Vous êtes sur la page 1sur 16

1

Joel Wright

May 6, 2008

Marion

Negative Certitudes

The Self Under the Knife: A Phenomenological Interpretation of Surgery

Over the past thirty years, there has been a growing movement to produce a body of academic

work that provides a philosophical analysis of the concepts of medicine, illness, and health care. This

work has been done by both philosophers and medical doctors with the general goal of providing a better

understanding of the meaning of these concepts and applying this understanding to the practical activity

of health care. To this end, for example, Dr. Sally Gadow of the University of Colorado has developed a

schema for possible modes of being in relation to the Body-Self dialectic in her article, "Body and Self: A

Dialectic." Gadow's method was appropriated and applied in the 2007 article "Unstable Embodiments: A

Phenomenological Interpretation of Patient Satisfaction with Treatment Outcome," co-written by P.L.

Hudak, a research scientist, P. McKeever, a professor of nursing, and J.G. Wright, a surgeon. This article

gathered empirical data from interviews with actual patients who had all undergone hand surgery and

analyzed the patients’ experiences using Gadow's method. In addition, Frederik Svenaeus, a member of

the Department of Health and Society at the University of Linköping, has been working on a

phenomenology of illness and has attempted "to analyse the experience of embodiment in illness." (125)

All of these essays have been written within the last thirty years, and all of them combine the methods of

phenomenology with contemporary issues in different medical fields.

Unsurprisingly, both Gadow and Svenaeus use the philosophy of Heidegger in their analyses of

distinct aspects of the medical culture. For Gadow, the issue at hand is the question of how the Self can
2

relate to its own Body, and how the experience of an illness or an injury can alter this relationship. While

this problem may not, in itself, be central to Heidegger's larger phenomenological project in Being and

Time, it is related to it in that it brings to attention the problems inherit in the metaphysics of the Mind-

Body dialectic. Any kind of illness or injury, Gadow notes, interferes with our ordinary everyday

understanding of ourselves as being essentially embodied minds.

Svenaeus, for his part, extends the kind of phenomenological project undertook by Gadow by

investigating how our concept of ourselves as being transcendental subjects is challenged by the

interruption upon our Being by illness or injury. Specifically, he explores the possibility of the subject

treating her own body as not part of her Self, but instead as being a kind of tool (in the Heideggerian

sense of the word) that can function as an object-of-concern for Dasein, and is therefore necessarily

considered as being separate and distinct from the Self as it conceives of itself as a transcendental ego.

This, Svenaeus claims, leads Dasein into a kind of "unhomelike being-in-the-body," a state of feeling

alienated from one's own body, which is in general accord with Gadow's analysis of the effects of injury

and illness upon the Self.

What I find surprising, however, is how little time or space either Gadow or Svenaeus spend on

surgeries or operations. I believe that these tensions that Gadow and Svenaeus explore concerning our

relationships to ourselves and to one another converge when we consider, philosophically, the meaning of

medical surgeries and operations. This is why the research conducted by Hudak, McKeever, and Wright1

is both fascinating and important. In their paper, they report: "We asked whether and how patients

described states of embodiment... As a general observation, it was striking how all participants

spontaneously described having current or past experiences of disrupted body-self unity." (36) A surgical

operation is literally a disruption of the relationship between the Self and the body. It is an engagement

with a person’s body for the sake of the health and well-being of that person that takes place while she is

unconscious. In other words, undergoing surgery requires a radical break on the part of the patient

1 Hereafter referred to as "Hudak", with apologies to Dr. McKeever and Dr. Wright.
3

concerning his sense of Self as being an embodied mind. An investigation into the phenomenology of

surgery will reveal new insights into the meaning and possibilities of this break or disruption and its

ensuing effects upon the patient’s ability (or lack thereof) to return to Being-in-the-world.

Surgery is unique not only in the way that it brings to light the inherit tension between the Body

and the Self, but also in the way that it can be interpreted by the patient as a kind of Negative Certitude,

as an Event that is beyond the patient’s control and yet determines the meaning of the patient’s being.

