My dentist is a well-trained and careful fellow. And he seems also to be a sympathetic sort. Perhaps that sounds odd in a dentist, but so it is. He does not like to give pain and takes care to supply enough novocaine to prevent it. He asks me to tell him if he hits a sensitive spot. He is willing, or so he professes, to stop and administer more novocaine if necessary. I have never tested this offer by actually requesting more, and it may be a clever form of psychological anesthesia. If so, it works. I feel that he is feelingly sensitive to my interest, and so I don’t reject him and run off to find another dentist. I trust him, more or less, having come to believe he must be the sort of doctor that Montaigne said was the only sort he would trust, namely, one who has suffered the malady he is treating. I don’t know why he would be so careful of my pain unless he knew, in the bone, so to speak, how it feels.

Why is it, then, that I am so reluctant to visit him? Silly question, eh? We’re all afraid of our dentists. But do we know why? The physical discomfort is pretty minor, certainly not enough to account for our terror. Is there a tradition of fear, still living from the days before fancy anesthetics? Or does it stem from the immediate experience of those of us whose teeth have survived, more or less, from anesthesia’s childhood, when the new electric drills ground slowly and long and the dentist gave us a nickel for being brave?

My wife tells me this essay is already too long. She stopped reading in the first paragraph with a shudder. “Why would I want to read about anything as horrible as a visit to my dentist?” she asks. Which illustrates my point, for those of you who are still with me. There’s something really dreadful about a trip even to the most gentle of dentists. And why is that? I have a theory.

Tyranny.

You’re sitting, or rather lying, in the chair, which is tipped far back, almost to the horizontal, to give the dentist and his assistant the best possible access to the remote reaches of your throat. They lean over you and poke strange instruments into your mouth, probing as few others will ever probe your intimate cavities (I won’t explore the exceptions to this rule), testing for soft spots and holes, which they will grind, clean, and fill because it will be good for you if they do so. You are entirely at their mercy, subjected to them in the (if I may) root sense of the word, utterly powerless under their hands because it is good for you. Moreover, you agree with this doctrine of benefits; you have put yourself more or less voluntarily into this situation, and will even pay your tormentors for their pains, if that’s the proper word for their part in the ceremony.

There is tyranny here, their benevolence and your willingness notwithstanding. They have the power and they exercise it over a passive and suffering you. The unrebellious oppressed always consent to their own subjection; that’s what their patience means. And, what is more to the point, the true beneficiaries of the arrangement, namely, the tyrants, enjoy their power and like to celebrate it, even if they are polite enough to mask their celebration.

Mask is the right word nowadays. They wear masks to protect themselves against AIDS. The dentist and his assistants lean over you, peering from behind their masks like surgeons, waving their rubber gloves, and asking you sweetly if you are feeling all right, if you would like more painkiller, if you are comfortable. What else can you do after mumbling “Mho, Awghammet, ahmez ahnkumhfublez thduvlnhull” but let them think you said, “Well, I guess so, about as comfortable as possible”? And they smile and smile, as why should they not? Every solicitous question they ask celebrates their power. They are not in that damn chair, under the rubber “dam,” suffocating and feeling guilty. They have arranged matters so that you will be the sufferer, that is, the patient, and will feel gratitude with your guilt.

And what do you think they are feeling? Superior, of course. It is you, not they, who lie weakly, helplessly beneath their instruments. And I think they must feel the more superior the more familiar they are with the patient’s experience. Compassion is not the only result of the knowledge derived from a shared experience. They may know how to treat you better, both technically and ethically, because they have been there. They also know how much more desirable it is to be in their position than in yours. The most benevolent of kings is yet a king.

The strongest of subjects, moreover, lies in the bonds of subjection. Guilt is the name of our chains.

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We know one reason why we feel guilty in the dentist’s chair. The dentist and the toothpaste companies and the radio and television media have conspired together for years to teach us guilt. If our teeth decay or our gums rot, our mouths are disgusting. And since the means of prevention are put benevolently at our disposal by caring anticarious toothcare companies, if we are disgusting it is our own fault. All you have to do to prevent such hideousness is (depending on who is caring most about you at the moment) brush, or floss, or stop eating chocolate bars, or use Toothpaste Alpha, Beta, or Gamma. You have a cavity? You must have done something wrong.

