Confessions of a Medicine Man: An Essay in Popular Philosophy (review)

Confessions of a Medicine Man: An Essay in Popular Philosophy. By Alfred I. Tauber. Cambridge: MIT Press, 1999. Pp. xviii +159. $25.

Near the end of his "confessions," Dr. Alfred Tauber tells a strange story about his father. He tells us that a Hungarian official was brought to his father at some time "before the Budapest Jews were submitted to the terrors of deportation and the concentration camps" (p. 105). "The man required emergency surgery," he goes on, "and my father performed the operation without complication, saving the gentile's life. Soon after, the patient supervised the rounding up of many of my father's compatriots and personally murdered several of them. Tormented by the irony of his position, my father explained his lack of choice."

This anecdote hangs unsupported in a section of the book subtitled "The Call of the Other." The section includes a summary of Levinas' philosophy--"we become selves in a mutual encounter with the Other"--and a tribute to Sir Luke Fildes' famous painting The Doctor, which is reproduced on the dust jacket. Tauber doesn't comment on the strange story of his father or give any more information. What was his father doing there? Was he already a surgeon in Hungary 50 years ago? Was the author born there? Was he himself deported? Did he escape? How did he feel about his decision? How does Tauber himself feel about his father's story, his father's decision? None of these questions are explored. Instead, this little fragment of narrative is suspended, like many other similar narrative fragments, in a book that roams allusively over vast areas of philosophy, health policy, clinical vignette, and autobiography.

Confessions of a Medicine Man is self-consciously modeled upon Augustine's Confessions, particularly its use of the introspective personal narrative. Thus, it seems worthwhile to try to put together some facts about Tauber's life. We learn that he was a medical student 25 years ago, at a time vaguely identified as "the sixties," though he claims that medicine was "above" the turmoil of that turbulent decade. "We lived in the hospital," he writes. "We took care of the ill. We responded to the needy. Society was racked with self-examination and radical criticism, but we were committed to science, the pure ethos of caring, and the advancement of our profession. We wore white and rode above the fray"(p. 2). How far above is suggested on the next pages, where Tauber suggests that the Hill-Burton Act was passed in 1964 (it was in 1948), and the Quinlan decision handed down in 1975 (it was 1977). But these details don't really matter. We learn that Tauber's physician father often treated his son's illnesses, that the elder Dr. Tauber opened his practice in 1949 and advocated socialized medicine. Tauber himself entered medical school in 1969, spent some time at the Mayo Clinic as a medical student, and was a resident at Boston City Hospital, where he loved the adrenaline rush of tertiary care ("the more desperate the patient, the sicker he or she might be, the more excited I became . . . I was a brash, arrogant technocrat" (p. 121). The thrill didn't last, apparently. After residency, he trained as a biochemist and spent the better part of his formative years as a physician in the laboratory. At age 40, he writes, "I began to disengage from science, to study philosophy seriously, and to appeal consciously to my kinder self." He attributes this reevaluation to his mother's death, but doesn't tell us much about that psychological process.

Putting together this life-story is not straightforward, since Tauber writes a strangely meandering book. It is similarly difficult to tease out a philosophic argument, but here is how I read his central thesis. The notion of autonomy, grounded in the philosophy of Locke, Kant, and Freud, depends...