I cannot understand the good fortune of what Roberto Calasso so generously described as my “fascinating scrapbook,” but I must accept it, though mindful of the customary obscurity and willfulness of Fortuna’s motives. For the reader the charms here are few, yet none of my books has been more successful—it has even set down on other languages! No amount of scheming on my part could have brought this about. What’s even stranger, I myself hardly felt my little barques were fit for navigating unknown craters.

Of the various descriptions of this work, my personal favorite is “a satirical booklet.” It came out in 1979 and still finds readers, some of whom write to me… And here I am, alive, meticulous, and rewriting. For the publication of a tenth-anniversary edition, I tried at the very least to revise and recolor the text and to offer both new and old readers little novelties, the results of self-criticism and of further meditation, stitched here and there into the settled fabric.

For years I have been fascinated by medicine, whose company I have kept in books and in my obsessive worries over health. Today (I have the distinct impression) it has come to defy all historiographic and speculative, not to mention ethical, supervision. Given the impossibility of forcing medicine back inside moral boundaries, thought, the assailant, strives to understand its terrifying object—the true Leviathan—by photographing from various angles the shadow cast upon the earth by this deadly comet. This comet is distinct from our other, everyday, every-hour Halley’s comets, though sometimes they tangle and are confused in their fatal orbits around this silent globe.

I am appalled by the passiveness of bodies, of our unhappy lives, of our mortal bodies, under the scourge of Medicine’s will. And I am dismayed by Medicine’s insatiable omnipotence, its desire to do everything it decrees for our own good, making us wholly dependent in johnnies that look like they came from a concentration camp.

We have lost count of medicine’s burglaries, violations of the flesh, demolitions, break-ins, barnstormings, kidnappings, blackmailings, consensual interceptions, rivers of black, white, and red blood, devastations, and cosmic robberies of both private and public money. Thought does not know in which category of evil to place it or how to digest so much pediatric blackmail, so much oncological, geriatric, obstetric, and cardiological blackmail, madly spread wherever there are doctors, health-care services, hospitals, laboratories, and clinics for chronic illness. Every bit of medical blackmail (which is sometimes attractively affectionate but always profoundly brutal) corresponds to a genuflection by the body’s scapulas and mental vertebrae, the immediate surrender of the whole to a cease-fire order delivered to a part that is under assault, or supposedly about to be assaulted, by pain.

Molière’s Imaginary Invalid is more distant than a star; all the old satires on doctors and medicine (until Jules Romain’s inimitable Knock, which marks a turning point and looks to the future) pounded away at human defects, cynicism, ridiculousness, and superstition. But no satire can rail at medicine like ours (we are unprepared, we still know too little, we are only beginning to understand); it governs us, elusively, over almost the entire earth.

Any university doctor is an armed and shielded giant, against whom the defenseless body-dwarf cannot do battle. Little does that doctor know that a little recalcitrance might be helpful, even beneficial, might have an ethical importance, a healing energy.

The depth of devastation wrought by medicine’s retaliation cannot be weighed against the immensity of its concessions—relief from pain. Thought is tortured by the appalling uncertainty of medicine’s moral pretexts and paralyzed by its triumphant results. If we even attempted to assess the damages, our heads would be left spinning.

IDOLATRY: Therein lies the only sin that gave goosebumps to the prophets of Israel and of Judah.

There is no need for a jailer: one need only use letterhead stationery and a telephone and behold the creation of interminable lines of worshippers in an unending pilgrimage, bringing before the idol their daily offerings of chilled urine and blood sucked from the veins, of feces and vaginal secretions to be translated into algebra. On the appointed day, at the appointed hour, they reappear, anxiously awaiting the response of the Sibyl, whose cryptic speech dispels or draws nearer each worshipper’s moment of death. —I have to be hospitalized in a week… —and there I am, suddenly with a woman who is “to be hospitalized as soon as possible.” Seven, eight, ten lives are caught in a whirlpool, all flowing together toward an entrance that is open night and day, where the guards stand around smoking.

