Stagger onward rejoicing

Tag: health (page 1 of 1)

Prologue to an Anti-Therapeutic, Anti-Affirmation Movement:

As a leftist, my core political assumption is that we are all responsible for each other’s material well-being, that we have a duty to build the kind of society where everyone’s basic needs are met, where everyone enjoys a certain degree of material comfort, and where our rights are respected equally regardless of race, religious, sexual and gender identity, ethnicity, or creed. That is the kind of mutual caring that I signed up for when I became politically conscious as a teenager. I never signed up for a vision of a society that helps everyone out there to constantly feel valid, mostly because society could never achieve such a thing. Nobody walks around feeling good about themselves all the time! Where on earth did people get the idea that human beings are meant to enjoy a permanent sense of mental security and social validity? That’s a totally unworkable and in fact quite cruel standard. If you want to be good to yourself, I suggest that you stop expecting society to be your therapist and go see licensed medical professionals in private to address the issues in your life that are appropriately treated that way. And if you want to be good to your society, I suggest you help to defeat the medicalization of everything, the casualization of the concept of trauma, the celebration of mental disorders, the assumption that everything that makes us unhappy is an injustice, the insistence that all conflict is abuse, and the infantilization of the human animal. That’s the best way to help. 

One of Freddie’s best posts ever. 

Megan McArdle, arguing that trying to use social media’s moderators to crack down on misinformation isn’t a good idea:

For one thing, moderators aren’t good at determining what constitutes actual misinformation. A lot of the dangerous nonsense about covid that circulated on social media came from the same public health experts social media companies were using as arbiters.

It was public health experts who initially told us masks don’t work, an assertion they knew to be false. It was public health experts who insisted, without good evidence, that covid wasn’t airborne. And many public health experts helped support prolonged school closures that have been proven to undermine learning.

That is not to say that public health experts are the moral or intellectual equivalent of quacks peddling balderdash about vaccine side effects. The public health community eventually recognized its most egregious errors, while the quacks doubled down. But free and open debate on social media assisted that process of course correction, and cracking down on what the experts then deemed false information would actually have slowed the pace of adjustment.

Michelle Nijhuis:

Speakers of Luganda, the most common indigenous language in Uganda, don’t have a word for “depression.” They use the terms yo’kwekyawa and okwekubazida, which roughly translate as “self-loathing” and “self-pity” and describe two distinct conditions; the former, which can include thoughts of suicide, is considered more severe. In Zimbabwe in the 1990s, researchers learned that the local Shona language had one word for everyday sadness (suwa) and another for a persistent, ruminative state that fit the clinical description of depression. This term, kufungisisa, which literally translates to “thinking too much,” unlocked communication between practitioners and patients.

In the early 2000s the Zimbabwean psychiatrist Dixon Chibanda recognized that his rural patients, many of whom were severely stressed by poverty and the multifold impacts of the HIV epidemic, were dying from a lack of mental health care. He recruited a corps of rural community members, predominantly grandmothers, and trained them to conduct informal therapy sessions with their neighbors on open-air “friendship benches.” In clinical trials, the grandmothers and their benches proved to be so successful in relieving the most incapacitating symptoms of depression that the approach has since spread to Kenya, Botswana, the Caribbean, New York City, and elsewhere.

refugees from human nature

Matthew Loftus:

Our communities and households must be active in reaching out to those whose lack of virtue, tradition, or culture is harming themselves and others, the countless refugees from human nature that technological destruction is creating. This of course includes political refugees fleeing climate change or violence, many of whom probably have a thing or two to teach us about human nature, but far more often it includes the people in our neighborhoods, towns, cities, and counties whose capacity for flourishing has been decimated by the forces conservatives love to decry but rarely have a strategy to do something about. Going from “a rearguard defense of tradition to take up the path of the guerrilla” means that we are no longer protecting “ourselves” from “them”, but trying to help the most of vulnerable of them become one of us. 

