Illness can not be the same as a mathematical equation: it has not one single solution.
In the relationship between the doctor and the patient, let’s not forget that we are always talking of two different people, each with their own vision of the illness.
We can better understand these tendencies by using another illustrative literary example in the novel “One, No One and One Hundred Thousand” by Luigi Pirandello, where, through subtle irony, he explains how each of us believe to be one single person and in fact are one hundred thousand different people, according to how we are seen by others and what we manage to transmit via words and gestures. This is why identity is dissolved into one hundred thousand people and we end up being no one in particular. This sense of “dispersion” of identity leads the novel’s protagonist to deep discomfort from his knowledge that he does not understand himself or others, to not get over the impossibility of communicating what he really feels since every other character gives him a new dimension and identity. At this point, everything is useless: what is the point of putting in effort, if no one knows who we truly are and we are not able to communicate it? According to Pirandello, there is no solution: we must accept being a mask, or rather a hundred thousand different masks, since the reality of this moment will be different from the next. Each of us plays a part according to the situation, who we are with, what we are experiences in that moment.
Let us return to our case: the doctor sees the illness in one way, the patient sees it in another, or rather in two different ways, with his own conscience and the other with his body. Two subjects and already three different ways of seeing what should be a single reality. How do we, therefore, move on from this faltering position? Maybe the only way to accept, implicitly or explicitly, that the role played by this relationship cannot be completely equal. Different from the Pirandellian paradigm above, here it is somewhat asymmetrical: a subject suffers a reality – an illness – another subject can eliminate it (the doctor). The first move would be to hypothesise, without a doubt, that it is the doctor that should prevail, in the interests of the patient. This position, however, cannot ignore the consideration for the sick person’s perspective in its cultural and social context, which today often has the pretext of digging through the professional nature and scientific truths of official medicine, bringing with it baggage of mistaken, but common, convictions led by the mass media which are followed more and more. The doctor then assumes the role of a “voice which is not one of the crowd”, which is less a relationship of trust which is at the root of traditional doctor-patient interaction.
This aberration can be imagined, figuratively well-represented in Edvard Munch’s “Night on Karl Johan Street”, work which, more than all his others, gives us a visual and symbolic interpretation of what no longer being able to or knowing how to communicate means for the modern man. The painting redefines the main street of a city, densely populated with people, or “human figures” who only intuitively and in rough form recall the idea of people. Their faces are like skulls, their eyes are wide-eyed and staring, their facial expressions are like ice, fixed in apathetic and terrifyingly indifferent grimaces. It is like a stream of individuals that walk through the evening, when the sunset reflects on the houses, turning them into reddish blinding glow which gives the entire image of a sinuous performance on the edge of dreams.
One detail, however, jumps out to the observer: on the right, a dark mark which is vaguely human form distinguishes itself from the flow of the middle classes which dominate the scene. It is Munch, the artist himself who is the voice outside the crowd. In fact, he seem to be going in the opposite direction, almost hidden in the darkest part of the picture, which deforms his outline so much as to confuses it, make it undefined, painful. The sense of anxiety is extreme and current: in mass society, those who want to say something different or even just “say something” become marginalised: put to one side, forced into obscurity. The only possible communication is unilateral, empty, imposing social conventions.
In our narrative paradigm, this dark outlined human figure is like the doctor, who finds him/herself having to make their voice heard no longer by just one patient, but by an entire front of people who are made to think in an identical way and believe illness to be the same as a mathematical equation, with one single solution.