Thought cannot help us transcend our wretchedness, since we need to know more than we can. It cannot help us assess the blind damage to humanity, to our human truth of struggle and death, and to our ability to wage spiritual warfare brought about by the permanent removal of childbirth from homes and from midwives and by the practice of forcing people, with fewer and fewer exceptions, to suffer and die in hospitals (lest they meet sudden, violent deaths). This death cannot even occur in beds meant for rest, but more and more frequently in rooms designed for therapeutic manipulations, where the patient is penetrated by machines and intimately disfigured by chemical treatments. Indeed, the Hospital has appropriated the alpha and the omega of birth and death. One cannot even deliver oneself to a (mechanically) ascertained death: the funeral must take place inside the structure.

I can only say that, since my day is also approaching (a thrilling adventure derided and even excluded by the possible!), my anguish is increased by the fear that I will be unable to die at home. Nevermore will the bell toll. Instead, the ambulance’s siren splits the traffic, announcing each time: “It tolls for thee.”

We cannot even assess the loss represented by the steady annihilation of the house call. It has been replaced by the telephone, which at the established times icily dispenses prescriptions for drugs or dictates a future appointment.

Triumphant medicine could not have left us more alone, more ailing from the lack of a hand tapping that spot on the armchair where it rested forcefully so many times. We are left admiring its ticker-tape parades from behind iron bars of despair.

The hand, for beings who have them (Martians do not: will we lose ours?), is a microcosm of the grace that preserves and cures with inscrutable finality. This is where all the cosmic therapeutic currents gather, between the first phalanx and the rasceta, and (among those unmarked by sadism or idiocy) compete to generate the hand’s secret energy, which can be increased through medical use, as it is in dance and mime. A doctor who does not carry his own hand, gracefully, into the sickroom (Munch’s doleful drawings) is a destroyer of the body and will battle it with his snarling silence of resigned mortality, of undeciphered living dead. Unfortunately, the absentminded specialist will know nothing of this and feel no remorse for his days of full schedules with no openings.

Goya and His Doctor, Arrieta (so far away, unfortunately—the Minneapolis Institute of Arts) is a poem of humanity that cannot be contemplated without tears, a grateful tribute to the good doctor who places his arms around his patient’s shoulders, coaxing the recalcitrant old man to swallow a potion; it is an amazing tribute. But where has Arrieta gone? Today, in all of America, who could say they have encountered an Arrieta?

Goya painted this scene as an ex-voto; in fact, it is a post-Christian ex-voto in a world of enlightened afrancesados (Francophiles). The physician is transfigured into visible sainthood, into a Rescuer for whom you rush to open the doors. In the shadows they were preparing the obsequies, but here is Arrieta, and the seventy-three-year-old Goya will once more succeed in standing up… Arrieta is awaited, even today, but what arrives instead is the ambulance: you will be shattered… In that haze of blood, atom among atoms, oh for your hand, Arrieta!

We cannot imagine the Hubris committed in the medical field or treat it as a calculable quantity, because these acts are éminences grises that accumulate without incorporating in order to manufacture destiny. The Hubrises coagulate to form what hermeticism calls “rule by demons”; they are active violations that become forms of sublunar life and assume leadership positions…

For a moment let us focus our attention on one point. The suffering that we cause animals used for experiments forms a chain of Hubris (a term I understand exclusively to mean a transgression of the impending and unrevealed moral law) covering all the Hellenism of this and other worlds with an icy pallor. Despite all its Greek vocabularizing of itself, and the invasions of American acronyms, Medicine has not found a way to annex Hubris, its basic illness, its flaw of power overstepping the Limit.

When the earth spews forth its stories, once again we shall see all the eyes of the weak creatures who were sacrificed.

