Self-ascriptions of one's current mental states often seem authoritative. It is sometimes thought that the authority of such self-ascriptions is, in part, a matter of their indubitability. However, they do not seem to be universally indubitable. How, then, should claims about self-ascriptive indubitability be qualified? Here I consider several such qualifications from the literature. Finding many of them wanting, I nevertheless settle on multiple specifications of the thesis that self-ascriptions are authoritatively indubitable. Some of these specifications concern how (...) other agents ought to treat one's self-ascriptions, while a final specification concerns how one is entitled to respond to others’ doubts about one's self-ascriptions. The result is a pluralistic view of self-ascriptive indubitability: different types of mental state self-ascriptions are indubitable in different ways, and for different people. (shrink)

Why does Descartes give some propositions, most notably cogito, a privileged epistemic status? In the first part of the paper I consider, and reject, the standard account of the indubitability of cogito championed by, among others, Hintikka, Ayer, Slezak, and Frankfurt. After examining what I call the Cartesian regress, I invoke the fiction of a self-blind individual, close to the one originally introduced by Shoemaker, to give an alternative account of the indubitability of cogito. I argue that Descartes initially needs (...) to exempt the self-attribution of thought from the scope of Cartesian doubt, because an individual who is self-blind, and, so, cannot self-attribute thoughts, cannot treat propositions about the external world as dubitable. (shrink)

Kirsten Besheer has recently considered Descartes’ doubting appropriately in the context of his physiological theories in the spirit of recent important re-appraisals of his natural philosophy. However, Besheer does not address the notorious indubitability and its source that Descartes claims to have discovered. David Cunning has remarked that Descartes’ insistence on the indubitability of his existence presents “an intractable problem of interpretation” in the light of passages that suggest his existence is “just as dubitable as anything else”. However, although the (...) cogito argument is widely thought to be central to the force of Descartes’ indubitability, for his part, Cunning does not consider its relevance and force. Accordingly, this article is concerned with the cogito argument and the question central to Hintikka’s seminal contribution, described by Cottingham as “Perhaps the most debated question,” namely, whether or not the cogito can be construed as a logical inference. Clearly, an inferential account has the potential to explain the certainty of Descartes’ conclusion that he exists. Recently, Sarkar offers what he characterizes as “novel and fairly conclusive reasons why the cogito cannot be construed as an argument,” asserting “the discovery of the cogito can only be an intuition not a deduction.” Obviously, it would greatly support the opposing inferential construal if a remotely plausible logical argument could be proposed. Toward this end, I defend the virtues of my ‘Diagonal’ account of Descartes’ cogito Above all, I show how my analysis meets the requirement that any satisfactory solution to the problem of the cogito would reconcile Descartes’ claim that the cogito is a certain inference with his claim that it is an intuitive kind of knowledge. Through a critical discussion of analyses such as that of Gallois , I show that it is possible to provide a textually faithful analysis that permits seeing the cogito as both inference and intuition because it may be seen as an exercise in the mathematical method of Analysis. Above all, as Feldman requires, I show that the Diagonal account is not only textually elegant, but permits crediting Descartes with a worthy insight, thereby resolving the tension between what Howell has termed the Humean and Cartesian problems, namely, the elusiveness and the certainty of the self. (shrink)

In this paper I propose an indubitability analysis of knowledge. The motivation for this analysis is a conviction I have that the Cartesian analysis of knowledge as indubitability is not completely mistaken, although it requires considerable weakening if it is to be satisfactory. My analysis may be contrasted to those which treat knowledge as a species of the genus justified true belief. For although on my analysis, ‘S knows that p’ entails ‘S has a justified true belief that p’, I (...) am not proposing indubitability as a differentia distinguishing knowledge from other members of the genus justified true belief. The situation here is analogous to that of the conceptual relation between vermillion and red: ‘X is vermillion’ entails ‘X is red’, but there is no straightforward differentia which would entitle us to think of vermillion as a species of the genus red. Another point of contrast is that species-of-justified-true-belief analyses start with an analysis which is too weak and strengthen it. My starting point is an analysis which is too strong which I then weaken. (shrink)

