Friday, April 24, 2020

A review of Tadeusz Szczeklik’s Catharsis: On the art of Medicine

Asclepius was the child of Apollo and Coronis, a mortal princess. Out of jealousy, Apollo struck Coronis with a lightning bolt when she was pregnant, but rescued the child in her womb. Medicine  begins with a femicide. We've always suspected as much.  But as always in the heavily redacted and montaged world of myth (where all that is deep is condensed with all that is shallow, where the cartoon apes the archetype), there is another story too: that Chiron the Centaur, who taught Achilles, also taught Asclepius. He taught music as well, which is how Achilles cured himself of his anger towards Agamemnon. As well, he taught the virtues that calmed the soul. Thus, as is pointed out in Tadeusz Szczeklik’s Catharsis: On the art of Medicine, Chiron taught medicine, music and justice as entangled one with the other and, ultimately, one.

There’s a certain kind of medical essay, a book-like essay, that obscurely keeps the faith with that unity. Lewis Thomas in the U.S. is the best known practitioner – Szczeklik was that figure in Poland.
One expects, from these essays, certain doxa: information that has the righteous aura of believe it or not. You will learn, in Catharsis, for instance, that there are 82 distinct terms for different types and properties of the pulse listed in Dorland’s Medical Dictionary. There’s paradoxical pulse, there’s bigeminal pulse, there’s thread pulse, and so on.

The music in Catharsis begins, literally, with the heart beat, and goes through myth and personal experience – the case studies, patient’s whose histories are eccentric, revelatory – and science.
Before the Internet there was Indra’s net. There was as well Ananke’s – Ananke, the Greek goddess of fate. Although Goddess is not quite right – the net of fate was stronger than the Gods. This is the starting point.  The essays in Catharsis are oriented to the modern mythographerk, Roberto Calasso,k taking myth as a soundtrack, lifetrack, culturetrack. In the vocabulary and procedures of medicine,  Szczeklik sees a thousand ties to what lies outside the “science of medicine”. In order to see this, Szczeklik seizes on the terms and practices of the doctor, for instance the “anamnesis” – the name for the patient’s recounting of his history – which Szczeklik associates with Plato’s notion that memory precedes perception in the order of knowledge. In medical terms, the patient’s story precedes the doctor’s observation. The net in which all cause and effect is caught, where memory and observation converge, is what medicine is always going to be about, at least practically. Ethically – which is to say socially and politically – it is about catharsis, purification. 

“Some people have assumed that the text about katharsis in the Poetics has been amputated by an “unknown censor”; others have expressed the view that it was the subject of a separate, irretrievably lost essay. Some have even said in hushed tones that the Stagirite deliberately left the crucial issue of art open ended, because it eludes unambiguous intertpretation. Did he perhaps notatice that in the first syllable of the word he meant to define an ancient, unfathomed mystery lay spellbound? We fist find “Ka” at the beginning of the history of ancient Egypt as “one of the most difficult concepts for the Wewstern mind to grasp”. It was associated with the force that sustains life, the power of creation, and the soul of man. Centuries earlier, at the dawn of Hindu civilization, Kas was the name of the father of the gods, the life-giving element that pervaded the world. The god’s name Ka meant “Who?” – and the first reaction to it was “boundless awe”?”

This is the theme that links Szczeklik’s humanism to his Catholicism. It is a seductive idea that Szczeklik presents without presenting its opposite – something like Bataille’s notion that filth (can) make us free. Something like the feminist notion that the construction of the virtue of purity has participated in that original, Apollonian femicide. The anti-humanistic theme is not addressed or even very addressable from Szczeklik’s point of vantage. 

The strong tones that contrast pollution and purity slow down Catharsis as it travels from Paracelsus to modern discussions of, say, doctor assisted suicide, which prompts credal negations that are all the more disappointing in as much as we know the vast referential pharmacopiea that Szczeklik deals in earlier is dispensed with abruptly by references to Pope John Paul.
Still: I’d recommend this book to anyone looking for medical essays this plague season. It should be cut, I think, with the harsher diatribes of James Le Fanu’s The Rise and Fall of Modern Medicine, which I reviewed in 2001, here

Thursday, April 23, 2020

Is it like fun

“Is it like fun? Writing
was always hard hard for me, but I think I’d love love
to be a writer.” To be a poppy, though…
The green pod bending
the bristly, slim green stem, or
- “right right right, I bet it must be
like a fucking orgasm if like everybody reads
your book” -
how a stem shoots out from the others
mission creeps the pod forward which stick out horizontal
to the ground
rather than the stem bearing the curling weight of
those downward pods.
They are built for wind,
for distribution, for coverage.
Can one imagine
(“what’s the name of your book?”)
what they imagine if such things  flicker
in the green vegetative soul? A world of poppies.
A utopia of poppies.
Every flower is an aggressor.
- Karen Chamisso

Tuesday, April 21, 2020

what is herd immunity?