As Loftus wrote in an earlier essay

This is not simply a matter of the rich and powerful sacrificing for the sake of people in poor urban communities. It is also not a matter of poor urban communities since many rural places and even many suburban places need more good neighbours working with local churches. But we need to come to terms with the fact that exercising ourselves in service and challenging ourselves by frequent, intimate exposure to another culture’s expression of faith is a means of discipleship. It also a testimony to the watching world that Christ’s sufficiency transcends our cultural impetus to protect ourselves from “those kinds of people.” We don’t need an elite corps of radical Christians, we need faithful believers with power and privilege to simply spread out and join with brothers and sisters who don’t have the same resources we do.

Good heavenly days, this is a challenge.

I want to return to these thoughts in a couple of months, when an essay of mine appears: I’ve written for The New Atlantis about the fiftieth anniversary of Oliver Sacks’s book Awakenings

Also, I’ll have more on “the path of the guerrilla” in another post. 

Andy Crouch:

What I say to students is, you are not unhealthy people in a normal world, despite these statistics that show how anxious, lonely, and depressed young adults are. What you are is normal people in an unhealthy world. It’s not healthy to be anxious, lonely, and depressed, but it is a natural response to a world that is not asking you to become anything, and is not giving you confidence that you can overcome difficulty — one that’s dissociating the different parts of you, compelling you to spend a good part of your time with your body disengaged and your mind occupied. It’s totally understandable that our young people are experiencing such distress, because the world we’re asking them to live in — this world of easy everywhere — this world of superpowers, is not good for them. It would be very odd if, in this world, people were doing just fine. It’s not at all surprising that they’re struggling and feeling disconnected. 

You can be almost certain that people who sneer with ready contempt at today’s college students don’t spend much time around them. Our young people have been given a raw deal, and most of them play it better than we have any right to expect. And the ones who don’t? They’re twenty years old. How put-together were you at age twenty? 

universal neighborliness

Re: my earlier post on an Ezra Klein column, I want to add that the universality of Christianity takes a very peculiar form, because it is a universality that also emphasizes neighborliness, a particular care for those who are nearby. Thus Matthew Loftus:

We cannot love “the whole world” except in abstraction, nor work for the mutual benefit of everyone in the same way that we can take care of our children or our sick neighbor. We must not fail in our duties to those close to us, even if our love ultimately does not stop there. Only by honoring the relationships that we have with others based on our common humanity and our common interchanges of trade and culture can we honor the God who created those people and places. Our local affections will have universal implications for how we use technology, farm the land, and execute trade. And in the global realm as well as the communal, love and sanity require limits.

I have forbidden the use of the EMR [Electronic Medical Records] in my mental health clinic at the hospital, at least for now. As I scribble my notes on paper, I look to the parent, sibling, child, or friend who has accompanied the patient to the clinic. When I ask how well the medications are working, sometimes the patient will say they are fine while their companion smiles and tells me the truth. Rarely do patients come alone; some friends or family members pay a day’s wages for an hour-long bus ride to the hospital to accompany their suffering loved one. I like to think that no one in our hospital suffers alone because the cultural ethos here forbids it. 

Please do read the whole thing. But this is key: “Our local affections will have universal implications.” And, conversely, our universal commitments will necessarily have local instantiations. 

I think Charles Dickens understood this paradox very well, as we see in the greatest of his novels, Bleak House. There we note Mrs. Jellyby practicing her “telescopic philanthropy” — meditating always on the suffering of the people of Borrioboola-Gha while utterly neglecting her own children — and the “business-like and systematic” charity of Mrs. Pardiggle. As Esther Summerson says, “Ada and I … thought that Mrs. Pardiggle would have got on infinitely better if she had not had such a mechanical way of taking possession of people.” When pressed by Mrs. Pardiggle to join in her “rounds,” Esther has a profound response (even if Mrs. P can’t grasp the import of it): 

At first I tried to excuse myself for the present on the general ground of having occupations to attend to which I must not neglect. But as this was an ineffectual protest, I then said, more particularly, that I was not sure of my qualifications. That I was inexperienced in the art of adapting my mind to minds very differently situated, and addressing them from suitable points of view. That I had not that delicate knowledge of the heart which must be essential to such a work. That I had much to learn, myself, before I could teach others, and that I could not confide in my good intentions alone. For these reasons I thought it best to be as useful as I could, and to render what kind services I could to those immediately about me, and to try to let that circle of duty gradually and naturally expand itself. 

