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The Costs of Systemic Disease

On Critical Days

by ELLIOT SPERBER

Whether it’s the most recent extreme weather disaster, environmental calamity, financial scandal, debacle, super-crime, or otherwise, political and social life these days is presented – if not experienced – as a succession of crises. Indeed, the economic crisis alone has generated its own not inconsiderable brood of sub-crises: the foreclosure crisis, the jobs crisis (aka the unemployment crisis), not to mention the health care crisis, and the perennial, ideologically distorted, debt crisis are accompanied by still others. And with the so-called fiscal cliff crisis approaching, we encounter this incessant succession of crises latest incarnation.

Insofar as it relates to the present crisis (which provides yet another pretext for the business class, and their acolytes, to pursue not only the elimination of social security, medicare, medicaid, and the rollback of the New Deal, but the fulfillment of their longstanding dream of totalized privatization) it is not only interesting, but revealing as well, to consider the history of the concept of the crisis.

While the word crisis is rooted in the Greek term krinein – which means to separate, distinguish, or judge – by the time the Hippocratic Corpus was assembled, beginning in the fifth century BCE, the concept of the crisis had already acquired an important place in ancient medical theory. According to this, a crisis is a turning point in the development of a disease – a point at which a patient’s disease begins to either intensify or diminish. Because Hippocrates, among other ancient thinkers, held that the organism possessed an intrinsic healing capacity, he also argued that the job of the physician was to pay attention to such crises (thought to occur preponderantly on what were termed “critical days”) and adjust the patient’s treatment so as to facilitate this natural healing process, and lead to the recovery of the patient’s health.

Elaborating upon this concept, the legendary Roman physician, philosopher, and medical theorist Galen made contributions to the development of the theory of the crisis. Writing and practicing in the second century of the common era, Galen’s theories would spread through the Roman Empire, influencing the practice of medicine in much of the world until well into the 19th century. And while much of Galen’s work would lead to its supersession in ensuing medical discoveries, intriguingly, his theory of the crisis provides considerable insight into the contemporary political situation. Indeed, insofar as the theory of the crisis is comparable to a notion of a rupture or break in the causal chain of history – enabling an intervention, and an alteration, into what would otherwise have been a more or less predetermined sequence – the classical concept of the crisis allows for a critical analysis of the present, and of political activity.

This notion of the crisis is even – in some respects – comparable to the contemporary philosopher Alain Badiou’s concept of the Event. Roughly defined as a moment of truth that emerges from a more or less predetermined “situation,” an “event” requires an intervention of some sort that disrupts, interrupts, or otherwise ruptures the inertial “situation” and allows the event – the genuinely new – to emerge into history. Akin to just such a rupture, the classical medical notion of a crisis as a turning point is similar. For a crisis is likewise a gap in the regular advance of a disease that allows for the turn to not only the patient’s recovery, but for a new health, a new life, to emerge.

(Of course, to the extent that the event is involved in the creation of the subject – and the subject’s existence, according to Badiou, is contingent on its ‘fidelity’ to the event – the event is considerably more complex than the crisis. Nevertheless, the two concepts still overlap insofar as each recognizes an affinity between an interruption of ‘fate’, an exertion of a sort of autonomy, and truth.)

Among other things, the present fiscal cliff “crisis” – along with contemporary crises in general – conforms to the classical, medical definition. For a crisis is just such a turning point, from which things can improve or worsen. With this in mind, Galen and Hippocrates would likely agree with Rahm Emanuel’s well-known statement that “you never want a serious crisis to go to waste.” Indeed, for Hippocrates as well as Galen the crisis is absolutely vital as it is the point from which recovery from a disease can begin. However, while Galen and Hippocrates may agree with Rahm Emanuel’s position concerning the importance of crises, it seems exceptionally unlikely that they would agree with any of Rahm Emanuel’s prognoses, or his recommended course of treatment.

For while Rahm Emanuel may recognize that crises are important for advancing the goals of his political-economic class, and their sympathizers, the policies that they in fact advance do not by any stretch of the imagination lead to health. On the contrary, they only accelerate the spread of disease. For, among other things, the economic policies they advocate lead to more and more work (at least for those precariously holding onto their jobs), accompanied by less and less pay, which leads to not only disease in the sense of the diminution of ease, but also contributes to and perpetuates disease in the more chronic sense. That is, their economic policies are inextricable from occupational and social stresses which lead directly to heart disease and cancer, not to mention poverty and homelessness, among others. Moreover, endless production also results in ever more pollution, resource destruction, ecocide, and global warming, leading to droughts, malnourishment, famine, and war, to name just some of the most prominent manifestations of economic disease.

As such, while people are in many respects aware of the fact that the present manner of organizing society is (not too) slowly but surely destroying the planet (and, a fortiori, the rest of our lives as well) the inertial situation continues. And although these crises, these potential turning points, come along regularly, instead of intervening in order to cure the systemic harms and wrongs of our institutions and ways of life, Emanuel and his ilk – the Romneys, Obamas, Koch Brothers, Bloombergs, Carlos Slims, and manifold kings, who happen to still exist, along with queens, and princes, among others – like thousands of Neros, merely fiddle with their riches in their palaces as the world burns.

