The Grey Zone of Health and Illness

284 Pages·2010·6.223 MB·English

by  Alan Blum

The Grey Zone of
Health and Illness

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WThhey GWree yM Zaoknee Art
of Haeta wlthhy iat nisd t aIullgnhetss
by Richard Hickman
by Alan Blum
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First published in the UK in 2011 by Intellect,
The Mill, Parnall Road, Fishponds, Bristol, BS16 3JG, UK
First published in the USA in 2011 by Intellect, The University of Chicago Press,
1427 E. 60th Street, Chicago, IL 60637, USA
Copyright © 2011 Intellect Ltd
All rights reserved. No part of this publication may be reproduced, stored in a retrieval
system, or transmitted, in any form or by any means, electronic, mechanical, photocopying,
recording, or otherwise, without written permission.
A catalogue record for this book is available from the British Library.
Front cover image: Antonin Artaud, La Bouillabaisse de formes dans la tour de Babel, ca.
February 1948 © Estate of Antonin Artaud / SODRAC (2010).
Cover design: Jenny Scott
Copy-editor: Jennifer Alluisi
Typesetting: John Teehan
ISBN 978-1-84150-364-6 / EISBN 978-1-84150-358-5
Culture, disease, and well-being (Print) ISSN 2042-177X
Culture, disease, and well-being (Online) ISSN 2042-1788
Printed and bound by Gutenberg Press, Malta.
Contents
Acknowledgements .................................................................ix
Preface .....................................................................................1
The Grey Zone as a canon ............................................................................1
Popular versions of the Grey Zone .............................................................3
Introduction ............................................................................9
Images of the body ...................................................................................12
1. The Grey Zone as a Primordial Figure: Greek Origins ..............17
Form, the hypothetical, the image ...........................................................23
Likely story ...............................................................................................25
Conclusion ................................................................................................27
2. Ambiguity as a Social Phenomenon: Reshaping the Greeks ...29
Views of the original division: inner, outer ..............................................30
Division as split: self-knowledge ..............................................................34
Analogy .....................................................................................................35
Same and Other ........................................................................................37
Analysis.....................................................................................................38
Division: transposition ..............................................................................42
3. The Elemental Vision of the Split .........................................47
Intersubjectivity ........................................................................................51
Dualism .....................................................................................................53
The magic of aesthetics ............................................................................56
The enigma of human nature ...................................................................58
The dialogue .............................................................................................60
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The Grey Zone of Health and Illness
4. The Official History and the Unwritten Text .........................63
History ......................................................................................................63
Absence and presence ..............................................................................64
Stories .......................................................................................................65
Seeing-as and history ...............................................................................68
Desire as the inward call ..........................................................................69
Professionalization ....................................................................................71
Enlightened discourse ..............................................................................73
The voice of the patient ............................................................................75
Being real..................................................................................................79
March of medical science .........................................................................82
Plato’s city of pigs .....................................................................................83
The force of the city ..................................................................................86
5. The Relationship of Knowledge to Life .................................89
Classic and modern ..................................................................................90
Desire and knowledge: desire for knowledge/knowledge of desire ........92
Specialization and excellence ...................................................................94
Fascination ...............................................................................................96
Excellence, expertise ................................................................................97
The redefinition of ethics: applying knowledge ......................................102
Market value: knowledge as a derivative ................................................103
6. The City of Pigs as Travesty ................................................105
Division of labor .....................................................................................106
Blind spot ................................................................................................109
Institutional logic.....................................................................................112
Parsons’ travesty of health and illness in modern society ......................117
The sick role .............................................................................................120
Secondary gain ........................................................................................121
Conclusion ...............................................................................................123
7. Health and the City ............................................................125
Unexamined question ..............................................................................127
The connection of health to death ..........................................................129
Extending the sense of health ................................................................130
Birth, death and the in-between .............................................................132
6
Sources ....................................................................................................132
Creativity and corruption ........................................................................133
Border crossings ......................................................................................133
Analogical thinking ..................................................................................134
The epidemic ...........................................................................................135
Variation as a communal problem ..........................................................137
Polis ........................................................................................................138
Infection...................................................................................................139
