Medicine in rural China. A personal account

Moreover, Pavlov's colleagues recognized that his postulated "cortical" reflexes and his later concept of "second signal system", with which he claimed to conquer the citadel of mind, were "illusory physiology", despite their respectful or fatuous praise for the Nobel laureate. Nonetheless, both the Party leadership and the educated public persisted in the naive belief that mind is or soon would be reducible to brain. This shared scientific fantasy sustained Pavlov's reputation and his funding in Russia; it ultimately made possible the artifical unity of psychology and neurophysiology in the Stalin era. As for Soviet psychiatry, Joravsky acknowledges that the political bosses left authority over the insane largely to the acknowledged experts. The fundamental fact remains, in his view, the power of an essentially Stalinist mentality to continue dominating the profession long after the dictator was gone. His explanation is that "something within psychiatry, a persistent need to equate intuitive convictions with scientific knowledge, generated an enduring affinity between doctors of the mind and the authoritarian leaders of their country" (p. xix). This is consistent with other recent scholarship on psychology, psychotherapy, and psychiatry under Nazism, which shows that in these cases, too, professionals functioned most effectively as transporters-if need be, as enforcers-of dominant cultural values when they imagined themselves to be altruistic, objective practitioners of applied science. These findings have disturbing implications for professional practice elsewhere as well. If Joravsky is correct, then non-Soviet psychiatrists' condemnation of their Soviet colleagues is shortsighted at best, hypocritical at worst. This tale is one of massive failure at all levels-those of science, of the attempted political direction of science, and of common humanity. Joravsky is deeply critical of the fragmentation and specialization characteristic of modern thought, and not only in Russia. He mourns most the separation of scientific "knowledge" from literary "wisdom". And yet, he fully acknowledges how necessary naturalistic and materialistic assumptions are for science of any kind to work, and how elusive the values of understanding and creative imagination treasured by the literary artist must seem from such foundations. Though he wants to weave a tapestry of wistful ironies in the spirit of Chekhov, he creates instead a Dostoyevskian universe, tragic, dark, and hopeless. Now that the Brezhnev era is past, a post-Communist era dawns in Eastern Europe, and the Soviet Union itself appears on the way to disintegration, this book could be read as an elegaic testament-if so much of …