Editorial Note: This post first featured on Samizdat Health, which later this month will publish The Decapitation of Care.
Samizdat Health – a writer’s co-operative that has taken shape in responses to changes in health and in publishing – will be borne this month. This post copies the feature on SamizdatHealth.org
The original Samizdat was an underground messaging system in the Soviet Union where dissidents passed on writings – often on toilet paper. A collection of Samizdat writings is now stored in the University of Toronto.
This Samizdat focuses on Health. Not in the form of health advice or guides. The focus is on a Health that has replaced Religion and Politics as our central area of concern. We used to have souls and saving them was our Religious mission. Then we had minds and putting them to use to tackle the problems of our day was our Political mission. Now we have identities and focusing on wellness and lifestyles has become our mission.
The new Health is totalitarian, a cradle to grave worldview, full of the passion that once drove politics and religion. The debates are vigorous – if the orthodoxy that lays down Guidelines let’s them happen. All sides can turn staggeringly nasty when threatened.
When Politics usurped Religion, you might have thought religious folk would have taken the side of the poor and dispossessed but not a bit of it. Religion became a conservative force. Now that Politics is being pushed aside by Health, you might have thought politicians would be on the side of those being harmed by treatment. Not a bit of it, whether on the Left or Right, politicians call for more access to Health, seemingly unable to cope with the idea that what was once a noble call – access to life-saving medicines – is now a one-way street to polypharmacy and an early death.
This poses a problem for anyone who occupies No Man’s Land – neither trying to sell the latest advance nor calling for a rejection of medicine. Middle ground is the wrong word – it suggests a fudge, a compromise – for this new territory. What is needed now is a call to each of us to exercise our own judgment, our own diagnostic skills, and not be hoodwinked by either those selling illnesses or those selling wellness. We have lost and need to regain the ability to have our say.
Even doctors have lost the ability to diagnose. Until recently they could acknowledge they were giving poisons to or mutilating people and that the success of what happened depended on both sides pulling together. Now doctors administer sacraments that can only do good. If something begins to go wrong on treatment, they cannot diagnose it as anything except your fault for concealing some odd quirk about you. At times like this, our pets are more likely to get person-centred care from a vet than we are from a doctor.
On the other side of the divide, more and more of us reject conventional medicine often using arguments that adopt the language of conventional medicine – here take these foods, they will boost your serotonin levels.
Publishing has also lost its soul. Increasingly a business, focused on a bottom line, publishers can see how to sell good news about drugs, devices and services, or claims that all is evil, a conspiracy. But they shun complexity – where’s the market in that?
Measures of blood pressure, lipid levels, and numbers of steps taken are all features of a neo-medicalism that appeared just before what is now called neo-liberalism. Rather than treat heart attacks or psychoses, doctors now manage numbers.
Neoliberalism is the same and it took hold in economics, at the same time as neo-medicalism arrived in medicine. It puts measures of money supply in the place where judgements about what is best for the country and concerns about real poeple used to be. Politicians and economists now manage numbers.
So also the media and publishing are now dominated by a neo-culturalism.
Starting in the 1960s, the culture industries, film, theatre, music, tracked who bought what and if Disney was more popular than Shakespeare, Hollywood gave us Disney rather than Shakespeare. The good was what most of us did – anything else was elitist.
In this Neo-world, measures give us governance. Individual judgements are suspect. None of us as individuals or in groups can be let govern ourselves.
Bizarrely this leads to ever wilder fantasies and conspiracy theories, where individual judgements run wild. If it is no longer possible to grapple with complexity, theories about why our cultural and personal lives are emptying out find expression in venues supported by rich patrons. Attracting niche audiences who blame Putin or Trump or Xi Jinping, or Anti-Vaxxers, these venues cast loose from the mainstream.
Governance by numbers is a centre that cannot hold and has not held. We end up with fake cultures, fake news and echo chambers.
The culture industries are unable to grapple with rotten barrel problems. Where are the data showing that people want to hear about problems without answers?
Rotten apples have traditionally made good TV – like the gripping BBC pursuit of that rotten drug Paroxetine which can only have become the best-selling nerve drug in the world because of some rotten apples somewhere in the company or the regulatory apparatus.
But when it becomes clear that everyone in GSK and all regulators are ticking boxes just as assiduously as everyone in the BBC pursuing them is ticking boxes, and pretty much the same boxes, the media are stumped. They cannot up their game and ask Big Questions that as yet have no answer. They cannot ask if they, the media, are part of the problem.
Samizdat hopes to ask Questions. In fiction, or something stranger than fiction, graphic or written or in forms yet to be invented. Work that we figure should get out there because it should get out there – whatever its reception.
You as readers, translators, spreaders of the word through social media, reviewers, commentators on Samizdat postings and as authors are key to making this a happening thing – A happening was one of those words that used to be heard in the pre-governance 1960s.
There will be publications. We need you to buy them, review them and if so inclined add your comments on the Samizdat website.
We need these publications translated into as many languages as possible – so we need translators or people willing to help sponsor translations. Over the next few weeks, we will post more details of how all this might work on the Samizdat site.
Illustration: The Sea of Medicine, © 2014 created by Billiam James