Wednesday, February 22, 2012

Simultaneity 3: the accident

It is a very bad career, but only a bad career gives the world the light that a not perfect, but still good writer wishes to produce, although unfortunately at any cost. Naturally, too, such people, observed from the outside, seem to wander everywhere, I could tell you about some of them, me of course included, but they are not in the least remarkable than through the work of illumination in rather good novels. One could say, that these are people that emerged a bit slowly from out of the previous generation, one can’t demand that everybody should follow the regular leaps of the times with the same regular leaps. But if one once gets behind in one’s march,  one will never catch up with the march of the crowd, obviously, yet even if the step left behind soon begins to look like one could bet that it was not a human step, one would lose. Imagine the view from a running horse in a track, if one could keep your eyes on it, the look of a horse springing over the hurdles, which surely shows one the most external, actual, wholly true nature of the race. The unity of the stands, the unity of the living public, the unity of the surrounding region in a specific time, etc., but even the last waltz of the orchestra and how one loves to play it nowadays. But if my horse turns around and doesn’t want to jump and goes around the hurdles or even breaks out and becomes spirited inside the arena or throws me off, naturally in appearance the collective view has won. There are gaps in the public that some fly over, and some fall in, hands wave here and there as by every possible wind, a rain of fleeting relations falls on me and it is easily possible, that some onlooker feels  it and is sympathetic to me, while I lie on the grass like a worm.
- Kafka, letter to Director Eisner, 1909

On June 6, 1885, F.R., a railroad conductor, was involved in a train accident in which the train derailed. The walls of the baggage car that he was in at the time caved in, and he was barely able to escape, after which he lost consciousness. However, when he regained consciousness he discovered that not much time had elapsed, and he was able to help drive the train to the next station. After that incident, however, he suffered “pains in the left thorax and back, flickering and colors in his vision. Also intervals of weakness of memory, fear and a racing heart.” These effects occurred when he was working, and he even once lost consciousness. He went to an eye clinic, but there was found no pathological damage to the eye.

J.R., a clothcutter in a factory, was involved in an accident in March, 1885, when he accidentally grasped a driver belt (which turned 80 times per minute and was carried by it up to the area between the belt and the ceiling, where he pressed his hands and head firmly against the ceiling to resist being sucked in by the belt and crushed. A worker held onto his legs while another worker rushed to turn off the machine. J.R.’s clothing was torn off, he suffered burns all over his body, and he experienced immediate shock. After a week he began to feel a hammering in his temples, his eyes would film up, and he had dizzy spells. He also began to forget things and to say “nonsensical things’.

R.V. was working in a wood finishing factory. On  June 18, 1886, his sleeve was caught by a bladed rotating machine used for planing wood. The rotating maching went at a speed of 2000 to 3000 rotations a minute. His right arm was twisted around it, but he was balk to use his free left arm to grasp an iron cart. The rotating machine ripped the shirt from his chest and shoulders, but this allowed him to free his arm. He saw that he was uninjured, but he felt fear to the extent that his entire body shook. Two days later his arm showed marks of being severely scraped up and swollen, with blood red, painful bruises. He worked six more months, essentially using only his left arm, while he took to medicating himself for the pain he felt in the right through alcohol.

All of these cases – and some thirty nine more – appeared in Hermann Oppenheim’s book, Traumatic Neuroses, which was a salvo in the long battle concerning medicine and politics that was the result of the accident insurance legislation that had been passed by the German parliament. Bismark publicly expressed his fear of the gains being made by the socialists, and to counter them, he began a process of reforming industrial relations, a key piece of which was workman’s compensation insurance.

Germany was soon followed by Austria. In the meantime, these matters were being debated in the United States and Britain. Wherever they were debated, the question of what to do about injurious effects that seem disproportionate to their causes. And thus, nosology was pulled by the nose into the class war.

In the United States, this war was fought, firstly, around the railroads. Eric Michael Caplan’s article about ‘Railroad sprain” – the symptoms that arose from the trauma of railroad accidents – follows the trajectory of the report of these injuries from their first description in John Eric Erichsen’s On Railway and other injuries, in 1866. The politics of the industrial accident in the U.S. followed a typically bifurcated path: while the courts generally found against claims made by workmen for injuries, they were much more sympathetic to passengers – for of course passengers were more likely to belong to the respectable class. They could even be judges. Thus, a diagnostic war was waged over whether ‘railroad spine” – whiplash – and other seemingly psychogenic illnesses were real or not. Real diseases are those with physiological causes, while those traumas that were psychogenic – well, courts and doctors tended to put them to the margins, close to overt fakes and malingerings.

