The Clitoris and Epistemic Humility

The NY Times has discovered the clitoris. It’s about damn time.

Stay with me here. I'll get back to it. When I was in my early twenties I started to have trouble with my eyes. I would get headaches from reading. This was a problem as I was a yeshivah student who spent all day every day reading. I went from doctor to doctor, all of whom proclaimed me healthy, often after extensive tests and scans. One specialist noted that I seemed to have a ‘focusing’ problem, but did not think it was treatable by the exercises he did because he believed it was caused by my history of thyroid problems. I convinced him to let me try them anyway, and it was a fiasco. No other medical professional understood his diagnosis or had any idea how to treat it.

Ten years later a strange constellation of symptoms were plaguing me. Aches and pains, fatigue, swelling in joints. Finally, following some weird blood test results I saw a rheumatologist who gave me a diagnosis: Lupus. I had reached the promised land of ‘knowing what is wrong with me.’ The medication I was given seemed to help for a few months, then I had a catastrophic series of medical events which left me mostly disabled for more than two years. This newsletter is a sign of how much I have recovered. I can use my hands enough to type, thank God.

Six months ago another rheumatologist ran more tests and ‘retracted’ the diagnosis of Lupus. He said, and after some time to adjust to the idea I believed him, that he did not see any evidence of an auto-immune disease. I should address my symptoms one by one and stop looking for a single answer that explains them all. That strategy is going well for me at the moment. I’m continuing to suffer, but doing better, despite the medical profession having no clear idea what’s causing any of this.

Medical science is often clueless. To be clear, it knows a lot, but its knowledge is very holy, and not in the good way. Practitioners often fail to distinguish what they do know and what they don’t know. Whole areas of medical science are built around a black, empty space whose existence they cannot see, let alone acknowledge.

The NY Times recently published an article about how the clitoris has been under-investigated (stop sniggering you school boys), and not well-understood or taught about properly in medical schools. This lack of understanding leads to medical debacles such as unnecessary severing of nerves which are required for normal sexual function during surgeries.

The clitoris has come to the fore because of our society’s obsession with anything sexual. For a less prurient example, fascia is the connective tissue that fills the space between cells. In the past it was hard for scientists to look at fascia under a microscope because the structure it constitutes is destroyed by cutting it up and killing it in order to get it under the microscope. A new method involving lasers (don’t ask me how this works) is able to look at the fascia, described in this article as a sponge, with the air pockets inside it being the structure, while it is still in the living body fulfilling its purpose and maintaining it’s shape. This method reveals that fascia actually moves and adjusts when we move. It does things which are necessary to the functioning of our body actively, not just as a passive bunch of gunk filling up the empty spaces and getting squished around as we move. This has led to some calling fascia a ‘new organ,’ dubbed ‘interstitial tissue.’

That’s right, the tissue which is in every part of our bodies and plays a crucial role in our health has basically just been ‘discovered’ by science, despite the fact that we knew it was there all along. Science was looking right at it, but was blind to it because of the technology available at the time.

A similar state of non-knowledge reigns in many other scientific or semi-scientific realms. In a recent piece on The Times of Israel one of my favorite writers on current events, Haviv Rettig-Gur, wrote about how raising the electoral threshold in 2014 caused exactly the problem it was meant to prevent. The threshold is the percentage of votes required for a party to enter the Knesset. It used to be 2% and was raised to 3.25%. This was meant to force the smallest parties to either band together or disappear entirely, leaving fewer parties in the knesset. The intent was to make governing easier, taking king-maker power away from miniscule parties with 2 lousy seats. Instead the craziest little parties hovering around the threshold now get full throated support from the larger parties, who need them in the Knesset to form a government, and in the mergers which occurred the more extreme, ideological faction, who is generally more willing to walk away, gets veto power and in essence gets to now steer the policy of the larger party. So instead of moderating our politics, this reform caused our politics to become more polarized and made it impossible to form a government with legs even after four elections, with a fifth in just a few days.

Doctors don’t know what’s wrong with me. They don’t know the anatomy of the clitoris. They are only now discovering the connective tissue that holds our bodies together. Political science professors pushed a reform through and it caused exactly the opposite of the results they expected.

It’s alright that our knowledge is incomplete. It’s OK to make mistakes. Such is the human condition. The problem I see with most of the doctors I’ve been to, with the poli-sci academics, with the entire cult of expertise, is a lack of epistemic humility, humility about one’s state of knowledge. For this my old buddy Socrates is the model. The Oracle of Delphi proclaimed him the wisest of all men, and at first he was puzzled. Finally he realized, “I am the wisest man alive, for I know one thing, and that is that I know nothing.”

Epistemic humility is when a doctor takes a minute to at least skim the new research article you sent them about the illness they have diagnosed you with or the side effects of the medication they have given you. It shows humility when one admits to a lack of knowledge where it exists and is open to new information. This often harms the pride of experts, practitioners, and flapping gums the world over. For all of our sakes, they need to get over it.

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P.S. Of course, epistemic humility could be the name of this newsletter as it seems to be a recurring theme pretty much every week. We all need it and most of us lack it. I am just pointing out the additional weight of responsibility here for people with power over others' health or political well being to exercise their humility regularly.

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Only the Good Stuff: What I’m Reading

• An excellent article about Ken Burns’ new documentary about the US and the Holocaust and how the well intentioned effort fails in very important ways. From Mosaic.

• Admittedly this one is weird, but I really enjoyed it. You have to get through the first few paragraphs before it gets good:

The internet is already over

• Ray Takeh on the currently running, second Iranian Revolution in Commentary Magazine.

• Also from Commentary, an article about the failure of Jewish studies in America to defend the actual Jews in favor of a misguided universalism:

The progressive Jewish left, heavily represented among American Jewish-studies scholars, used a term borrowed from the Nazis to describe what they considered the existential sin of the existence of a Jewish nation-state: Jewish supremacy. In the tradition of generations of anti-Semites, many of my colleagues in Jewish studies thus identified the Jews with the most monstrous sin of their era, thereby inverting the relationship between perpetrator and victim and holding the Jews responsible for the hatred and violence directed against them.

• Matti Friedman writes in the Jewish Review of Books on Mizrahi music, those who made it in the Middle East and North Africa, brought it to Israel, and kept it alive until its current triumphant cultural revival.

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Attitude of Gratitude

I am grateful for…

• Botulinum toxin. I just got it injected into my face and head. It really helps with migraines!

• Routine. Now that the roller coaster of the holidays has ended the kids are back in school, the baby is back in preschool.

Please hit reply to this email and tell me something you're grateful for so I can include it next week!

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Peace and Blessings,

-Eitan