Today we respect the great goddess health. Health-care spending as a percentage of gross domestic product has more than doubled in the past fifty years. The health food industry has grown apace; David Brooks at the turn of the millennium already noted that selection of organic foods in the grocery store is a “barometer of virtue.” A visible class-based geographic separation emerges based on how much surplus wealth can be spent propitiating the vague sense of living a healthier lifestyle. A Pret A Manger sandwich, perhaps twelve dollars, “prices in” natural ingredients and an employee who exhibits Pret Behaviors such as being “happy to be themself.” Across Middle America, up goes the “Breadmother” who personifies the proprietary sourdough starter used in Panera’s baked goods, and who symbolizes the company’s mission to make a healthier and happier world. A friend enjoys relating the part of his training video that describes Panera’s corporate employees performing a “bread homage,” where they share a baguette and wipe tears from their eyes describing what they love about bread. Then, unto this already health-worshiping society and especially its aging founders, came COVID-19.
When the virus came, survival became the only imperative. Giorgio Agamben calls this bare life. (Readers of The Lamp will be familiar with his testimony, written at that time, that we are witnessing the apogee of a medical religion.) Hospitals forbade priests from performing the last rites, valuing the health of bodies absolutely above the consolation of the dying and aggrieved, even above the salvation of the soul. I expect every Catholic has heard these painful stories. Gesundheit is a jealous goddess. Churches were shuttered. When they re-opened, masks and bottles of hand sanitizer took the place of hymns and holy water. Occasionally, Church leaders protested that churches remained shuttered while shopping malls were allowed to open, as in the case of the bishops of Minnesota. Often, however, the ministers of the Church were only virtually present when they were needed most. In a moving homily that laid bare his prayerfulness and moral seriousness, our pastor apologized. I wonder if he should have. Where is the ever-shifting line between right reason and the fanaticism of fear as our modern society faces a novel epidemic?
The very ancient Roman goddess whose name means both salvation and health, Salus, was invoked at the birth of modern democracy. Salvation is reduced to self-preservation and good health. Everyone can agree that self-preservation is a great good, and in the seventeenth century this became the first principle of modern arguments for democracy. Men should only risk their lives fighting for salus, Spinoza thinks, though they are tricked by false ideas of salvation into fighting for servitude. Salus is the patron deity of democracy. Spinoza, Nietzsche, Foucault, and Agamben all suggest that the egalitarian and compassionate doctrines of Christianity are intermixed with the cult of health. Nietzsche imagines that ascetic priests, concerned with the salus of the “sick herd” of slaves who internalize deep resentments, and who wish to concoct ways for them to vent their hatreds, give them hope for a world to come where their masters will burn in hell. Foucault imagines that the Christian pastorate, surveilling souls in the confessional, are the forerunners of modern biopolitics. Agamben imagines that the Christian idea of the end times becomes the medical religion’s state of permanent crisis.
Nietzsche was a sick man. Chronic headaches, eye trouble, intestinal pain, and viral infections plagued his entire life. Yet Nietzsche tried to find meaning in pain. He saw sickness as a stimulus to a higher life and a higher health. Nietzsche’s higher health and happiness are aristocratic ideas, and he looks with unparalleled contempt at those who only seek release from their sickness and pain. The all-too-common democratic desire for health is beneath him—such people cannot embrace life, its sufferings, its sacrifices, and so forth. Only through pain, he insisted, can the artist create some higher happiness. Nietzsche’s illnesses led him to spurn the consolations of Christianity and the ordinary, democratic desire for self-preservation. He enrolls himself in the history of thought as the implacable critic of the great goddess Gesundheit, the anti-prophet of Salus.
How did Nietzsche, of all thinkers, come to inspire the Left? The short story is that in the late 1950s, Nietzsche began to appear on the reading lists for the agrégation, the national written and oral exams that qualify one to teach philosophy in a French university. The newly minted post-structuralists of that generation, such as Gilles Deleuze, Jacques Derrida, and Foucault, found themselves teaching their most motivated students works such as The Genealogy of Morals. This was the seminary of what is indiscriminately called post-modernism. In a longer story, the starring role is played by the seminarian-turned-pornographer Georges Bataille, and his secret society that talked a lot about human sacrifice but never practiced it. I shall spare the reader its telling. Allan Bloom tells yet another story about the Nietzscheanization of the Left and vice versa, worth mentioning only because Americans’ goofy agreeableness is largely to blame for the enthusiastic reception of postmodernism in American universities.
