Psychiatry

All schizophrenia patients are mad, and none are sane. Their behaviour is incomprehensible. It tells us nothing about what they do in the rest of their lives, gives no insight into the human condition and has no lesson for sane people except how sane they are. There's nothing profound about it. Schizophrenics aren't clever or wise or witty — they may make some very odd remarks but that's because they're mad, and there's nothing to be got out of what they say. When they laugh at things the rest of us don't think are funny, like the death of a parent, they're not being penetrating, and on other occasions they're not wryly amused at the simplicity and stupidity of the psychiatrist, however well justified that might be in many cases. They're laughing because they're mad, too mad to be able to tell what's funny any more. The rewards for being sane may not be very many but knowing what's funny is one of them. And that's an end of the matter.

The popular medical formulation of morality that goes back to Ariston of Chios, "virtue is the health of the soul," would have to be changed to become useful, at least to read: "your virtue is the health of your soul." For there is no health as such, and all attempts to define a thing that way have been wretched failures. Even the determination of what is healthy for your body depends on your goal, your horizon, your energies, your impulses, your errors, and above all on the ideals and phantasms of your soul. Thus there are innumerable healths of the body; and the more we allow the unique and incomparable to raise its head again, and the more we abjure the dogma of the "equality of men," the more must the concept of a normal health, along with a normal diet and the normal course of an illness, be abandoned by medical men. Only then would the time have come to reflect on the health and illness of the soul, and to find the peculiar virtue of each man in the health of his soul.

Criticism should not be focused on Nazi Germany alone but extend beyond to include physicians in democratic countries, as well. Physicians outside Germany before the war, in the United States in particular were well aware of the evolving racist thrust of the health care system. They chose to remain silent.