Sunday, May 27, 2012

Renouncing Paul Farmer: A Desperate Plea for Radical Political Medicine

Everywhere there are people of goodwill who quite honestly believe that they are working for the overthrow of class-distinctions. The middle-class Socialist enthuses over the proletariat and runs 'summer schools' [clinics?] where the proletarian and the repentant bourgeois are supposed to fall upon one another's necks and be brothers [partners?] for ever; and the bourgeois visitors come away saying how wonderful and inspiring it has all been (the proletarian ones come away saying something different).
-George Orwell, ‘The Road to Wigan Pier’, 1937

In my first year at Harvard Medical School (HMS) in 2008, Drs. Paul Farmer and Jim Kim co-taught ‘Introduction to Social Medicine’ to all first-year medical students.  For those not familiar with Farmer and Kim, they are prominent physician-anthropologists who trained at Harvard and co-founded ‘Partners in Health’ (PIH), a transnational organization which is “providing a preferential option for the poor in health care.”[1]  Most medical students interested in global health and social medicine are, as I was, quite enamored with Partners in Health, given its emphasis on providing quality healthcare to the ‘wretched of the earth’, the global poor.  Indeed, their presence at Harvard was one of the main reasons I decided to attend medical school there, as I too had/have ambitions of becoming a doctor dedicated to global health.

I was initially tremendously excited about the ‘Introduction to Social Medicine’ course.  But it turned out to be an enormous disappointment.  First, its level of engagement with the social determinants of healthcare was (perhaps appropriate to a politically conservative institution like HMS) superficial.  We were taught little more than the banal fact that poverty is a major etiology of disease.  Second, instead of being taught careful methods of engaging with poverty as physicians, Jim Kim presented to us, in conjunction with Michael Porter of Harvard Business School, ‘global health delivery’ models, ways of using logistical tools of commercial production to improve efficiency and efficacy of the ‘delivery’ of global health care.[2]  Instead of urging us to engage in deeper scholarship of history, anthropology, and philosophy, Kim – who later left to become president of Dartmouth College, and now, tellingly, stands president-elect of the World Bank – encouraged first-year HMS students to pursue MBAs.[3]  Third, and most importantly for me, was a fleeting conversation I had with a PIH-affiliated tutor in the course.  At the time, I learned that the Sendero Luminoso, a Maoist rebel group, had bombed a PIH clinic in Peru.[4]  How, I wondered, could a Marxist group find PIH objectionable?  I knew that Farmer’s own intellectual work was informed by the world-systems theory of Marxist Immanuel Wallerstein, and that his personal beliefs were confluent with liberation theology, a blend of socialism and Catholicism.  Asking my tutor to explain what seemed to me a confusing contradiction, I received a metaphorical shrug.  Turning to Farmer’s own Infections and Inequalities (2001), I was dismayed to find the same response:

Sendero’s analysis [of PIH as reformers in the pejorative sense]…was less easy to dismiss.  We were patching up wounds.  Such interventions would not, it’s true, alter the overall trends [of poverty] registered in the slums of Lima, settlements growing at a rapid rate.  With a certain degree of angst, we continued our modest attempts… (pg. 30)

This discomforting absence of rational explanation, this will to act in the absence of self-critical thought, was in hindsight the impetus for my own decision to enter graduate school in medical anthropology, and also the beginning of my theoretical and practical renunciation of the humanitarian approach of Paul Farmer.  After two years of reading radical philosophy and critical anthropology, I recently came across Jeremy Weinstein’s Inside Rebellion, a political science ethnography that, through interviews of former rebels and rebel commanders, seeks to understand the logic of rebellion from within insurgent groups.  One of Weinstein’s cases was that of the very same group – the Sendero Luminoso – that bombed the PIH clinic.  Let us put aside discussions of whether the group genuinely embodies Maoist praxis, if its violence is excessive and cruel[5], if some of its factions’ involvement in narco-trafficking compromises its revolutionary principles[6], etc.  These are no doubt discussions of tremendous importance.  But as I am more interested in Farmer’s reading of the Sendero Luminoso, which seems largely sympathetic, let us assume for our purposes that the Sendero Luminoso is a revolutionary Maoist organization that, despite its various internal struggles, genuinely seeks radical equality for the poorest indigenous groups in Peru, even at the cost of political violence.  Weinstein’s historical tracing of the conflict between the Sendero Luminoso and the government of Peru then provides an invaluable insight into why the rebels might have bombed the PIH clinic.  In the early 1990s, Weinstein explains, as an explicit part of its counterinsurgency program, the Fujimori government began building roads, schools, and health centers to reduce civilian support for the insurgency.  Among those military officers involved in the counterinsurgency campaign was Ollanta Humala, pictured below with PIH co-founder Jim Kim in April 2012, shortly after Kim’s appointment as president-elect of World Bank.  