It is worth dwelling, however, on Foucault, who is perennially the most cited scholar in the humanities. A history professor of mine, who seemed to deserve his no-nonsense reputation, told us that Foucault was the only man whom he had ever met who had an aura. Politics majors certainly read the haloed one. Discipline and Punish was assigned in four of my classes—the old Vintage edition adorned with colorful implements for execution, imprisonment, and torture. Since then, Alan Sheridan’s translation has been more handsomely jacketed with a ruler on the front. The new cover better reflects Foucault’s idea that power operates as normalization. (If the stories about the sisters are true, Catholics of an older vintage will detect the double entendre of the ruler.) Authority and judgement are replaced by a system of averages, norms, and rules that influences our behavior. Examinations in schools and hospitals measure deviations from a norm. We worked hard for good grades and now we work to get our blood pressure to 120/80 mmHg. Foucault studies prisons, hospitals, and schools that secure our compliance not by twisting our bodies, the wont of medieval torture, but bending our minds towards a norm.
The most famous chapter of this most-assigned book by this most-cited author, “Panopticism,” begins with a description of a seventeenth-century plague town. The town is quarantined, “everyone locked up in his cage.” Only people “of little substance” are permitted to be in contact with plague-ridden bodies. Inspections are ceaseless. “The magistrates have complete control over medical treatment.” Confronted with plague, “discipline brings its power, which is one of analysis.” The plague town is Foucault’s seminal moment in the history of disciplinary power. He emphasizes how power operates more efficiently in this new configuration. During a series of lectures at the Collège de France, Foucault described this regime of public hygiene, imposed upon a population to monitor mortality rates and improve measures of public health, as “biopolitics.” In a famous debate with Noam Chomsky five years earlier, Foucault declared that the “real political task” was to unmask how power works in institutions that appear to be neutral and independent.
I read Foucault with interest in a Charlottesville house across Fourteenth Street from Venable Elementary School, where Carrie Buck’s daughter made the honor roll in 1931. Carrie Buck was sentenced to the state mental hospital for the “crime” of having been raped by her foster parents’ nephew and surgically sterilized on the basis of her supposed promiscuity and imbecility. This was not the work of a rogue clinician, like the so-called “uterus collector” alleged to have performed hysterectomies on women detained in an I.C.E. facility in Georgia without their consent a couple of years ago. Carrie Buck was sterilized to test the constitutionality of Virginia’s compulsory sterilization law. Eugenicist research concluded that imbecility and criminality were hereditary, and the one-tenth of Americans deemed socially inadequate ought to be sterilized. When Buck v. Bell reached the Supreme Court, eight justices agreed with Oliver Wendell Holmes that three generations of imbeciles were enough. The lone dissent came from Pierce Butler, the court’s only Catholic justice. In his concurrence to Box v. Planned Parenthood, Clarence Thomas connects abortion and the political abuse of obstetrics to the Court’s dark history promoting eugenics.
It is well known that American eugenics laws became models for Nazi Germany, where the most unspeakable tyranny wore the white coat. More than half of German physicians were N.S.D.A.P. members, and they joined at a faster rate and in greater numbers than in other professions. They fabulated a murderous hoax about a crisis of racial hygiene, and collaborated in a eugenic mandate to secure the health of the future members of their race, at an unimaginable cost of lives. Buck v. Bell is still the law of our land, though the Supreme Court has since ruled that habitual white-collar criminals cannot be exempted from laws that sterilize repeat offenders. Forced sterilization is on the books in thirty-one states plus the District of Columbia. Carrie Buck’s daughter’s academic record at Venable Elementary School challenges the notion that hereditary imbecility plagued public education in the commonwealth. On the other hand, most Thursday and Saturday nights, Fourteenth Street testifies to the fact that criminal imbecility can be passed down no less as a legacy of the well-educated.
Psychiatry is particularly prone to political abuse, against which the American Constitution is a dubious shield. Foucault’s Madness and Civilization proposes that madness is diagnosed in order to maintain hierarchies. There are spectacular examples. According to an article published in the New Orleans Medical and Surgical Journal in 1851, courageous fugitives from slavery might suffer from drapetomania—from the Greek drapetēs, “runaway.” Jonathan Metzl in The Protest Psychosis describes how the demographics of Michigan’s Ionia State Hospital for the Criminally Insane changed during the years of the civil rights movement, when African-American men were more likely to be perceived as aggressive, and therefore more likely to be diagnosed with schizophrenia. The political abuse of the “sluggish schizophrenia” diagnosis in the Soviet Union, which psychiatrists developed at the behest of the K.G.B., is well documented. Regimes may pathologize their enemies in more subtle ways as well. The Associated Press stylebook cautions against describing political opponents of L.G.B.T. entitlements as homophobes or transphobes, for example, since the suffix phobia suggests a clinical disorder.