How should we understand both the nature, and the epistemic potential, of Descartes’s Cogito? Peter Slezak’s interpretation of the Cogito’s nature sees it strictly as a selfreferential kind of denial: Descartes cannot doubt that he is doubting. And what epistemic implications flow from this interpretation of the Cogito? We find that there is a consequent lack of knowledge being described by Descartes: on Cartesian grounds, indubitability is incompatible with knowing. Even as the Cogito halts doubt, therefore, it fails to be (...) knowledge. (shrink)

Kant clearly endorses some version of the ‘old formula of the schools’, according to which all volition is sub ratione boni. There has been a debate whether he holds this only for morally good actions. I argue that a closer look at the distinction between the good and the agreeable does not support this conclusion. Considering Kant’s account of the detrimental and the correct use of this thesis, I argue that rational beings always will sub ratione boni, even when they (...) act immorally, because they act on principles. I argue that Kant’s accounts of self-love and self-conceit support this view. (shrink)

This article demonstrates how and why "meditations on first philosophy" is an unsuccessful attempt by rene descartes to reconcile his rationalist philosophy with his apparently conflicting voluntarism and with his adherence to certain theological principles.

Descartes is generally not very inclined to admit what he owes to his predecessors. His relationship to the greek Skeptics is all the more difficult to identify, that it has been paradoxically hidden by the skeptical reception of his work : in spite of the indisputable contribution of the Academics to the writing of the argument of the Meditations, the cartesian venture has been interpreted as inaugurating a new and radical Skepticism doomed to mark a break with the tradition. However, (...) Descartes uses Academics’ Skepticism, and particularly the sorit argument, in order to criticize the whole philosophical tradition, and to grant his mind such a licence, that neither knowledge, nor even one belief could be a priori preserved. Nevertheless, uncertainty is not entirely dismissed from his philosophy which inherits, in science as in morals, the skeptical insight of probability, as this latter notion has been passed down from Cicero’s Academica. (shrink)

Max Weber is indubitably one of the very greatest figures in the history of the social sciences, the source of seminal concepts like 'the Protestant Ethic', 'charisma' and the idea of historical processes of 'rationalization'. But, like his great forebears Adam Smith and Karl Marx, Weber's work always resists easy categorisation. Prominent as a founding father of sociology, Weber has been a major influence in the study of ancient history, religion, economics, law and, more recently, cultural studies. This Cambridge Companion (...) provides an authoritative introduction to the major facets of his thought, including several which have hitherto been neglected. A distinguished international team of contributors examines some of the major controversies that have erupted over Weber's specialized work, and shows how the issues have developed since he wrote. The articles demonstrate Weber's impact on a variety of research areas. (shrink)

One of Hume's most well-known works and a masterpiece of philosophy, A Treatise of Human Nature is indubitably worth taking the time to read.

Person‐centred practice indubitably seems to be the antithesis of technology. The ostensible polarity of technology and person‐centred practice is an easy road to travel down and in their various forms has been probably travelled for decades if not centuries. By forging ahead or enduring these dualisms, we continue to approach and recede, but never encounter the elusive and the liminal space between technology and person‐centred practice. Inspired by Haraway's work, we argue that healthcare practitioners who critically consider their cyborg ontology (...) may begin the process to initiate and complicate the liminal and sought after space between technology and person‐centred practice. In this paper, we draw upon Haraway's idea that we are all materially and ontologically cyborgs. Cyborgs, the hybridity of machine and human, are part of our social reality and embedded in our everyday existence. By considering our cyborg ontology, we suggest that person‐centred practice can be actualized in the contextualized, embodied and relational spaces of technology. It is not a question of espousing technology or person‐centred practice. Such dualisms have been historically produced and reproduced over many decades and prevented us from recognizing our own cyborg ontology. Rather, it is salient that we take notice of our own cyborg ontology and how technological, habitual ways of being may prevent (and facilitate) us to recognize the embodied and contextualized experiences of patients. A disruption and engagement with the habitual can ensure we are not governed by technology in our logics and practices of care and can move us to a conscious and critical integration of person‐centred practice in the technologized care environments. By acknowledging ourselves as cyborgs, we can recapture and preserve our humanness as caregivers, as well as thrive as we proceed in our technological way of being. (shrink)