This historical framing of the bombing of a PIH clinic in Peru illuminates the paradoxical nature of Farmer’s oft-proclaimed ‘partnership’ with the poor and attention to the historical and political dimensions of poverty and disease.  When his organization began work in slums around Lima in 1994, it was historico-politically inserted into a counterrevolutionary government policy.  Where Farmer laments his own inability to philosophically reconcile his practice of ‘patching up wounds’ with the revolutionary approach of the Sendero Luminoso[7], his remarkably ahistorical account fails to grasp the very simple fact that, all ideology aside, PIH was in practice directly – and seemingly naively, given Farmer’s inattention to this fact – inserted into a reactionary campaign on behalf of the Peruvian government.  Yes, they were delaying the radical transformation of Peruvian society in the abstract, as Farmer assumed; but, to invoke the political history of oppression which occupies a central part of Farmer’s anthropological methodology (particularly in his work on Haiti), they were concretely aligning themselves with the government against the Sendero Luminoso in what can, at best, be described a inexperienced, ahistorical, and apolitical humanitarian intervention for ‘the poor’.[8]

Increasingly, it seems, Partners in Health, that darling of the American left (including many medical anthropologists) supported by ‘liberal communists’ such as Bill and Melinda Gates, has found itself trapped in what Slavoj Žižek has called the “liberal trap of ‘humanitarian help’”.  Despite being left-of-center and claiming partnership with the poor, it is increasingly finding the apolitical float of ‘humanity’ and ‘human rights’ on which it perilously balances melting below its feet.  Just last month, in Belladere, Haiti, Partners in Health/Zanmi Lasante staff were targeted by arson and other attacks.  A ZL healthworker died in the fire, and other ZL workers and their family members were injured.  According to a PIH worker with whom I recently spoke, this attack was orchestrated in response to the actions of a PIH/ZL worker who sought to connect the good image (or symbolic capital) of the organization’s work to an electoral candidate’s campaign.  In a statement released on their website, PIH naively proclaims:

…we urge partisans to respect the neutrality of PIH and ZL in the political process…In advocating for access to free services for the poorest and most vulnerable communities in Haiti, PIH and ZL work with the Government of Haiti to strengthen the public health care sector, in close partnership with affected communities and other local partners. While we work with democratically-elected officials and their appointed officials of the government, PIH/ZL neither participates in the electoral process, nor affiliates with any political party. Despite the recent acts of violence that have occurred, we remain committed to serving our communities in an impartial manner. (PIH Statement: Political Violence in Belladere)
The Ethical Turn of 1968
Of course, there is no such thing as neutrality or impartiality in humanitarianism.  Didier Fassin, a fellow physician-anthropologist and former vice president of Doctors without Borders (MSF), has repeatedly stressed how contemporary humanitarians shift attention from the causes of violence to its consequences in a way that replaces a politics of justice with a politics of compassion – in essence, refuses politics for ethics.  Humanitarians, he argues, operate on an inequality of life and a hierarchy of humanity, aspiring to moral untouchability while avoiding a ‘parrhesia’ – a truth that, once told, can incur a high cost for the teller himself.  For humanitarians, this truth is precisely that humanitarian interventions are always political.  They are guided, as Peter Redfield (citing Renée Fox) points out, by a ‘non-ideological ideology’ – that is, an ideology that refuses to recognize itself as such.  When PIH insists that all life, especially the poor’s, is worth saving, it partakes in a negative form of politics that denies the selective reality of its political practices, including questions of sacrifice and triage.  In Peru, it stood with the government against the Sendero Luminoso; by accepting funding from Bill Gates, it stands politically together with the notion that a ruthless pursuit of profit can be counteracted by charity. 

Farmer and Kim are, no doubt, embodiments of the dark side of the spirit of 1968.  In the face of increasing poverty and a new, flexible capitalism, the protests of 1968 belonged, Luc Boltanski and Eve Chiapello argue[9], to one of two basic categories: cultural-artistic or social.  Examining these protests in France, they observed that the cultural-artistic critiques of capitalism (by students, against the alienating and dehumanizing aspects of capitalism) won out over the social critiques (by workers, against the exploitation of capitalism).  Some of those same protestors later took up government posts and corporate jobs, transforming wage labor into a more personal, humane, and anti-authoritarian experience without challenging the capitalist mode of production itself.  Instead of dismantling capitalist relations of production, they bargained for a more palatable form, and with it, left behind the language of ‘exploitation’ and ‘inequality’ for ‘exclusion’.  The term ‘excluded’, as Boltanski and Chiapello argue, refuses accusation or denunciation.  Instead of pointing to the causes of exploitation, it regresses to mere indignation at suffering.  In the humanitarian sphere, this resulted in an epochal shift[10]: where humanitarian action had previously been condemned as a hypocritical diversion from political action, it became the preferred mode of acting on suffering.  Concretely, as Fassin has noted[11], this meant that privileged volunteers no longer went off to fight alongside people in their liberation struggles, in the political name of revolution; instead, they became professionalized aid workers who went to take care of people in the ethical name of human rights or psychiatric harm. 

Politics has become a matter of ethics, and Partners in Health is deeply embedded within this historical turn as it claims ‘neutrality’ and ‘impartiality’.  Indeed, ‘structural violence’, the very phrase which Farmer has popularized (itself introduced by Johan Galtung in – tellingly – 1969), is precisely so powerful and widespread because it substitutes indignation for accusation.  As Loïc Wacquant implies in his critique of Farmer, the concept of ‘structural violence’ timidly eschews assigning any agency for this violence, which becomes - in Farmer’s own words - “ostensibly ‘nobody’s fault’ ”.  It is precisely in this turn that the parrhesia is avoided, the danger of self-exposure averted.  In the rhetoric of being a ‘partner’ to the poor, the realities of class analysis fall softly but fatally out of Farmer’s theory and work.  An elite, bourgeois group of doctors, activists, and donors help the poor out of moral sentiment[12], refusing or erasing their own class responsibility in what Marx rightly called out as ‘conservative, or bourgeois, socialism’:

A part of the bourgeoisie is desirous of redressing social grievances in order to secure the continued existence of bourgeois society…To this section belong economists, philanthropists, humanitarians, improvers of the condition of the working class, organisers of charity, members of societies for the prevention of cruelty to animals, temperance fanatics, hole-and-corner reformers of every imaginable kind…The Socialistic bourgeois want all the advantages of modern social conditions without the struggles and dangers necessarily resulting therefrom. They desire the existing state of society, minus its revolutionary and disintegrating elements. They wish for a bourgeoisie without a proletariat.
-Karl Marx, ‘The Communist Manifesto’, 1848

The Critique of Liberalism: Where has the Enemy gone? 
If PIH refuses politics in favor of ethics on the thin, melting ice of ‘humanity’ and ‘human rights’, it does so, Carl Schmitt would argue, at the risk of entering into the perilous domain of liberalism.  Liberalism, Schmitt wrote in 1932, had introduced an age of ‘depoliticizations’, negating the political while really only hiding it.  Liberalism is, he points out, an intellectually inconsistent idea that evades or ignores the State and politics in favor of the ethico-ideological conception of ‘humanity’.  Indeed, when man ceases to be political, Schmitt argues, he ceases to be human.  To claim ‘humanity’ is to deny the possibility of an enemy, or at least, to recreate that enemy as inhuman (one only has to think of today’s militarized humanitarian discourse and practice about ‘terrorists’ eliminated[13] by unmanned drones).  For Schmitt, the concept of humanity was used as an ideological instrument of imperialist expansion, an ethical-humanitarian form that promoted economic imperialism.  Providing what remains today a useful defense of politics over ethics, Schmitt insists that the distinction of friend-enemy persists even if ethics dominates politics; it merely hides in the shadows, repressed by liberal thought.

For PIH, the poor of Peru, Boston, Haiti, and countless other sites is the ‘friend’.  But, for an organization whose theoretical foundation is so intensely humanist, faceless ‘structures’ automatically become the enemy.  For Farmer, it is the inhuman structural adjustment policies and the lifeless imperialist doctrines that oppose humanity.  Not Bill Gates, whose donations to PIH seem to ‘cancel out’ the over $60 billion worth of capital he has extracted from the poor.[14]  Nor PIH’s own Director of Corporate and Foundation Relations, whose naivety facilitates the co-optation, as Žižek suggests, of the Porto Alegre’s World Social Forum by Davos’s World Economic Forum, who lets (both ideologically and practically) liberal communists give back a little in the afternoon of what they brutally stole in the morning.  Nor, most importantly, those bourgeois ‘partners’ in health themselves, who – with, let there be no doubt, great existential angst[15] - ignore the problem of class through the contradictory humanist philosophy of liberation theology.

Toward a Radical Political Medicine Yet-to-Come: In Memory and Spirit of Dr. Norman Bethune
 The fact that has got to be faced is that to abolish class-distinctions means abolishing a part of yourself. Here am I, a typical member of the middle class. It is easy for me to say that I want to get rid of class-distinctions, but nearly everything I think and do is a result of class-distinctions…I have got to alter myself so completely that at the end I should hardly be recognizable as the same person.
-Orwell, ‘The Road to Wigan Pier’, 1937

If Farmer’s approach to the health of the poor is naively humanist at best and actively oppressive at worst, if it refuses politics for ethics, if it claims no human enemy, and works hand-in-hand with capital, then where can or should progressive medicine move?  One starting point is to revive the memory of a now-forgotten predecessor to Paul Farmer, a truer ‘partner’ to the poor – the Canadian surgeon Dr. Norman Bethune.[16]  Bethune (1890-1939), like Farmer, refused a resigned approach to what was broadly perceived to be incurable tuberculosis.  Infected with TB and confined to a sanatorium where he expected to die, Bethune pursued a then academically suspect form of treatment (induced traumatic pneumothorax[17]) and made a seemingly miraculous recovery.  His life restored, he became interested in the socioeconomic determinants of health, advocating socialized medicine and developing an interest in communism.  As he became more politically aware, he joined the anti-fascist forces in the Spanish Civil War as well as the Chinese communists in their battle against Japanese imperialists.  Although not actively involved in political leadership and strategy, Bethune became a doctor on the frontlines, developing mobile blood transfusion units that saved the lives of soldiers at the battlefront who had hitherto been dying of blood loss, unable to reach distant clinics before death caught them.  Make no mistake – Bethune was not interested in ‘humanity’ or the ‘structures’ that killed it.  Instead of practicing medicine in the abstract, apolitical service of the ‘poor’, he was saving the lives of soldiers who were fighting political wars against imperialism and fascism.  Although he also treated Japanese POWs, he effectively applied his medical skills and developed medical innovations in service of politics, not ‘impartial’ and ‘neutral’ ethics; to save the men and women fighting the political enemy, not abstract ‘humanity’ or the ‘poor’.   

