The current state of medical practice is going through tremendous and rapid changes. There is an increasing prevalence of burnout among physicians, where they are questioning the value of practicing medicine. There is also a growing frustration among patients over reduced access to physicians, feeling rushed at appointments and generally feeling that they are not being heard. These conditions point to a sense among doctors and patients that the doctor-patient relationship is compromised without a viable pathway to repair this vital connection. In this paper, I want to show how applying philosophy, particularly, Martin Heidegger’s discussion of angst and death can help to show a way for doctors to have a deeper ontological understanding of their patients’ conditions, which can provide a bridge for doctors to re-establish a deep doctor-patient relationship. I will use vertigo as a paradigm condition of a disorder in which doctors have a poor understanding of their patients’ condition. This leads to frustrating interactions with patients and breakdown of the doctor-patient relationship. Ménière’s disease is a particular type of vertigo disorder which will serve as the foundation for this study which will examine the severe vertigo attacks and chronic disequilibrium these patients experience through the lens of Heidegger’s highly technical phenomenological analysis of angst and death. Ménière’s disease is an inner ear disorder that causes violent vertigo attacks and hearing loss followed by severe disequilibrium. During the attacks patients are incapacitated by the vertigo, and after the attack subsides, the disequilibrium makes life’s normal pursuits meaningless. These patients understand the role of entities in their lives, but entities do not matter to them. Heidegger introduces the concept of for-the-sake-of-which to describe how entities in the world are interrelated with Dasein’s purpose of disclosing a world. He provides a sense of for-the-sake-of-which where everyday entities are used to fulfill Dasein’s activities which is an existentiell mode of for-the-sake-of-which. His famous example is the hammer in the workshop. He also gives a sense of for-the-sake-of-which where the totality of entities in the world are related to Dasein’s ultimate goal of being a discloser of its world. This is Dasein’s ultimate for-the-sake-of-which, which is an existential mode. In this paper I show that for-the-sakes-of-which can be thought of as having an existentiell and existential sense, and the existentiell for-the-sakes-of-which can be inauthentic or authentic. I will show how Heidegger’s analysis of Dasein can be applied to concrete human existence, using the inner ear disorder, Ménière’s Disease as an example. I am suggesting that the disequilibrium from Ménière’s disease is a naturalized account of Heideggerian angst and is being-towards-death. I am also suggesting that the Ménière’s attack is an experience of existential death because all possibilities and solicitations are impossible. I show that some Ménière’s patients are able to take on authentic for-the-sake-of-which by becoming resolute and anticipating death.

An analysis of Heidegger’s concept of angst and death in the Ménière’s disease patient

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2026年5月6日

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David M. Kaylie

摘要

The current state of medical practice is going through tremendous and rapid changes. There is an increasing prevalence of burnout among physicians, where they are questioning the value of practicing medicine. There is also a growing frustration among patients over reduced access to physicians, feeling rushed at appointments and generally feeling that they are not being heard. These conditions point to a sense among doctors and patients that the doctor-patient relationship is compromised without a viable pathway to repair this vital connection. In this paper, I want to show how applying philosophy, particularly, Martin Heidegger’s discussion of angst and death can help to show a way for doctors to have a deeper ontological understanding of their patients’ conditions, which can provide a bridge for doctors to re-establish a deep doctor-patient relationship. I will use vertigo as a paradigm condition of a disorder in which doctors have a poor understanding of their patients’ condition. This leads to frustrating interactions with patients and breakdown of the doctor-patient relationship. Ménière’s disease is a particular type of vertigo disorder which will serve as the foundation for this study which will examine the severe vertigo attacks and chronic disequilibrium these patients experience through the lens of Heidegger’s highly technical phenomenological analysis of angst and death. Ménière’s disease is an inner ear disorder that causes violent vertigo attacks and hearing loss followed by severe disequilibrium. During the attacks patients are incapacitated by the vertigo, and after the attack subsides, the disequilibrium makes life’s normal pursuits meaningless. These patients understand the role of entities in their lives, but entities do not matter to them. Heidegger introduces the concept of for-the-sake-of-which to describe how entities in the world are interrelated with Dasein’s purpose of disclosing a world. He provides a sense of for-the-sake-of-which where everyday entities are used to fulfill Dasein’s activities which is an existentiell mode of for-the-sake-of-which. His famous example is the hammer in the workshop. He also gives a sense of for-the-sake-of-which where the totality of entities in the world are related to Dasein’s ultimate goal of being a discloser of its world. This is Dasein’s ultimate for-the-sake-of-which, which is an existential mode. In this paper I show that for-the-sakes-of-which can be thought of as having an existentiell and existential sense, and the existentiell for-the-sakes-of-which can be inauthentic or authentic. I will show how Heidegger’s analysis of Dasein can be applied to concrete human existence, using the inner ear disorder, Ménière’s Disease as an example. I am suggesting that the disequilibrium from Ménière’s disease is a naturalized account of Heideggerian angst and is being-towards-death. I am also suggesting that the Ménière’s attack is an experience of existential death because all possibilities and solicitations are impossible. I show that some Ménière’s patients are able to take on authentic for-the-sake-of-which by becoming resolute and anticipating death.