Words to live by, say I. And let me conclude with words still wiser, from Helmut Thielicke’s great sermon on the Parable of the Good Samaritan: 

You will never learn who Jesus Christ is by reflecting upon whether there is such a thing as sonship or virgin birth or miracle. Who Jesus Christ is you learn from your imprisoned, hungry, distressed brothers. For it is in them that he meets us. He is always in the depths. And we shall draw near to these brethren only if we open our eyes to see the misery around us. And we can open our eyes only when we love. But we cannot go and do and love, if we stop and ask first, “Who is my neighbor?” The devil has been waiting for us to ask this question; and he will always whisper into our ears only the most convenient answers. We human beings always fall for the easiest answers. No, we can love only if we have the mind of Jesus and turn the lawyer’s question around. Then we shall ask not “Who is my neighbor?” but “To whom am I a neighbor? Who is laid at my door? Who is expecting help from me and who looks upon me as his neighbor?” This reversal of the question is precisely the point of the parable.

Anybody who loves must always be prepared to have his plans interrupted. We must be ready to be surprised by tasks which God sets for us today. God is always compelling us to improvise. For God’s tasks always have about them something surprising and unexpected, and this imprisoned, wounded, distressed brother, in whom the Saviour meets us, is always turning up on our path just at the time when we are about to do something else, just when we are occupied with altogether different duties. God is always a God of surprises, not only in the way in which he helps us — for God’s help too always comes from unexpected directions — but also in the manner in which he confronts me with tasks to perform and sends people across my path. 

P.S. I meant to schedule this to post tomorrow – sorry for all the stuff in one day. If I don’t post anything for the next day or two, just read this post several times. It’ll do you good. 

Leah Libresco Sargeant, in a post called “Defining Human to Leave Out Almost Everyone”:

Wrinkles are what a person looks like if they’re lucky enough to grow old. Physical weakness is part of who we are at the beginning and end of our lives, and, especially for the chronically ill, for large parts of the middle. And, as Richard John Neuhaus points out in Death on a Friday Afternoon, we can’t strike the normal progression of life out of our definition of humanity.

It has always struck me as puzzling that some people say that an embryo or a very small fetus does not look like a human being. That is exactly what a human being looks like when it is two weeks or two months old. It is what you looked like and what I looked like.

The restitution narrative treats suffering and dependence as an unnatural state—a privation of something that we rightfully have. But (to paraphrase Hamlet) the thousand natural shocks are what flesh is heir to. The lively health we experience for a time as teenagers and in our early twenties is not the way our bodies will work for the rest of our lives. It is not what we had at the beginnings of our lives. We do better with a supportive culture for all persons and capacities, rather than an expectation we’ll sustain that sort of strength forever.

R.I.P. Paul Farmer

I am absolutely gutted to learn of the death of Paul Farmer, the only contemporary, I believe, that I have called simply My hero. He fought the long defeat, and he fought it brilliantly. What devastating news. What a loss for the world.

UPDATE: Here is the first thing I ever wrote about Farmer, thirteen-plus years ago. I still believe every word.

Rest in peace — and well done indeed, thou good and faithful servant.

the beginning of politics

Leah Libresco Sargeant on an “illiberalism of the weak”

To give an honest accounting of ourselves, we must begin with our weakness and fragility. We cannot structure our politics or our society to serve a totally independent, autonomous person [which is the person imagined by liberalism] who never has and never will exist. Repeating that lie will leave us bereft: first, of sympathy from our friends when our physical weakness breaks the implicit promise that no one can keep, and second, of hope, when our moral weakness should lead us, like the prodigal, to rush back into the arms of the Father who remains faithful. Our present politics can only be challenged by an illiberalism that cherishes the weak and centers its policies on their needs and dignity. 

