Although Stevenson’s fieldwork was unusually thorough, mainstream scientists rejected reincarnation as a viable explanation and instead focused on potential methodological weaknesses such as retrospective testimony, cultural influence, and the difficulty of ruling out information leakage. Stevenson described the cases as “suggestive,” but he made clear that reincarnation—or at least the survival and transfer of some aspect of personality—was, in his view, the most plausible interpretation.

The twenty cases in the 1966 volume represented only a fraction of the material Stevenson had been collecting since 1960. His early publications had attracted the attention of Chester Carlson, the inventor of the Xerox process, who left a bequest of one million dollars to the University of Virginia upon his death in 1968. The Department of Psychiatry used the gift to establish the Division of Perceptual Studies (DOPS), with Stevenson as its founding director. The name provided an academically respectable umbrella for research that included, but did not explicitly advertise, the study of children’s past-life memories.

Over the next three and a half decades, Stevenson and his colleagues expanded their investigations across Asia, the Middle East, Africa, Europe, and the Americas. By the time of his death in 2007, Stevenson had published twelve additional books and more than three hundred papers, documenting over 2,000 cases. In 1999, journalist Tom Shroder’s detailed investigation, Old Souls. The Scientific Evidence for Past Lives offered an intimate portrait of Stevenson’s fieldwork and helped bring the research to wider public attention.²

Leadership of the program passed to child psychiatrist Jim Tucker in 2002, when Stevenson retired.³ Tucker became Director of DOPS in 2014 and, in 2021, published Before, an updated synthesis of his own two earlier books. ⁴ Tucker reports that the DOPS database now includes more than 2,500 cases worldwide, including many from North America. Only a minority—roughly 15–25 percent—qualify as “strong cases,” meaning that the child’s statements were independently verified as matching a specific deceased individual.

The strongest cases share several converging features: verified statements about the previous life, verified identification of the deceased individual, physical correspondences such as birthmarks or birth defects, behavioral continuities, and early onset of statements. One of Stevenson’s most striking findings involved physical correspondences. By 1997, he had documented 210 cases in which a child had a birthmark or birth defect corresponding to a wound on the deceased individual, and in 49 of these, he obtained autopsy reports confirming the precise wound locations.⁵ These findings were presented in detail in Where Reincarnation and Biology Intersect and in his massive two-volume monograph Reincarnation and Biology.⁶

Here is an example of one of Ian Stevenson’s earlier strong cases. When Swarnlata Mishra was three years old, she began singing unfamiliar songs and performing dance steps her family had never seen, dances from a region of India more than a hundred miles from the family’s home. Soon she was describing a former life as a woman named Biya Pathak, recalling the layout of Biya’s house, the names of her children, and even a stash of money hidden in a wall. Stevenson documented her statements before any contact with the Pathak family, and when they eventually visited, Swarnlata greeted them with an ease and specificity that startled everyone present. She correctly identified family members, teased one man with a childhood nickname only Biya had used, and pointed out a brother’s limp. The encounter had the uncanny feel of a reunion rather than an interview, and for Stevenson it became one of the clearest examples of a case where detailed memories, personality traits, and verifiable facts converged before any possibility of normal information transfer.

More than half a century later, Jim Tucker encountered a very similar pattern in the case of “Ryan,” a young boy from the American Midwest. At age four, Ryan began speaking urgently about a previous life in Hollywood—describing movie sets, agents, and a bustling life in Los Angeles. His parents, who had no interest in reincarnation, tried to reassure him, but the boy’s distress grew until Tucker became involved. Using Ryan’s spontaneous statements, Tucker and the family identified a long-forgotten bit-part actor and Hollywood extra from the 1930s and 40s. Ryan had given more than fifty details about this man’s life, including the street he lived on, the name of a restaurant he frequented, and the fact that he had danced on Broadway before moving west. Many of these details were later verified in archives and autobiographical sources unavailable to the family. What made the case especially compelling to Tucker was not only the accuracy of the statements but the emotional tone: Ryan spoke of the former life with longing and confusion, as if caught between two identities, until the memories gradually faded around age six.

Here is an example of a case in which the child had birthmarks corresponding to the deceased person’s wounds. In rural Burma, a young boy began speaking at age three about having been a man who was shot from behind while walking along a road. His parents were startled not only by the specificity of his statements but by his two unusual birthmarks: a small, round mark on his chest and a larger, irregular one on his back. When Stevenson later investigated, he found that the boy’s descriptions matched the death of a man from a nearby village who had been killed by a close-range gunshot. Eyewitness accounts and medical documentation confirmed the wound pattern, which corresponded closely to the boy’s birthmarks. The child also showed a deep, visceral fear of guns and loud noises, reacting with panic in ways that seemed disproportionate to anything in his current environment. The case combined early and detailed verbal statements, independently verifiable information about a violent death, and physical marks on the child’s body that mirrored the trauma he described.

