The Prostate Gland: A Story

By N. N.

A book for men and women from middle age to advanced years who have suddenly and unexpectedly become confronted with the huge effects that the male prostate can have on the body.
It is a tale of what can happen to both men and women when the prostate transforms over time as the body changes, free of any of the minor or major taboos surrounding those involved.

The book presents both a subjective and an objective account, from a female and a male perspective, of what the prostate is and of the physical, psychological and social effects that changes to the prostate can bring as one ages or reaches old age. The latest medical, psychotherapeutic and social measures available to help men with prostate issues and their partners are discussed.

It also addresses the therapeutic taboos that have previously prevented us from attempting a systemic approach to the physical, psychological and social transformation that men and women undergo when they reach middle age and beyond.

• Language: English
• Publisher: tredition
• Release date: Feb 26, 2024
• ISBN: 9783384157638

N. N.

N. N. studied Human Medicine and Systemic Management before obtai­ning a doctorate on the subject of corticosteroids. Over the course of their clinical activities N. N. developed an interest in the systemic links between the organism, the psyche and the social system and the asso­ciated recursive, paradoxically organised control loops.

Book preview

Prologue

When I began my first semester at the Faculty of Human Medicine, I was taught about the history of the university faculties. ‘Faculty’, I was told, comes from the Latin word ‘facultas’ – meaning ‘ability’ – as this is something one can acquire at university. For example, in the Faculty of Life Sciences one could acquire the ability to study nature and become a life scientist; in the Faculty of Law one could study the legal system and acquire the ability to become a legal scholar; and in the Faculty of Humanities one could study the thoughts and knowledge of humankind and become a philosopher.

A doctor, I was told, must understand a little of each: of the nature of man, of man’s thoughts and social system, which is in turn founded upon the legal system. Thus, the Faculty of Medicine was instated as the fourth faculty with the objective of training doctors, of bestowing upon them the ability to examine humans, to understand their nature, their thoughts and their social system, and to provide treatment to help them get better.

Another objective was said to be to teach future doctors to recognise their own humanity; to examine their own medical interventions, their own thoughts, their own social system and to adhere to the Ancient Greek maxim ‘know thyself’, such as it was advocated in the cradle of Western culture.

Now, 50 years later, I have discovered that this triadic concept of human knowledge has been reformulated by systems theorist and medical doctor Professor Fritz B. Simon in his work Formen (‘Forms’).

In Formen, the human abilities acquired at university – namely the ability to understand human nature, the ability to understand how humans think and the ability to understand law-based social systems – are described as an ability to understand phenomenologically distinct, auto-poietic human cognition systems; as an ability to acquire knowledge of/from the organism, of/from the consciousness and of/from the social system.

These three phenomenologically distinct human cognition systems – organism, consciousness and social system – are described as being linked, just as I was taught in my first semester studying human medicine.

One could thus posit that any knowledge acquired of/from human beings or of/from medicine is both facilitated and confined by the cognitive possibilities and limitations of our organism, our consciousness and the social system in which we live, our culture.

Over the 50 years that have passed since my first semester studying medicine, the field has changed paths. Its new path has led it away from the concept of ‘universitas’, away from an all-encompassing triadic, auto-poietic understanding of humankind, and towards a ‘pure’, allegedly objective science of the nature of man.

Though it has not done so explicitly, the field of medicine has nonetheless implicitly returned to the philosophy of René Descartes (1596–1650), to res cogitans and res extensa, to our everyday experience as thinking subjects, res cogitans, surrounded by objects, res extensa, that appear to exist independently of us.

In order to eliminate all traces of subjectivity from the objective study of humankind, the thinking subject – res cogitans, the individual human – has been replaced by physical measurement systems that provide reproducible results, data in the form of images or numbers, analytics generated by artificial intelligence. Individual observations have been labelled ‘subjective’ and cast aside, replaced by quantifiable, standardisable data – by statistics. Intersubjectivity has become devoid of value in objective terms.

Despite (or perhaps because of) all the progress achieved and the arrival of modern technology, today we are no closer to solving the questions and problems to which the field of medicine has devoted itself. This should give us pause for thought. To quote British mathematician and logician George Spencer-Brown: ‘If a method leads to serious complications, as this one does, history teaches us that it is inappropriate.’

Thus, my aim with this book is to apply – from a subjective, first person perspective – a comprehensive, universal, systemic approach to the characteristics/diseases of an organ (namely the prostate gland), the medical diagnosis and treatment of which is associated with major physical, psychological and social collateral damage.

This may pave the way for treatment approaches which, instead of resulting in physical, social and psychological mutilation, offer a chance for healing.

→ George Spencer-Brown, Laws of Form, Preface to the 1979 Edition

1. The Theory

1.01 Medicine

Sometimes it is worth taking the time to elucidate the etymolog- ical roots of a term. ‘Med’, so I have read, is Indo-Germanic and means ‘to measure’, ‘to ensure compliance’, ‘to care’. And the word ‘heal’ is related to ‘whole’.

Wikipedia describes medicine as an empirical science. Medicine, then, is pure empiricism. That is what I learned at the start of my clinical semester studying human medicine. This statement is based on the assumption that things can always turn out differently to what we know from our experience. And that was indeed the case at patients’ bedsides. There was also talk of ‘tried-and-tested techniques’; techniques that had proven their efficacy. At an early stage in our systems theory studies we were also introduced, without any further justification needed, to the maxim ‘ut aliquid fieri’ – the idea of simply doing something with the expectation that this will eventually bear fruit.