During the operation, the patient is anesthetized on a table - his consciousness eradicated - and is being

dissected by another man (very rarely a woman), the surgeon. At stake during this procedure is the health

and well-being of the patient, and, very often, his very life. But at this point, the patient has absolutely no

control over the events that will determine his quality of life for the rest of his life. By this point - which

is supposed to be the crucial moment - he has already surrendered that power over to the surgeon. But

what, precisely, does this power consist in? How is it that a certain chain of events can lead the patient

up to this moment - unconscious and sliced open with a scalpel - in which his everything is being risked,

and yet he is in no way aware of it?

In this paper, I aim to analyze this concept of "surgery" using Heidegger's phenomenology as put

forward in Being and Time, while borrowing from the preparatory analyses conducted by Gadow and

Svenaeus. In particular, I will use the Heideggerian concepts of vorhanden and zuhanden, Being-

towards-Death (Sein-zum-Tode), and authenticity (eigentlichkeit) to show how undergoing surgery

requires the individual to deny herself her own eigentlichkeit over her own Being. Surgery, I argue,

brings to Dasein's attention the fact of its own embodiment, and transforms the body into an object-of-

concern and a tool for Dasein, forcing the body out of the standing reserve category of vorhanden and

into the mindful or concernful category of zuhanden. This, in turn, forces Dasein to confront itself s a

kind of malfunctioning tool, which challenges its mode of interpreting the world and reorienting it

towards its own Being-towards-Death, but not necessarily in an authentic manner. Instead, the prospect
4

of surgery puts the patient in the unique and paradoxical position of facing the possibility of her own

death, but also of demurring that moment of authenticity or acceptance by treating her death in merely

biological terms. This amounts to the patient being forced to accept two mutually exclusive

interpretations of her experience - one that sees her body as an object-for-concern or as a tool for another,

and one that sees her experience as an event that is enabling her to project her Dasein (and its

possibilities) into the future.

Hudak uses an analysis of the Body-Self dialectic put forth by Gadow in her 1980 paper "Body

and Self: A Dialectic." In this paper, Gadow articulates four different states of embodiment and the

means by which a subject can transition from one state to another. This schema is designed to show how

our conceptions of ourselves as embodies minds is challenged by the onset of illness or injury. The first

of these synthetic states is the "Lived Body (primary immediacy)" which Hudak describes as "... the

experience of taking the body for granted, and not thinking about it... The lived body, or unity of body

and self, is experienced when the body is unproblematic." (35) The next of Gadow's states of

embodiment is the "Object Body (disrupted immediacy)," which is signified by the "experience [of]

opposition or tension (disunity) between the body (or a body part) and the self. As the body makes itself

known, an acute or intense conscious awareness of the body part occurs." (35) The property that marks

the shift from the state of Lived Body to that of Object Body is that of "disruption," of a kind of a call

that is exercised exclusively upon the body, be it in the form of an illness or of a physical injury.2 This

disrupting phenomenon is what Svenaeus calls Unheimlichkeit or "uncanny unhomelikeness." He says

that "To be ill would consequently mean to experience a constant sense of obtrusive unhomelikeness in

one's being-in-the-world." (126) Therefore, Svenaeus analyzes this moment of the onset of illness or

injury in much the same way as Hudak and Gadow - Dasein is unable to retain its state of being-in-the-

world or of Lived Body (primary immediacy) because the illness or injury acts as an obtrusion or a

2 I am excluding from this analysis the possibility of certain psychological disruptions having this kind of effect on the
body.
5

disruption that brings to Dasein's attention the opposition and tension between itself and the body. This

causes Dasein to enter a state of Unheimlichkeit, of seeing its own body as a kind of object that demands

concern.