You remember the hygienist, with what gentle yet firm insistence she explained, during your last visit, what you might have done, or (which amounts to the same) what you might do next time, to prevent the calamity now afflicting you. She did not pronounce an overt judgment on your malfeasance. But that delicacy on her part only makes it harder for you to clear your mind of bad feelings and rebel against her authority. You want to cooperate with her, she is so very caring, and that means sharing in her unexpressed judgment. When you say or think, “You’re right, I’ll be sure to do that from now on,” you all but add, “I promise,” as if she really were a judge and could grant you leniency in recognition of your sincerity and good behavior.

What runs through all this training in guilt that we receive from hygienists and media and parents, what gives it its force, is our faith, our desire to have faith, that they have expert knowledge which we lack. With respect to our own diseases, whether of the teeth or some other organ, all we know is some sloppily identified symptoms and a great many feelings. “You’re right” means “you must be right—what do I know about it? All I know is confusion. You’re the expert.” It’s the same with the teacher and—dare I say it?—with writers. “I’m listening; you tell me. If you don’t know, I’m in trouble.” And that can’t help also meaning, “I’m stupid, ignorant, and helpless—that is, sinful—through my fault, through my fault, through my most grievous fault.”

With the dentist himself there is on the surface less of this hypocritical game of authority and blame which one might call “Who’s the Guilty Party?” The affair in the chair is more nakedly a matter of power. You have committed your crime. Tooth decay, like death, is the unmistakable wages of sin. But your dentist, like some technician of purgatory, can help you heal the blots upon your body. You will never again be innocent of cavities, but they can be filled and tended and made to gleam almost like new. Better than new, with the potions, minerals, and devices the dentist can now deploy to make him more powerful still. Technology comes in aid of strength. He injects you, inoculating against pain with pain. He grinds away decay, as many a minister, rabbi, and priest would dearly love to do. He installs in place of your corrupted tissue substances noted for their purity: porcelain, silver, sometimes gold. (Nowadays, too, there is plastic, which looks clean, despite its oily descent.)

Suddenly, or so it seems from within the stupefaction you have entered during the rough hour of your cleansing, the procedure comes to an end. The rubber dam and its spring support are carefully ripped from your mouth, tools are dropped into a tray, the probing light is snapped off, your paper bib is taken away, and the seat comes back up pushing you erect. You are released into the world of upright adults once more, but you no longer know how to act, even how to walk. Like a liberated slave or prisoner, you stumble from the room, fumbling with your tie and blinking at the light. Your soul is so numb you cannot be sure about your mouth, but talking is difficult. No one wants to talk to you, anyhow; no one has the time for you except the receptionist, who wants to schedule your next encounter with healing.

I’ve never encountered a woman dentist, though I understand that even in earlier days they were not unknown. The president of our local university in his commencement address claimed that 20 percent of the dental-school graduates were women. He was bragging about the progressive stature of his institution, but it still seems a small proportion. Even these few, where do they go? Into the labs? Today’s women, perhaps, still in process of liberation for themselves, have yet to learn the fullness of masculine power lust. Even a dentist as seemingly careful about pain as mine is must enjoy his patients’ discomfort as the occasion for his display of power, if for no uglier reason. It may be that few modern American women have progressed far enough in the ferocity of freedom to have developed a preference for this particular form of dominion. The dental assistants are women, and the hygienists, and the receptionists. Their place is in the margin of the polity. They are instrumental, functionary, facilitators of oppression, not oppressors. The dentists are men. We have kings in the land of toothcare, but few queens.

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But my distinction is invidious. Women, I have no doubt at all, are fully as capable as men of being hideously brutal and power hungry. Perhaps a greater subtlety of mind has led them to prefer other political enterprises over dentistry. There are women doctors in plenty, for example—a fact which perhaps correlates with a somewhat greater subtlety, a less frank brutality, marking the doctor’s subjection of his, or her, patients when compared with the dentist. This is not to say that doctors are democrats, however. Au contraire, my brothers and sisters. And in case we were inclined to overlook their eagerness to govern, a turncoat member of their party has come forth recently to correct our misapprehension. Dr. Oliver Sacks, an English neurologist, has written several books giving accounts of his attempts to understand his patients’ experience of some unusual and extreme diseases—sleeping sickness and migraine, for example—and has in the process provided an intriguing but disquieting picture of doctors.

Now, I do not mean to add to doctors’ troubles by my little modicum of malice. Medicine has been much—all too much—in the news in recent years because of numerous malpractice suits and the consequent difficulties physicians have had with insurance companies. It is obvious that we generally and most unreasonably expect perfection of our doctors. When something is wrong with us, they are supposed to know exactly and quickly what it is, to know how to correct it painlessly, or at least efficiently, and infallibly to provide correction. No mistakes are allowed in either knowledge or diagnosis or treatment. If the doctor makes some mistake, so we now litigiously believe, we should sue the bastard. He’s dealing with human beings, after all, and what’s more to the point, with little old me and my health. There’s no room for error, and no excuse for slipshod work. Take him to court!

