Me, Myself and My Brain Implant: Deep Brain Stimulation Raises Questions of Personal Authenticity and Alienation
Patient 3, a 45-year-old female executive, married with 3 children, had levodopa-responsive PD for 6 years […] with severe motor complications. Before the operation, she was ashamed to be sick and concealed her disease from her colleagues and employer. She invested herself in her work, assumed more and more responsibilities, and had great hopes that the operation would help her to progress in her career: ‘If I’m not operated in the coming months, the beast is going to sleep. As long as I have my work, I still exist; the day I can no longer go to work, it will be as if the curtain came down on my life. ‘Six months after the operation, she had no trace of a motor handicap […]. She put off going back to work, however, because she felt anxious, had lumbar pain, dizziness, difficulty walking, but had no neurologic substrate. […]. An episode of severe depression was treated successfully. Eighteen months after the operation, she had tried several times without success to go back to work:’ I don’t have the same ability to concentrate as before. I have a lot of work and prefer to spend my time doing other things. ‘She requested unjustified sick leaves, preferred to go out, buy things on the Internet. She threatened to divorce, although there had been no marital conflict before the operation. She announced her disease to her entourage, was active in associations, and wanted to ‘be recognized as sick.’ In short, a loss of professional status after the operation occurred, in spite of spectacular motor improvement, which was the cause of a marital crisis.\nHere, at first glance, the picture is very similar to the first case: now that the patient’s condition has improved, she experiences leisure as authenticity, whereas she experiences work as alienating. The cured patient prefers to spend her time doing other things outside her employment, spending money on the internet and joining social activities. However, in contrast to the first case study, it is interesting to see that now that the patient’s body condition is improved drastically, she somehow paradoxically wants her disease acknowledged.\nBefore the treatment, she had attempted to hide her disease from her family, employer, and colleagues. Now that she is better than before, it seems that she, to a certain extent, actually denies being better and does not want to recognize her own improvement. The fact that she demands attention for and recognition of her diseased state, even when she is ‘healthier’ than before, suggests that she identifies her diseased state as her authentic state. Similarly to Patient 1, the bodily self-image of Patient 3 seems to be dissociated from her mind. Her mind is still that of a sick person, although it has gained the strength to now recognize and even publicly proclaim her disease, whereas her body improved already – a fact that does not seem to have made it through to her consciousness. Her battle-cry is: ‘I want to be recognized as sick’, now that her symptoms are much better than before surgery.\nAll in all, to me the case of Patient 3 reads like a story of emancipation, revelation, or even revolt. It even sounds as if she regarded her personal, retrospective coming out as a Parkinson’s patient as a political mission, probably also willing to fight for the rights of other people in her situation.\nIf we use the notions of alienation and authenticity, we can shed light on Patient 3’s experience. We could interpret the patient’s situation before treatment as alienating: she used to live a life under permanent pressure, being an ambitious working mother who has PD, and who, on the top of that, felt the need to conceal her ailment. DBS helps this patient reach a state authenticity, insofar as she is now able to be sincere, honest, and self-confident with respect to herself. In hindsight, the patient truthfully recognizes her own past condition and pays herself due respect for all she has undergone and has nevertheless achieved. Paradoxically, this happens at the very moment she experiences a substantial relief of most of her preeminent PD symptoms. Her newly gained self-confidence makes her demand full recognition for her achievements from others as well. In this vein, due to the treatment, she has gained the strength to be truthful and open with the people in her life, making her disease public instead of shamefully trying to hide it. Now that her bodily symptoms have remarkably improved, it seems that the time is ripe for her to reap some ‘reward’ and compensation for all the hardships she underwent during her disease.\nTo sum up: interpreted this way, what is important in this third case study is that the patient escapes from felt-alienation through treatment and achieves a state of authenticity as a result. Here, authenticity means liberation and emancipation.\nSo far, I have offered an interpretation of these three case studies within the philosophical framework of authenticity and alienation; however, as I mentioned above, my interpretation differs from the conclusions that the authors of the study draw. In the following section, I want to turn my attention to their conclusions and to what, from my vantage point, is unsatisfying in their account.