This is a strong and vital word. But genuinely to hear it we will have to dethrone the two idols that almost everyone with a political opinion worships: My People and Winning. The goal of almost every political activist and pundit is the same: My people must win, and those who are not my people must lose. Do not be deceived by talk of the “common good,” because the often quite explicit message of the common-good conservatives is: My people are the ones who know what the common good is, and that common good can only be achieved if my people win. A politics of weakness and dependence, a politics of bearing one another’s burdens, can only begin when those two idols are slain. 

UPDATE: Rowan Williams, from a review of God: An Anatomy, by Francesca Stavrakopoulou: 

Stavrakopoulou … takes Hans Holbein the Younger’s famous picture of the dead (and prematurely decaying) body of Christ as illustrating the way in which Judaeo-Christian orthodoxy ends up in a conspicuously unbiblical position, presenting human bodies as “repulsive” (her word), unfit to portray the divine. But – apart from the fact that in Holbein’s lifetime the glory of the human form as representing divinity was being reaffirmed by artists in southern Europe as never before – the point of a picture like this, or of any other representation of the torment and suffering of Jesus, was to say that “the divine” does not shrink from or abandon the human body when it is humiliated and tortured.

In contrast to an archaic, religious sacralising of the perfect, glowing, muscular, dominant body, there is a central strand in Jewish and Christian imagination which insists that bodies marked by weakness, failure, the violence of others, disease or disability are not somehow shut out from a share in human – and divine – significance. They have value and meaning; they may judge us and call us to action. The biblical texts are certainly not short of the mythical glorifications of male power that Stavrakopoulou discusses; but they also repeatedly explore divine solidarity with vulnerable bodies, powerless bodies. Is this a less “real” dimension of the Bible? Even a reader with no theological commitments might pause before writing it off.

Christians and the biopolitical

Matthew Loftus:

Christians must develop and encourage practices of suffering that accompany those in pain, like Simon of Cyrene carrying the cross during Christ’s passion. The ethical imperatives of the Church are only intelligible to a watching world to the degree that Christians are willing to walk alongside those who suffer and bear their pain with them. Without these practices of accompaniment, Christian moral teaching about issues like abortion or assisted reproductive technology is a cold set of rules enforced by people who have the privilege of not having to bear their cost. It is through these experiences — and not just experiences with those who forsake an accessible but immoral technological intervention, but also accompaniment with the poor, the imprisoned, and those whose suffering cannot be relieved by any human means — that Christians are able to experience growth through suffering and acquire the perspective from below that shapes their advocacy for those who need the work-towards-shalom the most. 

A powerful essay. 

The themes of that essay do not immediately seem directly related to the themes of this interview with Loftus, but I think they are. Responding to claims by some doctors that we should ration Covid care to favor the vaccinated and disfavor the unvaccinated, Loftus, himself a physician, says, 

I think it is a matter of justice not to ration care away from the unvaccinated, because to do so, I think, is to pass a judgment on someone’s other personal health decisions that we would never apply in any other case. All health care is a mixture of trying to provide justice while also being merciful to others. It’s impossible to be a good health-care worker and not be willing to be merciful with people who, quite frankly, got themselves into the trouble that they’re in and had many opportunities not to do so. But it’s also a matter of justice in giving that person what they need to survive or, if not to survive, to die in a way that honors the person they are. 

Loftus is pointing here to a version of what Scott Alexander, in one of the more useful ethical essays I have read in the past decade, calls “isolated demands for rigor.” When doctors treat people for health problems that arise from obesity, they don’t withhold care until they learn whether those people have some kind of genetic predisposition to obesity or are fat because they eat at McDonald’s every day — they just treat the patients. Oncologists don’t give better treatment to lung cancer patients who smoke less or don’t smoke at all. We only think to subject the unvaccinated-against-Covid to that kind of strict scrutiny because the discourse around Covid has become so pathologically tribalized and moralized. 