But I wonder to what extent humanity, incurably healed by Western medicine, is now trapped by the rats it exterminates with such ingenious nonchalance in its laboratories. I mention only rats—though they are not alone in suffering the experimental madness masquerading as icy reasoning—because rats are the majority, and on the lowest level, the cheapest commodity, the one that least disturbs the conscience. In most, why not say all, prescriptions, the hand that writes is inspired by a rat. The rat rules over the shelves of the Pharmacy, and its clever little nose pops out of the white coats sashaying down the corridors cheerfully greeting one another. The little rodent gnaws gnaws gnaws…

The Body never wanted relations with the rat, the rattus, the dweller of granaries, sewers, and tunnels, the defiler of cadavers in watery places, the phallic symbol, the soiler of kitchens, the incubus of wells and prisons. Medicine forced it into this marriage, which takes place via drops, pills, and cosmetics, parenterally and rectally. Medicine wished to set the Body between the Rat’s paws in order to restore memory and movement to the joints, to lower arterial pressure, restore sleep, dispel anxiety, set the intestines back in motion, and disinfect wounds. The rat blocks the thyroid gland, administers cortisone, shrinks the prostate, prevents pregnancy, banishes polio, washes our hair, and tightens wrinkled skin.

The modest mind of this tiny gnawer of living and dead paper is what makes today’s historic decisions, winning and distributing the Nobel Prizes in Medicine, assuming responsibility for peace and war, archiving the famous data without which knowledge would grind to a halt, and providing for the irreparable, devastating scientific locking o the gates to the world. A rat’s skull stares at us from a rotting doorway.

There is something more powerful than a pandemic and analogous: a circle that was established from rat to flea and that determined human history. The influence of the rat on human existence (via pharmacological tests) introduces psychic and intellectual modifications unknown to Yersin’s plagues. Today the rat nibbles at us from the depths of its unnatural suffering, from its tiny lazarettos of certain, excruciating death. It is more inside our lives than when its ancestors jumped off the docks and followed the caravans. Is not such research on cancer already cancer? Is not such psychiatric research already madness?

Is there such a thing as an AIDS of the mind—hiding, escaping, and falling from spiritual immunity? There are huge arsenals full of remedies—but what remedy is there for this? You can plug such a leak with a drug that gets rid of eczema in two days but compensates for its efforts by boring a hole in the stomach, where it deposits its formula and, after a brief period of usage, lays the solid foundations for the inevitable carcinoma! All treatment for the ailing spirit is administered by matter that acts as matter, that cannot grasp that which is foreign to matter but can modify it by ineffably acting on the body.

A chilling thought: The only things keeping the city from collapsing are analgesics, liquid anxieties, psychopharmaceuticals, sleeping pills, and sedatives; it does not collapse because it is sustained by the consuming worm’s nest of legal and illegal drug addicts. Are they the Fifty Righteous Men? Or is the city sustained because hidden in its sewers are ten unimaginable Righteous Men, with the beard of Shem Tov and the eyes of lost Sophia?

The truth is that the city’s resistance is an unending collapse: it falls apart and the law retreats. Drugs can keep it alive only provisionally and desperately. Maybe the city is already dead, like Beckett’s visionary in Endgame or the earth in Jeremiah 4:23-26. I also wonder where all the anxiety we repress but cannot extinguish ends up. In a Mississippi of urine? What chains of psychic sewage hold together each of these megalopolises (each with a mayor!) speaking English, Italian, French, Urdu…

Medical triumph is human failure because we have not found a less unfair way to overcome pain and old age and death.

Such a broad power necessarily employs many scoundrels, dreadful scoundrels with degrees in hand. Absolute probity lives uncomfortably there, and succumbs. The relative probities can only slightly attenuate the tremendous destructive energy of such a nonstop show of force.

There is fear of the body: see it in Eros confessing, in crime enthralled by obsession, and in medicine that has tamed and now observes the body. (The expression “under medical surveillance” is meant to be reassuring, but imagine, for a moment, being always surveyed, internally, by instruments—the thought makes me shudder.)

