Grey's Anatomy of the Medical Ego

Dana, 24 Medical Student

"I must be a new medical student (in fact I am completing my first year).  I am with other medical students and I know I have to go into the next room and watch an autopsy. I dread this and I really don't want to. But, I feel I have no choice. I take a deep breath and go in.  The sheet is uncovered and a female child is on the table.  I feel sick and I think I'm going to faint.  They start the autopsy and I wake up."

Mr Hagen's Reply; The Autopsy of a Child's Ego -or- The First Person Ego

We can enter your dream via the first person keywords found in your dream which psychologically organize your mind's thoughts, feelings, motives, choices, body ego-ego consciousness and your social role (medical). Your dream can be reorganized from your ego's egocentric and subjective   perspective. It is noteworthy, that an egocentric person has difficulties empathizing, which may be understandable in this case, since you would need to think, identify and empathize with a dead child. 

  • "I must be a new medical student",
  • "I am with other medical students",
  • "I know I have to an autopsy",
  • "I dread this",
  • "I really don't want to",
  • "I feel I have no choice",
  • "I take a deep breath",
  • "I feel sick",
  • "I think I'm going to faint",
  • "I wake up".

The Existential Philosopher Physician -or- Theatre of Empathy and Psychopathy

Rene Descartes coined the philosophical phrase "I think, therefore I am", placing the cognitive ego at the Western philosophical centre of experience and existence. From an existential perspective, your dream can be viewed and understood through the philosophical optics of Soren Kierkegaard's ego perspective of Sickness Unto Death. The apprehensive ego thoughts and feelings of your dream, the deep breath, the sick feeling, the feeling of having no choice (no sense of freedom), being caught in a bind, all happen before you even see the child's dead body. All these prospective thoughts and feelings are philosophical and medical signs that point to what has been existentially called "Angst" or what Kierkegaard The Concept of Anxiety called dread. When the cultural shroud of death is uncovered, it reveals the dead body of the child. This is when you think you are going to faint.  The unveiling and facing the sight of death is one of the most painful aspects of life and the human condition that the human ego will ever be faced with. Ernest Becker The Denial of Death places the fear and cultural denial of death at the centre of the creation of the meaning of life and the process of civilization.

Exitential psychotherapy attempts to provide a philosophical framework for the ontological symptoms and problems of the thoughts and feelings surrounding (medical) role conflicts that your dream addresses. Your dream then reads that you must learn if you want to become a physician to take on an existential responsibility for empathizing with all your patients both living and dead. In forensic medicine, the medical investigation attempts to reconstruct the crime by seeing through the eyes of the victim. This entails the medical use of empathy. Thinking about abuse of a child is grotesque, some believe we have a built in defense mechanism to turn away from that which we find disgusting. Thinking about the heinous crime of the abuse of a child's mind-body then becomes an exercise in thought about the theatre of the grotesque.

A medical student must (as a categorical imperative) perform their duties, learning to think and empathize with the dramaturgical paradox of both the living and dead. In the modern medical oath and obligation of the physician, the words; "I will...", are repeatedly spoken in terms the physician's duties. While we are not told why the child has died directly in the dream, your associations provided with the dream (not posted) indicate that the child was abused. You feel you are being forced to go watch an autopsy in the next room, which seems for you to be a shocking theatre of human cruelty. Apparently you are asking yourself; How can people act without empathy towards a child? It makes you sick, to think otherwise. Once your thoughts exit the theatre of empathy and begin to think the social evil, your conscious mind must enter the hell of the medical theatre of cruelty and the grotesque.

Your dream attempts to use the thought of fainting as a defense mechanism to cope with this frightening prospect. You defend yourself against becoming conscious of the noir side of civilization (read IIDR article Film Noir) . Work in the field of children's psychohistory reveals a dark trans-generational pathology of abusive child care. The statistics on children dying on the planet everyday because of starvation, disease, poor or non-existent health care is staggering. We are witness to the everyday depersonalizations and narcissistic mortifications in a variety of dream forums which generally existentially point to the human continuum of everyday thoughts of empathy and psychopathy. The IIDR has received many dreams that speak to the dramatic problems of the empathy-psychopathy spectrum; 

  • The Theatre of Cruelty includes a variety of people who inhabit our planet and our dreams where their cruelties can play out.
  • Caylee Anthony
  • General Hospital features a doctor who looks at his watch, because time is money, which appears more important than his patient.
  • The Autopsy of a Marriage, where parents who do not care effects of their domestic dispute. Instead of thinking about what is in the best interest of the child they often only think about their own.
  • Occupational Hazards over-empathizing can cause symptoms of stress.  

On a final note, The IIDR has posted the article The Hippocratic Oath which from a historical perspective points to the use of the dream as an important medical tool. Unfortunately, for the most part the medical humanities do not use the dream as an instrument to medically test and measure the vital signs of society, patients or medical students like yourself.




All material Copyright 2006 International Institute for Dream Research. All rights reserved.