Stevenson’s long-term research program—and Tucker’s continuation of it—poses a direct challenge to the assumption that consciousness is wholly generated by the brain. Across more than 2,500 investigated cases, they documented young children who spontaneously described memories, behaviors, and emotional dispositions corresponding to identifiable deceased individuals. While most cases are incomplete or ambiguous, a substantial minority meet stringent evidential criteria, and more than two hundred combine multiple independent lines of evidence: verified statements, behavioral continuities, and physical correspondences. Critics have proposed cultural contamination, suggestion, fraud, or loose investigative methods, but none of these explanations plausibly account for the best-documented cases, especially those with medical records, multiple independent witnesses, and physical anomalies. Even the most skeptical reviewers have struggled to articulate a coherent alternative hypothesis that explains the full pattern of data.⁷

For more than sixty years, however, mainstream scientists have dismissed the research. Critics argue that the stories of past lives are most likely due to coincidence, misinterpretation, parental influence, observer bias, or other sources of error. They emphasize the complexities of contextualizing and translating these “memories,” especially in cultures with strong beliefs in reincarnation.⁷ Yet critics rarely engage with the case narratives themselves; instead, they rely on hypothetical sources of error. To attribute all of these cases solely to flawed methodology would require assuming that Stevenson, Tucker, and DOPS have repeatedly committed the same errors for six decades despite their detailed rebuttals of such claims.

The deeper criticism, however, is philosophical. Although surveys show that most Americans and physicians believe in a soul or spirit, most philosophers and neuroscientists endorse a materialist-reductionist view: the brain creates the mind through electrochemical activity, and consciousness ends with the death of the body. Clinically, there is ample evidence that consciousness depends on a functioning brain—brain injuries and diseases clearly alter mental states, and imaging techniques reveal neural pathways associated with various emotions and thoughts. For clinical purposes, consciousness appears entirely dependent on the physical brain.

Yet this dependence does not settle the metaphysical question of what consciousness is. Critics of Stevenson and Tucker often assume, without argument, that the physical world as described by contemporary physics is the totality of what exists, and that consciousness must therefore be a byproduct of physical interactions. But subjective experience—the interior world of personal identity—does not obviously follow from any known property of quarks, electrons, photons, neutrinos, or the forces that govern them. The gap between third-person description and first-person experience is conceptually radical. No arrangement of particles, however complex, seems to entail subjectivity, i.e. interior life, in the way that arrangements of particles entail objects, organisms, or chemical bonding. To assume that this gap will close through further study of neural circuitry is to smuggle in a metaphysical conclusion under the guise of scientific optimism.

The quantum world is exceptionally weird – in many ways it violates common sense. Particles are also waves and waves are particles. An electron can be in multiple places at once. The behavior of one particle may determine the behavior of another, even though they are too far apart for a message to pass between them. Particles can tunnel through barriers apparently without having enough energy to do so. However, none of this weirdness suggests that large accumulations of particles (e.g. atoms, molecules, brains) could generate an interior world of personal identity There must be a deeper, more complete, theory of what exists in the universe that does account for the generation of consciousness; a quantum of subjectivity, if you will. As science writer Jim Holt summarized in Why Does the World Exist?, “The properties of a complex system like the brain don’t just pop into existence from nowhere; they must derive from the properties of the system’s ultimate constituents. Those ultimate constituents must therefore have subjective features themselves.”⁸

This is why the possibility that consciousness has a fundamental place in the universe is not mystical speculation but a legitimate philosophical alternative. Some philosophers and neuroscientists propose that consciousness may be an intrinsic aspect of matter, or that the universe contains a fundamental “interior” dimension alongside its measurable exterior. Panpsychism—the view that consciousness is woven into the structure of matter—is endorsed by a small, but growing, minority of philosophers, including David Chalmers⁹, Philip Goff¹⁰, and Galen Strawson.¹¹ Another group, notably Thomas Nagel¹² and John Searle¹³, acknowledge that our current physical ontology is incomplete, although not fully endorsing panpsychism. Physics has repeatedly revised its understanding of matter; it is not unreasonable to suspect that consciousness may require a similarly deep revision. To quote Thomas Nagel, “Consciousness is the most conspicuous obstacle to a comprehensive naturalism that relies only on the resources of physical science. The existence of consciousness seems to imply that the physical description of the universe, despite its richness and explanatory power, is only part of the truth.”¹²

Given these considerations, the continuation of consciousness, at least in some form, after death seems at least a possibility. Stevenson and Tucker’s work may well represent the identification of a previously unknown natural phenomenon, perhaps analogous to reported near-death experiences — well-documented yet difficult to explain. To my mind, this conclusion is more likely than is six decades of repeated errors.