What is herd immunity?
A lot of old fights continue long after they should in science, if science were this instrument that the positivists extol. We are seeing one now, which is all about epidemiology and “herd immunity”.
It is worth noticing that the groups attacking epidemiology are using the same instruments that were honed in the fifties. In 1951, Doll and Hill, in Britain, published a famous epidemiology paper linking cigarette smoking to cancer. This was the first of a flood of studies linking the two. The cigarette companies, under the guidance of certain genius advertisers, found many a compliant scientist to batter against the whole idea of using the statistical models employed by Doll and Hill. These people made one of the most significant discoveries of the 20th century: in the interest of ideology and profit, you can legally obfuscate mass murder and get away with it. Thus, as cancers connected to smoking regularly swept away half a million peeps per year all through the late sixties, seventies, eighties, government did nothing but put warnings on cigarette packs. While Cold War scholars regularly brought up Lysenko to show how ideology crazily led to terror in Stalin’s Russia, they simply ignored these figures and this social phenomenon.
Their heirs have made it impossible for the world’s second largest economy, the U.S., to do the least thing towards averting the climate catastrophe we know is coming. And they are the same peeps who are behind the “let’s open the economy” crowd. Having those cancer deaths under their belt, the Corona-virus deaths will be as nothing.
One of the weapons that they bring to this battle is an unexamined notion called “herd immunity.” From the halls of George Mason University to the streets of Stockholm, this “mathematical model” is supposed to show that lockdowns are poopy ways of dealing with a minor problem.
So, what is herd immunity? A simple definition is that it is the resistance of a population to the invasion and spread of an infection. We should contextualize this definition – it arose from considerations of the level of vaccination needed to suppress an infection. Thus, for instance, they vaccinate against the hoof and mouth disease among cattle trying to firewall that disease so it does not have relays to get into the unvaccinated part of the population. There are new cows being born all the time, so there is, de facto, a new unvaccinated population coming into the picture. And the disease itself is evolving in relation to the vaccine, so that if enough of the population is not vaccinated it is possible that the evolution of the microbe will lead to resistance that overwhelms the vaccine.
Notice that all of these situations depend upon a vaccine. They also depend on the situations of the population, which can be determined by many factors. Among humans, sanitation and nutrition are pretty strong factors in the spread or suppression of infection. The percentage of the vaccinated in terms of the suppression of a disease can vary. For polio, for instance, Jonas Salk thought that an 85 percent level was needed. In practice, 70 percent was achieved in most countries, and even then there were occasional outbreaks. Still, by 2016, one of the most common oral poliovirus medicines was withdrawn, because it was no longer considered necessary. Still, other polio vaccines are in place and have been implemented in mass.
Compare this regime to the regime of having no drug to cure the disease. In this case, herd immunity means something like: the herd will be culled so that the resisters will survive. Or as George Scott said in Dr. Strangelove, I’m not saying our hair won’t be mussed, 15 to 20 million casualties tops!
The traditional method of fighting against infection, in the absence of a vaccine, has been quarantine. Quarantines are notoriously hard to enforce, since they require coordinated action by a large group of people, some of whom might find it in their interest to violate the quarantine. This is especially true if the population is composed of groups with different levels of vulnerability. This kind of thing is embodied in, say, infrastructure. In the late nineteenth century, many cities embarked on enormous and ambitious sewage projects, because sewage was a well known vector for disease. Though the wealthy had alternatives, they as a group were still vulnerable in cities, so they cooperated. Contrast this with AIDS, where one group is most affected, and a whole population can get by without too much worry about catching it. In this case, the vulnerabilities of one group can be seized by others as a political ploy, or they can be ignored, etc.
When we hear the comforting words, mathematically modeled, we have to remember that the modeling is only as good as the empirical data, and that is not very good. So far, mortality rates have differed considerably. Testing rates which are supposed to give us samples of the larger disease picture often end up giving us pictures of how much testing is going on – especially when we have wildly different samples.
What is brought into focus in these times of crisis is the expendability of a population in terms of the larger socio-economic system. In the 50s, when the AEC became aware that fallout was spreading a potentially lethal radiation load on a population located hundreds of miles from the bomb sites, they came up with a phrase that beautifully condensed the way established power thinks: the low use population. Indeed, is only a matter of time before some rightwing economist dances on the heads of all our dead parents and crows about the silver lining in terms of entitlement for all these old folks dying. Not to speak of the white settler offspring who have absorbed the idea that the virus has much more severe consequences in African American communities – communities that have seen their asset growth basically frozen or in decline from 2000 – and starts celebrating.
And this is the lesson of herd immunity in the C-Virus era: the herders don’t care.

