Medical Nemisis (or: if you don’t stop it’s going to freeze that way)

I recently came across reference to Ivan Illich’s 1975 Medical Nemesis, in which he discusses the effect of the assumptions and processes of contemporary medicine on social and personal views of the body; including those of “alternative medicine”.

While it is widely accepted that the leading cause of death in the United States is that of modern medical practice as shown by recent studies, this was not the focus of Illich’s concern. It was, rather, the corrupting effects of the authority of institutions and of the economic culture of the West on our intuitive and conscious understanding of ourselves as entire beings.

Illich expressed concern over the medical establishment’s technological widening the mind-body split engendered by Descartes. Medicine’s technologically determined diagnoses result in the fragmentation of our physical and mental states into discrete “syndromes”.  We begin to see ourselves as units of systems-based, technological datum. We distance awareness of our messy, chaotic bodies and our ever shifting consciousness from that of the pure “self”.

When we are able to so completely fragment the “self” from our bodies, sensations and emotions detachment becomes the default in understanding the self and others. The logical endpoint is that it becomes increasingly easy to distance one’s self from the other and their lived experience; as we cannot truly see them as human. We see them instead as a distinct collection of physical and emotional syndromes, rather than someone who is experiencing a state of “dis-ease”. For example: we understand that Ms. X has diabeties with PTSD and varicose veins. Or Mr. Y has a urine fetish, high blood pressure and presents as an INTJ on the Meyers-Briggs personality scale.

I have long held a less than positive view of current medical establishments. They are literally “dehumanizing” in their practices. And while individual physicians, psychologist and other assorted professionals may have the best of intentions toward individual patients, they are overwhelmed and often overruled in their best efforts by corporate interests. Whether it’s the institution they work for directly or from for-profit insurance interests.

People, being binary thinkers, often assume this means I am in wholly in favor of “alternative medicine”. To put it succinctly, no. Any practice that partitions the “self” into parts is suspect. This includes allopathic medicine, psychology, psychiatry, some alternative medical practices and some specific religious and intellectual practices.

In America, much of popular alternative medicine is focused on the “filth” of the body, the “parasites” it harbors and on the entirely natural process of aging. The colon as a focus of anxiety is a holdover from John Harvey Kellogg in the last century’s version of alternative medical practice. Kellogg popularized fiber as a way to cleanse the colon and enemas to remove fecal remnants that were surely, in his view, pollutants and the cause of almost every physical and mental distress experienced by the body.

Anxiety over fecal material is normal, as it can cause severe and widespread illness if mishandled. But anxiety over the feces itself transferred to the body as a permeable container of feces, in particular the colon. So we continue Kellogg’s regimen of fiber, chemical laxatives and various types of enemas in the hopes that we will be able to rid our colon, our liver and other digestive functions, as things separate from us, from the degrading filth that contaminates “us” by proximity.

The embracing of food as “nutrition” creates the same dissonant separation of essence and esse. We don’t enjoy meals; we “get our carbs”, we ingest “fuel”. We take great care to incorporate regulated and discrete units of vitamins, minerals and other nutrients, which are seen as somehow superior to the delivery systems that are merely “food”. People develop unhealthy aversions to aspects of nutrition that are vital to our well-being. Fat, for instance, has become an epithet. So people develop an almost phobic reaction to any food which incorporates fat. Little do those people realize the major source of nourishment our brain cells utilize to communicate is a type of fat called cholesterol.

The other “disease” that is of primary concern in alternative medicine is aging. Yes, getting old is considered a disease. The post-war generation, popularly known as “Boomers” has so thoroughly embraced the Youth Culture ideal, that the entirely normal physiological process of aging has become, to them, a thing perverse and unnatural.

In their initial response, allopathic medicine placed their focus on gerontology and on coping with the slow systemic breakdown of older patients. Popular alternative medicine, being more responsive to the marketplace, developed a host of dubious processes and products designed to forestall time and entropy.

With more and more of their patients demanding a cure for the process of time, medical practitioners likewise, have moved their profit centers into plastic surgery, liposuction, joint replacement and other procedures related to “reversing” the aging process. Rather than finding an adaptive, creative response to the inevitable changes aging brings, both the patient and the physician find it more expedient to fracture the body; replacing the offending parts wholesale. Either that or physicians offer isolated chemical solutions to discrete aspects of a larger, individual process. This approach is not only lucrative for the physician and the attending corporate interests; it relieves pressure from patients insistent on a “cure”. In the end, it allows patients to feel some illusory measure of control over a process they have come to see as “unhealthy” and separate from themselves.

This separation also occurs in scientific fields addressing cognition and in the disciplines of psychiatry and psychology. We are taught to view conscious and unconscious processes as lacking integration with that which we consider “us”.  We have compulsions, we have disordered thinking, we have splintered personalities; as if these are things we hold or discard at our leisure. It is a convenient way for practitioners to discuss a syndrome or disease. But, by the shortcomings of language, it creates a crippling distance between a particular state of being and the person experiencing that state. This separation discourages understanding of the useful, functional aspects of a particular cognitive process and impedes progress in coming to an integrated resolution to a client’s “dis-ease”.

Within this framework, the fracturing and forced separation of the aspects of self are implicate in the current divide between those who view rational, scientific and critical understanding as completely separate and distinct from those favoring intuitive, spiritual and unconscious knowing. This simply parses a whole consciousness into discrete and segmented units. Cognitive modalities like religious fanaticism and skepticism as it is currently practiced or spirituality as an internal exploration and critical thinking as an external exploration, are then mistakenly considered distinct. In reality, they are all examples of a western worldview using identical thinking processes and methodologies; reaching conclusions that differ only in name.

To suggest that one can or should reclaim the whole self echoes a New Age philosophy that has long passed its uncorrupted zenith. There is no intention here to forward a particular “cure” for humanity’s fractured states of being. Instead, I am suggesting that it is possible, with intention, to consciously utilize adaptive and creative processes encouraging individual re-integration; moving toward a personal version of what Edward O. Wilson has termed consilience.


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