However, that doesn’t mean the “former lives” data necessarily support a traditional doctrine of reincarnation, in which a unitary soul passes from one body to another. If a psychic dimension of the cosmos exists, a one-to-one transmission of “mind-stuff” to a newborn baby in the same country and culture seems overly simplistic, more in line with supernatural beliefs than with an unknown natural phenomenon. It is notable that the phenomenon is rare and the memories transient and strongly associated with traumatic death. Could it be that, under certain conditions, a “package” of psychic impressions may transfer from a dying person to a newborn, occasionally even influencing the child’s body? This, like any other scenario, is speculative, given our ignorance of the origin and meaning of consciousness in the physical world.

The broader point is that most philosophers and neuroscientists begin with an unexamined premise: that everything real must be physical in the sense described by current physics. But consciousness—the one phenomenon we know from the inside—does not obviously fit within that framework. Before declaring that mind must be reducible to matter, we should ensure that our conception of matter is adequate to account for mind at all. Consequently, Stevenson’s and Tucker’s six-decade quest to understand the experience of children who report having lived former lives should, if anything, leave us wondering whether we really know what we think we know about the way the universe works.

References 

1. Stevenson, Ian Twenty Cases Suggestive of Reincarnation, University of Virginia Press, 1980 [First published in 1966] 
2. Schroder, Tom. Old Souls. The Scientific Evidence for Past Lives. New York, Simon & Schuster, 1999 
3. Tucker, Jim B. Ian Stevenson and Cases of the Reincarnation Type, Journal of Scientific Exploration. 2008; 22: 36-43 
4. Tucker, Jim. B. Before: Children’s Memories of Previous Lives, St. Martin’s Press, 2021 
5. Stevenson, Ian. Where Reincarnation and Biology Intersect. Westport. Praeger, 1997 
6. Stevenson, Ian. Reincarnation and Biology: A Contribution to the Etiology of Birthmarks and Birth Defects, Westport, Praeger, 1997 [Two volumes] 
7. Matlock, J. G. ‘Reincarnation Case Studies: Criticisms’. Psi Encyclopedia. London: The Society for Psychical Research. <https://psi-encyclopedia.spr.ac.uk/articles/criticisms-reincarnation-case-studies/>. (2022, retrieved 24 March 2026) 
8. Holt, Jim. Why Does the World Exist? London, W. W. Norton & Company, 2012, p. 194 
9. Chalmers, David J. The Conscious Mind: In Search of a Fundamental Theory. Oxford University Press, 1997 
10. Goff, Philip. Galileo’s Error. Foundations for a New Science of Consciousness. New York, Pantheon Books, 2019 
11. Strawson, Galen. Consciousness and Its Place in Nature, Imprint Academic, 2024 
12. Nagel, Thomas. Mind & Cosmos. New York, Oxford University Press, 2012, p. 35 
13. Searle, John. Mind: A Brief Introduction, Oxford University Press, 2005 

Web image by Medhum.org

Among the scores of essays Montaigne wrote, while occasionally serving in various government roles, are accounts and commentaries concerning many of his infirmities. Kidney stone attacks in particular plagued Montaigne, and so they became subject matter for several essays. His focus on “the stone,” as he called this condition, generally concerned the physical and mental suffering acute attacks caused him, his work at reconciling a life with intermittent attacks, and from these two features, the profit his attacks afforded him. (N.B. I have drawn Montaigne’s words from the Everyman’s Library collection of Montaigne’s essays.)

Attack of The Stone

Pain from acute kidney stone attacks always ranks amongst the worst humans suffer from diseases, injuries, or various conditions. Montaigne’s vivid and horrifying descriptions of his kidney stone attacks lend credibility to these rankings: “I am at grips with the worst of all maladies, the most sudden, the most painful, the most mortal, and the most irremediable.” (p. 698)

To others looking on during one of his attacks, Montaigne says: “They see you sweat in agony, turn pale, turn red, tremble, vomit your very blood, suffer strange contractions and convulsions, sometimes shed great tears from your eyes, discharge thick, black, and frightful urine…” (p. 1019) No observer could doubt the intensity of pain kidney stone attacks produce after reading Montaigne’s accounts; no current sufferer would contradict them. 

