The ideologies of progress, individuality, and health are among those that strongly affect our attitudes toward illness. Modern society’s elimination of a range of social and medical ills lends much credence to the argument for progress. Most modern people assume, until perhaps very recently, that human culture, over the long run, is improving, as demonstrated by the feats of technology, science, and the power of rational thought. Those who doubt the value of these apparent goods and point to higher populations, greater poverty, and increased environmental destruction are often dismissed as moral softies, political Neanderthals, or neo-Luddites.
We easily forget that the concept of human progress is recent. Not more than three hundred years ago, and in traditional and fundamentalist cultures today, human history is imagined as a fall from an original state of grace or a descent from a once- upon-a-time golden age. In this view, the evolution of humanity is inconceivable except as a result of divine intervention.
Individuals may take steps along a path toward perfection, but any success they experience typically occurs in spite of, rather than because of, the existing social order. So difficult is the real evolution of being and consciousness, according to some traditions, that its attainment is possible only after many lifetimes of effort.
The belief in the ideology of progress continues despite what Danieli calls a “fourth narcissistic blow” to humanity’s self-love (in addition to the three that Freud proposed make it difficult for people to accept psychoanalysis— Copernicus’s solar-centric universe; the human membership in the animal world implied by Darwin; and Freud’s own suggestion that the individual ego is not even master in its own house): “I believe,” Danieli writes, “that Nazi Germany gave humanity the fourth, the ethical blow, by shattering our belief that the world we live in is a just place in which human life is of value, to be protected and respected.”
The belief “for every problem, there is a solution,” is a cliché with which we are all familiar. It is a message, as many critics have noted, that is reinforced by the facile endings of so many television shows and the barrage of advertising for goods that promise to fulfill so many desires or remedy so many ills. Our unquestioned commitment to the ideologies of progress and health contributes to the drive of many physicians to leave no treatment stone unturned or intervention untried.
Patients, too, are often willing to undergo whatever miseries the attempted cure may bring. For a number of people with chronic illness and their families, I believe it is an unexamined and unwarranted attachment to a belief in progress and a problem-solving orientation, as much as a hope for recovery, that keeps them searching for a cure despite disappointments. The grip that these taken-for-granted ideologies have on us also adds to the anger some feel toward their physicians and other care providers when their condition does not improve.