It is an indubitable fact that our thoughts are always about something or some state of affairs in the world. Again, it is true that we use language to express some of our thoughts, and that in such a use of language which philosophers call a speech act, language also comes to be about something or some state of affairs in the world. E.g., when someone asserts that Peter is married to Mary, the sentence, 'Peter is married to Mary', (...) comes to be about the state of affairs of Peter's being married to Mary. This property of being about something which characterizes our thoughts and speech acts is called "intentionality" by philosophers. ;In Intentionality, John Searle claims that the Intentionality of language and the Intentionality of speech acts performed by using language is derived from the intrinsic Intentionality of mental states which accompany the speech act. In the dissertation I propose to examine this claim of Searle's. ;Searle's view regarding the Intentionality of speech acts is incomplete and wrong. Searle does not show how the Intentionality of referring and predicating in a speech act is to be derived from mental reference and mental predication in the corresponding mental state. In this sense his theory is incomplete. Further, his theory is false. Taking the case of belief, I propose to show that it cannot be the source of the Intentionality of the corresponding assertion. Either a belief is a disposition and does not have any Intentionality or it is a mental act of accepting a proposition in which case the Intentionality of the belief and the Intentionality of the assertion have the same linguistic nature and the former cannot be the source of the latter. We are faced with a dilemma which shows that Searle's view cannot be correct. In the dissertation it will be argued that the Intentionality of a speech act is as intrinsic to it as the Intentionality of a mental phenomenon is to the mental phenomenon. The nature of speech act referring and predicating, mental referring and predicating, linguistic concepts and linguistic acts using those concepts will be discussed. (shrink)

Seemingly so indubitable, the credentials of the self can prove vexingly elusive, if not worse. That the Emperor of the world that is my world, the being that is me, has no clothes has been a repeated verdict in the history of modern philosophy. In the course of Appearance and Reality, F. H. Bradley, too, drags himself to this conclusion.

Epistemic reasons exist indubitably, yet confusion surrounds just what exactly they are, in and of themselves. In this paper I argue that there is only one thing they could credibly be: the favoring attitudes a god is adopting toward us believing what is true and following methods of belief formation likely to result in true beliefs. As the existence of epistemic reasons is indubitable then if this analysis is correct, it will provide us with an apparent proof of a (...) god’s existence. (shrink)

Despite claims from prominent scientists that SARS‐CoV‐2 indubitably emerged naturally, the etiology of this novel coronavirus remains a pressing and open question: Without knowing the true nature of a disease, it is impossible for clinicians to appropriately shape their care, for policy‐makers to correctly gauge the nature and extent of the threat, and for the public to appropriately modify their behavior. Unless the intermediate host necessary for completing a natural zoonotic jump is identified, the dual‐use gain‐of‐function research practice of viral (...) serial passage should be considered a viable route by which the novel coronavirus arose. The practice of serial passage mimics a natural zoonotic jump, and offers explanations for SARS‐CoV‐2's distinctive spike‐protein region and its unexpectedly high affinity for angiotensin converting enzyme (ACE2), as well as the notable polybasic furin cleavage site within it. Additional molecular clues raise further questions, all of which warrant full investigation into the novel coronavirus's origins and a re‐examination of the risks and rewards of dual‐use gain‐of‐function research. (shrink)