And as it burns, accompanied by various forms of misery, a variety of treatments are distributed in order to stave off total social collapse. Instead of intervening and treating the root of the disease, though, only the symptoms (which, incidentally, happen to be a huge source of profit) tend to be treated – treated, in general, by bombardment by a barrage of pain-killing and sleep-inducing anesthetics. Indeed, beyond the more conventional aspects of the anesthetics industry (represented mostly by alcohol, street drugs, TV, and religion), with the advance of the disease over the past few decades anti-depressant and anti-anxiety prescription drugs like Prozac, Paxil, Zoloft, and others, have become the top-selling pharmaceuticals in the US. But anesthetics do not begin, nor do they end, there. Along with the other ‘opiates of the masses’, smart phones, endless television channels, and other forms of entertainment ensure that people are properly anesthetized. And just as the general disease (which includes the sickness of the planet) is growing only more extreme, more and more extreme forms of anesthetics are being developed in order to just keep up with its growth. In some respects, this growing numbness may account for the extreme intensification of various activities such as the hypertrophy of sports into extreme sports, and the concentration of sex into extreme, unlimited amounts of pornography, among other things.

If anesthetics and the anesthetics industry is as prevalent as it is, though, it is important to note that the opposite of anesthetics is not the intensification of sports, and other activities, which are merely an extension of the problem. Rather, the opposite of anesthetics is aesthetics. Defined broadly as the critical examination of art, culture, and nature, more than merely the opposite of anesthetics, aesthetics may be seen as its corrective. As opposed to the practice of aesthetics which – as prevalent as it is confused – tends to spend its energy pondering the latest monochrome painting, series of dots, or installation of wires – among other derivative anesthetic and consumer items – an actual aesthetics pays more attention to the relationships and intersections between “culture” and “nature.” Moreover, where it is not creating them, a meaningful aesthetics ought to not only pay attention to the arrival of crises, but ought to also contribute to the discussion of how these turning points may be recognized for the turning points they are, thereby allowing us to turn away from disease, privatization, and austerity, and toward health.

Returning to Hippocrates and Galen, it may be helpful to consider the fact that what they most often prescribed for their patients was not medicine so much as rest. Believing that ease was required to overcome disease, they maintained that the organism was endowed with an innate healing power (the vis medicatrix naturae) and healed itself under the correct conditions. According to this view, supported by contemporary medical research, the physician’s role is to create the conditions that allow this healing function to manifest best. As such, it should not be too difficult to imagine that, in examining the present political-economic situation, Galen might prescribe just such a treatment for this society.

As anathema as it may be to the capitalist economy – which requires unlimited expansion and work – the requirements of health, and of crises, demands just the opposite. For although it is necessary for health, rest is opposed to the economic functioning of capitalism – and, in spite of the harms its deprivation causes, it is systematically subordinated to the dictates of the economy. To be sure, it is not only human beings’ rest that economic exigencies destroy. Not even the sky is afforded any rest.

Indeed, who does not recall the fact that the eruption of the Eyjafjallajokull volcano in Iceland, in April and May of 2010, led to the grounding of thousands of air flights, and that this resulted in not only noticeably cleaner skies, but healthier air as well? Though less discussed than the economic loss engendered by the cancellation of so many flights, the cessation of air traffic also resulted in the elimination of what has been estimated to be between 1.3 to 2.8 million tons of carbon dioxide emissions – contributing to not only less pollution, but to less disease as well. Likewise, the general strike in Spain this week led to decreases in Spain’s national energy consumption (measured on November 14 at 8 a.m. by Spain’s national energy grid) of 18.6% compared to a normal work day at that time. As was the case with Eyjafjallajokull, not only does this decrease in work and activity lead to less disease, and more ease to heal, it leads as well to less pollution, and less disease in that respect, too. And while health requires that energy must still be used, the critical judgment of a meaningful aesthetics, among other disciplines, must consider that, among other things, much of the energy and work that is pursued in present economic production in fact results not in goods and services at all so much as in atrophied health on one end, and hypertrophied wealth on the other.

As we consider this latest so-called fiscal cliff crisis, and contemplate the austerity measures that many policy-makers hope to leverage into being with it (of which the gutting of social security, and the cutting of medicaid and medicare, are only the most obvious of the continuing efforts to completely privatize the globe), it is particularly ironic that Obama should state, at a press conference this week, that “health care costs continue to be the biggest driver of our deficits.” For these costs are not so much the costs of health, they are the costs of systemic disease. And the continuation of exploitative economic policies, rather than ameliorating the general condition, will only reproduce, exacerbate, and accelerate conditions of disease, all the while making it more difficult to treat them.

If our consideration of the classical, medical concept of the crisis elucidates anything, it should lead us to the position that a crisis is indeed a turning point. As such, it should also lead us to agree with the pronouncements of Rahm Emanuel, Obama, Romney, and others, that we require austerity. However, the conditions required for justice (which in many respects are articulable as the concrete conditions of health) requires not the austerity of work and disease. Rather, it requires the austerity of rest and ease. The austerity that recognizes that the elimination of poverty requires the elimination of not only extreme concentrations of wealth, but the elimination of the institutions that allow such concentrations to amass in the first place, is required in order to move out of this crisis and recover our collective health. In other words, a critical austerity recognizes that a crisis is, indeed, a turning point – and that another term for such a turning is revolution.

Elliot Sperber is a writer, attorney, and contributor to hygiecracy.blogspot.com. He lives in New York City, and can be reached at elliot.sperber@gmail.com