Foucault practiced what he preached with respect to his suspicion of the medical profession. His distrust of medicine may have stemmed from his appointment with Jean Delay, the psychopharmacological pioneer, who told an undergraduate Foucault that his obsession with self-harm and suicide was rooted in the distress he felt about his homosexuality. After publishing Discipline and Punish, he took L.S.D. in Death Valley with a historian at Claremont Men’s College and his boyfriend, tearing up to Richard Strauss’s Vier letzte Lieder, in what he called a life-changing experience. Foucault’s remaining years were dedicated to a series of volumes on the relationship between sex and truth. He used the library resources of Le Saulchoir, the Dominican school of theology in Paris’s thirteenth arrondissement, to which he donated undisclosed sums of money. Anyone who has read the second, third, and unfinished fourth volumes of The History of Sexuality must imagine Foucault composing them in a 1970s-style building alongside the whispered labors of priests and religious sisters. (As he told Claude Mauriac, he would have been a good monk but for his atheism.) The truth was that sex killed him. Foucault died in the early days of the last epidemic, A.I.D.S., which was then still widely described as Gay-Related Immune Deficiency syndrome (G.R.I.D.S.). In an interview with the Nation, Edmund White recalls Foucault’s skepticism in 1981 that any such virus existed, preferring to see it as a technique for disciplining sexual and racial minorities in the U.S.: “This is some new piece of American Puritanism. You’ve dreamed up a disease that punishes only gays and blacks? Why don’t you throw in child molesters too?”
Why, then, was there no academic anti-lockdown left in the United States? Even if one grants that the public health response to COVID-19 has been reasonable, or allows a charitable margin of error for an easily communicable novel virus, one must admit it is remarkable that there has been little or no resistance to lockdowns and vaccine mandates in left-wing academia. Two generations of teachers and students of the academic humanities primed by the critique in Discipline and Punish; zero emerge as critics of public health officials. As far as I can tell, nobody on the academic left in the United States emerged as a skeptic of the virus’s lethality, a detractor of the medical field’s analysis of the disease, or a protestor against masking and other lockdown measures. In May 1968, Trotskyite students shouting anti-psychiatric slogans attacked Delay’s offices and eventually forced him into retirement. To my knowledge, however, there were no student protests against university closures in March 2020, even though many students were left paying tens of thousands of dollars in tuition and fees for services that could not be rendered. Nor were there significant student protests when many universities did not re-open. For two years the mostly young and (physically) healthy community of student activists neither challenged the rule of the old, the frightened Baby Boomer gerontocracy, nor protested rules made in deference to the sick or immunocompromised. To the contrary, even now many college students appear to be willing to wear face masks longer and observe public-health recommendations more stringently than the general public. It is a cautionary tale for intellectual history, or anyone who expects academic scribblers to influence practical politics in proportion to their citation index.
People interested in this puzzle tend to agree that Foucault has been co-opted by the political right. This would be a coming-home of sorts for anti-psychiatry politics. In one early example, anti-communists feared that the Alaska Mental Health Enabling Act of 1956 would create a domestic Siberia-style gulag for Americans. Stephanie Williams and her organization of approximately one hundred Catholic housewives in California, the American Public Relations Forum, sounded the alarm. The A.P.R.F. published Brain-Washing: A Synthesis of the Russian Textbook on Psychopolitics, ostensibly the work of one Lavrentiy Beria but probably in fact written by L. Ron Hubbard. Senators were mystified by the groundswell of opposition to a federal land-grant for a psychiatric hospital in the Alaska Territory. This alliance of conservative Catholic mothers and Scientologists, united by a distrust of psychiatry, successfully pressured Barry Goldwater to sponsor an amendment which clarified that non-residents of Alaska could not be transferred for psychiatric confinement in the Great North. Plandemic: Indoctornation is part of a storied tradition.
As the medical establishment and the scientific community in general is perceived to support the left in the culture wars, the critical Foucauldian posture is increasingly taken up by the right. Perhaps A.I.D.S. changed everything, and the Foucault I read in the late 2000s was already a dead letter. The medical establishment is no longer perceived as a conservative establishment, in no small part due to the rise of the gay pride movement in the early 1970s. Homosexuality was no longer listed as a mental disorder after the seventh printing of the DSM-II in 1974, and distress over one’s sexual orientation—Foucault’s diagnosis from Delay—disappeared from the DSM-V in 2013.