A Life Accommodated

The pain and agony kidney stones inflict are never forgotten. And, the fear of knowing they will strike again is ever present, with good reason; they often return time after time. Indeed, this threat is a form of suffering of its own. Montaigne was cognizant of this reality, and writes about how he learned to live with the inevitability of a next attack. 

In the eighteen months or thereabouts that I have been in this unpleasant state, I have already learned to adapt myself to it. I am already growing reconciled to this colicky life; I find in it food for consolation and hope. So bewitched are men by their wretched existence, that there is no condition so harsh that they will not accept it to keep alive. (p. 697).

His primary approach was adopting a mentality allowing him to maintain as much function as possible while under frequent sieges of the stone: “I have kept my mind, up to now, in such a state that, provided I can hold fast, I find myself in a considerably better condition of life than a thousand others, who have no fever illness but what they give themselves by the fault of their reasoning.” (p. 701) Montaigne advises these thousand others they would do well to adjust their reasoning because the problem “occupies in us only that much room as we give it.” (p. 47) As for how much room to give the stone, he says, “we have no cause for complaint about illnesses that divide the time fairly with health.” (p. 1020)

With his reconciliation of a life with the stone, Montaigne carries on as close to a normal life as possible and not being obsessed with his condition: “Do not expect me to go and amuse myself testing my pulse and my urine so as to take some bothersome precaution; I shall be in plenty of time when I feel the pain, without prolonging it by the pain of fear.” (p. 1023) 

Profitable Kidney Stones

“I have in [my] time become acquainted with the kidney stone through the liberality of the years. Familiarity and long acquaintance with them do not readily pass without some such fruit.” (p. 697) The fruit is the profits he gains with kidney stones. The profits derived mainly from lessening his fear of death, better appreciating the health he had, and getting on with his life more easily. As such he has profited from receiving benefits exceeding the costs he incurred through suffering. 

“I’m not dead yet.” Montaigne wrote that when the stone visited him, he felt he was “so far forward into death that it would have been madness to hope, or even to wish, to avoid it, in view of the cruel attacks that this condition brings.” (p. 771) He had come face to face with death on those occasions only to survive. What he gained from these encounters he eventually appreciated as a form of profit. 

I have at least this profit from the stone, that it will complete what I have still not been able to accomplish in myself and reconcile and familiarize me completely with death: for the more my illness oppresses and bothers me, the less will death be something for me to fear. (p. 698) 

“What a feeling.” The perception of good health is created mostly either by various metrics like physical fitness standards (e.g., weight, strength, endurance), medical diagnoses, and other empiric findings, or by contrasts to states of bad health. Montaigne claimed great profit because his kidney stones reminded him how good his health is generally when he’s not in the midst of an attack. 

But is there anything so sweet as that sudden change, when from extreme pain, by the voiding of my stone, I come to recover as if by lightning the beautiful light of health, so free and so full, as happens in our sudden and sharpest attacks of colic? Is there anything in this pain we suffer that can be said to counterbalance the pleasure of such sudden improvement? How much more beautiful health seems to me after the illness, when they are so near and contiguous that I can recognize them in each other’s presence in their proudest array, when they vie with each other, as if to oppose each other squarely! (p. 1021)

Montaigne also perceived profit from the finite nature of kidney stone attacks. He points to the abrupt resolution of an attack followed by a quick return to good health in contrast to other diseases causing their victims continuous suffering: “My sickness has this privilege, that it carries itself clean off, whereas the other always leave some imprint and change for the worse that makes the body susceptible to a new disease.” (p. 1022)

“Brush off the clouds and cheer up.” To Montaigne, kidney stone attacks are gruesome and can make the sufferer wish to die. But, by their nature, and as a form of profit, they can make life better between attacks than it would be otherwise. Montaigne sees this profit in the certainty that any attack will end and lives can go on as planned, because the stone is “a disease in which we have little to guess about. We are freed from the worry into which other diseases cast us by the uncertainty of their causes and conditions and progress—an infinitely painful worry.” (p. 1023) This means for Montaigne, that the stone “almost plays its game by itself and lets me play mine. (p. 1022)

The idea that there can be profit or any form of benefit from having kidney stones is likely preposterous to modern day sufferers, especially when effective analgesics and surgical techniques for acute attacks and methods for preventing them are available. Many people, however, still struggle with chronic kidney stones making Montaigne’s observations and advice relevant yet. Drawing from a cultural analog, he might tell them to look for the profit kidney stones generate, and when found, they will see that gray skies are going to clear up, so put on a happy face. Alas, his admonition would likely be met with stony silence. 

