he will advance because he has good Karma. Her husband’s business partner expects N. M. to be a good businessman just as he is. He knows N. M. will be there shortly to sign the checks because that’s what he would do. The son’s ideal self places duty above all, a heroic concept. He will come home at the proper time, not realizing that his mother needs his emotional support now. The daughter speaks to N. M. as her father who has never failed her, rather than a dying man. Like the good daughter she pictures herself to be, she encourages her mother to take control as she would and tragically misunderstands the situation. Finally there is the physician, who for the most part has obtained his ethical training at the bedside and in the emergency room. He prides himself that he is a materialist. He has been trained that there is no place for the supernatural in his performance. He is personally responsible for everything that happens to his patient. When his patients say ”Give it to me straight, Doc.!” They know he will. Yet, because of his conviction that life ends with the permanent disappearance of self-awareness, he now finds himself trapped in a frustrating dualism of a dead patient and a living body. The wife, to whom he must convey this to, has abandoned her dualism. She now feels if the body is there, her husband is also.

I would like to tell you the rest of this story but it gets worse. What can Mrs. N. M. do in this situation? Her options are limited. She can ask CPR, resuscitation, not be given. Resuscitation of a person with no hope of improving his status is considered optional by law. Can she withhold life support? If there is definite evidence that the brain is irreparably damaged and the body is incapable of maintaining itself without it, again that is legally allowable. This is not the case of

N. M. He is stable off life support. Are food and water treatment? Could they be withheld? Without clear direction of N. M. himself, we now enter murky legal waters. Could this have all been avoided? The answer is yes!

Many people spend a great amount of time pondering if they will have eternal life. They overlook the fact that our lives on this earth do not end with the permanent loss of our self-awareness. Well, let me put it another way. To ourselves our life is over as we know it when we are no longer aware. That’s it. But that isn’t “it” to our friends and relatives. They don’t really know whom we are inside. For most of us that’s a good thing. You don’t really want people know about the time you sneaked into the movie, that blond you acquired when the wife was out of town, your chronic constipation. It’s better they remember you as the loving father, the good husband, the frequent benefactor. No one cares who you really are, except yourself. Did you ever hear anyone walk by a casket and say, “I bet he really misses himself?” What you really want to do is to take care of that part of you that may hang around long after the self has checked out. There’s a body to be dealt with, an estate to be dispensed, and of course, business matters. All of this can be directed by you, even if you are not personally aware.

N. M. should have done four things to make life livable for those who loved him. He should have drawn up a will. Most of us think that a will is necessary only if you have money. The truth is the less you have the more people will fight over it. A lawyer will help you but the forms are easily obtainable. Next a “power of attorney” would have given N. M. ‘s wife the right to act in his stead when he became incapacitated. This would have allowed his wife to go and sign the checks for his partner and, indeed, insured that she received her share of the business if it was sold. Without it, his wife will have to go to court to be empowered to act. Next a “living will” is legal in all states. It allows you outline the care you wish to receive before you become incapacitated. It is usually a checklist that is fairly specific. If irreparable, give no care? You got it. Do everything you can as long as you can? You can have that too. It’s a good idea to discuss what you want with your wife and children but the least you can do is to fill in the form. Finally you need a “durable power of attorney for medical care”. This allows you to chose a person you trust to make medical decisions for you if you are not yourself, incapacitated. This is usually combined with the living will. You should be sure that the person you chose and your doctor have a copy. Usually the next of kin has this power without a document. Usually. But what happens when the daughter flies in and decides she knows what is best? If it’s on paper, a lot of pain is avoided.

Most of you, I hope, through your doctor, lawyer, or accountant have already filled in these forms. They are easily obtainable from most clinics or hospitals. Studies, however, show that only 20 to 30% of the population has them. Check and be certain they are up to date. The ones that cause concern here are our children and grandchildren. Most of them are convinced they are immortal. Most have not earned enough money yet to worry about a will. These are the people who die suddenly from accidents, heart attacks, and the like. Take the time to review with them the steps they should take. They should thank you.

So, after all of this, was I able to find myself? When you have an unanswerable question you may be asking it incorrectly. This is not a question that can be answered collectively. There are

people throughout history who have believed devoutly in the dualistic philosophy, that we have a metaphysical mind in a physical body. They have contributed greatly to human progress. They have created great architecture; the Vatican, Notre Dame, great music; Mozart’s Requiem Mass, Handel’s Messiah, great art. But in societies and cultures where you had to believe what the majority believed, the Middle Ages, the Holy Roman Empire, and now countries like Iran, individuals suffered greatly. There have been people throughout history who were materialists. They have given us vaccines, medicines, inventions that have made life more comfortable and livable than ever dreamed. But when this philosophy was enforced on people, you had such disasters as communist Russia, China under Mao, and currently North Korea.