This state, the state of Unheimlichkeit, of not being-in-the-world, or of the Object Body (disrupted

immediacy), is the state that the patient is in when he first seeks out his doctor. However, the meaning of

this Unheimlichkeit remains unclear. What is it about not Being-in-the-world that motivates the patient to

seek out medical aid and, if necessary, surgery? Gadow's Object body (disrupted immediacy) state of

being is one of a fundamental splitting of the patient's sense of self (or of herself as a unified Subject), as

is Svenaeus' Unheimlichkiet. These two conceptions of being share the idea of a kind of finding of a

strangeness and an alienness by Dasein of itself; the existence of the illness or injury in the body

necessarily gives rise both to a sense of distance between Dasein and its body and of a compelling feeling

of anxiety on the part of Dasein for its body. Therefore, Unheimlichkeit is characterized by the sense of

one not being at home within one's home, one's own body, and Object body (disrupted immediacy) is

characterized by the patient suddenly finding himself having a mediated relationship with his own body,

a relationship mediated via the illness or injury. Hudak's findings reinforce this conception of an (often

literally) broken self. Their description follows:

The experience... of the Object Body state... is revealed in participants' descriptions of


constraints (including pain, weakness, stiffness, and loss of functional abilities), which
highlight how their hands felt distinct from their usual senses of themselves. Some
participants systematically use language reflecting detachment from their hands, referring
to "the hand" or "it" rather than "my hand." Others overtly allude to the partition ("It
seems that my hand is not a part of me") or refer to affected hands as an "alien part,"
"encumbering object" or "dangerous thing." The sense of disunity between the hand and
self is also described as a struggle or opposition: "It [finger] has a mind of its own - that
finger wants to go right back down" or as vigilance with respect to the hand , including the
avoidance of activities which disturb or bring the hand to mind, attempts to protect it, or as
anxiety about the future ("I'm more apprehensive, and I'm careful what I do with my
hands"). Finally, intense positive or negative focus on the hand's appearance reflects a
heightened awareness of the hand and is characteristic of the object body state. (36)

The language that the authors use in this passage emphasizes the picture drawn of there being a
6

distressing split between the self and its body that demands a course of action. This language also

encourages a Heideggerian analysis of the phenomenon of surgery. Examples of this include the

expressions of being more "careful" or "apprehensive" in regards to the patients' hands, of the notion that

"the hand is not a part of me," and of feeling anxiety about the future. This evidence brings forward three

crucial Heideggerian concepts. The first of these is the notion that, in illness or injury, the body becomes

an object of concern for Dasein. The second is that there are two interpretations open to Dasein in

addressing this concern, one being Being-towards-Death in the mode of Eigentlichkeit and the other

being the bodily demise. The third is that of Dasein's anxiety towards its own future and the possibilities

of its future.

Gadow's conception of the Lived Body (primary immediacy) and Object Body (disrupted

immediacy) are equivalent to Heidegger's concepts of objects in the world being either vorhanden or

zuhanden to Dasein. While the subject remains in the state of primary immediacy towards her body, she

treats it not as an object to be used (zuhanden) but rather as one whose meaning and function is assumed

as a part of the totality of significations that make up Being-in-the-World. However, as soon as she

suffers an injury, her body becomes an object for concern for her Dasein. Heidegger says that:

When we concern ourselves with something, the entities which are most closely
ready-to-hand (zuhanden) may be met as something unusable, not properly adapted
for the use we have decided upon. The tool turns out to be damaged, or the material
unsuitable. In each of these cases equipment is here, ready-to-hand. We discover its
unsuitability, however, not by looking at it and establishing its properties, but rather
by the circumspection of the dealings with which we use it. (H73)

When the body becomes damaged, when it becomes unsuitable for the activities that it is needed to

perform, its readiness-to-hand becomes revealed to Dasein. Hudak's data shows how this phenomenon

occurs regularly in medical cases. They concur (for the most part) with Heidegger's analysis, such as

when they describe how "any experience of embodiment is not static but may rapidly change from one

state to another depending on the social context or physiological state," by giving the example of an

individual "walking down the street in a taken-for-granted way (lived body) and shift instantaneously to
7

an experience of the object body upon twisting an ankle. The ankle quickly comes to the foreground of

consciousness and is pre-eminently disruptive." (38) When the body fails to function properly - that is,

when it fails to act as it ought to - it becomes an object of attention or of concern (besorgen) of Dasein

and ceases to be present-at-hand (vorhanden) and becomes ready-to-hand (zuhanden). This, as we shall

see, pulls the body out of its home in Being-in-the-world and requires Dasein to develop a new meaning

for it.