The overwhelming fear of the body is one of those ancient, ancient fears, adopted and never relinquished by Christian women (the Patriarchs’ De virginitate, the confessors’ manuals, sinister coffins…). It could not be diminished by repeated stormings of the Bastille from the eighteenth century on, or even by the decrease in infections. This fear belongs to the metaphysical terrors from which only death can deliver us. (In dermatology, observations of merciless interest can be made on this.)

What an error to think this fear is absent from contemporary medical power, that enormous, cannibalistic whale; it seems to have been erased from medical practice, but the will to subjugate is the fruit of fear. The secularization of death expands the desert: sacred shelter from decay. We also observe the symptom of fear-of-the-body in the specialized atomization of power. Medical specialization allows the physician to look away from the totality of the body and to avoid the bravery needed to know the body all over. A cavity is enough—the mouth, the uterus—and may the rest leave us alone…

In a certain sense our persistent fear of the body (and even of the frightened and thus less frightening infirm body) partially salvages the body-symbol, its otherness, and its evil powers (which do exist, and how!). This fear betrays a fault, an impotence, an unconscious weakening of the subjugating instrument.

The body manifests its fundamental restiveness in the mind’s longing to reappropriate its lost magic power over the elementary spirits of infection and over parts of nature. But it is infinitely easier and more comfortable to enroll in a school and graduate brilliantly, to inspect the inorganic and the living world scientifically, than to become a sorcerer by developing the faculties that have been left to rot in the mystery of the body. This sorcerer could heal—as well as assist, gently and bloodlessly, whoever wishes to die—through the traditional knowledge of the intact but neglected sensibilities, the qualities and substances, blowing Yang into the dark Yin territories of aching matter.

The hunger for magic is quite reasonable. The risk is that malign Destiny will steer this hunger toward the star of evil. But today there is much greater need for good magic than for good medicine.

The relationship that science has forged with living and nonliving matter, with the soul and with God, is that of the psycho killer with his victims. Whoever wishes to be saved must never stop suspecting this, although it makes every inevitable dealing with doctors and their cures more agonizing.

The relative but undeniable success of certain organ transplants (outrageous Hubris) has forced the underworld gods to withdraw completely. The rights of the living have been infringed by the introduction of laws that change, soften, and rattle the notion and legal definition of death. There must be enough death for the body to be taken and its vital organs removed, but not so much as to completely freeze the remaining pulse of life in the organs destined to emigrate, on long journeys, to a body freed of its own useless or ailing organs.

Medicine is thus about to take one more step toward becoming the absolute judge over life and death. Every government is adjusting its laws. As in the myth of the Minotaur, the idol commands and must be served immediately.

A few more years of this incredible fin de siècle, the most crucial of them all, and every aspect of manipulating living cells and bodies declared usefully dead will be legal. At the same time there will be a feverish shrinking of the ethical and conceptual boundaries on being dead. I wonder how we will be able to stop criminal organizations willing to serve the (growing) demand of the market by providing clinics buried deep in the woods with tender young bodies deliberately sacrificed—here and there, darkness on darkness, in the poor and defenseless world. To operate on the dead, the demonically possessed will make use of computerized accounting and of other doctors inured to massacres, like Petiot.

This could become a traffic that is almost tolerated, indeed—like today’s drug traffic, over which evil has absolute rule—barely disturbed by modest legal persecutions. I could hardly imagine it if I did not know that such events already occur, behind a shifting gray curtain of blood… The hour will arrive when Modern Medicine will overcome death—the mortality at the essence of man’s being. For sixty interminable minutes, over all the inhabited earth, in a compact darkness never before seen, there will be a tremendous silence. No one will rejoice: for one hour everyone will be prisoners of life, materially a-mortal but not (ever) Dii immortales, amid the criss-cross and cascade of American and pontifical voices. It will be the true, the supreme heart of darkness.
 
February 1990