In the memory and spirit of Bethune, we urgently need to move beyond the liberal communist approach to medicine made so popular by Paul Farmer.  In attempting to revive Bethune as an alternative idol for the medical Left, I desperately plea for a more radical and explicitly politicized medicine yet-to-come.  What could this medicine look like?  It certainly will not be one based on human rights, humanity, or humanism of any simple kind.  It cannot hypocritically undercut radical attempts to revolutionize the ‘structure’ committing ‘structural violence’.  Nor will it follow Farmer’s bourgeois socialism that maintains a bourgeoisie without a proletariat.  Indeed, it will require tremendous self-sacrifice and – more importantly – constant self-criticism and selective self-destruction to weed out the class-distinctions of doctors and activists who advocate for the poor.  In the spirit of Orwell (cited above), not only medicine but also its practitioners (including myself and my HMS classmates) will be radically transformed, so drastically altered as to “hardly be recognizable as the same person.” 

As Subcomandante Marcos of the Zapatista movement has put it bluntly, “We are all human beings, but some are sons of bitches, and some aren’t.  That is the truth.”  As rational, progressive physicians, we cannot be afraid of this truth, nor timid of its consequences – especially for our own lives, sentiments, fragilities, and inconveniences.  Let us abandon the contradictory liberalism and love of ‘humanity’ to which we so desperately cling in self-deluded self-preservation, and embrace the political domain to which, no matter how hard we try to deny or avoid, we inevitably and integrally belong. 

Last edited June 5, 2012

[1] See PIH slogan and learn more about PIH history and philosophy at
[2] See more about the Global Health Delivery Project at
[3] My classmates eagerly obliged; tens of them are pursuing joint MD-MBAs at HMS and HBS, although Kim’s influence was likely not determining in many cases. 
[4] In Peru, Partners in Health is known as Socios en Salud
[5] Farmer, incidentally, calls Sendero violence ‘arbitrary’, a designation that any political scientist or scholar of political violence knows to be shoddy scholarship at best and ideologically-driven at worst.  See, for example, Stathis Kalyvas’s ‘The Logic of Violence in Civil War’ (2006). 
[6] In particular, the Comité Regional del Huallaga is said to rely on coca production as its dominant source of funding, and to have over time grown less attentive to and less guided by the revolutionary ideology of the central committee. 
[7] Farmer’s silence here is adeptly filled by Slavoj Žižek: “…when Sendero Luminoso took over a village, they did not focus on killing the soldiers or policemen stationed there, but more on the UN or U.S. agricultural consultants or health workers trying to help the local peasants—after lecturing them for hours and then forcing them to confess publicly their complicity with imperialism, the Sendero Luminoso shot them. Brutal as this procedure was, it was sustained by the correct insight: they, not the police or the army, were the true danger, the enemy at its most perfidious, since they were ‘‘lying in the guise of truth’’—the more they were ‘‘innocent’’ (they ‘‘really’’ tried to help the peasants), the more they served as a tool of the United States. It is only such a strike against the enemy at his best, at the point where the enemy ‘‘indeed helps us,’’ that displays a true revolutionary autonomy and ‘‘sovereignty’’ (to use this term in its Bataillean meaning). If one adopts the attitude of ‘‘let us take from the enemy what is good and reject or even fight against what is bad,’’ one is already caught in the liberal trap of ‘humanitarian help.’” (Žižek, ‘From Politics to Biopolitics…And Back’, 2004, pgs. 512-513)
[8] In mistaking a politico-historically situated act for a purely ideological act, Farmer says, “A couple of years earlier, a Sendero communiqué had ordered nongovernmental organizations out of Peru because ‘you give crumbs to the people to entertain them and fail to realize that the correct path is that of the people’s war’” (Infections and Inequalities, 2001, pg. 30).  This reference to Sendero ideology is precisely the problem with Farmer’s approach: he cites (in footnote 23) reports from 1984, 1986, and 1989 – a full five years before his own organization’s insertion in the midst of a dynamic guerrilla warfare campaign and before the Fujimori government began to use clinics, schools, etc. as a tactic of reducing support for the Sendero.  It is astounding that his account makes no mention of this practical complicity with the corrupt Fujimori government.  In 2009, Fujimori was sentenced to 25 years in prison for ‘human rights abuses’ committed in a 1991 massacre during the counterinsurgency campaign. 
[9] See ‘The New Spirit of Capitalism’ (published in French in 1999; in English in 2005)
[10] And, in the Foucaultian sense, an epistemic shift
[11] See his 2008 article, ‘The Humanitarian Politics of Testimony’, published in Cultural Anthropology
[12] A sentiment that recognizes the suffering imposed by capitalism, without thoroughly investigating the logic of that mode of production or its own positionality within it. 
[13] The word choice of ‘eliminate’ instead of ‘kill’ should be evident: one cannot kill the ‘terrorist’ because he is already inhuman.  He can only be eliminated, removed, destroyed. 
[14] I do not have space here to explain Marx’s theory of surplus value, or his (along with Smith and Ricardo’s) conception that wealth is derived primarily from labor.  Refer especially to Chs. 4-6 of Marx’s ‘Capital, Volume 1’.
[15] I am currently working on a brief essay exploring this bourgeois angst, which will be posted on this blog in the near future. 
[16] For those interested in reading more about Dr. Bethune, I would recommend Allen and Gordon’s “The Scalpel, the Sword: The Story of Doctor Norman Bethune” as well as Stewart’s “The Mind of Norman Bethune”.  Mao’s ‘In Memory of Norman Bethune’ (to which this section’s title alludes) offers a warm obituary following Bethune’s death in 1939. 
[17] Of course, this was prior to the discovery of now first-line antimycobacterial drugs such as isoniazid or rifampin, developed in or after the 1950s. 