LET ME BEGIN this inquiry with the simple but fundamental fact that the flow of time, or passage, as it is also known, is given in experience, that it is as indubitable an aspect of our perception of the world as the sights and sounds that come in upon us, even though it is not the peculiar property of a special sense. Consider, by way of illustration, that I am now sitting at the desk in my study. This particular (...) event was not present at any earlier time, nor will it be present shortly as I become involved in other activities. The present, as I experience it, is regularly associated with later and later events. It does not hop about capriciously from here to a later time, to a previous time, and then to a much later time, or trace out some other such indiscriminate pattern; instead I find it always in association with the next moment, and as I look backward and inward, so to speak, I find that the prior moment was present and that this next-later moment is present. Quite often this condition is expressed by means of imagery. We are asked to envision either a moving present racing along a fixed track of moments or events from earlier to later, or alternatively a fixed present through which stream a series of moments or events, first the earlier and then the later ones. One is in truth hard-pressed to find references to passage which do not employ quasi-poetical tropes and metaphors, and while these do help in some sense to say what we mean, great caution is required when handling them because of their ready tendency to draw us away from the actual phenomenon requiring explanation. (shrink)

Abstract On Schellenberg’s formulation of the problem of divine hiddenness, a loving God would ensure that anyone capable of having a relationship with Him, and not resisting it, would be granted sufficient evidence to make belief in God rationally indubitable. And He would do this by granting a powerful religious experience to every person at the moment he or she reaches the age of reason. Here I lay out a new reason why God might delay revelation of himself, justifiably (...) allowing for some nonresistant nonbelief. Content Type Journal Article Category Article Pages 1-11 DOI 10.1007/s11153-012-9338-5 Authors Travis Dumsday, Department of Religious Studies, Livingstone College, 701 West Monroe St., Salisbury, NC 28144, USA Journal International Journal for Philosophy of Religion Online ISSN 1572-8684 Print ISSN 0020-7047. (shrink)

This book makes four bold claims: 1) life is an ultimate datum, open to philosophical analysis and irreducible to physical reality; hence all materialist-reductionist explanations - most current theories - of life are false. 2) All life presupposes soul (entelechy) without which a being would at best fake life. 3) The concept of life is analogous and the most direct access to life in its irreducibility is gained through consciousness; 4) All life possesses an objective and intrinsic value that needs (...) to be respected, human life possesses beyond this an inviolable dignity. Life and personal life are pure perfections, it being absolutely better to possess (personal) life than not to possess it. Chapter 1: the metaphysical essence and the many meanings of 'life, ' as well as its 'transcendental' character. Chapter 2: the irreducibility of biological life, its amazing empirical and philosophically intelligible essential features, and the ways of knowing them. Chapter 3: the immediate evidence and indubitable givenness of mental, conscious life as well as questions of (brain-) death and immortality. Chapter 4: the inviolable objective dignity of personal life and its self-transcendence; a new theory of the fourfold source of human dignity and rights. Chapter 5 (in dialogue-form): methods and results of philosophy versus those of empirical life-sciences. (shrink)

There are three different degrees to which we may allow a systematic theory of the world to embrace the idea of relatedness—supposing realism about non-symmetric relations as a background requirement. (First Degree) There are multiple ways in which a non-symmetric relation may apply to the things it relates—for the binary case, aRb ≠ bRa. (Second Degree) Every such relation has a distinct converse—for every R such that aRb there is another relation R* such that bR*a. (Third Degree) Each one of (...) them applies in an order to the things it relates—with regard to the state that results from R's applying to a and b, either R applies to a first and b second, or it applies to b first and a second. Whereas the first degree is near-indubitable, embracing the second or third generates unwholesome consequences. The second degree embodies a commitment to the existence of a superfluity of distinct converses and states to which such relations give rise. The third degree embodies commitment to recherché facts of the matter about how the states that arise from the application of one non-symmetric relation compare to any other. It is argued that accounts that purport to offer an analysis of the first degree generate unwelcome second or third degree consequences. This speaks in favour of our adopting an account of the application of relations that's not an analysis at all, an account that takes the first degree as primitive. (shrink)