But Christians in particular have a very strong reason not to employ such strict scrutiny: We believe in a God who sought out and saved “people who, quite frankly, got themselves into the trouble that they’re in.” In an earlier reflection on this general subject, I mentioned Eve Tushnet’s wise comment that “mercy to the guilty is the only kind of mercy there is.” The rationing of medical care away from the unvaccinated is structural mercilessness. It is anti-shalom

The Deep Places

I’ve just read Ross Douthat’s forthcoming memoir The Deep Places and it is truly exceptional: a vividly narrated account of his disorienting spiral into chronic illness, and of his eventual recovery. (Not quite a complete recovery, I take it, but nearly so.) Ross manages a really remarkable thing here: to weave together his story of a body’s pain, a mind’s vacillations, and a spirit’s struggles with an account of how the medical establishment deals with, or simply refuses to deal with, conditions it does not understand — and, as if all that isn’t enough, an account of how, in response to the establishment’s failures, sufferers form communities that sometimes carry them to healing and at other times take them down long paths of confusion and illusion. That Ross can weave all this into a unity and even make the book a kind of page-turner — that’s something special.

Let me close by pointing out one more layer of meaning: Ross’s illness happened to him in an era of self-presentation through social media — an almost universal phenomenon, yes, but one that’s intensified for public figures like Ross. I’ll end with this passage from the book, in which Ross discusses meeting, during his various professional travels, a kind of hidden nation of sufferers, most of whom were rather older than him:

There was comfort there, of a sort: I was just living under a storm front that had rolled in a little early. But there was also a feeling of betrayal, because so little in my education had prepared me for this part of life — the part that was just endurance, just suffering, with all the normal compensations of embodiment withdrawn, a heavy ashfall blanketing the experience of food and drink and natural beauty. And precious little in the world where I still spent much of my increasingly strange life, the conjoined world of journalism and social media, seemed to offer any acknowledgment that life was actually like this for lots of people — meaning not just for the extraordinarily unlucky, the snakebit and lightning-struck, but all the people whose online and social selves were just performances, masks over some secret pain.

the wait

This piece by Don McNeil (which in a sane world would have appeared in the New York Times, but that’s another story) is a sobering reflection on just how chaotically incompetent the vaccine roll-out is here in America. People are getting vaccinated, to be sure — my wife being one of them, thanks be to God, because she has a medical condition that would make contracting covid-19 very dangerous indeed to her. But it’s happening in a way that seems almost random. As McNeil points out, being a frat boy appears to be a qualification for getting vaccinated; but I, teacher of frat boys, don’t have a snowball’s chance in a Texas summer of getting the jab. I’ve been teaching students in person for almost an entire academic year, and that doesn’t factor into anyone’s calculations. I fully expect to be the last person in America to be vaccinated against covid-19 — I mean, assuming that I don’t get the disease itself. 



IMG 0206

I wrote a post about love and death.

UPDATE: A helpful comment from my friend Tim Larsen about people  who think as Ezekiel Emanuel does: “They also don’t seem to mention that an awful lot of people have worked very hard, quite unpleasant jobs their whole ‘active’ lives and have earned a bit of play and rest.  Maybe if your career is being a cultural critic you think it would be a step down to give it up to play shuffleboard or dominos, but if you cleaned hotel rooms for 47 years, it presumably looks rather different.”

unmanly emotion

In my squandered youth I was a friend of Ian Hamilton, the biographer of Robert Lowell and J. D. Salinger and a justly renowned figure in London’s Bohemia. His literary magazine The New Review was published from a barstool in a Soho pub called the Pillars of Hercules, and editorial meetings would commence promptly at opening time. One day, there came through the door a failed poet with an equally heroic reputation for dissipation. To Ian’s undisguised surprise, he declined the offer of a hand-steadying cocktail. “No,” he announced dramatically. “I just don’t want to do it anymore. I don’t like having blackouts and waking up on rubbish dumps. I don’t like having no money and no friends, smelling bad and throwing up randomly. I don’t like wetting myself and getting impotent.” His voice rising and cracking slightly, he concluded by avowing that he also didn’t like being repellently fat, getting the shakes and amnesia, losing his teeth and gums, and suffering from premature baldness. A brief and significant silence followed this display of unmanly emotion. Then Ian, fixing him with a stern look, responded evenly by saying, “Well, none of us likes it.”

Christopher Hitchens