More thoughts reading Rosen
Like a recurring bad dream - you’re in a waiting room, but why? it smells of sweat and damp, you just sit and hope your number gets called, you awake angry that before your day of having the time of your only life be siphoned off in fifteen minute increment you’ve had the same happen during sleep, which could be a time of experiences of fanciful freedoms like flying or eating telephone-flavored ice cream and at the very least should be just a time of temporary lack of forced boredom - I return without warning to your inbox and/or browser. Sorry gang! Stop me before I post again, I guess?
Anyway I had another half thought while reading this Rosen book on the history of public health and, frankly, getting bored by some of the details, and I figured I’d type it up. With the book the issue is partly just that I'm tired, impatient, indisciplined, plus agitated by life in a hellscape (do you find, fellow second class passengers, that the screams from steerage come through the walls of your cabin too? we should petition the captain about this). Part of where I'm getting bored though is in those passages that are descriptions without analysis or are like 'cool, an improvement, hopefully there will be more of those too.' To be fair there is a lot that's very good in the book and I really am learning a lot, but some of it's uncritical, so to speak, and I'm frustrated with that. It's also very annoying that sometimes frustration is engine for new thoughts. (You know that thing where thinking takes work...? I hate that thing!)
So here's my current thought, which I worry is obvious or inert or both, and which is pretty speculative since I'm an ignoramus. Anyway: public health as a field, in its professional knowledges and related activities and institutions, is a political project of trying to influence and manage how capitalist social relations are lived out by other people. Its stakes and direction aren't given or fixed - they're determined by struggle in the field, in response to struggle and other developments outside the field - but there is an upper bound, a ceiling. That ceiling is there by virtue (vice!) of the fact that public health can't suppress capitalist social relations - the field's scope of possibility is always a scope bounded by capital - so the best possible outcome is always some version of capitalism, and all such versions impede human flourishing and actively harm some people.
That's all about achievable outcomes - politics as vision of desired world or something like that. There's also the matter of how outcomes of any sort are achieved - politics as the active doing of pursuing some desired world. (This is probably just repeating things I say in my social murder chapter but whatever.) This is to say that I think in addition to a problem of mostly having system-compatible goals (thus leaving off the table the solving of pathologies that require massive sheltering of some social domains from capital's logic - ie, providing massive freedom or democratization in some are of life - let alone the pathologies that require abolishing capital), there's also a problem of system-compatible comportments: in upward-facing direction, this means making cases to authorities as part of requests for resources ('truth to power' as the phrase goes); in downward-facing direction, this means a mix of giving information to people about actions they can take in their own sphere of influence ('smoking is bad for you! exercise is good!'), organizing people to participate in legitimate institutional channels for political action ('call your senator!'), and governing over people in coercive and condescending ways sometimes in cooperation with other institutions ('to keep your WIC benefits it's time for your quarterly lead screening!')
I see much of this as analogous to or as another version of what I think is the basic dynamic with the labor movement as shaped by labor law (I've written about this over at Organizing Dot Work, Open Mode completionists must be tired of hearing me say that!) and with electoral approaches to socialist politics, which I am at present thinking of this way: sometimes working class populations are represented among those with some governing authority in society. That representation tends to be effect of large scale disruptive collective action, and furthermore that representation tends to be conducted in ways that supplant collective action - ie, the mode of politicking becomes the action of representatives (at best, and I think often justified as, the actions of your representatives is your action as mediated via institutionally valid actors), which at best doesn't draw on capacities for collective action and at worst causes those capacities to atrophy and participates in actively policing those capacities into further reduced existence. That representation is often of limited use in delivering gains even within the limited bounds of capital-compatible possibilities - direct action gets the goods, as the old slogan goes, and representation displaces direct action - let alone for delivering things that are above the ceiling set by capital.
None of this is to say 'fuck public health!' (or down with the labor movement!'), it's to say that the higher aspirations of the field and a great deal else about the field are contradictory or in tension with each other, and that eventually - often sooner than later - people face hard choices over in-field success vs service to those highest aspirations. (I suspect that well meaning people who become vehicles for the dominant ideology are often people who flinched in the face of those hard choices, which is pretty understandable unfortunately, as part of life in the hellscape - no one in a decent cabin wants to get demoted down to steerage, let alone tossed overboard. And of course no one wants to think about any of this, which is part of why there are a lot of resources that facilitate action without much thinking, ie, for preventing unwanted and distressing self-awareness/self-contextualizing/self-reflexivity. I suspect that one could use the account of basic ideological dispositions - fear, resignation, etc - in Goran Therborn's book on ideology to flesh out ways people in tension-laden positions of institutional authority learn to live with this stuff, whether consciously or unconsciously.) Ultimately really serving those highest aspirations for human flourishing means action out of the ordinary by ordinary people and relatively unprofessional activities of siding with that action.
Having typed that out the thought bubbles up in the back of my mind that, conveniently, some of my other preoccupations - longstanding and inadequately pursued interest in the tradition of British socialist humanism in the late 50s/early 60s during the UK's first new left, and recent, likewise inadequately pursued (it's hard enough just finding out the names of stuff that's it a good idea to read, let alone actually reading it! I got a job, and kids, and I need to exercise a little, not to mention listening to records and playing guitar occasionally and staring in horror...!) interest in Negt and Kluge's book on proletarian public spheres tied in part to William Paris's use of it in his article on what critical theory has to do with emancipation - are relevant here and worth trying to both get back to and connect with this stuff. Specifically, part of what I'm suggesting in this lil post o' mine (it's a guttering, faint, smoky light but I do let it shine, however shamefacedly - a life lived at the dimly luminescent intersection of ‘can’t stop, won’t stop’ and ‘can’t go on, must go on’ I guess?) is that there is a larger subjective context of collective action, political activity, what have you, that's necessary for any effective and significantly left role of public health (ditto the labor movement and anything else really - I sort of alluded to this in my essay for Labor Online about our screening of Matewan as part of our efforts in the ILHS).
I dunno that I'm using the terms right here (I'm only in the translator's or editor's intro to the Negt and Kluge book) but whatever, thought needs terms even if inadequate and to be discarded in the future for better ones… ANYWAY… for now - radical public health requires the existence of a proletarian public sphere and a disciplined relationship to it. Contributing to constructing and maintaining that, participating in it, etc, is likely to be under resourced and underappreciated at first, I mean by those in power specifically, but one might be able to walk a line while such efforts are at fledging stage. I've used this metaphor for a while re: the labor movement, I think it applies more generally. Collective action is fire. Institutional representation is a gas stove. The stove supplies helps fuel fire, channel it to make it useful for instrumental purposes, contain it, and put it out, each of those depending on the context. Pardon the mixed metaphor (or don't! I have no right to be forgiven! Catholic education lingers a lifetime) but when the fire of a proletarian public sphere gets beyond fledgling stage the powers that be then will not look kindly on professionals who participate in that sphere. To put it another way, early on it may be possible to be have a disciplined responsible relationship to a proletarian public sphere and also to act in the imperatives of a job. If things are going well politically, in a far left sense, squaring those two things will get rockier. For now, I think, fortunately in a personal sense and unfortunately given what it means in terms of the hellscape and its body count, the political tasks are largely those 'early' ones of trying to construct proletarian public spheres and relate to/act within/serve them in virtuous/disciplined ways. Many miles to talk, feet will only get more sore, but no other option. Well, no BETTER option.
Alright that’s it for now. Keep on trucking, friends! Over and out.