Yesterday, I had the opportunity to attend GRF Magdala’s rose cafe about the pathological versus normal. This conversation was extremely interesting as it got me to think the degree to which society is so fixated on everyone being compared to this “average”, so much so that if you don’t fit into whatever social role expectations you are supposed to, you are considered an outcast or abnormal. On a broader level, I believe that the reason there is so much negativity in the world with respect to not valuing other races, or people of different gender identities, is because we are so fixated on using binary classifications to make our live easier, yet at the same time contradictory, these binary classifications complicate the way that people are able to freely express themselves.

In that regard, while I believe that we don’t need to have a “normal society” in order to function, I feel that given current social role expectations, it will be challenging for us to divert from this viewpoint.  For example, we are  so used to comparing things to certain “normal ideas”, in order to detect right versus wrong, unhealthy versus healthy. For us to not have these classifying factors, will increase the amount of confusion and gray matter we have over ideas. Thus, I believe that a normal society, where we have an average expectation of how things are supposed to be is important just so that we have metrics to track progress or the regression we make as society in developing cures to vaccines, solving mental health problems,etc. We thus will continue living in a world that is abnormal due to its constraints on the normal, perceived views of how society should operate and a world that is normal as perceived by society since all our actions fit into this measure box of ideas, values. etc. Anything that deviates from this would be considered normal in this context of pathological versus normal, however abnormal to society given that we have binary,and definite ways of classifying ideas, problems,etc. In that sense, through analyzing our discussion, it is evident that there seems to be contradiction in what society perceives as normal versus not abnormal and what the French Naturalists perceive as normal and abnormal. When I try and imagine a society that is without any binaries, I feel that it would be more inclusive and that I would not have these pressures to live up to. Everybody has their own expectations from themselves, but these expectations seem to be arising on this one central idea of who we should be and what we should do.  In trying to emulate this average idea, we all tend to act similarly. Sometimes, I wonder how different my life would be if there was no pre-defined metric to classify “success”, or “who I should be and what I should do”.

Last Wednesday, I attended GRF Magdala’s very fascinating Rose Cafe on medicine in French literature, and on the concepts of “normal” versus “pathological.” Early on in the discussion, Magdala asked the group what we believed the word “normal” to mean. The answer that we arrived at was that it was just another word for “average” or “mean” (I am referring to these words in a purely statistical way). While I think that many people, myself included, do not always use the word “normal” in this context, I suspect that this is due to a lack of understanding, whether conscious or not, of what the word means. I think that if we truly treated the word “normal” as a synonym for “average,” we would have a much different reaction to the word than we do now.

This difference in how we view the words “normal” and “average” can be seen through the binary that exists between the concepts of “normal” and “pathological.” According to this binary, if something is not “normal,” then it is “pathological.” However, statistics never suggests that there is something “pathological” about being away from the mean. Statistics treats those above the mean and those below the mean in the same way, while society treats them differently. For example, consider intelligence. Society considers those with above-average intelligence to be “smart” or “a genius,” both of which are considered to be good things, while those with below-average intelligence are deemed “stupid” or “dumb,” which are considered to be bad things. Yet there are the same number of people with above-average intelligence as below-average intelligence.

Furthermore, consider the word “outlier.” In statistics and data analysis, this word refers to a data point that is far out on one extreme, and does not seem to follow the general trend. In the “normal” vs. “pathological” binary, outliers would be considered to be pathological. Indeed, the outliers in our society are often viewed poorly by the masses. However, the word “outlier” itself has far less of a negative connotation than the word “pathological,” even though the outliers in society would be considered to be the most pathological.

A large part of our discussion was on whether or not we should utilize the concept of “normal” in medicine, or if we should focus on the individual’s narrative. Personally, I believe that the concept of “normal” does belong in medicine, but we are often using it wrong. The example of the normal body temperature was brought up during the discussion. While it is true that not everybody has the exact same standard body temperature, it could still be useful for a doctor to have a general idea of what a patient’s body temperature should be under healthy conditions. This is especially true if a patient comes in because they believe that they may be sick, and the doctor may not know what the patient’s body temperature should be. Knowing the average body temperature can help a doctor decide if the patient has a fever or not.

Finally, consider this statement: On average, smokers have a lower life-expectancy than non-smokers. Sure, it is possible to smoke and live a long life, just as not smoking does not guarantee that one will not have a short life. Yet this statistic can help us realize that it is probably healthier to abstain from smoking than it is to smoke. Averages can be very useful. But we should not treat everyone as if they should be the average.

It’s been almost a week since I attended the Rose Cafe hosted by GRF Magdala. The reason was that I wanted the discussion to sink in. To use a word that was frequently cited during the discussion, the ‘narrative’ that our societies’ focus on and measuring of individuals against a normal (different from but nearly synonymous with, depending on your point of view, average) standard removes the autonomy and individual worth that individuals seek. Put bluntly, and as rgc94 pointed out, this argues that our individual conception of self is taken from them when we reflexively evaluate their worth with respect to some normal. Instead, particularly in medical practice, the medical professional should treat the patient, rather than the illness, the latter of which necessitates the comparison of the patient to a more normal “healthy” individual.