Doxa as sickness and the city .................................................................144
Excess as a social force ...........................................................................144
8. On Being Old .....................................................................149
Physical decline/passing time .................................................................153
The aged as a minority group ..................................................................155
The division in age ...................................................................................157
Trajectories, graph of desire ...................................................................157
The body of common culture ...................................................................159
Justice: corporeal and aesthetic ..............................................................162
Fate, symptom, caricature ......................................................................163
9. The Formula: Medicalization and Its Guises ........................167
Advance or infantilization? ......................................................................167
What is medicalization? ...........................................................................170
Being classified ........................................................................................172
Weakness .................................................................................................173
Influences, fate, chance, taking hope ......................................................175
The reassurance of the mark ...................................................................176
Towards a grammar for public health .....................................................178
10. Prosthetics ......................................................................183
The imaginary of medicalization .............................................................187
Prosthetic desire ....................................................................................189
11. The Recurrence of the Body ...............................................191
The materiality of language ....................................................................192
Stepping over..........................................................................................194
Disfiguration ...........................................................................................196
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The Grey Zone of Health and Illness
Commonplaces ........................................................................................198
Stress .......................................................................................................201
The body has a mind of its own ..............................................................202
Mind over matter ....................................................................................204
Is a person more than a body? ...............................................................205
Habitualization .......................................................................................207
Expression ..............................................................................................208
Symptom, trauma ...................................................................................209
12. Moods of Being .................................................................213
Typification ..............................................................................................214
Covering up (aka: repression) .................................................................215
Measuring up and/or not .........................................................................216
Freud’s scenario ......................................................................................217
Tongue-tied and talkative .......................................................................220
Anxiety .....................................................................................................222
Excursus on disfigurement .....................................................................224
Primal scene/discourse without speech .................................................226
Elementary situation ..............................................................................228
Equality and its demands .......................................................................229
The mystery of birth ................................................................................232
13. Conclusion .......................................................................235
Negations .................................................................................................237
Narrative and the Divided Line ..............................................................239
First and second speaker .........................................................................241
The discourse of mastery .......................................................................242
The remainder ........................................................................................244
The body as remains ...............................................................................248
Remains as such .....................................................................................250
Life and death .........................................................................................250
References ............................................................................253
8
Acknowledgments
This book reflects influences developed from my collaboration with Peter McHugh
and the different generations of graduate students we worked with over the years at
universities in New York, Toronto, London, England and at workshops, seminars, and
meetings in other places. The support of the Canadian Institutes of Health Research made
possible our research project The City and Well-Being: The Grey Zone of Health and Illness,
giving me an opportunity to make this approach palpable through application to the area
of health and illness and to the historic study of medicine and the place of doctoring
from Plato’s Republic through those such as Freud, Parsons, Foucault, and Lacan. The
generous support of the administration of the University of Waterloo, particularly
Amit Chakma who was then Provost, and Dean of Arts Ken Coates, contributed to the
perpetuity of our Culture of Cities Centre in Toronto as an intellectual and civic centre,
recognizing the import of providing a place for students and researchers to meet and
discuss their work in a vital urban environment. Despite the signature of this university
as a centre of scientific research, their creativity in relation to our research astonished me
in comparison to the relations I had endured with previous university administrations.
My colleagues, the principle investigators on the project, have always engaged me in
valuable ways over its course, and here I mention Kieran Bonner, Tristanne Connolly,
Kevin Dowler, and Sholom Glouberman, never appearing too impatient, sometimes
nurturing, often civil but not bureaucratic, invariably ready to engage me intellectually.
Our project workshops over this period have centered a continuous and vital exchange of
ideas, reflecting a collective willingness to participate critically and to give trouble where
it was assumed to be needed, trouble only in the way of inviting rethinking of what had
been treated as secure. The Grey Zone research collective includes: J. C. Cloutier, John
Faichney, Elke Grenzer,Amelia Ruby Howard, Saeed Hydralli, Diego Llovet, Jan Plecash,
Stephen Svenson, Gord Thompson, and Morgan Tunzelmann. The workshops benefited
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