The onset of illness or injury acts as a disruption or obtrusion upon Dasein, bringing it out of its

home in Being-in-the-world and replaces this mode of being with a relationship towards its own body as

an object for concern. This shift of meaning for Dasein manifests itself as a recognition of the

immanence of its own death. Therefore, the onset of an illness or an injury and the disturbance that it

causes "throws" Dasein into a state of being that must recognize the possibility of the impossibility, that

is, the inevitability of its own death. Heidegger writes that, "Thrownness into death reveals itself to

Dasein in a more primordial and impressive manner in that state-of-mind which we have called 'anxiety'."

(H251) It is this state of "anxiety" that is key to understanding the relationship between the patient and

the surgeon. When Dasein treats its body as an Object, as something that is zuhanden, it necessarily must

distinguish between the body and itself. But, as Svenaeus points out, "My body is not just a tool that I

use or a dwelling I live in (this is the basic mistake of dualism) - it is me (failing to recognize the

significance of this 'mineness' is the basic mistake of reductionism." (131) He goes on to say, "The body

is alien, yet, at the same time, myself. It involves biological processes beyond my control, but these

processes still belong to me as lived by me." (131) Herein lies the central difficulty to interpreting one's

body as an object ready-to-hand, or as a broken, lacking, piece of equipment. In being injured, in having

some kind of lack within itself, the body becomes zuhanden. But it does not therefore cease to be me or

mine, and it is in this impossibility of conceiving of my body as both me and not me that the challenge of

going "under the knife" rests.


8

When the patient goes to the surgeon, she puts her Dasein at risk, in the sense that she submits the

meaning of her Being to others. It is her care (Sorge) and her concern (besorgen) that motivates her to

confront the zuhanden of her own (broken) body and the sense of Unheimlichkeit that accompanies it.

This confrontation opens up the possibility of Dasein "finding itself"; as Heidegger says, "Dasein finds

'itself' proximally in what it does, uses expects, avoids - in those things environmentally ready-to-hand

with which it is proximally concerned." (H119) There are different ways in which Dasein can be

concerned with its body as something ready-to-hand, and in this possibility there lies another possibility

for Dasein to achieve what Heidegger calls "authentic care" through "solicitude". He says, "Even

'concern' with food and clothing, and the nursing of the sick body, are forms of solicitude." (H121) This

concern (Sorge) has the potential to become "solicitude", or "caring-for." (Fürsorgen) He goes on to say,

"Solicitude proves to be a state of Dasein's Being - one which, in accordance with its different

possibilities, is bound up with its Being towards the world of its concern, and likewise with its authentic

Being toward itself." (H122) It is Fürsorgen that I seek out in my doctor. I give him the power to "leap

in" (einspringen) for me take away my care. "This kind of solicitude, which leaps in and takes away

'care', is to a large extent determinative for Being with one another, and pertains for the most part to our

concern with the ready-to-hand." (H122) The burden of care is now on the surgeon. In caring for me as

something that is now zuhanden for him, Heidegger claims that he can either "dominate" me by leaping

in for me and displacing my Dasein, or he can "liberate" me by leaping ahead (vorspringen) of me and

"thus become authentically bound together, and this makes possible the right kind of objectivity, which

frees the Other in his freedom for himself." (H122) The surgeon will always have this relation of

Fürsorgen towards the patient; his very job is to disburden them of their Sorgen. But he can do this in

either a dominating way or a liberating way, depending upon his relationship with his patient, and this

decision has an immense impact on the ability for the patient to grasp a new and authentic for her Being

after and in light of her surgery.