I have two concerns with this. The first involves our conception of self itself, and where it comes from. If I understand the post made by rgc94, this point is also made there. I heard of this idea somewhere else as well, and I think it goes back to Hegel; that our understanding of self is built from our contrasting ourselves with an “other”. It is not a perfect mapping, but suppose we map on to this conception “other” instead the conception “normal”. Our ability to develop a sense of self then is necessarily dependent on my ability to differentiate myself from an external model, in this case the “normal”. So, if we value self, this is necessary.

But that last is a big if – should we value self? I’m increasingly in the camp that argues we should not. Self consciousness could easily be an illusion, and our conception of self leads to selfishness, greed, and an ill society. The counter is simple, that an elimination of self leads to oppression, a lack of rights, and dominance hierarchies, and while this may be somewhat true in Western societies that have forced a conception like this (a huge debate I won’t get into here), my (limited) understanding of Eastern societies with similar conceptions suggests that it can be highly functional. Either way, a disregard of a self in this sense I think plays well into Magdala’s thesis; If disease is truly a form of natural harmony, and good health merely the absence of suffering (thus the only disease needing to be cured is one leading to any amount of suffering), then a patient treating that disease is treating the wider conception of suffering, the patient’s “narrative”, rather than the patient as an individual. To treat the patient as an individual would necessitate this comparison to the “normal” that she wants to avoid, and with this (perhaps disingenuous) re-characterization of the argument, I am back on board with accepting its claims.

Last Wednesday, I attended the GRF Magdala’s Rose Café about the normal vs. the pathological in French medical literature. At first, it sounded like an esoteric topic, but she immediately began breaking it down for us and it soon became clear to me that this topic is extremely  applicable to our lives, despite her focus being on 19th and 20th century literature. I realized that I have always accepted the idea of some arbitrary standard of normality in all aspects of my life without ever questioning why those standards were chosen or how they may be damaging to people who may deviate from what is perceived to be “normal.”

In my opinion, some of the most important and controversial topics we discussed were the idea of normal vs. healthy vs. pathological and whether it is necessary to even have some standard of normal. At the time, I was convinced that having some standard of normal was necessary for medical practitioners under our current system, because otherwise there could be no way to generalize medical practices for a large and diverse human population. Many people at the Café disagreed, saying that the idea of normal does more harm than good, and Magdala brought to our attention a book by Emile Zola that subverted the notion that being different from the norm precluded having a fulfilled life (the protagonist of the novel was a woman with a limp). Even now, I am still intrigued and undecided on these issues, but at the very least I still believe in the utility of having a standard of healthiness that is not necessarily enforced (so that those who do not prescribe to the standard are not ostracized) but at least allows doctors to have some notion of an individual who needs care versus an individual who is not suffering.

This week, I attended a Rose Cafe lead by GRF Magdala, where she discussed her PhD study of normal vs. pathological. Basically, she is proposing the idea that instead of comparing people to a normal standard, we should compare them to themselves. For example, in the medical field, a person with a cold will be compared to themselves without a cold to find treatment. However, a person born with a limp would not be seen as one who needs treatment to fix the limp, but rather as one with a limp. While this idea is interesting to think about, I do not think it is entirely necessary and, to some extent, already exists.

The standard of being normal is argued to remove individuality. I would argue the opposite. The normal standard is simply an aggregation of an average of the population for personality traits and an ideal scenario for standard of living. For life expectancy, medical procedures, and such, normal is what people strive for in order to live a longer, healthier life. This purpose of the normal is very good, as people should strive to live longer and the normal serves to be a benchmark for how people should live. If we compare an overweight person to themselves, it can increase long term risk of disease and shorten their life span. For the personality function of the normal, this actually highlights what people do differently, as if everyone was 100% different, finding common ground would be more difficult and everyone’s little quirks and alternative interests would not be as interesting to talk about. I think the major criticism of the normal is that it drives people to the middle, but from my experience, it actually makes the individuality of people more pronounced.

At today’s Rose Cafe, Magdala spoke with us about her research in the intersection between French literature and the philosophy of medicine. Specifically, we discussed the idea of normal and how the conflation between health and normalness have led to intrusive medical treatments and oppression of the docile different. After a careful philosophical dialectic, we were left debating exactly what repercussions there are with imposing a binary based on normality on to the medical treatment and classification of others.

After this discussion, I have come to the opinion that the very idea of normalcy is completely unnecessary. We use normalcy to easily organize and describe desirable ideas. For example, doctors consider healthy to be normal. But with that, we are labeling the unhealthy as not normal. Why not simply call the healthy healthy and the unhealthy unhealthy? This translates into other areas of society. Because the average person has a partner of the different sex, we consider heterosexual relationships the norm. By doing this, we are designating LGBTQIA+ individuals as not normal. And with this act, there are debilitating effects on society, such as the alienation of those who are different without hurting others. Overall, I have left this rose cafe with a better perception of the philosophy of medicine and what it really means when I label something as “normal”.