Now, 50 years on, the field of medicine has become double-blind. Subjective experience is no longer relevant. Instead, it is a question of providing double-blind, statistically sound evidence in service of a desire, an ability – perhaps even an obligation when one looks at the latest medical guidelines – to heal causes rather than symptoms. Though it should be noted that here, ‘heal’ is used in the sense of preserving life, of preventing death.

In medicine, measurements are used for a specific purpose, namely to heal, to prevent death. And healing, we are told, is a result of medical intervention.

It appears that whether or not a person has heard of the warning ‘medicus curat natura sanat’ – the physician cures while nature heals – issued by the physician Paracelsus (1493–1541) is nothing but an indication of whether or not they are trained in classics. The awareness of its relevance in our daily activities has been lost.

Although clinical measurement and observation is the first step in any medical intervention – in the words of Dr Franz Volhard, ‘the gods placed diagnosis before therapy’ – one must nonetheless ask the question: ‘what is the doctor looking at?’ or preferably ‘what else could they look at?’.

Paracelsus Theophrastus Bombastus von Hohenheim (1493–1541)

1.02 Object

The quote from the German text Regulationskrankheiten from the year 1987, with which I have prefaced these musings on the prostate gland, is still an accurate description of how the field of medicine deals with organs classified as diseased in order to help – even 36 years later. This is also true of the organ that we will be discussing: the prostate gland. Objective observation, objective examination, objective assessment – these are the premises of today’s scientifically defined medicine.

As in all the life sciences, observations must be objective and consensually verifiable or falsifiable. In medicine, this process of objective observation is referred to as diagnosis.

The diagnosing physician turns their focus to an object as they would to an item, a thing, ‘that prohibits their own action, that they are confronted with, that offers resistance to their own movement’. This resistance may take the form of a mass, a feeling, a functional disorder, a thing that demands their attention.

An object, an item, a thing; a metaphorical cube, a black box that is distinct from its environment. This object has boundaries, is ascribed a name and a value.

To once again cite British mathematician and logician George Spencer-Brown, a distinction is made, an object appears and is given a name or an ‘indication’, and a value inevitably emerges.

→ Fritz B. Simon (2021) Systemtheorie reloaded. Online Seminar Series

4D Hypercube – Tesseract

1.03 Organ

Similarly to objects, organs are regarded as distinct from their environment, their boundaries are defined and they are given a name. Just like any object that is delineated and named, the organ is ascribed a certain value. This value reflects the significance of that organ to humans, to the phenomenologically distinct realms of being: a person’s organism, their psyche, their social system.

As an anatomical and functional component of the organism, the organ is cognitively coupled with the organism. One could argue that the organ is under permanent cognitive observation by the organism, which is in turn observed by the consciousness, which is in turn coupled with the social system. This is an example of the ‘expansion of the boundaries of the field of observation and investigation’ as described and advocated in systems theory.

When an organ performs its function as a component of the organism, and the organism and organ work in perfect harmony as is biologically expected, this state of being of the organ and organism is not coupled with the consciousness; it resides unconsciously in the cognitive realm of the organism.

It is only when a state of non-alignment occurs, when an expected functional biological behaviour is not performed, that this dysfunctionality reaches the realm of the consciousness and from there the social system in the form of communication.

In other words, when an organ is not aligned with the expectations of the organism, with the expectations of the consciousness and/or the social system that are coupled therewith, the organ is observed, named and ascribed a value.

The organism expects the organ to perform its function. The consciousness expects the organ to behave discreetly, appropriately. The social system expects the organ to refrain from disrupting the social order. If the organ meets these expectations, it is granted the title of ‘healthy’.

→ Fritz B. Simon (2021) Systemtheorie reloaded. Online Seminar Series

1.04 The Norm

Organs that are not disruptive are regarded by the organism, by the consciousness and by the social system as normal – as healthy. The term ‘healthy’ is a layman’s term for which there is no more precise definition. This term is not used in scientific medicine, as there is no scientific criterion for measuring ‘healthiness’.

The term ‘ill’ is also a layman’s term. There is no scientific criterion for measuring ‘illness’ either. The term ‘ill’ is used within the social system to express the idea that a human within that system is not functioning as expected, for example because they cannot go to work. If a physician is of the opinion that such a person is able to return to work, they issue them with a doctor’s note that provides social acknowledgement of their ‘healthiness’.

Healthy and ill are not terms used in scientific, objective medicine. Instead, evidence is collected and diagnoses are made. Objective, physical measurements are taken. Data is gathered.

If, as systems theorist and physician Professor Fritz B. Simon notes, numerous different states of being fall under the definition of ‘survival’, this begs the question: which people in which state can provide data that defines the norm, the normal state, and can be used as a benchmark for objectively distinguishing between ill health and good health?

We are not talking about the subjective question of which measured values a person needs to demonstrate in order to feel fit and healthy, but the question of which values represent the norm, the state in which a person can objectively live their life or survive.

→ Seminar: Systemtheorie Reloaded with systems theorist and physician Fritz B. Simon

Normal Distribution Curve Gauß’sche Glockenkurve

In order to define this norm, tests are carried out on a statistically defined number of apparently healthy individuals. These individuals are divided into cohorts: newborns, infants, children, adults. For some of the tests, the adults are divided up by age and gender. A normal distribution curve