Kidney stone image from the gallery at KidneyStoners.
Title image credit: Three Kidney Stones Highlighted in Red. Sanderlewis, CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0, via Wikimedia Commons

Literature mirrors the general culture. There has been a recent explosion of books in which AI is the central plot device moving the narrative forward to endings that range from a utopian fulfillment of human destiny to the catastrophic collapse of civilization and the annihilation of humankind. But AI infiltrated the literary space several decades ago. Philip Dick imagined a world in Do Androids Dream of Electric Sheep? where cyborgs were being hunted down because of fear that they might take over the world. In 2001: A Space Odyssey by Arthur C. Clarke, a robot named Hal murders nearly all the crew of a spaceship on a planetary mission because of a programming error. 

Speak by Louisa Hall is more recent addition to the AI library. But it was published several years before large language models became a routine tool to plan a vacation or write a letter of recommendation. Is it still worth reading in 2025? 

The novel is a composite narrative centered around five interwoven stories spanning the time period from 1663 to 2040. In the first narrative, a young Puritan girl who finds herself in an unwanted marriage, records her thoughts in a diary that she is writing on a treacherous ocean voyage to America. Fast forward to the 20^th century and we meet Alan Turing who is writing letters to the mother of young man to whom he was emotionally attached and who died prematurely. He is troubled by his inability at times to communicate with people. A decade later we meet Karl and Ruth Dettman, a couple whose families escaped Nazi Germany but under vastly different circumstances. The husband, Karl, is a computer scientist who has developed a program named MARY to enable computers to interact with humans. Ruth, his wife, is a historian who has built a career centered on the publication of old diaries like the one written by the young woman traveling to America. She is trying to convince Karl to expand the memory of his computer program and enrich it with more human material, but Karl stubbornly refuses because he is concerned about the power of his program to overwhelm its users if its database is expanded. Finally, we jump ahead to 2040, and we read the transcripts of the trial of Stephen Chinn, a man who is being prosecuted for the production of robots that are too life-like. Chinn is being accused of causing physical and psychological harm to the people who have used his robots and of weakening normal relationships between people. A young adolescent named Gaby, who was given a doll powered by a version of MARY, is one of his alleged victims. His own personal recollections are folded into the trial proceedings, as he tries to describe his intentions, justify his actions, and make amends for where they may have gone awry. 

Taking stock of our world today, there is clear evidence that AI can improve the day-to-day lot of people, make life more convenient and efficient, and promote better health outcomes. However, much of the current angst that permeates discussions of AI is focused on the potential economic and sociopolitical consequences. There is fear that systematic adoption of AI will lead to widespread loss of jobs and financial distress for people left behind. The generation of false data and uncontrolled dissemination of unfiltered information may, it is feared, foster social unrest and destabilize democratic institutions.  

All of these predictions, for good or for bad, center on the word “intelligence.” If it is defined as the creative use of information towards a specific goal– my definition, to be sure — then it exists along a gradient and there is not an opposing term. In that case, the mixed picture about the future of AI seems accurate. Humans can process information to both noble and destructive ends. If machines are provided information by humans, then it is likely that there will be worthy and flawed outcomes. It is not a reflection of the logical structures or neural networks that are built into us as humans or artificially placed into machines. It simply is the nature of intelligence. Information is agnostic and it can be processed in a limitless number of ways; there is no guarantee of what will happen when it is processed. 

On the other hand, if we center our predictions on the word “artificial,” there is an opposing term, namely “genuine.” Speak looks beyond AI as intelligence and forces us to think about its impact on interpersonal communication and interactions. The design of the robots that are being created in fiction and in our world of 2025 is steadily improving. The voices become more lifelike, the reactions more emotionally appropriate, the reactions more convincing. They display keen intelligence and manifest seeming empathy with their handlers. Like the artificial friend in Klara and the Sun by Kazuo Ishigura, the robots may even appear to have more feelings and awareness of the ever-changing psychological state of their owners than family members and friends. But it will always remain artificial. Speak forces us to ponder whether interactions between human beings have an element that cannot be programmed, that is not simply manipulation of information. It is that piece that accounts for the genuine nature of relationships between people and it is that component that is vital for human growth and maturation. The interconnected stories in Speak raise the concern that reliance on AI, in whatever embodied form it takes, to provide support and companionship may inevitably fail and leave damaged humans in its mechanical wake. The intelligence of AI may not be sufficient for humans to thrive. It remains difficult to put into words exactly what to call this additional component of human interaction. Thankfully, there is literature, and creative novels like Speak, to help us grapple with what it might be and to help us steer a course where AI is developed thoughtfully with full awareness of its limitations and potential for good and harm. 