Herbert Page,  a surgeon who worked for the London and Northwest Railroad, produced the most interesting theory. Page took up the idea of neuromimesis, first articulated by the French psychologist, Paget, to suggest that “fright itself… was capable of eliciting neuromimetic symptoms by way of some willful hypnotic state.” [396]  And, slyly, Page suggested that there was evidence for the neuromimetic hypothesis:  “The existence of a certain amount of control is shown moreover by the disappearance of the mimicries, when all cause for their representation is removed. The matter of compensation as we have seen, exerts in many cases a very favorable influence on the symptoms of nervous shock.”

This is an argument that continues to break out on various fronts to this day. Certainly the railroad companies, at the time, were losing in courts – juries tended to believe accounts of injuries from people like themselves, so that surveys showed plaintiffs winning 70 percent of the time. This became a chronic source of irritation to the stockholders of railroad companies. 

Railroad spine and other “traumatic neuroses” were caught in a set of rather confusing forces. For one thing, while  it might be very well to say that the injured were actually under hynpnotic suggestion, what this meant, in effect, was extending hysteria from women to men.  At the same time, there was a general suspicion of any explanation that relied on psychological factors – it went against the materialism of the times. The pressure from the population through the courts was one of the pressures that made industries reluctantly adopt state regulations for injury, in fact, as the costs could be controlled and predicted, then.

Because the way the sides are marked does not correspond to a clear battle between the ‘progressive” and the “regressive”, it is easy to misunderstand the context here. Hermann Oppenheim’s career is a good example of the casualties to which a ‘regressive’ materialism is heir.

Oppenheim is now a semi-forgotten figure. Although he was one of the founders of neurology as an independent discipline in Germany, he ran into a solid wall of hostility in World War I from neurologists, many of whom had been his students, when he maintained that that soldiers traumatized at the front were suffering a real material injury that was signaled in post-traumatic symptoms. The neurologists, seeking ways of sending traumatized soldiers back to the front as quickly as possible, were invested in the psychogenic explanation. Like the Railroad surgeons, these neurologists represented, from one point of view, the progressive side of according reality to psychological factors – but they came to that point of view for the most regressive of reasons: money in the one case, nationalism in the other.

Andreas Killen has pointed out that Oppenheim’s career as a neurologist, which began in the 1880s, coincided with the new importance of interpreting seemingly unaccountable pains and symptoms: ‘Arguably the most important factor in this disease picture was the accident insurance law itself. The law compensated work related neuroses within strictly defined limits. Entitlement to benefits was made contingent upon proof of direct causal connection to an accident.”

Oppenheim re-asserted the importance of material cause – that is, the material displacement of neurons – against the French school of suggestion, led by Charcot.  The shaking experienced by truck drivers, firemen, steelworkers, textile mill roller operators and the like had unexpected effects not because there was variances in the degree of suggestibility of different people, but because there were different degrees of material stress that were put upon the neural system.  That system was hooked into the emotions felt.

On the basis of the comparative analysis of his “observations”, Oppenheim presented as their common symptom the fact that the initiatory accident or injury always “had to produce a strong psychic emotiom or lead to them.” Oppenheim expressly refered to the fact that the symptoms of the traumatic neurosis occurred independently after the event, even though the patient laid claim to compensation,  grounding this forensically important affirmation with his unilorm clinical experience.  Oppenheim described a central problem of all the victims as ‘disquiet, excitement, fear and terror”, and more, a “hypochrondrial-melancholic mood, anxiety and finally an “abnormal sensitiveness” (Oppenheim, 1889) The anxieties mostly manifested themselves as panic attacks with agoraphobia, through which obsessive petty fears and compulsions can manifest. On the basis of their ‘intensified sensibitivity” the patience are extremely inclined to “pull back from society into solitude.”

Oppenheim was never clear about how, if the basis of these neuroses was changes in the microscopic configuration of the cerebellum – his guess – they could, as symptoms, feed back into the disease. This is an ontological paradox that didn’t worry Oppenheim, but in the end, it left him behind – having no place in his etiology for the psyche, he, in a sense, failed to explain the evolution of these disorders.

The industrialized experience of accident is one of the great social symptoms of the felt divide between organic time and vehicular time. Heidegger, in the 20s, speaks of how a background comes into view when there is a break in the routine – he uses the example of a missing or misplaced tool. The example that comes into view in the late nineteenth century when the tools were the toolusers – and what is embodied is something missing, filled in by pain. If in fact neuromimesis was happening, what was being imitated? For Page, fear was imitating real organic diseases, diseases that occurred in organic time. The accidents, however, shook the unconscious frame of the users of the industrial system – their assimilation of the eternal return of the same. That eternal return of the same is the metaphysical heart of the simultaneous, considered as a form of social time. Its poet is Kafka, an industrial accident insurance man. 

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