One could argue that Foucault does not belong to the left any more than he does to the right. Foucault’s general left-wing bona fides have always been questionable: Sartre called The Order of Things the “last barricade” of the bourgeoisie, and Marshall Berman, a rare American leftist not smitten with Foucault, said his freedom-less world offered Sixties radicals a “world-historical alibi” for their failures in the Seventies.
Yet Foucault valorizes speaking one’s mind, even if the Internet and our constant auto-surveillance on social media makes toeing the party line more important than ever. This is parrhesia, the cliché of speaking truth to power in the face of danger. It is one mark of a Christian, also. In Acts, Saint Peter and Saint John speak boldly, with parrhesia, before Annas, Caiaphas, and the rest of the Sanhedrin. This boldness reveals both that they are ordinary and uneducated men, and companions of the great parrhesiast, Our Lord. Since they have been primed for parrhesia for so long, it is surprising that there are no schismatic Foucauldians in American universities criticizing our public health regime. There are many campus causes célèbres that are presumptuous and strategically stupid in the extreme. Why nothing about the disproportionate harms of vaccine passports inflict upon communities of color? Community leaders even lobby for medical paternalism, as when the president of the N.A.A.C.P., Derrick Johnson, cheers on the F.D.A. for proposing a ban on menthol cigarettes that is expressly aimed at black smokers.
Either Foucault was nonsense and bluster all along, or he was correct—indeed, so deeply insightful that even students and teachers armed with Foucauldian critique cannot but Follow the Science.
In other words, either the post-modern humanities are humbug, or Discipline and Punish is an absolute humdinger that lays bare the carceral texture of school and society. The former possibility concerns me deeply as a symptom of the much-touted “death of the humanities.” Humbug is pretentious carrying-on or performative speech. To spout humbug (or its more vulgar synonym described with exactitude by Harry Frankfurt) is to exempt oneself quietly from the old norms of academic conversation. The speaker merely aims to make an impression on the listener, perhaps that she is learned or politically radical, so that the truth becomes irrelevant. The instructor opens Discipline and Punish and reads about the drawing-and-quartering of the regicide Damiens only to titillate students. Humbug is a professional hazard of teaching and politics. I have been accused of it, even.
The puzzling absence of the campus anti-lockdown activist concerns me as an indictment of humbug. Does anything we teach in the humanities really matter in the rare moments when the chips are down? Hannah Arendt poses this question sharply, and it orients her approach to teaching. How do you teach someone to think for himself in times of political crisis, when the stakes of independent thinking seem too high? I worry that for all our lip-service to transformative education, critical thinking, and character, humanities classes are often simply zombie-like performances. We shrink from constructive public engagement with common questions in order to advance cynical, corrosive critiques. Our inquiry remains undead but not quite alive, reproducing knowledge without any purpose outside of impressing others in our tiny theaters. Here are a few Foucauldian bon mots. The punk kids have their law-school applications in already. The soul remains the prison of the body.
The second possibility is that Foucault is a Cassandra, who speaks the truth about the medical regime, and yet who is powerless to inoculate his students against its power. To examine this possibility, we can think of Foucault as an anti-prophet. He foretells the future coming of a god, not with eager expectation, but rather to poison the well. He prepares the way for the atheist of the future. In Foucault’s day, the cult of health was still in its infancy. The Order of Things came out in 1966, after the peak of cigarette consumption in the United States, and the same year that Jogging convinced Americans that it is a perfectly normal activity to run out of their homes and then run back again, for the sake of a normal amount of exercise. Casualwear was then distinct from sportswear. Today the ritual practices and attire of the cult of health are everywhere.
Despite his prescience, writing on the cusp of the health-care revolution, Foucault can only be counted among the latter anti-prophets of the goddess of health. Ultimately, he repeats the earlier warnings of Nietzsche. A further history might follow Nietzsche’s obsession with Plato, and follow the brilliant Father Justin Brophy, O.P., back to the shortcomings of the physician Erixymachus’s medical perspective in the Symposium. However, fundamentally, it is Nietzsche who notices that the nineteenth-century work ethic no longer respects the “great goddess Gesundheit,” though he predicts she will come again in the mouth of Zarathustra. The small-minded Last Men will have their little pleasures for the day and their little pleasures for the night, but above all, they will respect health. This is the concluding flourish of Zarathustra’s first discourse: the last men will honor this last goddess. Since Nietzsche’s influence on the academic humanities is profound, the mystery of the missing anti-lockdown student protest deepens.