Monday, April 20, 2020

The game of dress up: male novelists/female characters

Angela Carter once wrote that she read novels when growing up for, among other things, insights into being a woman. She read the English writers of the period – a period when Leavis’s “Great Tradition” – and naturally she read D.H. Lawrence – the Leavisite candidate for the truly great English writer (Virginia Woolf being bashed for snobbishness and Joyce for being not sound). As Carter writes, “I smelled a rat in D.H. Lawrence pretty damn quick.”

This does not mean she dismissed Lawrence as an artist. But he was the kind of novelist she wanted to pit herself against, moving aside that stone on the English novel – up to and including my quasi Christian metaphor of the stone being moved aside, the kind of resurrectionary theme Lawrence was all about.

One of her insights into Lawrence involves, well, the same problems that I think about when writing fiction with female characters. 

It has to do with dress-up.

If you read Raymond Chandler, you will notice that, for all of Marlowe’s tough guy gestures, he has the heart of a clothier, a Hollywood costumer. Take this from The High Window:

‘She was wearing a brownish linen  coat and skirt, a broadbrimmed straw hat with a brown velvet band that exactly matched the color of her shoes and the leather trimming on the edges of her linen envelope bag.”

Her linen envelope bag! The fetishizing aura overflows – as auras tend to – when we reach that fashion accoutred bag. Freud isn’t in it, brother.  How many of us know what an envelope bag even is? On the other hand, Marlowe is a product of Hollywood, no bones about it, so that we read these heroic descriptions without wondering too much about this information, as why does Marlowe even know about an envelope bag?

Lawrence, as Carter notices, is also indefatigably fussy about women’s clothing. For all that he was after an encounter with the dark gods buried in Etruscan vases, he was always going on about what his women were wearing. Carter has some great remarks about Women in Love, his “most exuberantly clothed novel” which  “furthermore, is supposed to be an exegesis on my sex,
trusting, not the teller but the tale, to show to what extent D. H. Lawrence personated women
through simple externalities of dress; by doing so, managed to pull off one of the greatest con
tricks in the history of modern fiction; and revealed a more than womanly, indeed, pathologically
fetishistic, obsession with female apparel. Woman in Love is as full of clothes as Brown's, and
clothes of the same kind. D. H. Lawrence catalogues his heroine's wardrobes with the loving care
of a ladies' maid. It is not a simple case of needing to convince the reader the book has been
written by a woman; that is far from his intention. It is a device by which D. H. Lawrence
attempts to convince the reader that he D.H.L., has a hot line to a woman's heart by the
extraordinary sympathy he has for her deepest needs, that is, nice stockings, pretty dresses and

Yet Lawrence clearly enjoys being a girl. If we do not trust the teller but the tale, then the
tale positively revels in lace and feathers, bags, beads, blouses and hats. It is always touching to
see a man quite as seduced by the cultural apparatus of femininity as Lawrence was, the whole
gamut, from feathers to self-abnegation. Even if, as Kate Millett suggests, he only wanted to be a
woman so that he could achieve the supreme if schizophrenic pleasure of fucking himself, since
nobody else was good enough for him. (The fantasy-achievement of this ambition is probably
what lends Lady Chatterley's Lover such an air of repletion.)