Clearly, no other vocation, no other sort of professionals—except, sometimes, space engineers and NASA managers—face such demands. Everybody makes mistakes at work; nobody is expected to be infallible—not even the Pope except on special and very rare occasions. Why are doctors cursed with impossible standards of conduct?

If we take some hints from Sacks’s books, we can absolve ourselves of blame. It is not because we are stupid and greedy. The doctors themselves are the guilty parties. They have led us to believe that they really are kings, and then, when they make a slip of some sort and reveal that they are no better than other mortals after all, we—turbulent underlings that we are—arise in resentment and rebellion and try to bring them down.

Sacks tells, for example, of one doctor, a surgeon named Swan, who treated Sacks himself after a terrible fall he took on a hill over a Norwegian fjord. I suppose many readers must know a good part of this story, for the episode of the fall itself was printed in the New York Review of Books, and the book telling the whole story, A Leg to Stand On, was widely reviewed. Suffice it, for the moment, to say that Sacks suffered rather severe damage to both the tendons and the nerve system of his left leg. A main tendon was severed in the fall and for a time he completely lost feeling and sense in the leg. The principal theme in the story for him is the conflict between his doctor’s attention to the mechanics of medicine and the patient’s—his own—frightening experience of disorder. In the telling Sacks infallibly turns the tables on his tyrant surgeon.

Dr. Swan sees Sacks’s injury as nothing more than an interesting case of a severed tendon, which he has the skill to repair—as a carpenter (this comparison is proposed by one of Swan’s assistants) has the skill to fix a broken chair. Sacks, though himself a doctor and sometimes able to take this coolly diagnostic point of view, is shocked to discover how indifferent to his feelings and experience Dr. Swan is. For his feelings are clamorous and full of alarm. He cannot feel his leg; he has lost part of himself—there is a hole in the self which he cannot fill. Yet the surgeon will not listen to his concerns before surgery. And afterward, on a triumphal tour with a flock of medical students in tow, he sweeps grandly through the ward to celebrate his victory over disorder. Sacks is not given the opportunity to describe his experience or express his doubts about his leg. Moreover, to his own dismay, he finds himself unable to insist.

One of Sacks’s chapters is called “Becoming a Patient,” and that is exactly the point: he has become you and me, and is shamefaced and guilty before his healer. He is unable to insist on expressing his feelings because in the face of his doctor’s disinterest he cannot quite believe in their importance or in his own righteousness or justice when he repines and feels discontent. Notwithstanding that he is himself the doctor in other situations, here he is the patient, and if his doctor seems to believe that surgery has been successful and matters are under control, then, well, probably he’s right. Doctor or no, you don’t challenge the king.

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Now, this state of weak subjection is frustrating to Sacks just because he is a doctor and has, by his account, been a remarkably vigorous and healthy type throughout his life. It is certainly not difficult, moreover, for me to sympathize with him. I have had my own bird-named doctor, who was as beautifully aloof from my experience as ever Sacks’s Swan was from his. My Dr. Fowl was unmistakably a talented physician, clear-minded, medically perceptive, and knowledgeable. Only, he wouldn’t talk. He would listen to your account of symptoms, giving an occasional unvoiced grunt of (I would guess) recognition. He would poke or probe, and run a test or so, as he thought fit. A quiet little smile would come over his face, he would make some notes on your medical record, and then he would write out your prescription and tell you, very succinctly, what you were to do. If you insisted on having from him some words as to the nature of the disorder afflicting you, he would suppress a look of slight irritation, or perhaps impatience is the word (the doctor was not patient in his doctoring), and give you the briefest of explanations, in language carefully reduced to the conceptual level of an imbecile. O, Dr. Fowl! If brevity is indeed the soul of wit, you were the wittiest doctor, nay, the wittiest man, the wittiest human person of my acquaintance. But so very dry.

On the other hand, so very right. And what, truly, did my feelings or my understanding matter if you healed me, eh Dr. Fowl? For after all he did heal me. He would not, or perhaps could not, tell me just what was the nature of the virus afflicting me, for which I consulted him once, ten years ago and more, but he gave me my prescription—vitamins and aspirins—and told me to lie down and be patient. Be a patient: it does not mean “become a rebel” or “go express yourself”; it means to submit for a while to this suffering and this healing. It occurs to me to wonder whether that is not just the thing needed after all, the right policy, and in more than the narrow business of suffering.