9

Fürsorgen can have a liberating effect when it brings me towards Eigentlichkeit allowing me and

demanding of me that I take ownership of my Being and body. This is why it is correct to say that in

visiting the doctor or in agreeing to go "under the knife," we are sacrificing our freedom, our autonomy

or Eigentlichkeit, for the sake of ourselves, that is, in order to keep ourselves alive. In turning to the

doctor or the surgeon, I disburden myself of the care of my own body. In this way, then, I fall into a

mode of Being that is Uneigentlichkeit; in a way, I become "no longer my own problem," and willingly

give over my autonomy and my authenticity to my surgeon. This phenomenon should not be understood

as any kind of moral judgment. Rather, it shows why the process of having surgery creates a split within

the patient's sense of self, a split that is not easily rectified. The patient must be prepared to sacrifice

himself (as an autonomous or free being, as a Leib) for the sake of himself (as a biological thing in the

word, or Körper). This split sets the stage for the dual interpretation of the surgery as both an event and

an object, as we shall see.

This state of Unheimlichkeit or of the Object Body (disrupted immediacy) that brings the patient

to see his doctor does so because it confronts Dasein with both the inevitability and the impossibility of

its own death. In recognizing her body as an object that is in need of care, the subject glimpses the

horizon of her own Being; she becomes a limited Being with a finite (defined) existence. As Svenaeus

says, "The moment of anxiety signifies a certain form of interruption of all activity in which the world

loses its meaning as a totality of relevance for human existence and stands out as perfectly irrelevant -

that is, as lacking sense." (129) The moment of anxiety functions as a kind of event insofar as it destroys

Dasein's meaning as Being-in-the-world and radically individuates Dasein by reorienting towards the

possibility of its death. Svenaeus describes this loss of meaning as a kind of a "breakdown," of

"interrupting our ongoing activity on account of the failure, malfunctioning or obtrusiveness of a certain

tool in the world." (129) This breakdown amounts to a removal of Dasein from the meaning-structures

that signify its Being-in-the-world. It also serves to individuate Dasein by forcing to stake out and to
10

claim its own meaning. Heidegger says in Being and Time, "Anxiety in the face of death is anxiety 'in

the face of' that potentiality-for-Being which is one's ownmost, and not to be outstripped. That in the

face of which one has anxiety is Being-in-the-world itself." (H251)

Death is a possibility-of-Being which Dasein itself has to take over in every case. With
death, Dasein stands before itself in its ownmost potentiality-for-Being. This is a
possibility in which the issue is nothing less than Dasein's Being-in-the-world. Its death
is the possibility of of no-longer-being-able-to-be-there. If Dasein stands before itself as
this possibility, it has been fully assigned to its own most potentiality-for-Being. When it
stands before itself in this way, all its relations to any other dasein have been undone.
This ownmost non-relational possibility is at the same time the uttermost one. (H250)

This uniqueness, I believe, comes from the fact that, at the moment of the operation, the patient's

body becomes solely an object-at-hand for the surgeon. For the purpose of self-preservation, the patient

has surrendered the "mineness" of his Being and has accepted the meaning of his own death as purely

biological; that is, meaningless. In order to endure an operation, the subject must give up all claims to the

possibility of an authentic mode of Being-towards-Death. In other words, even though the patient must

directly confront the possibility of her own death in agreeing to undergo surgery, she must also therefore

agree to submit herself to her surgeon and make her body an object or as equipment for the surgeon's use.