SPEAK  
Louisa Hall 
EccoPress, New York 2016, 356 pp 
Web image by Medhum.org

Shortly before the outbreak of The Great War, a young engineering student arrives at a tuberculosis sanitorium high in the mountains of Central Europe. Over the course of his visit there he will share many meals (and drinks) with some of the other patients, a group which will include among others a Catholic conservative and a liberal humanist; there will be long, leisurely after-dinner discussions of varied philosophical topics; temperature charts will be compared; and he will become intrigued by a mysterious woman who is also a patient.  

And no, this is not The Magic Mountain. 

The Empusium is the latest novel from the Nobel- and International Booker Prize winner Olga Tokarczuk. The author subtitles her book “A Health Resort Horror Story,” which is exactly what it is. But it is a horror story which the author has cleverly folded into not just the setting of Thomas Mann’s novel, but the setting and certain elements of the plotline, all of them slightly altered, but recognizable. In fact, recognizing them is part of the fun of this well-plotted, rather Gothic tale. 

As the novel opens Mieczysław Wojnich, a young Pole from Łwów, has arrived at the tuberculosis sanitorium at Gӧbersdorf, in Lower Silesia (currently Poland, formerly Prussia), to be treated for his illness. There is no room at the main building, so he is assigned a room at Opitz’s Guesthouse for Gentlemen, where he meets his fellow (male) patients, who come from various Central European cities and differing viewpoints, but who seem to agree on one thing: the general inferiority of women. Philosophical discussions, which often take place over or after leisurely meals and the consumption of a magic mushroom-laced liqueur called Schwӓrmerei, range widely over several topics (war, language, the nature of reality) but most of the time are intensely misogynistic—what is the purpose of women? Do women have smaller brains than men? Do women’s bodies belong to the State? Have any great discoveries ever been made by women? Should women even be educated at all? (Tokarczuk helpfully includes an appendix to the novel in which she notes that all of the quotes of her characters on this subject are paraphrased from quotes by well-known prominent authors of the past, from Augustine of Hippo to William Butler Yeats)  

Things at the sanitorium go badly from the beginning of Wojnich’s stay. He stumbles upon the dead body of a woman laid out on a table, who turns out to be the wife of the guesthouse proprietor, and his companions tell him surreptitiously that she may have been murdered. He hears noises—voices—coming from empty rooms, and cries in the night from outside the guesthouse. An art student who is terminally ill confides that “people die here,” and not just from tuberculosis; every November, apparently, a young man disappears in the surrounding woods, only to have his body turn up ripped to pieces. And what exactly is going on with those woodsmen in the forest, anyway? 

The Empusium works on many levels. It is an homage to The Magic Mountain, but it is definitely not a retelling of The Magic Mountain. The allusions to Mann’s novel are multiple: the pre-World War I setting at a sanitorium in both novels; the fact that both Mieczysław Wojnich and Hans Castorp are engineering students; the philosophies of Settembrini and Naphtha in the Mountain, analogous to the conservative and humanist positions taken in The Empusium; the close childhood relationship between Castorp and Pribislav Hippe (Mountain) and Wojnich and Anatoly (Empusium), in each case bonding over a pencil. And as in The Magic Mountain, there is a narrator who occasionally breaks the fourth wall; verb tenses in The Empusium shift repeatedly from third-person singular past tense to first-person plural present. These are not subtle, nor are they intended to be.  

Allusions aside, The Empusium is its own story, and a totally different narrative. It is a horror story, a revenge story, a wryly feminist tale of the supernatural set in a place hopefully of healing but also of chronic illness and the ever-present specter of death. Tokarczuk builds suspense slowly, bit by bit, with increasing tension. Almost from the beginning there is the undeniable sensation that something is very wrong at Gӧbersdorf, although it’s hard to pin down exactly what it is. Wojnich often has the feeling that he is being watched. The story line draws from a tradition of folk horror, and specifically from the notion that bad things can happen to “city people” when they are out in the country, among the “old ways.”  

