在尼采的病房里：卡夫卡、权力意志与一种悲剧性的护理本体论

文献信息

中文摘要

护理哲学此前曾借鉴弗里德里希·尼采，但几乎总是为了理论化护士的职业身份或该职业的政治立场：他的超人作为自我克服、对抗管理工具化的形象；他的道德谱系学作为一种透镜，揭示关怀本身是对医学权威的怨恨式颠倒；他的价值重估作为对抗新自由主义收编的资源。每一种解读都止步于病房政治的门口。本文转而探讨护士与一个无法被治愈的身体之间的本体论关系，首次在这一文献中将两种资源结合起来：弗朗茨·卡夫卡对疾病作为官僚式与身体性荒诞的戏剧化，以及尼采关于肯定与自我克服的哲学，并将其追溯至《悲剧的诞生》中最初提出的酒神式个体化消解这一源头。此外，两位作家都以自己的身体检验了自己的思想。卡夫卡死于喉结核，无法说话，以书面笔记交流，临终时由一位伴侣和一位医学生朋友维持生命，后者为他注射吗啡。尼采在其哲学中那位主权性的、创造价值的个体所无法描述的崩溃中度过了最后十年——这场崩溃的妄想书信，若与其早期美学并读，看起来不像是对其思想的打断，而更像是对其思想的不由自主的字面化——先由母亲照料，后由一位在他已无法为自己作答时改写其思想遗产的妹妹照料。通过将这两场死亡并读，本文主张，护理本体论既不应建立在苦难总能被赋予意义的预设之上，也不应建立在一种无法经受真实依赖之接触的自足权力哲学之上，而应建立在一种悲剧性的关系性立场之上，这种立场在脆弱性之内而非之外肯定生命，尽管它无法化解这种脆弱性。

英文摘要

Nursing philosophy has drawn on Friedrich Nietzsche before, but almost always to theorise the nurse's professional identity or the profession's political position: his Übermensch as a figure of self-overcoming against managerial instrumentalisation, his genealogy of morals as a lens that unmasks caring itself as a resentful inversion of medicine's authority, his transvaluation of values as a resource against neoliberal capture. Each reading stops at the threshold of the ward's politics. This paper turns instead to the ontological relation between the nurse and a body that cannot be cured, bringing two resources together for the first time in this literature: Franz Kafka's dramatisation of illness as bureaucratic and bodily absurdity, and Nietzsche's philosophy of affirmation and self-overcoming, traced back to its origin in the Dionysian dissolution of individuation first set out in The Birth of Tragedy. Both writers, moreover, tested their thought against their own bodies. Kafka died of laryngeal tuberculosis, unable to speak, communicating in written notes, kept alive at the end by a companion and a medical-student friend who administered his morphine. Nietzsche spent his last decade in a collapse that his philosophy of the sovereign, value-creating individual has no vocabulary to describe-a collapse whose delusional letters, read alongside his early aesthetics, look less like an interruption of his thought than an involuntary literalisation of it-nursed first by his mother and then by a sister who rewrote his intellectual legacy while he could no longer answer for himself. Reading these two deaths together, the paper argues that nursing ontology should rest neither on the presumption that suffering can always be made to mean something, nor on a philosophy of self-sufficient power that cannot survive contact with real dependency, but on a tragic-relational stance that affirms life inside, rather than despite, the vulnerability it cannot resolve.