For I find myself feeling rather skeptical about Dr. Oliver Sacks, who wants so very much to take my side against his fellow doctors, but bullies me unmercifully as a doctor and as a writer. I want to believe him, to be sure, given my feelings about my dentist and my Dr. Fowl. Finding feet of clay would wonderfully shake the composure and mar the marble face of the hauteur I cannot help resenting. But Sacks exaggerates everything so. His manly vigor and health and strength as he fairly bounds up the mountainside; his fall so low into the despair he calls limbo during his difficult convalescence—in presenting these and the other sufferings of afflicted patients that he comes to share, Sacks is like an explorer into an unknown land, one of those late-Victorian chaps whose salient quality was their absolutely imperturbable faith in the accuracy of their perception, the importance and righteousness of their mission, and the rectitude of their judgment. At least they give the impression of imperturbability, though, like Sacks, they work at it; they find drama where they need it. If necessary, they indulge in melodrama. And like them, Dr. Sacks returns from his trial of courage as an evangelist, proclaiming the good news: “Imagine this: the natives of the country of pain, like those of Africa, are human! They feel, they speak, they cry out. Hear, oh hear!” And who counts as the natives in this allegory, the poor benighted denizens of uncivil wilderness? Who but you, my friend, and I?

Sacks in his explorer’s account of the adventure of illness is the spit and image of the aloofly confident, unself-doubting doctors whose bubble he wants to prick. The medical facts, the mechanics of health, may be their special domain, where they are king. But he has his realm, too, where he now is the knowledgeable expert. It is the world of the patient’s experience: there he knows, he rules, he demands obeisance.

Why do I resent this? Resent it more, in fact, than I resent my dentist’s power or Dr. Fowl’s taciturnity?

I do not trust thee, Dr. Sacks.
The reason why, my reason lacks.
Yet still, of this my feeling smacks:
I do not trust thee, Dr. Sacks.

Perhaps I can probe the matter some and make a stab at saying why I find myself so wounded.

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The answer, I suspect, has to do with the difference between literal politics and metaphorical politics. It is fun to talk about the power relation between my dentist and myself. The talk gives me an opportunity to play with things, with pain and disease, that can be all too serious; it gives me a play arena—a playpen, if you like—in which to act out resentments and angers which I do in fact feel, without giving them more importance and privilege than they deserve. What I have said about our relationship is, I believe, true: he has power over me; I feel it; I do not altogether like it. But the power is not the point. Or rather, the power is the point, but the politics of power is not. I submit myself to my dentist or my doctor because they do have power—the power given them by knowledge and skill. They can help me, and I believe that they will use their power in order to help me, benevolently. They are not in sober fact kings, not usurpers upon my private domain of feeling and preference and experience. They are no threat to my dominion over myself; rather, helpers, givers of power. With their help I will gain in the power of free action and pleasure that the healthy enjoy. Therefore I submit to them and their authority. And how stupid I would be if I took the playful politics literally and turned loose in the real world the little, raging democrat that roams maniacally in the basement of my soul, looking for escapes and excuses.

The situation is the same, or ought to be the same, with respect to teachers and writers, whom in this latter end of time our raging democrats also oppose. To them, if we are to get the good of them, we submit our minds. Not slavishly, regardless of incompetence or charlatanry. We have a thing called judgment, which we may employ, to withhold respect where it is not deserved, or to grant it in the due degree. But your eager democrat, your person of perpetual principle, touchy beyond belief about infringement upon his domain, lacks the patience necessary for judgment, is too desperate to await the formation of judgment. “Either my own king, and now, or a slave,” is the dilemma, and the party slogan, of those who know their own greed too well to trust to the beneficence of others, and who thus abandon judgment in favor of rebellion. To them no dependence is tolerable, no subordination to power. Every relationship is consequently seen as essentially political, and the politics is not playful or metaphorical, but all too earnest and emphatic.

We have had an abundance of theorists in the past twenty years—educational theorists, literary theorists, sexual theorists—proclaiming the ubiquity of power and justifying the politics of rebellion. The literary sort have been struggling against the authority of authors in order to empower their own minds. No patient construing of words and sentences for them, no curious following of the motions of an interesting mind. They will not be followers or patients, but leaders, kings—and doctors. They dissolve the author’s identity and deconstruct his text to free themselves by throwing off dependence on such pretenders. Or, if they admit that the author exists and the work has meaning, they rise against them and strive to overthrow them by willful but clever misinterpretation. They become “strong readers.”