I’m sure that my own games of dress up, as much as I research them and try to think of the clothing in terms of the choice of the wearer rather than the judgement of the observer, as much as I agonize over the style of the clothing and the styling it evidences, are cons as well.  On the other hand (he said, defensively)  the way my male characters dress is, as well, a bit of a con, in as much as these are fictions. Clothing is so helpful because it is, as well, a an attempt to fictionalize – wearing clothes might warm us, but it also shields us, helps us stagemanage our bodies, gives us a feeling of being ourselves as characters.  It is true, often, that there are breakdowns in the clothing game in fiction. To give a movie instance – I just rewatched  Terminator (yes, this lockdown is dragging) and the Schwarzenegger character successfully clothes himself in pants and shirt that come from a person maybe four sizes smaller than him, without ripping, while the human from the future – I forget his name – steals trousers from a drunk tramp without noticing once that these trousers are well pissed in. They even fit him, the human from the future, I mean.

This is supremely not having an eye for clothes, and it is unusual in a Hollywood film.

The clothing option doesn’t necessarily make the character. I can know and feel many of Dostoevsky’s characters without remembering his descriptions of their clothing, because they are perfunctory – unlike Tolstoy’s, or Lawrence’s. That is the deal with characters, male or female, and what they wear – wearing is meaningmaking. I think that we go from the clothing in when we make characters. I don’t think of my female characters, oddly enough, as naked. And that is perhaps a fault. God, as he made abundantly clear in Genesis, definitely meant us to be naked.

“Who told you that you were naked?” asked the LORD God. “Have you eaten of the tree from which I commanded you not to eat?”

And thus the Lord God learned that his characters do have their own lives.    

Sunday, April 19, 2020

Why the Labour party should split up

The leaks about the Labour party that came out last week have been, I think, largely overlooked, partly because the same media that sympathized with overturning Corbyn and collaborated on the project doesn’t really want to revisit the story. But it is definitely an exemplary story.
The leak shows that the rightwing of the party – the third way people, the Blairites – spent much of their time in the election against Theresa May, which Corbyn just missed winning, doing things like dissing black members of the party, knowingly diverting and wasting party funding, and goldbricking in order to bring about a Tory victory. The thinking was, the Tory victory would then overthrow Corbyn.
Now, every leftist is, by nature, paranoid, for good reason: if you attack powerful forces, it is common sense to think they will attack you back and operate in the sneaky ways they have operated to get, say, tax breaks and shit. But the whole Corbyn moment was premised on the idea that Labour is still a viable party for the left.

In America, this is often viewed in terms of… America. American provincialism, right? So that Labour is the Democratic party, the Conservatives the Republicans, etc. However, this seems to absurdly de-contextualize Britain, which, in spite of its Brexit, still has more similarities, as far as its political system goes, to a European country than to the U.S. In Europe, over the past twenty years, we’ve seen an enormous breakup of the Left. In France, the Socialists have simply disappeared. In Germany, the SPD is now on par with the Greens. In Italy, the Communists metamorphosed into many combinations, all of which packed a smaller and smaller political punch, until the ultimate Third Way politician, Matteo Renzi, a historic failure.

In Britain, the context is rather similar.  Colin Kidd in the LRB in 2012 has argued that Labour without Scotland would be a permanent minority party, and that divorce from Scotland has come to pass. Ross McKibben at the same mag pointed out that Labour dropped from 54 seats in Scotland to 1 in 2015.  Just last week, a Guardian columnist, Andy Beckett, pointed to the ten year run of Tory rule and asked, justly, whether Britain had turned into a one party “democracy”, like the Christian Democrats in postwar Italy.
All of this poses a question: if the center right is so ardent about keeping its Blairite claws into Labour,  and if Labour has no map to victory for the foreseeable future, why continue to contest possession of a moribund property? Why not start a separate party, a Corbynist party, using Momentum’s infrastructure to begin with?  Parties do die. Or evolve into something totally different. Corbyn’s moment in the Labour party looks more like the last hurrah for a once vital Labour left than the future.

One can easily imagine the realigments that would take place while the Tories rule for the next decade, as looks most probable. A green-red coalition with a British Left party – a Center coalition between a Blairite Labour party and the Lib-Dems – and the dominant Conservatives, sometimes allied with various ephemeral fascist parties.

Of course, I am discounting one of the major realignments that could well happen: the further split up of the UK, as Scotland becomes independent and Northern Ireland votes to reunite with Ireland. One thing seems probable to me, though: Labour is dead as a vehicle for the “left”. It will never happen.

The ethics of integrity or the Baker at Dachau

    Throughout the 19th and 20th century, one stumbles upon the lefthand heirs of Burke – Red Tories, as Orwell called them. Orwell’s inst...