The Empusium is also more than just a horror story, and an important aspect relates to the misogynistic attitudes mentioned earlier. Tokarczuk takes a position on the nature of male-female relations (perhaps the use of a sanitorium as the setting is meant to suggest that misogyny is an illness infecting educated society). In this book “civilization” seems to be identified with maleness, and maleness is located in the sanitorium and the guesthouse, a controlled environment with its dining rooms and drawing rooms and intellectual conversation—and in the medical world, since this is a facility for medical treatment— and it is here that women are demeaned. The forest, on the other hand, is the home of the Tuntschi, female figures created by laborers out of sticks and moss and other forest detritus. It is a place both beautiful and enchanting—and dangerous. Men venture into the (female) forest, and the forest—in the form of the Schwӓrmerei, which Wojnich describes as redolent of mushrooms, moss, and earth—is brought into the guesthouse; boundaries are porous. Male and female, the guesthouse and the forest each have their secrets…and Wojnich is the last to know. But Wojnich has a secret of his own.   

And the title? A word created by the author. Empusa, in Greek mythology, was a shape-shifting female spirit who seduced young men, drank their blood, then devoured them.  

The Empusium
Olga Tokarczuk 
Riverhead/Penguin Random House, New York, 2022 
302 pp. 

Web photo by Marek Piwnicki 

At one point Ragin accidentally visits Ward #6, the mental ward, where he encounters Ivan Gromov, a brilliant patient, and strikes up a conversation with him.  Gromov, who carries a diagnosis of paranoia, loves life passionately.  His passion attracts Ragin, whose sensibilities are blunted by the emotional numbness from which many physicians suffer.  Ragin is attracted to Gromov like a moth to a candle. He begins to visit Ward 6 daily to debate with Gromov. Since the other doctors never visit Ward 6, this behavior is considered very peculiar. 

Ragin yearns to feel something, anything, even to experience suffering, rather than to remain suspended in his emotionless cocoon.  He develops an obsession that only suffering can redeem him.  This obsession makes him even more dysfunctional, a situation which allows a junior doctor to have him fired as hospital director and, ultimately, admitted to Ward #6 as mentally ill.  Once Ragin has become a patient, a “nobody,” the ward orderly hits him, thereby giving him the opportunity to suffer.  Shortly thereafter, he has a stroke and dies.

Enormous demands and poor working conditions contribute to Ragin’s predicament, but Chekhov suggests that Ragin’s character is also deficient.  Something is missing.  He experiences a sense of futility and numbness.  Is this an inevitable consequence of medical practice?  Or is he particularly vulnerable to burnout?  The deeper theme in “Ward No. 6” is Ragin’s failure to live an authentic life, to discover a sense of wholeness and meaning in his existence.  It is possible that Ragin’s early enthusiasm for hospital practice disguised the fact that he never came to terms with his own needs and values.  

Lady With Lapdog and Other Stories
Anton Chekhov
David Magarshack (Ed.)
London, Penguin Books, 1964.

A previous version of this review was published in the NYU Literature, Arts, and Medicine Database (Litmed).

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Enemies by Anton Chekhov

Jack CoulehanJan 11, 2025

“Should we worry about the reliability of medical knowledge?” asks philosopher John Huss (University of Akron). We consider this question from the perspective of Thomas Kuhn’s classic, 1962 book, The Structure of Scientific Revolutions. Kuhn explains how science does not evolve incrementally, one step following another, but rather undergoes wholesale revolutions disconnected from all that came before. He called these revolutions, “paradigm shifts” (to his everlasting regret). While Kuhn draws mostly from astronomy to make his case, we draw from recent and past medical examples to show how his concept applies to medicine as well. We talk about how various groups dependent on reliable medical knowledge (e.g., patients, health care professionals, educators) can be affected by the possibility of major shifts in established approaches to health care at any time. There’s no escape from reality, as the song goes.

Primary Source Citation
Kuhn T. The Structure of Scientific Revolutions, 3rd ed, Chicago: The University of Chicago Press; 1996.

Links
Russell Teagarden’s related blog posts on According to the Arts:
-Kuhn’s book, The Structure of Scientific Revolution
-Michel Foucault’s book, The Birth of the Clinic

Dr. Barry Marshall’s story of how he and Dr. Robin Warren engineered the change in peptic ulcer disease from acid based to infection based.
The Clinic & The Person Episode 12 (September, 2023), featuring the paradigm shift from lobotomies and other forms of psychosurgery to psychopharmacology.
Sir Brian May’s bio (guitarist for Queen and PhD-level astrophysicist).

The Clinic & The Person is a podcast developed by our editor Russell Teagarden to summon or quicken the attention of health care professionals, their educators, researchers and others to the interests and plights of people with specific health problems aided through knowledge and perspectives the humanities provide.