In this way reading is replaced by the politics of reading, when the power of a work, which made it worth reading in the first place, is taken as an imposition on the reader’s sovereignty. To be sure, we are free to take this stance. Author and text, for all their hated authority, do not have the power to impose submission and patience upon us; there are no literary police. If we want to find politics in literature, even against the grain of our chosen text, we shall assuredly find it. But when we take this route, and reduce an interest in literature to an interest in ourselves, in our own liberty and power, we should not be surprised to find that our audience is reduced to our competitors in the political arena, fellow politicos, fellow democrats. If I am interested in James Joyce and you are interested in you, there is no ground for conversation.

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But are there no literary police? The theorists of education, especially of the brand labeled “higher,” are here to teach us otherwise, or used to be here; the lesson is dated. The teacher is a policeman, we were to learn, and an agent of cultural oppression; if not a tyrant, at least a functionary in the tyrannous structure of an unjust society. It is the professor who imposes Milton on us, or Proust, or authors who are middle class and men. The professor, moreover, insists that we learn not only certain bodies of fact but certain doctrines. How can we be free, how can we become what we truly are, or would be, if we submit to the tyrannical will of professors to teach us something? And considering what it is they teach—the evils that Milton believed and Proust loved and middle-class men prefer—it is a political crime to be patient, to be docile, cravenly to submit to so vicious a form of oppression. It is our duty, under the circumstances, to take a stand as free students in opposition to the politics of established professors. Since—remember the 60’s—it would be difficult or dangerous and, anyhow, silly to rise in actual rebellion, the shrewder course, the action of choice, is, naturally, to become professors ourselves. When we put on the robes, policemen will be transformed into liberators. Then we can teach correct doctrine—provided that our students will submit to learn from us, with the proper submission and docility (because we have the truth, and . . . it will be good for them). And, in fact, the students who used to proclaim, or imbibe, such doctrines have by now become professors, or graduate students on their way into the profession they would reform.

For it is, of course, professors who have taught us this evil of professors, as Dr. Sacks has taught us the evil of doctors: they have power; they use it on us (more than Milton can), and sometimes abuse it; they ignore our feelings.

This teaching is, moreover, true if you use another name than “evil.” They do have power, and use it. But that, after all, is why we sought them out to offer our submission, to learn from them by the teaching their power makes possible through their talent, knowledge, and skill.

On the other side, we do have feelings, to which they, whatever horrible tyrannous “they” we are currently resenting, are not notably attentive. We feel put upon, ignored, weighed down by their authority and their requirements of us. Like Sacks, we feel distress and pain, which we do not know how to convey or bring to their attention. Since they have authority, we would like them to confirm the importance of our feelings. But they don’t seem to notice, and we feel hurt, angry, wrong, guilty. We may find ourselves feeling jealous of them, moreover, unless we take care to prevent that transformation. And since that is the political emotion, since being political means being jealous of power, since political action is built on jealousy, we may find ourselves all at once in rebellion.

If we but wait, however, other feelings are likely to come along in their turn. The doctor heals us, the professor teaches, the author teases and illuminates. Sacks himself was healed. He learned patience and his clamorous feelings of outrage changed to pleasure and gratitude and affirmation. Would the surgeon Dr. Swan have done better for him if he had sat upon the ground and joined him in lament? He was a surgeon, and could cut and stitch and mend. So he did that.

An odd notion has gotten abroad, that because we have feelings, we must do something with them, something public, and the sooner the better. Proclaim them. Act upon them. Maybe there is a better policy, something rather less dramatic and desperate to be done with our feelings, such as my Dr. Fowl suggested: be patient with them. And play with them a little in some inner theater where their clamor may do less damage than if we send them rushing up the aisles and out into the streets to rage along the barricades and gutters.

As for my dentist, well, I confess I am glad he is concerned to avoid causing me pain by his probing and drilling, even if it gives him a pleasure in his own power and superiority. And I am glad, no less, that he does not know, or at any rate does not pay any attention to, those other feelings of mine, the subject’s angry resentments. He leaves them alone where they play their bits on my private stage, and goes about his business. If he ever mentioned them to me, after all, we should have to discuss them, and enter into negotiations about rights and the limitations of power and the other elements of sober, literal politics. We should without doubt end up quarreling over my rebellious feelings and his sense of duty. How would that help my teeth or in any way hold back the encroachment of universal rot?

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