In agreeing to be operated upon, the patient recognizes his own finitude. In order to remain as

"Being-there," Dasein must constantly project itself into the future towards its future possibilities. But a

surgical operation necessitates the closing off of Dasein's possibilities because it reduces the patient into a

defined and frozen ontological state as merely a body. The paradox involved with this recognition is that

an individual must make a decision for the benefit of his future possibilities that necessarily requires him

to conceive of those possibilities as being beyond the limit of his experience and of his existence.3 This

demands the possibility for the patient to simultaneously ascribe to two separate and mutually exclusive

interpretations of her situation: one that sees her body as an object with a biological demise, the other as

Dasein that is not yet actualized and is still projecting itself into the future towards its limitless

3 This is akin to Kierkegaard's notion of faith as presented in Fear and Trembling, in that it requires a kind of madness to
make a sacrifice and yet to fully expect to regain that which you sacrifice.
11

possibilities. In other words, she needs to believe both that she is going to die and that she will not die.

Heidegger tells us:

The 'ahead-of-itself', as an item in the structure of care, tells us unambiguously that in


Dasein there is always something still outstanding, which, as a potentiality-for-Being for
Dasein itself, has not yet become 'actual'. It is essential to the basic constitution of Dasein
that there is constantly something still to be settled [eine ständige Unabgeschlossenheit].
Such a lack of totality signifies that there is something still outstanding in one's
potentiality-for-Being. (H236)

In agreeing to have a surgery, I am making a decision based on my plans for my future life, the life that I

have yet to live. I am always agreeing to the surgery because "it will make me feel better," "it will make

my day-to-day living easier," etc. But, in acknowledging this, I am also acknowledging that this future of

mine is a limited one. This is what Heidegger calls Dasein's going "ahead-of-itself," of Dasein's

projecting itself into the future.

Crucially, when the patient gives himself over to his surgeon, he achieves, phenomenologically

speaking, the equivalence of being a corpse (Körper) to the surgeon. Heidegger says that, "when

someone has died, his Being-no-longer-in-the-world... is still a Being, but in the sense of Being-just-

present-at-hand-and-no-more of a corporeal Thing which we encounter... The end of the entity qua

Dasein is the beginning of the same entity qua something present-at-hand." (H238) This state of Being,

he makes clear, is the existential equivalent to being a corpse, of being a "possible object for the student

of pathological anatomy." (H238) The relationship between the surgeon and the patient mirrors that

between the medical student and the cadaver, insofar as the patient is no-longer-in-the-world at the

moment of the operation, and that his body is merely a "possible object" for the surgeon. However, the

difference is that the body of the patient is something zuhanden to the surgeon - it is an object lacking

something, and is in need of care. Yet there remains an inherently perverse and unequal relationship

between the patient (as a body that is nothing more than an object ready-at-hand) and the surgeon (as the

sole subject and possessor of Dasein during the operation.) Svenaeus echoes this sentiment when he says

that biology, the science charged with investigating life, sees "(t)he human body... as a living object
12

(Körper), and not as a lived, experienced body (Leib) [and] thus a part of the world just as other objects."

(126) This is the necessary relationship between surgeon and patient. Their relationship is one of two

conflicting interpretations, of the patient rendering herself an object present-at-hand to the surgeon, upon

whom the patient has disburdened the ownership qua Sorge and the possibility of Eigentlichkeit of her

Being, whereas the surgeon sees the patient as a mere object, as a thing in the world that can be reduced

to its (biological) components, as something that can and must be predicted and manipulated according to

the causal laws of science. Svenaeus expresses this idea when he says, "The lived body... is not identical

with the material body, and consequently not identical with our biology. Our Leib is to a certain extent

dependent upon the ways of our biological Körper, but it is also a vector of existence that attains meaning

through the life of the individual person." (134) In signing herself over to the surgeon as an object-for-

concern for him, the patient also sacrifices control over the meaning of her own Being, she makes her

Leib, her lived body, a Körper, an object body, a mere corpse, for the surgeon. The significance of her

Being has been reduced to that of a body - as Heidegger says, as long as the expression "death" has a

merely biological signification, then Dasein's Death is essentially a meaningless one. (H237)

Up to this point, I have analyzed the phenomenon of the surgery by considering the modes of

being that motivate an individual to go "under the knife." These modes have been the rendering of

