“My entire existence is really the deepest irony.” Søren Kierkegaard
“The value of irony, when it is deployed well, is that it opens up the possibility of hearing an internal call to goodness—the call of an ideal, the call to one’s better self—that might not be opened up in another way.” Jonathan Lear
On the entrance to the toilet in the airport, the cleaner remarks “welcome to my office” and smiles a big grin. This is irony. The ironist balances on the border of wit and cynicism. In America, irony has become conflated with in-authenticity: the hipster pretending to be unfashionable in an effort to impress, the racist friend commenting dryly about his token minority friend. The recent conflation of irony with, for lack of a better phrase, being a jerk, obscures the depth of its’ power.
Kierkegaard noted this astutely, and thought of irony as playfulness with one’s social role. To be ironic is to call into question ones social standing – by adjusting your position to it to reveal the construction of the position. For Kierkegaard, irony is not just a series of funny quips, but an approach to life. The penultimate question for Kierkegaard was “Of all the Christians, is there really a Christian?” meaning, whether one person can truly embody the ideals of an identity. As a result, to be a Christian meant constantly negotiating one’s position both inside and outside of Christian dogma by posing this very question.
What might a professions’ relationship to irony say about the profession itself? I would argue that it says a lot – as a proxy for a combination of playfulness, humility, and serious inquiry. To start with an easy one, of all philosophers, is there really a philosopher? This question is in fact part of doing philosophy – to constantly reposition oneself. And then, of all doctors, is there really a doctor? The doctor who answers, “yes, me” and then proceeds to do his job is clearly missing something about his work. And yet, part of training as a doctor is to confidently pronounce “yes, me!” out of self-affirmation and also to inspire a sense of trust in patients. Where, if anywhere, is there room for irony in medicine?
There seems ample room for sarcasm, which is a dim shadow of irony. If the ironist approaches her profession with the intent of exploring depth, the sarcastic person retreats into a corner. After discharging a patient, one may hear the comment “another life saved,” sarcastically commenting on the futility of one’s work. Here there is a denial of ones’ role, a negation that closes off dialogue. In contrast, the most ironic thing for a doctor to say might be, after a long day, “What is it that we are truly doing here, anyways?” Or, “given all the chronic disease I am treating, what does it really mean to heal?”
Irony need not be morose or deep – it can be lighthearted, like the nephrologist who, when reading an EKG, says, “Ok. Should we try to do something with these scribbles?” The nephrologist is being more than sarcastic here – in calling the electrical signals “scribbles” he is calling into question the authorial knowledge of medicine – this is not astrophysics, folks, we are just looking at scribbles. Similarly, the geriatrician who remarks, “when all else fails, go examine the patient,” is slyly making it known that medicine is not yet completely technological.
I am arguing for a call to irony in medicine, but I would imagine a similar claim could be made in all professions. Of all the teachers, is there truly a teacher? Of all the religious scholars, is there a religious scholar? The point of the exercise is not merely to compile a list of traits, but to explore the periphery of the very identity, and in doing so, to recreate it.
References:
- Lear, Jonathan. 2009. To Become Human Does Not Come That Easily. The Tanner Lectures on Human Values
- Søren Kierkegaard’s Journals and Papers, Vol 2, F–K, ed. H. V. Hong and E.H. Hong (Bloomington: Indiana University Press, 1970)
Image courtesy of Contributing Scholar Elise Alexander.
Tom, it sounds like you’re saying that irony is using humor to pose deep questions about the nature of things that we might take for granted. Is that right?
If so, then I agree that it’s invaluable. If we can’t step out of ourselves in the work that we do daily, then how can we imagine things being different? If we can’t see other possibilities than those that we are presented with currently, how will we grow?
Great piece Tom. Irony is truly the single thing most missing from the medical world in the US and American life in general. It would be useful to get our definitions straight. Sarcasm is saying one thing while meaning the opposite. As you point out sarcasm, funny as it may be, is nonetheless bitter negation while irony is life affirming. Cynicism however is equivalent to neither irony nor sarcasm, it is the inclination to doubt other people’s motives. Being cynical can refer either to being skeptical and mistrustful of ones fellows or doing something that has the appearance of having a laudable aim while actually looking out for ones own interests. Sarcasm has a tang of bitterness but is usually socially innocuous as its poisonous arrow is eventually directed at one’s self. Cynicism is somewhat more pernicious. American life is blessed (this is sarcasm incidentally) with a good amount of sarcasm, which more often then not reflects people’s inevitable disillusionment with the promises of individualism and self-fulfillment – the “pursuit of happiness” that the good natured slave-owner Thomas Jefferson fought so hard to keep in the declaration of independence. His somewhat less cynical opponents, by the way, wanted to go with the original and straight forward “life liberty and the pursuit of property”. The US of course still has its share of cynics. Washington and Wall Street could probably boast (sarcasm again) the world’s greatest concentration of the latter per square foot. But irony alas is direly missing. Most Americans, on the left and on the right and in the middle (American doctors included) like their world in black and white, right and wrong, good and bad. It is a nation as deaf to irony as an achromatopic person is blind to color, a home for the eternally confident and brave with no room for the occasionally baffled. If Saddam Hussein is bad then toppling him must be good. If cocaine is destructive then aerial spraying of herbicide on Columbian farmers must be beneficial. If military intervention is malignant then sitting by while religious extremists overrun northern Nigeria must be benign. If Democracy is the righteous path then the Muslim brotherhood is an assembly of saints. So in the medical world…If patient autonomy is sacred then being firm with a malingering patient must be sacrilegious. If medical paternalism is wrong then telling a scared, anxious terminally ill patient that she and she alone must decide whether to be ‘Full Code’ or ‘Do Not Resuscitate’, is right. If missing an unlikely diagnosis on the first encounter is never excusable then there must be an excuse to send every abdominal pain for a CT. It by no means (sarcasm) can be seen as a cynic’s way of making sure one never gets sued at the expense of subjecting hundreds of patients to unnecessary and potentially harmful tests. Life however, cynicism or naivety notwithstanding, happens in the gray and in all the subtle shades between the colors. Irony is a celebration of life and the universe, their unfathomableness and immeasurability, the unattainability of the values we hold dearest, the unsolvable human predicament, the impossibility of man’s quest for truth and justice, for trying to do the right thing, which is precisely what makes this quest so noble. For Kierkegaard the ultimate ironist is Socrates, the man compared to whom sayeth the Delphic prophet ‘there is no wiser’. Of the cynics of his time (politicians, artisans, poets) Socrates is quoted as saying something like ‘they believe that they know something while not knowing anything. I, on the other hand, just as ignorant as they, do not believe that I know anything’. Socrates did not mean that nothing could be known, but that nothing can be known with absolute confidence. And as you say it is irony, the aptitude for ironic self-doubt, the insistence to forever explore the periphery and poke needles at the bubble of one’s own identity that is perhaps, though ultimately never wholly attainable, the greatest virtue of them all. Go tell that to your bow-tied Boston professors and the medical residents so eager to grow up to be just like them….