Feature photo by National Cancer Institute

People can have certain desires stemming from their illnesses, for the arts, health, companionship, serenity, and meaning among other possibilities. The scholar, writer, and teacher David B. Morris considers these desires a form of eros that should be taken into account as a part of what people go through with their illnesses and what could potentially help them. We speak with David Morris about the relationship between eros and illness, and evaluate it using examples from art, literature, and theater. We muse about possible applications.

Primary Source Citation
Morris D. Eros and Illness. Cambridge MA; Harvard University Press, 2017

Links
Russell Teagarden’s relevant blog pieces:
— David Morris’ book, Eros and Illness
— Anatole Broyard’s book, Intoxicated by My Illness
— The play, Farinelli and the King
— Montaigne’s essays about his kidney stones

Modigliani’s reclining nude series:
— Reclining Nude, 1917
— Reclining Nude (Nu Couché) 1917–1918
— Reclining Nude (Le Grand Nu) 1919
— Nude on a Blue Cushion 1917

David Morris’ CV

Thanks to David Morris for coming on this episode and providing his thinking on the role of eros in illness.

The Clinic & The Person is a podcast developed by our editor Russell Teagarden to summon or quicken the attention of health care professionals, their educators, researchers and others to the interests and plights of people with specific health problems aided through knowledge and perspectives the humanities provide.

Feature Photo by The New York Public Library

That is just the start of it. 

The plot has numerous twists and turns. The perspective and writing style shift from character to character with each passing chapter.  There is movement backward and forward in time. The backdrop changes with the suddenness of the movement of scenery between acts in a play. The lives of the characters branch out in many directions, venturing into uncharted territory and intersecting unexpectedly at key moments. The prose and the imagery are textured to match each character. However, all the elements cohere, creating the experience of reading in a lived world. 

The trajectory of each parent evolves darkly over time. Dickie is blackballed because of an identity he has kept secret all his life. Imelda becomes increasingly desperate, and her actions become more and more unhinged. The two children can only turn to one another to fill the gap left by their wayward parents. As disaster draws closer and closer to Dickie, he partners with a  laconic neighbor to build an underground bunker in the woods to survive the coming Armageddon. Don’t say I didn’t warn you. 

This 643- page book is extraordinary.  When I started it on the strong recommendation of my dependable oldest daughter, I was unsure if I would have the patience to persevere to the end. But this is an all-encompassing novel. Paul Murray has created a world, hauls you into it, and hurtles you forward into the turbulent stream of the characters’ lives. The artistry is astonishing. The setting, the interior monologues, the conversations, the actions are aptly described. 

The story has an air of inevitability to it, which brings me to an aspect of this book that made it truly special: do things happen in the world at random or is everything linked in a deterministic web of causation? The classic expression of the determinist view is — if one single monarch butterfly flaps its black and orange wings in New York, then the subtle change in air flow in the Big Apple is passed along across the Atlantic, through Europe, across Asia in countless incremental steps and culminates in a monsoon in Bangladesh. The bee sting that furnishes the title for Murray’s novel is a seemingly innocuous event on the day of Imelda and Dickie’s wedding. But in the world of the book, it unleashes  a sequence of events for each member of the Barnes family that defines their destiny. It seems as if they are trapped in a dense web  and cannot escape the forces driving them forward to their ultimate doom. Yet, each character confronts moments of crisis, episodes of personal vulnerability and they make choices. They fail to answer the phone call, they opt to go to the party, they invite relatives to visit. Who or what is controlling their fate?

Philosophers have traditionally debated and continue to argue whether free will is a reflection of reality or whether it is a convenient delusion. We may never fully know or comprehend why things play out the way they do in each of our lives. It may always appear as if we are being moved around by relentless forces that are bigger than and invisible to each of us. At the same time, we feel that we have agency. That is the mystery of life. In a novel, there is an inscrutable controlling power, the author who is the puppeteer manipulating all the movements of his characters and the story. She can make events play out in whatever way she thinks best matches her vision of the paginated world. But good authors know that they must create human characters and not marionettes. They have to walk the philosophical tightrope between determinism and free will. Within a tightly constructed literary universe, authors must create a world in which the narrative captures the larger forces buffeting  the characters drawn on the page, be it climate change, immigration to a new county, or the outbreak of war. But there must be space for the characters to behave as recognizable people subject to the consequences of their own choices or those of others. When authors succeed, the readers of their books realize that have been offered a precious insight about what it means to be fully human. No one has done this better than Paul Murray in this monumental book.

THE BEE STING
Paul Murray
Farrar, Strauss, and Giroux
New York, 2023 pp 643

Photo credit: Boris Smokrovic