Dasein from its "home" in Being-in-the-world by the disruption of an injury upon its body, and the shift

in Dasein's relationship towards its body as one from Lived Body (primary immediacy) or vorhanden to

Object Body (disrupted immediacy) or zuhanden. As being a piece of broken equipment that is ready-to-

hand, the body becomes the object of Dasein's concern, and must be re-interpreted and reintegrated into

the patterns of meaning for Dasein. However, these are only the considerations leading up to the actual

moment of this attempt at a return to meaning for Dasein through an actual medical operation. For the

patient, this moment has the interpretive meaning of a phenomenological event. However, from the
13

surgeon's point-of-view, it is essential that the operation have the meaning of an object.

In "Phenomenon and Event," Jean-Luc Marion provides criteria by which a phenomenon is

interpreted as being either an object or an event. He lays out the criteria for eventhood by listing them as

follows:

(1) unpredictable because they are not reducible to the sum of their supposed parts; (2)
unrepeatable because they are inseparable from their own material and temporality; (3)
without having a cause that one might assign in advance, and sometimes without even
leaving themselves open to being interpreted as effects; and (4) equipped finally with an
existence that does not validate any essence but imposes itself at the very effectivity of
that which our thought, until that moment, took to be impossible.4

For the patient, being operated upon fulfills all of these criteria. The surgery takes place beyond space

and time, and so cannot be predicted according to any sort of causal laws, nor can it be repeated.

However, criterion (4) is perhaps the most crucial of the qualities for eventhood, as it emphasizes the

ability for the event to impose itself and its meaning in an unexpected way upon the patient. The moment

of the operation is an event because it has the power to re-interpret the meaning of the patient's Dasein,

and yet the patient has no control over this moment. It resists conceptualization (or interpretation) as an

object in the sense that it does not occur in space or in time (for the patient). The operation also functions

as an event because it can serve to restore the rationality of the world for the patient, but because it is

necessary for the surgeon to conceive or interpret his patient as an object ready-to-hand or a tool, the

operation must simultaneously be an object.

During the operation, which is the real moment of crisis, the attempt to "fix" the body and return

it to its "home", the patient has been anesthetized, lying unconscious upon the operating table. He cannot

move, speak, listen, feel pain, remember, or dream. In this way, the state of the patient is more similar to

death than sleep. Being a corpse amounts to the patient being nothing more than a tool for the surgeon;

indeed, this interpretation is facilitated by the fact that the patient also has interpreted her own body as a

broken tool by the time of the operation. These two facts, that the operation has the power to change

4 Marion, Jean-Luc. "Phenomenon and Event," Poeisis: Graduate Faculty Philosophy Journal. Vol. 26(1) pp. 147-159.
New School for Social Research Philosophy Dept. New York, 2005. p. 153.
14

Dasein's mode of being by holding the promise of returning it to its state of seeing its body as vorhanden

or of Gadow's Lived Body (primary immediacy) and of doing so by reducing the body to the state of

being a corpse, an object ready-to-hand for the surgeon, accentuates the inherent tension of meaning that

is in the surgery.

Most importantly, the Dasein of the patient is absent during the surgery. He is neither here nor

there; he is nowhere. This means that the patient has no faculty with which he could conceptualize the

surgery. In"Phenomenon and Event," Marion says that the event "has already finished occurring before

we begin to wonder what is happening (to us)." (149) Because the surgery itself, for the patient, does not

happen, she has no experience of it happening, it occurs for her not as something that can be categorized

as any kind of experience. The surgery cannot be represented or reproduced; it is a unique and singular

(non)phenomenon. In this way, also, the surgery mimics death. Heidegger says, "In 'ending', and in

Dasein's Being-a-whole, for which such ending is constitutive, there is, by its very essence, no

representing." (H240) A surgery is also such an "ending" without the possibility of being represented

(even if the same person goes back to the operating table over and over again). Yet the surgery also has

the property of eventhood for the patient because of its potential to open up new possibilities for the