In a virtuoso display of erudition, thoughtfulness and humour, Terry Eagleton teases apart the concept of hope as it has been conceptualised over six millennia, from ancient Greece to today. He distinguishes hope from simple optimism, cheeriness, desire, idealism or adherence to the doctrine of Progress, bringing into focus a standpoint that requires reflection and commitment, arises from clear-sighted rationality, can be cultivated by practice and self-discipline, and which acknowledges but refuses to capitulate to the realities of failure and defeat. (...) Authentic hope is indubitably tragic, yet Eagleton also argues for its radical implications as ‘a species of permanent revolution, whose enemy is as much political complacency as metaphysical despair’. It is a means of facing the future without devaluing the moment or obviating the past. Traversing centuries of thought about the many modes of hoping – from Ernst Bloch’s monumental work through the Stoics, Aquinas, Marx and Kierkegaard, among others – this penetrating book throws new light on religious faith and political ideology as well as issues such as the problem of evil, the role of language and the meaning of the past. Hope Without Optimism is a brilliantly engaged, impassioned chronicle of human belief and desire in an increasingly uncertain world. (shrink)

McDowell's claim that "in mature human beings, embodied coping is permeated with mindedness",1 suggests a new version of the mentalist myth which, like the others, is untrue to the phenomenon. The phenomena show that embodied skills, when we are fully absorbed in enacting them, have a kind of non-mental content that is non-conceptual, non-propositional, non-rational and non-linguistic. This is not to deny that we can monitor our activity while performing it. For solving problems, learning a new skill, receiving coaching, and (...) so forth, such monitoring is invaluable. But monitoring what we are doing as we are doing it degrades performance to at best competence. On McDowell's view, there is no way to account for such a degradation in performance since the same sort of content would be involved whether we were fully absorbed in or paying attention to what we were doing. McDowell claims that it is an advantage of his conceptualism that it avoids any foundationalist attempt to build up the objective world on the basis of an indubitable Given or any other ground-floor experience. And, indeed, if the world is all that is the case and our minds are unproblematically open to it, all experience is on the same footing. But one must distinguish motor intentionality, and the interrelated solicitations our coping body is intertwined with, from conceptual intentionality and the world of propositional structures it opens onto. The existential phenomenologist can then agree with McDowell in rejecting traditional foundationalisms, while yet affirming and describing the ground-floor role of motor intentionality in providing the support on which all forms of conceptual intentionality are based. (shrink)

Back in 1950, while a physics major at Harvard, I wandered into C.I. Lewis’s epistemology course. There, Lewis was confidently expounding the need for an indubitable Given to ground knowledge, and he was explaining where that ground was to be found. I was so impressed that I immediately switched majors from ungrounded physics to grounded philosophy.

When in May 1930, the Council of Trinity College, Cambridge, had to decide whether to renew Wittgenstein's research grant, it turned to Bertrand Russell for an assessment of the work Wittgenstein had been doing over the past year. His verdict: "The theories contained in this new work . . . are novel, very original and indubitably important. Whether they are true, I do not know. As a logician who likes simplicity, I should like to think that they are not, but (...) from what I have read of them I am quite sure that he ought to have an opportunity to work them out, since, when completed, they may easily prove to constitute a whole new philosophy." "[ Philosophical Remarks ] contains the seeds of Wittgenstein's later philosophy of mind and of mathematics. Principally, he here discusses the role of indispensable in language, criticizing Russell's The Analysis of Mind . He modifies the Tractatus 's picture theory of meaning by stressing that the connection between the proposition and reality is not found in the picture itself. He analyzes generality in and out of mathematics, and the notions of proof and experiment. He formulates a pain/private-language argument and discusses both behaviorism and the verifiability principle. The work is difficult but important, and it belongs in every philosophy collection."--Robert Hoffman, Philosophy "Any serious student of Wittgenstein's work will want to study his Philosophical Remarks as a transitional book between his two great masterpieces. The Remarks is thus indispensible for anyone who seeks a complete understanding of Wittgenstein's philosophy."--Leonard Linsky, American Philosophical Association. (shrink)

