Stuff … and nonsense

by Rebecca Barnett

Some time back in a former century, I spent a few years working as a research assistant at the uni where I completed my undergraduate degree. I was working in an academic area that many would reflexively think of as useless, wasteful and frivolous – in the “yarts”. And many would also think that the particular enterprise I was engaged in was, frankly, a total wank.

So let’s start with the full disclosure: I worked for a somewhat famous and feted English Literature professor researching the 19th century history of Shakespearean criticism. [Insert your own astonished stream of expletives here.] It was actually part of a larger, planned 3-volume history of Shakespeare criticism. {Any expletives left in your arsenal?]

As obscure and pretentious as the endeavour may sound, the stuff I learned doing those blissful, contemplative and solitary years has informed everything I have done since, including all of my engagements with science (specifically in the domain of medicine and healthcare).

So what the hell does Shakespeare criticism have to do with 21st century healthcare?

Well, those 19th century critics definitively showed me that meaning and value are constructed rather than inherent – that every culture invents meaning and value in its own image. They taught me that narratives aren’t neutral and can be used to propel unhelpful hegemonies. They demonstrated that the stories we tell ourselves are a way of staking claim to real estate (be it actual, metaphorical, intellectual, political, social or cultural property).

In the case of Shakespeare, it’s easy to see how this played out in England in the 1800s. The rise of the middle class and literacy meant that Shakespeare was ripped out of the theatre and into the parlour. Reading Shakespeare was now valued more than seeing a performance. The canon was stripped of anything that might be unpalatable to a Victorian audience, so the gory raw revenge fest that is Titus Andronicus  had to be ascribed to other playwrights, along with significant chunks of many Shakespeare plays not seen as worthy of the lofty, transcendent talent of the Bard. Apparently, Shakespeare never had a bad day at the office.

The logic goes something like this: some Shakespeare is “in” and qualifies for glorification. Other Shakespeare is “out” and is therefore not Shakespeare. This non-Shakespeare Shakespeare must therefore be subject to “disintegration” and attributed to another agent/author.

When is Shakespeare not Shakespeare? When the dominant narrative can’t remake him in its own image. In the New World, this took the form of not only disintegrating the canon but claiming that Shakespeare didn’t actually write any Shakespeare at all. All it took was a magic hat, some gold tablets and a hidden cipher for the US to remake both Jesus and Shakespeare in its own image. However, that’s definitely a story for another blog post.

So how does our culture construct the meaning and value of healthcare in the 21st century? What is the healthcare equivalent of the generations of schoolchildren that have been tortured with the sanitised, painfully middle class version of Shakespeare that 19th century critics gave us?

In the western world, we’ve lived with biomedicine as the predominant healthcare paradigm for over a century. The heroic medicine physicians won the healthcare real estate war of the 1800s. (I heartily recommend Marketplace of the Marvelous: the Strange Origins of Modern Medicine  for an account of the history of modern medicine.)

But is the narrative of biomedicine any more neutral or disinterested than the one constructed by the middle class Shakespeare critics of the 1800s? What is the value and meaning of healthcare in the 21st century and who is defining it?

I read an article recently that sharply underscored just how serious biomedicine is about its ever-expanding real estate. The author argued that the health consequences of loneliness are so manifold and complex that we need to start treating it as a medical condition. Is this kind of medicalisation of life the colonialism of the 21st century? Where once we might have looked for social supports, we’re now being lobbied to invest everything within the domain of health. That’s one helluva property portfolio.

Believe it or not, all of this drivelmusing was inspired by a blog post  I read this morning about the hegemony of “health people” and the dominance of middle class, university-based systems in healthcare. It’s an excellent piece and I warmly encourage you to read it.

“Health has been ‘expropriated’ by the health system, which has wealth, power, knowledge, and methods and crucially “defines” what is health and how it should be measured.”

What is health and how should it be measured … sound familiar?

When is healthcare not healthcare? When the dominant narrative can’t remake it in its own image.

You don’t have to search terribly far to find which healthcare practices are “in” and which are “out” or the hierarchies that guard the boundaries between the two. The 21st century medical disintegrationists are masters at delineating the territory.

Which leads me back to the theme I return to over and over again like a broken record: the identity of massage therapy within healthcare. I am not sure about you but I don’t want to be a colonist or a landlord. Perhaps, in the end, being “recognised’ is less important than being of service?

“Skepticism is when you consider seriously the possibility that you have been supporting the Evil Empire all along, and not as you had assumed or were told, the Rebel Alliance.”

@EthicalSkeptic

About the Author

As accidental CEO of AMT, Rebecca Barnett has been at the coalface of professional advocacy for 12 years. She is devoted to neologism and foodstuffs with the same specific gravity as havarti cheese but it’s Friday afternoon at 5.40pm so surely it’s beer o’ clock?

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