Dasein of the patient. Marion says that, "The event does not limit phenomenality - it opens and protects

it." (153) If the surgery is interpreted as an event by the patient and for the patient, then it will open up

new possibilities for her. On the other hand, if she allows it to be interpreted for her as an object, then,

according to Marion, the phenomenon will be impoverished, restrained, and masked. (153) If the initial

injury disrupts the meaning of the patient's body and throws her out of the world, then the aim of the

surgery is to "fix" the patient's body and return it to its Heimlichkeit state as something vorhanden. But

this kind of return requires the patient to be able orient the meaning of her experience for herself, as an

event, and to do so authentically by claiming that interpretation as her own.

All of these factors combine to set the stage for the actual surgery as an event for the patient, one
15

of which he can have no memory and yet one that will determine the meaning of his Being, and yet also

as an ordinary everyday object for the surgeon, for whom the operation must remain something eternally

at-hand, something that repeats itself incessantly with a minimum amount of special significance. For the

surgeon, the operation must be interpreted as an object. As Marion says, the object "remains as

controllable as it is predictable, producible, and reproducible..." (149) This, in effect, is the surgeon's

task; to render his patient's body controllable, to know in advance all of its possibilities, from from the

amount of hemorrhaging that it can endure to the odds for an infection to develop to the ability for its

bones to resist pressure without breaking or shattering. If the surgeon does not interpret the patient as

such, that is, as an object that can be ultimately known and manipulated according to predictable,

scientific laws, then he is neglecting his duties. But this interpretation stands directly opposed to the

equally necessary interpretation on the part of the patient that sees the surgery as an event, as

unknowable, as unpredictable, as singular, and as meaning-giving. This unequalness in relationship

between the patient and the surgeon at the moment of surgery is manifested by the patient being "under"

anesthesia. While she is unconscious, the patient becomes merely a part - a thing - in the world of the

surgeon. It is as if, at this point of crisis of the event, the patient is already dead.

And yet the cutting open of the patient's body on its own cannot restore the meaning of the

patient's Dasein to Being-in-the-World. Through its disburdening of itself and of the interpretation of its

meaning to the Surgeon, Dasein has embraced an Uneigentilichkeit mode of Being, one that can only be

rectified by the possibility of Dasein (re)defining itself in light of the historical impact of the recent event.

Authenticity, in Being and Time, is marked by a "mineness," by the recognition that das Man cannot

provide an adequate meaning for Being. However, it is precisely this interpretation that is

Uneigentlichkeit, that belongs not to Dasein but to others, that the patient must accept when she agrees to

be operated upon. Essentially, the patient must somehow be able to let go of this interpretation of his

body as an object, which was an interpretation that the patient necessarily had to adopt in order to view
16

his body as something that demanded concern. But this kind of "letting go" is not an easy action to take.

Svenaeus says that, "In illness the body is experienced as alien, as a 'broken tool,' which gives rise to

helplessness, resistance, and lack of control." (134) It is this sense of alienation from one's own body that

must be encountered and overcome. This entails seeing one's surgery as a phenomenological event, one

that determines meaning, and not as a mere object.

The consequences of this analysis are startling. There is a need or desire to view an operation as a

fixing of one's self, of making us "better", "healthier", "whole again," etc. The works of Svenaeus and

Hudak bring this phenomenon out in different ways. But it would be a mistake to see a surgical

procedure as being some kind of "cure", as if for a disease, or, indeed as a kind of return to a naïve

relationship towards one's body. For, in phenomenological terms, an operation is as traumatic as the

initial disruption that throws Dasein out of the world into Unheimlichkeit, and this sense of being can

never be regained exactly as it once was. As Svenaeus says, "To regain homelikeness, to be

rehabilitated... might be a long and hard process... it is first of all a matter of the person himself actively

adjusting to a new way of being-in-the-world." (135) Indeed, the requirements that are placed upon

Dasein during the course of preparing for a surgery themselves must be reversed if it is able to achieve

some sense of "homelikeness" with itself.