Does consciousness exist? In “The Meta-Problem of Consciousness” (MPC) David Chalmers sketches an argument for illusionism, i.e., the view that it does not. The key premise is that it would be a coincidence if our beliefs about consciousness were true, given that the explanation of those beliefs is independent of their truth. In this article, I clarify and assess this argument. I argue that our beliefs about consciousness are peculiarly invulnerable to undermining, whether or not their contents are indubitable (...) or even obvious. However, the reason that they are peculiarly invulnerable to undermining points to a fundamental flaw in modal arguments for dualism. (shrink)

Next to the problem of evil, the problem of divine hiddenness has become the most prominent argument for atheism in the current literature. The basic idea is that if God really existed, He would make sure that anyone able and willing to engage in relationship with Him would have a rationally indubitable belief in Him at all times. But as a matter of fact we see that the world includes nonresistant nonbelievers. Therefore God doesn’t exist. Here I propose a (...) reply to the problem that shifts focus from the nonresistant nonbelievers to those who are resistant. I claim, Howard-Snyder, and others) that for many such people, having God’s reality forced upon them unwillingly might result in significant spiritual/moral harm, inhibiting their ability to develop a positive relationship with God. general critique of any strategy that references the notion of God’s proper non-revelation to the resistant.) If this is true, it could help explain why God refrains from revealing Himself in a rationally indubitable manner not only to the resistant, but even to the nonresistant. Why? Because it may be that under present circumstances God is actually more concerned about the welfare of the resistant than of the willing; and revealing Himself to all of the willing could actually result in the truth of theism being forced on the resistant. (shrink)

How did the relations between philosophy and science evolve during the 17th and the 18th century? This book analyzes this issue by considering the history of Cartesianism in Dutch universities, as well as its legacy in the 18th century. It takes into account the ways in which the disciplines of logic and metaphysics became functional to the justification and reflection on the conceptual premises and the methods of natural philosophy, changing their traditional roles as art of reasoning and as science (...) of being. This transformation took place as a result of two factors. First, logic and metaphysics were used to grant the status of indubitable knowledge of natural philosophy. Second, the debates internal to Cartesianism, as well as the emergence of alternative philosophical world-views progressively deprived such disciplines of their foundational function, and they started to become forms of reflection over given scientific practices, either Cartesian, experimental, or Newtonian. (shrink)

The ‘mineness’ of thoughts has often been accepted as indubitable in philosophy. However, the symptom of thought insertion in schizophrenia seems to be an empirical counterexample to the dictum that every introspected thought is one's own. We present a thorough conceptual analysis of mineness of thought, distinguishing between ownership and authorship . We argue that it is indeed a conceptual truth that introspected thoughts are owned by the introspector. However, there are everyday and pathological cases of thoughts, for which (...) we do not ascribe authorship to ourselves. To explain inserted thoughts, however, we need an additional factor which is constituted by the lack of control over inserted thoughts . We present a review of empirical data on thought control and thought insertion in the light of the conceptual analysis. We conclude with a summary of the most important future direction of research. (shrink)

This chapter contains sections titled: Aristotle's Declaration of a General Science of Being qua Being A Problem for the Science of Being The Content of the General Science of Being Including Axioms in the General Science of Being The Notion of the Firmest Principle Proving Something about an Axiom: the Indubitability Proof of PNC PNC as the Ultimate Principle Defending an Axiom: the Elenctic Proof of PNC Theology and the General Science of Being Notes Bibliography.