Sunday, March 11, 2012

What can we do in response to Kony 2012?

“We do not have a choice between purity and violence, but between different kinds of violence”
-Maurice Merleau-Ponty, Humanism and Terror, 1947

Kony 2012, a recent social media activism campaign by Invisible Children to raise support for the capture of Lord’s Resistance Army/Movement leader Joseph Kony, perpetuates all the usual stereotypes about ‘Africa’, as a land of barbaric violence and innocent victims in desperate need of Western intervention.  It erases history, politics, economics, reducing Kony to pure taboo alongside bin Laden and Hitler.  I’ve been pleasantly surprised that most of my lay friends (particularly on Facebook, through which the campaign has spread rapidly) have been quick to ask questions and challenge the infantilized story they’ve been fed.  But, I’m asked, what should we do instead? 

We are perpetually caught between a rock and a hard place.  At the risk of reproducing a simplified explanation of the LRA/M conflict, I think the best way to think about the suffering produced (if that is indeed what we are interested in relieving) is to compare the violence enacted during the course of this conflict.  About 10% can be attributed to the LRA/M’s acts – abductions, mutilations, targeted killings, and so forth.  But about 90% can be attributed to the government, its military, and humanitarian organizations themselves[1], all of whom forcibly displaced the population of the north into camps in which far greater deaths and suffering ensued.  What we have (again, to dangerously simplify to conform to the rules of the very social medium through which Kony2012 has spread) is a case of an exciting spectacle of almost magical physical violence overshadowing the dull, slow, endemic, everyday structural violence that caused far more suffering.  And today, with Kony2012, we are asked in a shockingly naïve and childish message (indeed, one delivered by a privileged bourgeois child), to perpetuate a culture of militarism by pursuing an ‘army’ that today poses little if any threat to the safety and wellbeing of a post-conflict northern Uganda.

But if the alternative to sending an elite force after Kony is to build infrastructure for healthcare, agriculture, and so forth in northern Uganda, then we cannot reproduce by inversion the rhetorical good-evil moral binary used by Kony2012: we are pure, Kony2012 is evil.  Rather, as I’ve suggested by beginning with this realist quote from Merleau-Ponty, we must recognize that there is no choice between violence and purity.  Every potential action is violent in its own way – from building infrastructure (which leads to all sorts of problems of dependency, depoliticization, support of local petit bourgeoisie instead of the poor, and so forth) to even ‘partnering’ with the ‘poor’ (to invoke Paul Farmer’s phrase; in which we risk suppressing genuine indigenous political movements, imposing liberal politics, perpetuating the role of the Western savior, and so forth). 

I don’t propose any solutions, although thinking is a remarkably useful and oft neglected tool today.  I want to boldly and provocatively argue: we should do nothing.  Nothing, because, as Slavoj Žižek argues, “sometimes doing nothing is the most violent thing to do.”  If we have to choose between different kinds of violence, let us choose (in Merleau-Ponty’s spirit) that which is most revolutionary, most radical, one that attacks the root of the problem with knee-jerk humanitarianism today.  In our case, the most radical thing to do is nothing.

What does it mean to do ‘nothing’?  First, of course, to not buy into the urge to ‘do something’ – to hold off on getting your Kony2012 action kit, to stay at home when asked to help plaster these frankly ridiculous posters across America.  Second, not to frantically panic to find other forms of intervening.  It may be surprising to some, but northern Ugandans are quite capable of recognizing and solving their own problems, albeit often against the political strength of the Museveni administration.  Finally, to do ‘nothing’ collectively as the ‘West’ – to withdraw US support for Museveni and to pull out US ‘advisors’, to stop siphoning oil profits out of Uganda, to stop implicit support of land privatization in the north. 

To do nothing is to stop, think, and examine ourselves – why must we define our young American identities against a phantasmagorical narrative of brutality, suffering, and innocence of northern Uganda?[2]  Why should we abandon political engagement (which is always moral) for the moral urge to act (which is always political)?  Why must we always think, as Jason Russell says in the Kony2012 video, that “we know what to do”?  For once, let us do nothing but sit, however uncomfortably, in deep self-reflection in and of our nothingness. 

[1] See the work of Adam Branch, among others. 
[2] Rather than, for example, our wars in Iraq and Afghanistan or our complicity in the Israeli occupation, to name just a few of the empire-sustaining projects in which our name, money, sweat, and blood are invested. 

Thursday, March 8, 2012

Kony 2012 from Kampala

I am reposting this work by Adam Branch for those interested in the Kony 2012 campaign.

Thursday, February 2, 2012

The Bourgeoisification of Childhood, or the Infantility of the Bourgeoisie

All children start life as baby bourgeois, in a relation of magical power over others and, through them, over the world, but they grow out of it sooner or later.
-Pierre Bourdieu[1]

I want to explore a simple yet powerful analogy between the temporary state of childhood and the permanent (but not ever-lasting) state of the bourgeoisie[2], drawing throughout on bits of scientific expertise in the form of child developmental theory.  I think this analogy can, at the very least, be made in two domains of life: a social cosmology (the way one imagines or constructs the surrounding social world) and behavior. [3]  I aim to reveal both the middle-class values and assumptions that inform child developmental theory, and, more importantly, to draw some conclusions on the bourgeoisie as a permanently child-like class.  