Perhaps then, we should ask, as an individual, what is the purpose of the self? This is a more productive approach. For one, as soon as a human develops language he needs a point of reference for description. Can you imagine telling someone where you are seated in this room without using the word “I”? Children usually don’t recognize themselves in a mirror until they begin to use language. The self also allows you to distinguish yourself from others. We take this for granted yet both insects and many mammals don’t recognize others of their species in their group as “different”. When the world became crowded enough, man’s worst enemy became man. Realizing that you were different from others and might be harmed because of it became a strong survival characteristic.

The concept of the self also became of high survival value to our inner environment. The self gives us a sense of detachment that allows us to handle things in the external environment that would otherwise overcome us with emotion. (Just put the bomb down and no one will get hurt). We can also survive pain and injury through it. (My arm is gone but my self is intact. It is the foot that hurts. My self can bear it.) Humans will voluntarily endure pain to protect their concept of themselves and the self in turn provides the necessary detachment. Finally, to humans, a permanent termination of self-awareness is inconceivable. We can no more accept death than we can visualize infinity. It is a concept that the consciousness fails to grasp. The concept of the self provides us both a justification and the possibility of an escape from this inevitable eventuality. The self becomes the final defense mechanism. The concept of the self is a fundamental one of Western society.

In 1875 a minor poet named William Ernest Henley wrote a poem called “Invictus”. As a student he developed tuberculosis of the lower leg and had it amputated. It then spread to his other leg. He refused to have it amputated, survived and lived to 54. “Invictus” was written on a hospital bed. Listen to what he says about the self in the last stanza:

It matters not how straight the gate,
How charged with punishments the scroll,
I am master of my fate,
I am captain of my soul.

Only you can find your self but the search is worth it. Take care of your self.

In Search of Myself
Bibliography

Alice’s Adventure in Wonderland. Lewis Carrol. The Macmillian Company. Chapter 5, page 39

Webster’s New World of the English Language. College edition. The world publishing company.

As You Like It. Shakespeare. Act 2/7

Variability in Pediatric Brain Death Determination. M. Mathur et al May 2008. Vol 121. Number 5. pg 988- 993

Guidelines for the Determination of Death. W. R. Barclay. JAMA. 1981;246:2194

A Treasury of Great Poems. Compiled and selected by Louis Utermeyer. Simon and Schuster, Inc. pg 745-746.

The Odyssey. Homer. Translated by Robert Fitzgerald. Farrar, Straus and Giroux. 1998. Book XI,.

The Odyssey. Homer. Translated by W. H. D. Rouse. The new American library. 1937.

Think. A Compelling Introduction to Philosophy. Simon Blackburn. Oxford University Press. 1999.

The Works of Plato. Selected and edited by Irwin Edman. The Modern Library. 1928.

Phaedo. Ibid

The Passion of the Western Mind. Richard Tarnas. Ballantine Books. 1993.

The Closing of the Western Mind. Charles Freeman. Alfred A. Knopf. 2002

Fifty Major Philosophers. A Reference Guide. Diane Collinson. Croom Helm Ltd. 1987.

Philosophy of Religion. John H. Hick. Prentice Hall. 1963.

Philosophy for Dummies. Tom Morris. Wiley Publishing, Inc. 1999.

The Conscious Mind. David J. Chalmers. Oxford University Press. 1996.

The Meaning of it All, Thoughts of a Citizen-Scientist. Richard P. Feynman. Perseus Books. 1998.

Religions of the World Made Simple. John Lewis. Made Simple Books. 1958.

The Iliad of Homer. Translated by Richmond Lattimore. University of Chicago Press. 1951.

The World’s Religions. Cambridge University Press. Ninian Smart. 1989.

Buddha. Karen Armstrong. Penguin Books. 2001.

An fMRI Investigation of Emotional Engagement in Moral Judgment. Joshua D. Greene et al. Science 14 Sept. 2001: Vol. 293. no. 5537, pp 2105-2108.

Q&A John Searle. Boston Globe. Harvey Blume. February 4, 2007.

Neurobiology: The Roots of Mortality. Greg Miller. Science. 9 May 2008. pp 734-737.

The Measurement of Regional Blood Flow during Glossiolalia: A Preliminary SPECT Study. Andrew B. Neuberg, et al. Psychiatry Research: Neuroimaging. Vol. 148, Issue 1, 22 Nov. 2006. pp 67-71.

How Does Consciousness Happen? Christof Koch and Susan Greenfield. Scientific American. Vol. 297 No. 4. Oct. 2007, pp 76-83.

Searching For God in the Brain. Scientific American.com. David Bello. Oct. 03, 2007.

Mapping the Mind. Rita Carter. University of California Press. 1999.

I Am A Strange Loop. Douglas Hofstadter. Basic Books, A member of Perseus Books Group. 2007

Believers and Beliefs. Gayle Colquitt White. Berkley Books. 1997.

The Elephant in the Living Room; A Will Is Not Enough. Richard Salmen. The Wall Street Journal. March 8-9, 2008. pp- S4-S6.

The Rediscovery of the Mind. John R. Searle. The MIT Press. 1994