Two claims are essential to foundationalist theories of knowledge. First, that there are directly evident propositions; secondly, that, in justifying a particular knowledge claim, one ultimately arrives at a directly evident proposition making another proposition evident. In this dissertation, both claims are being defended. ;In defense of the first claim, a week definition of a proposition's being directly evident is suggested. Any attack against foundationalism rejecting the first claim must show that there are no contingent directly evident propositions in the (...) sense of this definition. According to the thesis of privileged access, what a man believes about his mental states is directly evident, or, according to different versions of this thesis, self-presenting, infallible, self-evident, indubitable, or incorrigible. Rejecting a number of objections to it, the thesis of privileged access in all of its versions is being defended. In defense of the second claim, an account of prima facie evidence is set forth, incorporating definitions of the concepts "e tends to make h evident," "i defeats the evidence e provides for h," and "e makes h prima facie evident for S." It is claimed that, if a proposition p is made prima facie evident for a person S, then there is no ground on which it is reasonable for S to doubt that p is true. ;Furthermore, two epistemic principles are being offered. The first lays down the conditions under which evidence is generated, asserting that evidence is generated in virtue of a person's being in a psychological state. The second lays down the conditions under which evidence is transmitted from a directly to an indirectly evident proposition, asserting that evidence is transmitted from a directly to an indirectly evident proposition if the former bears to the latter the relation of "e making h prima facie evident.". (shrink)

In lieu of an abstract, here is a brief excerpt of the content:'Difficult Patient':A Reflective EssayDaniel McFarlandThe patient who sat across from me knew too much about all brain tumors. According to her, she would never know enough about the one sitting uncomfortably close to her brain's temporal lobe. In her quest for the 'right' answer to her meningioma problem, she became certain that its surgical removal would upend her life, leaving her in neurological taters.She was a small business owner (...) of a practice dedicated to medical massage. Indubitably, she had helped countless clients heal themselves of medical mishaps and avoid or recover from the tyranny of [End Page E13] a medical community that did not always provide respectable, hospitable care. She was certain a craniotomy would end her business, nullifying everything she had spent her life building. She became fluent in the legalese needed to transfer or sell her business in anticipation of surgery. To stave off losing her life's work from a surgical mishap, she sought opinions from a dozen neurosurgeons. They reassured her that a routine surgery like this would be effective with little chance of neurological collateral damage. She did not believe them. In her business she had treated numerous exhausted professionals. Many surgeons with whom she worked professionally frequently referred patients to her. She had seen the poor self-care that many surgeons and doctors brought on themselves in the form of unrelenting stress, drinking, bad eating habits, and even drugs. This made her nervous and untrusting about the care she could receive at the hands of an overworked or impaired surgeon. She scheduled appointments with every neurosurgeon she could find and interviewed them relentlessly, looking for the slightest sign of incompetence, unprofessionalism, antipathy, or lapse in compassion. Given her insistence and dogged nature, she usually found what she was looking for. She would bring her research to the appointments and interview the neurosurgeons on what other doctors had opined. If they were incredulous of research she brought or a technique on which she inquired, they were summarily dismissed.At first glance, which is likely all that she got from many of her visits, these encounters put a spotlight on a 'difficult' patient refusing care. The deeper look that my patient deserved revealed a personal narrative of the oldest child who survived a broken home riddled with drug use and prostitution. She learned to rely on only herself for protection. She took unapologetic control of her fate. Her own mother had at one time offered my patient work as a prostitute. Her father was no better in providing protection and a decent upbringing. He had left her as an eight-year-old with the neglectful mother and four younger siblings to fend for herself, which she did against the odds. She suffered physical, emotional, and spiritual abuse.As an adult, her strong sense of selfhood and boundaries allowed her to have a guarded relationship with both of her parents at a comfortable emotional distance. Her mission and passionate drive to help others heal saved her life. In healing others, she was healing herself. Importantly, her experience marked for her indelibly that while she could do this for herself, others were not reliable and could not heal her. She had only ever trusted and relied upon herself. She was the only one who had never let her down. She was terrified that this might be the first time. The potential surgery risked her cognition, physical capacities, and ability to care for herself. The risk was too great.We met numerous times, uncovering her past, reliving the stories of her tumultuous background, and examining how she established her place in the world away from the horrors of her insecure childhood. She took in my reaction to her stories and saw the horror on my face when I tried to imagine a world where one's parents were not only neglectful but the source of danger. Through my reaction, she may have begun to have some compassion for her own story and put the pieces together. One several occasions, she became enraged when I didn't meet her expectations, or I didn't entertain the diatribe of neurosurgical scholarly work.On one of those... (shrink)