As Bourdieu notes, baby and bourgeois social cosmologies are very similar.  At 9 months, a baby begins to develop ‘favorite toys’; at 1 year, has ‘favorite things’; and at 4 years, ‘often can’t tell what’s real from what’s make-believe’, and ‘talks about what she likes and what she is interested in’. [4]  In psychologist-philosopher Jean Piaget’s theory of child development, children from age 2-7 remain in the preoperational stage, in which ‘magical thinking’ and egocentrism are the norm.  Not only do children think less logically and more fantastically, but they are unable to understand situations from any viewpoints but their own.  In Marxist terms, the bourgeoisie share similar ways of thinking about the social world around them.  They too have favorite toys and things (which, in child development theory, become naturalized as appropriate ways for children to relate to the world around them), and – in the form of commodity fetishism – often think about these things magically.  Things – the Droid Bionic phone with its supposedly futuristic, fighter robotic origins[5] comes to mind – appear as just that: things or toys with no sense of the social labor of production of the various components, etc.  What’s ‘real’ – where the Droid is made, by whom, under what conditions of labor, for what wages, for whom, who can afford it, who uses it, what connects who uses it to who makes it, and so forth – is ignored (indeed, almost impossible to know unless one is an inside expert) in favor of what’s ‘make-believe’ – that these phones really are magical: they download data from outer-space in microseconds, they tell you exactly where you are and where you need to go (one only needs to think of the relatively new ‘Siri’ – a piece of software acting as a human personal assistant – released by Apple: ‘Ask Siri to help you get things done.’).  The phones of course do all these things, but we tend to marvel at these technological effects rather than its production (in all its forms).  This commodity fetishism is only part of a generalized ideology whereby the bourgeoisie – focused primarily on themselves and things – cannot imagine how others live, who/what brings them their morning omelette, or why one might object to wage labor, the stock market, and all the other games of capital.  All this is to say that, on the whole, their imaginations of the social world are indeed child-like. 

Behavior is the other domain where babies and bourgeoisie find much in common.  When children do something ‘wrong’, we often fall on the recourse that they ‘don’t know any better’.  At 4 months, they might cry when you stop playing with them; from 9 months, they may begin to be ‘afraid’ of strangers; at 18 months, they ‘may have temper tantrums’; at 3 years, they ‘may get upset with major changes in routine’; and at 5 years, they are ‘sometimes demanding and sometimes very cooperative’.  That these developmental milestones or expectations are socially constructed in the image of bourgeois life should be immediately evident – severely malnourished children lack the energy to have tantrums; nomadic children are unlikely to expect the tedious routine of a ‘nine-to-five’, ‘weekday-weekend’ conception of time; etc.  More importantly, however, is that these behaviors characterize bourgeois attitudes and beliefs.  The question of ‘not knowing any better’ is the question of ideology.  Temper tantrums and crying are egocentric considerations of self-need without the ability to rationalize the absurdity of these needs or to consider those of others.  Being upset with ‘major changes in routine’ is an excellent naturalization of counter-revolutionary sentiment, an assurance that what is normal is natural and should not be resisted or changed.  And being ‘sometimes demanding and sometimes very cooperative’ is characteristic not only of babies but of shift managers or any type of boss.[6]
So perhaps children and bourgeoisie think and act more similarly than we think.[7]  To extend this argument, we should think about the contradictions posed to bourgeois development stages and their corresponding materio-moral sentiments by certain categories of people and actions – child soldiers and child criminals tried as adults, for example.   Certainly, there are plenty of cases in which children are ‘brainwashed’ or forced into serving as combatants.  Yet those children who fully understand what they are fighting for (usually a peasant or proletarian cause) – as politically informed and selfless soldiers – go unacknowledged, in part because they appear as abnormal or unnatural, defying the codes of bourgeois child development.  Their distance is usually sanctified, and their ‘innocence’ constructed, through Orientalist humanitarian eyes, mainly because images of African child soldiers circulated in US media.  On the other hand, at home in the criminal justice system, members of the public (white or Black) may be more likely to favor trying Black children than white children as adults[8], suggesting that these codes of child development are not ‘appropriately scaled’ to poor Black kids who are so deeply Othered, hated, and feared. 
What are the implications of this whole thought-exercise?  First, of course, child developmental stages, along with so many other biomedical ‘norms’, are social constructions of a consumerist society calibrated towards or with bourgeois values and codes of conduct.  But also, these codes re-create the values and expectations of bourgeois life.  Second and more philosophically, one might come to conceive of the bourgeoisie as not fully human – that is, they exist in a child-like form of social life, incompletely developed (even according to their own standards).  This is, in a roundabout manner, precisely a historical Marxist treatment of the bourgeoisie; Georg Lukács’ History and Class Consciousness posits the proletariat as the subject-object of history, where (in teleological Marxism), capitalism is said to be a temporary phase of history to be replaced by communism (and with it, the disappearance of the ‘primitive’ bourgeoisie, as with the disappearance of feudal lords before them).  Third, if the bourgeoisie are to be considered in this way – let’s put in their own developmental terms –as suffering from a ‘developmental disorder’, we might do better than Dr. Frederic Jameson[9] in diagnosing the condition of the bourgeoisie.  They are not, in today’s ‘postmodern’ consumer society, condemned to schizophrenia (a condition which, clinically speaking, onsets in late adolescence or early adulthood).  Rather, they are developmentally disabled from birth, condemned, as Bourdieu suggests, to live perpetually with childish thoughts and behaviors out of which, unlike children, they are unable to grow. 
I close with one final conclusion on children and the bourgeoisie in relation to Immanuel Kant’s notion of ‘perpetual peace’.  In a recent essay[10], anthropologist Liisa Malkki suggests that the proliferation of cultural artefacts linking children with peace depoliticizes and infantilizes the very notion of peace in favor of ‘the adult world of real politics, real history’.  I think we can fruitfully extend her analysis by recognizing the very notion of ‘world peace’, at least in its Kantian origin and in today’s culturally dominant form, as bourgeois.  Kant, in his remarkable late 18th century essay suggesting some conditions and forms of government for the assurance of international peace among states, suggests that commerce and money could play important roles:

The spirit of commerce, which is incompatible with war, sooner or later gains the upper hand in every state. As the power of money is perhaps the most dependable of all the powers (means) included under the state power, states see themselves forced, without any moral urge, to promote honorable peace and by mediation to prevent war wherever it threatens to break out. They do so exactly as if they stood in perpetual alliances, for great offensive alliances are in the nature of the case rare and even less often successful. (From First Supplement, ‘Of the Guarantee of Perpetual Peace’; emphasis added) 

As today’s US imperial wars have best taught us, commerce and war often go hand-in-hand: Halliburton and Iraqi oil, Lockheed Martin missiles in Pakistan, and so on.  Kant’s argument – to the effect (elaborated by economist Joseph Schumpeter, among others) that capitalism guarantees peace – should thus strike us as not only bourgeois, but also childish.    

[1] Bourdieu, P. 1984. Distinction. Richard Nice, trans. Cambridge: Harvard University Press.  Pg. 54.
[2] I intentionally use ‘bourgeoisie’ and ‘proletariat’ here because these although these class categories sound outdated, they are today more relevant than one might suspect reading recent social theory (even Marxist work).  The Occupy’s 99% vs. 1% discourse could be read as a euphemism of this set of terms. 
[3] Language and language development is another important area, but I leave this for linguists to elaborate. 
[4] These developmental milestones come from the CDC:
[5] See the advertisement here:  The slogan “Made from machines to rule all machines” is fetishistic in the extreme.
[6] One might point out that these particular observations could equally be ascribed (by the bourgeoisie) to the proletariat: as being prone to tantrums (strikes, revolutions, etc.); as ‘not knowing any better’ (‘uneducated’); as being sometimes demanding and sometimes cooperative (management’s characterization of workers); and so on.  These characterizations have historically been and continue to be instruments of class control, infantilizing workers for the purposes of union-busting, stifling class consciousness, etc.  The recent banning of Paulo Freire’s ‘The Pedagogy of the Oppressed’ in a Tucson school district – affecting working-class children – is an important example that suggests that child development theory functions to naturalize class oppression more directly than it might appear. 
[7] This, of course, gives us another, perhaps unexpected explanation for why bourgeois children find it easy to become bourgeois adults.  In addition to the material continuity of ease, there is a continuity of thought and behavior! 
[8] For example, see Feiler, S. and J. Sheley. 1999. Legal and racial elements of public willingness to transfer juvenile offenders to adult court. J Crim Justice, 27: 55–64.
[9] Jameson, F. 1991. Postmodernism, or the Cultural Logic of Late Capitalism. New York: Verso. 
[10] Malkki, L. 2010. Children, Humanity, and the Infantilization of Peace. In In the Name of Humanity: The Government of Threat and Care. Ilana Feldman and Miriam Ticktin, eds. Durham: Duke University Press.

Monday, December 12, 2011

The Morality of Play for the Capitalist Subject

Recently, I’ve been perplexed with what I might call the ‘morality of play’.  By this I mean to ask: how can a politically committed subject living in a capitalist society experience pleasure or play that is not already co-opted or incorporated into relations of power?  Or, more simply, is it possible to imagine a Marxist form of ‘play’ or recreation in a capitalist society?  

Let me start with a simple, personal example: football (soccer) is one of the few enduring passions in my life.  I play weekly, but more importantly I am a supporter of Arsenal Football Club, whose matches I follow keenly and attend whenever I am in London.  As a cultural critic, I am intellectually aware of the problems of supporting/paying what is now more a company than a club; of being transformed from a supporter into a consumer; of, as a result of the creation of the Premier League and its lucrative global satellite TV deals, becoming a distant supporter of a remote club thousands of miles away; and of yielding to the ‘cult of personality’ of the club’s superstars, who I’ve never even met, yet feel like family to me.  I have read, with a painful, knowing grimace, Terry Eagleton’s cutting critique of football as the opium of the people (although I think he underestimates the potential for revolutionary organization by local, fan-owned clubs like FC United of Manchester or AFC Wimbledon, among others).  And yet, like a physician who - knowing all the health risks - continues to smoke, I cannot help but remain glued to the Arsenal, looking forward with such joy and pleasure to matches, around which I carefully plan other events in my life.  Is such pleasure immoral?

