"But Doctor, Is It Curable?"

We’ve come a long way towards believing that the doctor ain’t god, and also that some patients are just not going to get well. You can find an interesting contrast to that attitude in an instructive, but perhaps obscure, source: Stefan Zweig’s novel, Beware of Pity, where Dr. Condor (who seems pretty clearly a mouthpiece for the author), unburdens himself on the concept of “incurable” in medicine.

Zweig is a provocative source for this sort of thing because he is writing about Vienna, his home and a city he understood well. Vienna is interesting because (in the early 20^th Century) it was a society in decay with a lot of attention to sickness and death—yet at the same time a center for explosive growth in knowledge, not least medical knowledge. It’s no accident that Vienna produced, along with Stefan Zweig, Dr. Sigmund Freud, whose great paper Analysis Terminable and Interminable, on the concept of cure, was published almost simultaneous with Zweig’s novel (link). In any event, I wonder what Freud would have thought of Zweig’s Dr. Condor:

You’ll never get me to utter the word “incurable.” Never! I know that it is to the most brilliant man of the last century, Nietzsche, that we owe the horrible aphorism: a doctor should never try to cure the incurable. But that is about the most fallacious proposition of all the paradoxical and dangerous propositions he propounded. The exact opposite is the truth. I maintain that it is precisely the incurable that one should try to cure, and, what is more, that it is only in so-called incurable cases that a doctor shows his mettle. A doctor who from the outset accepts the concept “incurable” is funking his job, capitulating before the battle begins. Of course I know that it is easier, more convenient to pronounce certain cases “incurable” after pocketing one’s fee, to turn one’s back on them with a sigh of resignation—indeed, extremely convenient and profitable to concern oneself exclusively with those cases that have been shown to be curable, in which one can turn up page so-and-so of the medical text-book and find the whole treatment set out for one in black and white. Ah well, those that care to can go in for that sort of witch-doctoring. As for me, it seems to me as pitiable a thing as if a writer were only to attempt to say what had already been said, instead of trying to force into the medium of the spoken word the unsaid, nay, the unsayable; as though a philosopher were to expatiate for the ninety-ninth time on what has long been known instead of tackling the unknown, the unknowable.

--Stefan Zweig, Beware of Pity 139
(NRB Classsics paperback ed. 2006)

When Condor/Zweig speaks of philosophers, I wonder if he is thinking of another famous Viennese—the one who said “"Whereof one cannot speak, thereof one must be silent” (link).