No Nietzsche- or Foucault-inspired activist protests our public health authorities, I would guess, because they are only ever taken half seriously. They fit the hyperbolic, hyperventilating style of the contemporary academic critique of society. They are taught so long as they seem to make students more compassionate to those who suffer subtle anguish, or whom subtle power dynamics marginalize. In other words, Americans turn to Nietzsche and Foucault to reawaken our commitments to equality. As soon as they challenge our common-sense democratic commitments to ordinary health, and they do, we suddenly wonder why we have tolerated these perverts so long. Ever thus do the philosophers wear out their welcome in the city, when they mock or even threaten its survival.
If we dare to question the gods, or at least if we are to avoid so much humbug, then we should think seriously about what health is. Foucault credits his advisor, Georges Canguilhem, for bringing the history of science down from its heights. He challenges the ontological picture of disease, where the researcher isolates the pathogen that is the essence of disease, and attempts to return the body to a fixed statistical norm of health. Louis Pasteur and his disciples who dreamed of a completely anti-septic world grant prestige to this view, where medicine is a branch of biology and ultimately of set physical laws. Influenced by phenomenology, Canguilhem points out that medicine begins when we feel unwell. He quotes the surgeon René Leriche: health is life in the silence of our organs. Canguilhem opens up the way we think about health in The Normal and the Pathological. He proposes that health is our ability to survive diseases that transform our bodies and establish a new equilibrium between the body and the environment. At stake is a debate with obvious political importance: who knows when we are sick and when we are healthy, the experts, or ourselves?
We can also think seriously about the role that disease, pain, and infirmity play in our lives. The normal increasingly rules these out. We increasingly live in Paul Valéry’s world where pain has no meaning. The norma of the world is not the T-square of the divine carpenter. Take for example the apostate friend of the narrator in The Diary of a Country Priest, l’abbé Dupréty, who defrocks himself because, he declares, “A busy, healthy life, normal in every way (the word normal underlined three times) should contain no mysteries.” We know how to be well. In The Palliative Society, Byung-Chul Han argues that the meaninglessness of pain makes the experience of any pain unbearable. Rather than expect to live and grow through infirmity and disease, we come to expect medicine to help us avoid pain. The pain-averse palliative society we live in seems to have more chronic pain than ever. Han is Catholic, but he points to Nietzsche’s dictum that pain and pleasure are twins who either grow together or remain small together. Han is a cultural and media theorist, so characteristically, he thinks that the increasing amount of time we spend in digital life is a further way of isolating ourselves from pain. But we also increasingly isolate ourselves from one another, from others who might cause us pain, from the risk of loving and losing.
These questions may reveal a hidden new normal. Our society seems to be increasingly intolerant to pain. Han calls this algophobia. Perhaps we can increasingly expect to live without enduring a serious disease. These are the last goddess’s promises of salvation, which is only salvation from temporal afflictions. I would add that pain is seen as fetishistic and even creepy: a good example is the morbid fascination with the cilice worn by the “Opus Dei monk” in The Da Vinci Code. Another is how Christopher Hitchens’s exposé of Mother Theresa fixated upon how her clinics in Calcutta lacked analgesics beyond aspirin, and how she consoled her patients by uniting their sufferings to Christ crucified. Those of us who gather each week to worship before an image of the tortured God need an answer. There are so many good Catholic nurses and physicians, faithful to Christ and His vocation as a healer, who are both learned professionals and thoughtful about the role of pain in God’s providence for the human race.
Those of us who are shyer of hospitals, especially, must wonder if algophobia will prevent us from becoming saints. Saint Lidwina and Saint Ignatius grew in holiness through their afflictions, much like the many afflicted persons of the Gospels who come to Christ for healing. Saint Charles Borromeo and Saint Marianne Cope fearlessly tended those afflicted by infectious diseases. There are many other examples. Does the promise of a pain-free life incline us to be risk-averse, shying away from painful but transformative experiences? Perhaps this is even true for those of us who can dare to be vulnerable, or indeed are tempted not to be. Do we make an idol out of our health? If the anti-prophet Nietzsche is correct, we risk clinging to our prophylactics and analgesics so tightly that we shall never experience life. This would be a strange echo of the true Omega, “the only Christian” as he calls Him: whoever will save his life shall lose it.
Robert Wyllie is assistant professor of political science at Ashland University and a contributing editor at The Lamp.