The short answer is, of course, yes.  Orthodox Marxist perspectives explain how cultural elements like sports, music, and so forth – especially in their mass produced forms – constitute a superstructure determined by the economic base of the capitalist mode of production.  In their Dialectic of Enlightenment, in which they write about the deceptive techniques of the ‘culture industry’, Theodor Adorno and Max Horkheimer argue that in pleasure, human beings divest themselves of thought.  Although inherently free of domination and discipline, pleasure in the hands of rulers is a rational measure of manipulation, administered to subjects in controlled doses.  In this sense, football is not the only form of pleasure already ‘poisoned’ by power.  One could think of any number of forms of play that are, in the ‘soft’ sense of ideology or the ‘hard’ sense of hegemony, already constitutive of, or at least linked to, techniques of manipulative domination – like going to the movies (cf. Guy Debord’s Society of the Spectacle) or enjoying a post-dinner dessert (cf. Sidney Mintz’s Sweetness and Power). 

Of course, these forms of play are all practices that continually re-constitute us as capitalist consumers, conditioned to find pleasure (and our own postmodern identities) in a way that reproduces the existing mode of production.  Even where we might have options to resist – e.g. via a boycott of a particular product – such resistance is merely a choice already constrained.  If you refuse to buy non-organic milk because of the way in which the drive for profit-maximization has led to the ill-treatment of cows, you have the option of buying organic milk, a purchase that – however moral it may seem – is still a purchase from a profit-making company within a system that exploits labor power (cf. Slavoj Žižek’s First as Tragedy, Then as Farce).  

But what about non-consumptive forms of play?  What are, in this particular historical moment, or conjuncture, the moral stakes of going to a dinner party?  Of having sex?  Of playing pick-up football?  Here, the problem of play arises in a different form, and requires us to think more deeply about the opposite of play or pleasure today: work.  Raymond Williams, in his excellent Keywords, traces the etymology of work before it acquired new connotations under industrial capitalism.  Today, of course, ‘work’ signifies ‘paid employment’, but it used to merely signify ‘activity’.  As a graduate student, when I say, “I need to get to work,” I’m often mistaken to mean that I am employed as an alienated wage laborer, when I simply mean I would like to read or write as part of an activity-process very much my own (one in which I feel I become more rather than less human, and thus ‘need to’ in the Foucaultian ethical sense of self-betterment rather than the sense of labor discipline).  My sense of work, I would like to think, is one that connotes its earlier meaning – merely a form of activity, rather than work in the sense of ‘labor’ that has become a commodity and a class.  And yet my sense of work is by no means dominant.  For the capitalist subject  (which I certainly am, in spite of the less alienating form of my labor), all forms of play – even the non-consumptive – are inextricably bound to the dominant sense of work, as a counter-alienating practice prepared precisely to balance the alienation of capitalist work.  Who doesn’t at times long to come home from work to enjoy a TV show, to make love to a partner, to have a family dinner?  For most of us, these are what we see as our ‘real’ lives, what we do outside of work.

This work-play complex is connoted best in that heinous expression (unfortunately, too commonly heard in medical school), “Work hard, play hard.” This mode of life creates the perfect circle to maximize productivity – one must do one’s best while at work, and then do one’s best while at play, only in order to be able to perform better at work.  If ‘play’, in the form of religion, sports, music, and so forth, is not taken as a way to rejuvenate our bodies and minds from the labor we perform for others, it at the very least orients us towards searching for life in our limited time off from work, preventing us from organizing work (in the sense of activity) such as the occupy movement (which is itself sustained by economic crisis, unemployment, and lack of opportunity for educated young people).  In Wage Labour and Capital, Marx writes of industrial labor:
[The worker] works in order to live.  He does not even reckon labour as part of his life, it is rather a sacrifice of his life…What he produces for himself is not the silk that he weaves, not the gold that he draws from the mine, not the palace that he builds.  What he produces for himself is wages, and silk, gold, palace resolve themselves for him into a definite quantity of the means of subsistence…And the worker, who for twelve hours weaves, spins, drills, turns, builds, shovels, breaks stones, carries loads, etc. – does he consider this twelve hours’ weaving, spinning, drilling, turning, building, shoveling, stone breaking as a manifestation of his life, as life?  On the contrary, life begins for him where this activity ceases, at table, in the public house, in bed.
[I should mention that today, capitalism operates largely through flexible accumulation, and actively promotes worker autonomy and creativity in some lines of work as a counter-measure against alienation. (cf. Luc Boltanksi and Eve Chiapello's The New Spirit of Capitalism)]

In this notion of ‘play’, even non-consumptive forms of pleasure exist ideologically, as though coming up to gasp for breath in a pool from which there is no escape or exit.  Dinner parties, sexual activity, and all other forms of non-consumptive play remain – to the extent that they do not offer an alternative Marxist hegemony – ways in which the capitalist division of work and life becomes self-affirmed.  They are means of adapting ourselves to a common sense that is not only non-sensical, but immoral within Marxist ethics. (I should say that this type of Marxist asceticism, however similar, should not be confused with the Protestant ethic of capitalism that Max Weber once wrote about.  Indeed, as E.P. Thompson describes in The Making of the English Working Class, trade unionism arose with similar asceticism and self-discipline, which I take to be necessary in any radical political struggle.)           
What would moral ‘play’ then look like for both an anti- or post-capitalist subject?  For an anti-capitalist subject, how can we begin to think of ‘revolutionary’ play in everyday life?  Can we think of ‘revolutionary’ dinner parties, ‘revolutionary’ sex, or ‘revolutionary’ football?  For a post-capitalist subject, for whom that negative connotation of ‘work’ associated with capitalism falls away in place of joy, what happens to ‘play’ altogether?  When labor becomes pleasure, what constitutes play, and what purpose does it serve?